{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:47Z","timestamp":1787022167041,"version":"build-2736575974"},"reference-count":72,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014823","name":"VGH and UBC Hospital Foundation","doi-asserted-by":"publisher","award":["n\/a"],"award-info":[{"award-number":["n\/a"]}],"id":[{"id":"10.13039\/100014823","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008483","name":"NOMIS Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008483","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec014\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>ABO blood group has been implicated both in susceptibility to, and severity of, SARS-CoV-2 infection. The aim of this study was to explore a potential association between ABO blood group and severity of COVID-19 infection in critically ill patients and the following biological mechanisms: inflammatory cytokines, endothelial injury, and adipokines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec015\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of 128 critically ill COVID-19 patients admitted to Vancouver General Hospital from March 2020-March 2021. Outcomes including 28-day mortality, need for mechanical ventilation and length of intensive care unit (ICU) stay were compared between patients with A &amp; AB blood type vs. B &amp; O blood type. Likewise, serum inflammatory markers, markers of endothelial activation, and adipokines were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec016\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The association between ABO and severity of disease was confirmed. Patients with A&amp;AB blood group had more frequent ventilation requirements compared to patients with blood group B&amp;O (N(%): 35 (71%) vs 41 (52%), p\u2009=\u20090.041), higher total ICU mortality (14 (29%) vs 9 (11%), p\u2009=\u20090.018), longer median ICU stay (days, median [interquartile range]: 10 [6-19], vs 7 [3-14], p\u2009=\u20090.016) and longer median hospital stay (26 [14-36] vs. 17 [10-30] p\u2009=\u20090.034). No association was found between ABO blood group and serum inflammatory cytokines or their receptors [IL-6, IL-1b, IL-10, TNF, sIL-6R, sgp130] measured within the first 10 days of ICU stay. No association was found between ABO and plasma markers of endothelial injury [Thrombomodulin, ADAMTS13, sP-Selectin, Factor IX, Protein C, Protein S, vWF]. Among the plasma adipokines, there were no differences between lipocalin-2, PAI-1 or resistin. Notably, however, median adipsin was higher in patients with A&amp;AB blood group compared to O&amp;B (16.3 [4.2-38.5] x10\n                      <jats:sup>6<\/jats:sup>\n                      pg\/mL vs. 9.61 [3.0-20.8] x 10\n                      <jats:sup>6<\/jats:sup>\n                      pg\/mL, p\u2009=\u20090.048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec017\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This retrospective single-center study confirms an association between A and AB blood type with more severe COVID-19. While an underlying mechanism was not identified, the finding of higher adipsin levels in patients with type A\/AB blood warrants further investigation in larger prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0320251","type":"journal-article","created":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T19:23:35Z","timestamp":1743621815000},"page":"e0320251","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["ABO blood group and COVID-19 severity: Associations with endothelial and adipocyte activation in critically ill patients"],"prefix":"10.1371","volume":"20","author":[{"given":"Sophie","family":"Stukas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Goshua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward M.","family":"Conway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes Y. Y.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan L.","family":"Hoiland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mypinder S.","family":"Sekhon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9551-2951","authenticated-orcid":true,"given":"Luke","family":"Y. C. Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"pone.0320251.ref001","doi-asserted-by":"crossref","first-page":"100785","DOI":"10.1016\/j.blre.2020.100785","article-title":"The impact of ABO blood group on COVID-19 infection risk and mortality: a systematic review and meta-analysis","volume":"48","author":"N Liu","year":"2021","journal-title":"Blood Rev"},{"key":"pone.0320251.ref002","article-title":"ABO blood group-related mechanism of infection of SARS-CoV-2: an overview of systematic reviews","author":"M Franchini","year":"2023","journal-title":"Clin Chem Lab Med"},{"issue":"1","key":"pone.0320251.ref003","doi-asserted-by":"crossref","first-page":"4775","DOI":"10.1038\/s41598-023-30714-9","article-title":"ABO blood types and SARS-CoV-2 infection assessed using seroprevalence data in a large population-based sample: the SAPRIS-SERO multi-cohort 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