Despite significant global morbidity associated with respiratory infection, there is a paucity of data examining the association between severity of non-SARS-CoV-2 respiratory infection and blood group. We analysed a prospective cohort of adults hospitalised in Bristol, UK, from 1 August 2020 to 31 July 2022, including patients with acute respiratory infection (pneumonia [n = 1934] and non-pneumonic lower respiratory tract infection [NP-LRTI] [n = 1184]), a negative SARS-CoV-2 test and known blood group status. The likelihood of cardiovascular complication, survival and hospital admission length was assessed using regression models with group O and RhD-negative status as reference groups. Group A and RhD-positive were over-represented in both pneumonia and NP-LRTI compared to a first-time donor population (p < 0.05 in all); contrastingly, group O was under-represented. ABO group did not influence cardiovascular complication risk; however, RhD-positive patients with pneumonia had a reduced odds ratio (OR) for cardiovascular complications (OR = 0.77 [95% CI = 0.59–0.98]). Compared to group O, group A individuals with NP-LRTI were more likely to be discharged within 60 days (hazard ratio [HR] = 1.17 [95% CI = 1.03–1.33]), while group B with pneumonia was less likely (HR = 0.8 [95% CI = 0.66–0.96]). This analysis provides some evidence that blood group status may influence clinical outcome following respiratory infection, with group A having increased risk of hospitalisation and RhD-positive patients having reduced cardiovascular complications.
Original languageEnglish
Publication statusE-pub ahead of print - 27 Nov 2023

Publication series

NameBritish Journal of Haematology
ISSN (Print)0007-1048

Bibliographical note

Funding Information:
AvonCAP is a University of Bristol sponsored study which is investigator‐led and funded under a collaborative agreement by Pfizer Inc. The study funder had no role in data collection, but collaborated in study design, data interpretation and analysis and writing this manuscript. The corresponding author had full access to all study data and had final responsibility for the publication decision. AH PhD studentship is supported by funding from the British Heart Foundation (FS/4yPhD/F/21/34162).

Funding Information:
CH is Principal Investigator of the AvonCAP study which is an investigator‐led University of Bristol study funded by Pfizer and has previously received support from the NIHR in an Academic Clinical Fellowship. JO is a Co‐Investigator on the AvonCAP Study. LD is further supported by UKRI through the JUNIPER consortium (grant number MR/V038613/1), MRC (grant number MC/PC/19067), EPSRC (EP/V051555/1 and The Alan Turing Institute, grant EP/N510129/1). AF is a member of the UK Joint Committee on Vaccination and Immunization (JCVI) and chair of the World Health Organization European Technical Advisory Group of Experts on Immunization (ETAGE) committee. In addition to receiving funding from Pfizer as Chief Investigator of this study, he leads another project investigating transmission of respiratory bacteria in families jointly funded by Pfizer and the Gates Foundation and is an investigator in trials of COVID‐19 vaccines including ChAdOx1nCOV‐19, Janssen and Valneva vaccines. The other authors have no relevant conflicts of interest to declare. The AvonCAP study is a University of Bristol sponsored study which is investigator‐led and funded under a collaborative agreement by Pfizer Inc.

Publisher Copyright:
© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.


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