Blood Type Effect on COVID-19 Infection And Tooth Movement

Abstract

Introduction: The objective of this study was to explore the influence of ABO blood type on COVID-19 infection rate. Discovered relationships may uncover whether genetic makeup may affect treatments and such information could be related to orthodontic tooth movements. Methods: The PubMed database was searched using the terms: ABO Blood Group System; Blood-Group System, ABO; System, ABO Blood-Group; H Blood Group System; H Blood Group; Blood Group, H; ABH Blood Group; Blood Group, ABH; Blood Group H Type 1 Antigen; ABO Factors; Factors, ABO. Also included, were studies of ABO blood type and COVID infection or outcomes. Opinion pieces, animal studies, in-vitro studies, studies using blood other than ABO, and pre-2000 papers were excluded, as were studies that were not published in or translated to English. Of the included studies, the references were manually screened to identify additional qualified studies. Two independent reviewers reviewed the initial batch of reports to select the appropriate publications. To resolve conflicts, they met to discuss for a consensus. Studies were appraised by the Joanna Briggs Institute appraisal index. For the meta-analysis, studies which used odds ratio in their statistical analysis and COVID-19 infection as an outcome were included. Outcomes were analyzed using Forest Plots. Results: Overall, this systematic review included 39 studies. 19 studies were cohort (2 prospective and 17 retrospective), 16 retrospective case control, and 4 were systematic reviews or meta-analysis. 31 studies reported a relationship between ABO blood type and COVID infection rates and 5 studies found no relationship. For the meta-analysis, 13 studies were included and analyzed. The estimated frequency of COVID-19 infection in terms of ABO blood groups and the overall effect size between blood groups was calculated with 95% confidence interval. The effect size of COVID-19 infection for blood group O versus the other blood groups was estimated as 0.174 (95% CI, o.o86-0.261) p<0.001. The effect size of COVID-19 infection for blood group A versus non-A was estimated as -0.174 (95% CI, -o.248- -0.100) p<0.001. The effect size of COVID-19 infection for blood group B versus non-B was estimated as -0.010 (95% CI, -0.107-0.086) p=0.831. The effect size of COVID-19 infection for blood group AB versus non-AB was estimated as -0.140 (95% CI, -o.344-0.064) p=0.179. Conclusion: This meta-analysis indicates individuals with type O blood may be less susceptible to COVID-19 infection while those with type A blood may be more susceptible. Numerous studies, however, were not methodologically strong, as they had small sample size or suffered selection bias. Furthermore, no randomized controlled trials to determine causal relationships were found. Clearly this is understandable, given the speed with which the studies needed to be published. Despite such limitation, these findings have important implications for orthodontics because it may indicate that those with variants of Type A blood are more prone to inflammation, as orthodontic tooth movement is facilitated by the inflammatory responses of periodontal tissues.