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

The first national public breast cancer screening program in Saudi Arabia

<b>Background and Objectives:</b> Despite its relatively low incidence in Saudi Arabia, breast cancer has been the most common cancer among Saudi females for the past 12 consecutive years. The objective of this study was to report the results of the first national public breast cancer screening program in Saudi Arabia. <b>Methods:</b> Women 40 years of age or older underwent breast cancer screening. Mammograms were scored using the Breast Imaging-Reporting and Data System (BI-RADS). Correlations between imaging findings, risk factors and pathological findings were analyzed. <b>Results:</b> Between September 2007 and April 2008, 1215 women were enrolled. The median age was 45 years, and median body mass index was 31.6 kg/m ² . Sixteen cases of cancer were diagnosed. No cancer was diagnosed in 942 women with R1/R2 scores, and only 1 case of cancer was diagnosed in 228 women with R0/R3 scores. However, among 26 women with R4/R5 scores, 50&#x0025; had malignant disease and 35&#x0025; had benign lesions. No correlation was found between known risk factors and imaging score or cancer diagnosis. <b>Conclusions:</b> Public acceptance of the breast cancer screening program was encouraging. Longitudinal follow-up will help in better determining the risk factors relevant to our patient population