Modelling suggests ABO histo-incompatibility may substantially reduce SARS-CoV-2 transmission

Area of Science:

• Epidemiology
• Immunology
• Virology

Background:

• Observational data indicates an over-representation of blood type A and under-representation of blood type O among COVID-19 patients.
• Blood group antigens are not conventional susceptibility factors affecting disease severity.

Purpose of the Study:

• To model a scenario where ABO transfusion incompatibility influences SARS-CoV-2 transmission dynamics.
• To investigate the implications of blood type on COVID-19 epidemic timing and relative risk.
• To evaluate the effectiveness of vaccination strategies based on blood type.

Main Methods:

• Modeling a scenario of ABO transfusion incompatibility impacting virus transmission.
• Analyzing epidemic timing and relative risk across different blood types.
• Simulating vaccination strategies targeting specific blood types versus random vaccination.

Main Results:

• ABO incompatibility may reduce virus transmissibility by at least 60% in Western populations.
• Type A/AB individuals act as "super-recipients" and type O as "super-spreaders", leading to epidemic timing offsets.
• Targeted vaccination is less effective than random vaccination; maintaining blood type diversity is key.

Conclusions:

• ABO incompatibility significantly influences COVID-19 transmission and epidemic progression.
• Blood type diversity is crucial for effective community spread mitigation.
• Urgent experimental investigation into the underlying biochemistry is warranted.