Individuals with a Rh-positive but not Rh-negative blood group are more vulnerable to SARS-CoV-2 infection: demographics and trend study on COVID-19 cases in Sudan

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In Sudan, several haematological studies were conducted to study the ABO blood group distribution among the population, in which the O blood group was dominant followed by the A blood group. However, there is no systematic study into any correlation between COVID-19 and the population's blood group types, therefore we have intended to study the possible effect of blood group on the acquisition of SARS-CoV-2 infection. A questionnaire-based case–control study was carried out on 557 individuals with COVID-19 in Sudan; factors such as age, blood group, previous malaria infection, history of ailments such as diabetes, hypertension and symptoms suffered were also considered and analysed. More women were infected than men, and individuals between 25 and 35 years were the most affected age group. O Rhesus-positive (O+) blood group was the least affected by the disease while A Rhesus-positive (A+) individuals were the most vulnerable. Fatigue, fever and loss of smell were the major symptoms among the patients, but 13% of SARS-COV-2-positive individuals remained asymptomatic. As the Sudan population is largely constituted of O Rhesus-positive inhabitants (approximately 50%) these results might explain the relatively lower COVID-19 incidence in the country.