Association Between Rhesus and ABO Blood Group Types and Their Impact on Clinical Outcomes in Critically Ill Patients with COVID-19: A Multi-Center Investigation

Khalid Al Sulaiman,1– 5 Ohoud Aljuhani,6 Ghazwa B Korayem,7 Mashael AlFaifi,8 Abdullah F Alharthi,9 Asma Alshehri,1,10 Mashael S Alaboud,11 Ibtesam Saeed Alzahrani,2 Batoul Abdullah Alenazi,2 Fai Farhan Alanazi,2 Hessah Alrashidi,2 Sara Mohammad Alotaibi,2 Khuld Aloufi,1,3 Rawan M Alotaibi,2 Mai Alalawi,11 Ali Faris Altebainawi,12,13 Mohammad Y Alshami,14 Abeer A Alenazi,10 Ghaida A Abalkhail,2 Renad Bin Naheet,1 Rawan Mohammed Abu Alnasr,15 Mohammed Alrashed,1– 3 Faisal E Al Mutairi,1 Khalid J Albarqi,2 Rawan S Alshammari,13 Norah M Abunayyan,13 Wadha J Aldhmadi,13 Ramesh Vishwakarma16 1Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia; 4Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia; 5Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), Riyadh, Saudi Arabia; 6Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; 7Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 8Pharmaceutical Care Department, King Saud Medical City, Riyadh, Saudi Arabia; 9Department of Clinical Pharmacy, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Al-D, Al-Dawadmi, 11961 Saudi Arabia; 10Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 11Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 12Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia; 13Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia; 14Pharmaceutical Care Services, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa, Saudi Arabia; 15Pharmaceutical Care Department, King Fahad Medical City, Riyadh, Saudi Arabia; 16Norwich Medical School, University of East Anglia, Norwich, UKCorrespondence: Khalid Al Sulaiman, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, PO Box 22490, Riyadh, 11426, Saudi Arabia, Email [email protected] Abdullah F Alharthi, Department of Clinical Pharmacy, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Al-Dawadmi, 11961, Saudi Arabia, Email [email protected]: There is increasing evidence suggesting that ABO blood type may play a role in the immunopathogenesis of COVID-19 infection. In addition to ABO blood type, the Rhesus (Rh) factor has also been implicated in various disease processes. Therefore, our study aimed to assess the association between both ABO and Rh blood types in critically ill patients with COVID-19 and their clinical outcomes.Methods: A multicenter retrospective cohort study conducted in Saudi Arabia between March 1, 2020, and July 31, 2021, involving adult COVID-19 patients admitted to Intensive Care Units, aimed to explore potential associations between rhesus blood group types (Positive versus Negative) and clinical outcomes. The primary endpoint assessed was the hospital length of stay (LOS). Other endpoints were considered secondary.Results: After propensity score matching (3:1 ratio), 212 patients were included in the final analysis. The hospital length of stay was longer in a negative Rh blood group compared with patients in the Rh-positive group (beta coefficient 0.26 (0.02, 0.51), p = 0.03). However, neither 30-day mortality (HR 0.28; 95% CI 0.47, 1.25, p = 0.28) nor in-hospital mortality (HR 0.74; 95% CI 0.48, 1.14, p = 0.17) reached statistical significance. Additionally, among the different ABO types, the A+ blood group exhibited a higher proportion of thrombosis/infarction and in-hospital mortality (28.1% and 31.2%, respectively).Conclusion: This study highlights the potential impact of blood group type on the prognosis of critically ill patients with COVID-19. It has been observed that patients with a negative Rh blood group type tend to have a longer hospital stay, while their mortality rates and complications during ICU stay are similar to the patients with a Rh-positive group.Keywords: rhesus blood group, Blood group, ABO, length of stay, intensive care units, Critically ill, COVID-19, SARS-CoV-2, acute kidney injury, mortality, MV duratio

Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017

Abstract Background Cardiovascular disease (CVD) is a common comorbidity in type 2 diabetes (T2DM). CVD’s prevalence has been growing over time. Purpose To estimate the current prevalence of CVD among adults with T2DM by reviewing literature published within the last 10 years (2007–March 2017). Methods We searched Medline, Embase, and proceedings of major scientific meetings for original research documenting the prevalence of CVD in T2DM. CVD included stroke, myocardial infarction, angina pectoris, heart failure, ischemic heart disease, cardiovascular disease, coronary heart disease, atherosclerosis, and cardiovascular death. No restrictions were placed on country of origin or publication language. Two reviewers independently searched for articles and extracted data, adjudicating results through consensus. Data were summarized descriptively. Risk of bias was examined by applying the STROBE checklist. Results We analyzed data from 57 articles with 4,549,481 persons having T2DM. Europe produced the most articles (46%), followed by the Western Pacific/China (21%), and North America (13%). Overall in 4,549,481 persons with T2DM, 52.0% were male, 47.0% were obese, aged 63.6 ± 6.9 years old, with T2DM duration of 10.4 ± 3.7 years. CVD affected 32.2% overall (53 studies, N = 4,289,140); 29.1% had atherosclerosis (4 studies, N = 1153), 21.2% had coronary heart disease (42 articles, N = 3,833,200), 14.9% heart failure (14 studies, N = 601,154), 14.6% angina (4 studies, N = 354,743), 10.0% myocardial infarction (13 studies, N = 3,518,833) and 7.6% stroke (39 studies, N = 3,901,505). CVD was the cause of death in 9.9% of T2DM patients (representing 50.3% of all deaths). Risk of bias was low; 80 ± 12% of STROBE checklist items were adequately addressed. Conclusions Globally, overall CVD affects approximately 32.2% of all persons with T2DM. CVD is a major cause of mortality among people with T2DM, accounting for approximately half of all deaths over the study period. Coronary artery disease and stroke were the major contributors