ABO blood group associated with cerebral venous thrombosis after Oxford-AstraZeneca COVID-19 vaccination: a case–control study
Gie Ken-Dror, Pankaj Sharma, Anita van de Munckhof, Katarzyna Krzywicka, Mayte Sánchez van Kammen, Abdoreza Ghoreishi, Afshin Borhani-Haghighi, Alberto Negro, Albrecht Günther, Alvaro Cervera, Anil Man Tuladhar, Annemie Devroye, Annerose Mengel, Avinash Aujayeb, Barbara Casolla, Beng Lim Alvin Chew, Carla Zanferrari, Carlos Garcia-Esperon, Christoph M. Wahl, Daniel Guisado Alonso, David Bougon, Domenico Sergio Zimatore, Dominik Michalski, Dylan Blacquiere, Elias Johansson, Elisa Cuadrado-Godia, Emmanuel de Maistre, Espen Saxhaug Kristoffersen, Fabrice Bonneville, Fabrizio Giammello, Florindo D'Onofrio, Francesco Grillo, Georgios Tsivgoulis, Igor Sibon, Jaime Masjuan, Jiangang Duan, Jim Burrow, Johann Pelz, Joshua Mbroh, Karl Ng, Katia Garambois, Kevin Lagarde, Sylvain Lanthier, María Hernández Pérez, Aarti R Sharma, Shyam S Sharma, Mar Morín, Marco Petruzzellis, Maria Sofia Cotelli, Marialuisa Zedde, Marta Carvalho, Matthias Wittstock, Mehrdad Roozbeh, Miguel Miranda, Miriam Wronski, Mona Skjelland, Monica Bandettini di Poggio, Mostafa Almasi-Dooghaee, Nicolas Raposo, Nima Fadakar, Nyika Kruyt, Paolo Candelaresi, Ricardo Vieira, Roberto Acampora, Robin Lemmens, Rolf Kern, Seán Murphy, Simon Nagel, Sini Hiltunen, Sophie Chatterton, Theodoros Karapanayiotides, Thomas Cox, Thomas Gattringer, Thomas Geeraerts, Thorsten Bartsch, Zahra Mirzaasgari, Bentalhoda Ziaadini, Zohreh Zamani, Thalia S Field, Charlotte Cordonnier, Timothy J Kleinig, Jukka Putaala, Sven Poli, Adrian Scutelnic, Mirjam R Heldner, Erik Lindgren, Turgut Tatlisumak, Katarina Jood, Marcel Arnold, Diana Aguiar de Sousa, Jose M Ferro, Jonathan M Coutinho,- General Medicine
Objectives
To determine whether blood group influences development of cerebral venous thrombosis (CVT) after administration of the coronavirus disease 2019 (COVID-19) AstraZeneca ChAdOx1-S vaccine.
Design
A case–control study. Univariate and multivariate logistic regression was used to determine the association between blood type and COVID-19 vaccination status.
Setting
Vaccinated and unvaccinated patients recruited from the international Bio-Repository to Establish the Aetiology of Sinovenous Thrombosis study and the Cerebral Venous Sinus Thrombosis With Thrombocytopenia Syndrome Study Group.
Participants
All patients were of European descent and age and sex matched. Cases ( n = 82) were patients ≥18 years old who suffered a CVT within 28 days of a first dose of ChAdOx1-S vaccine. Controls ( n = 441) were unvaccinated CVT patients ≥18 years old. All patients were of European descent.
Main outcome measures
Frequency of blood type and ABO allele distribution by vaccination status.
Results
Blood group O was found to be more prevalent among CVT patients with vaccine-induced thrombotic thrombocytopenia (VITT-CVT) after ChAdOx1-S vaccination compared with unvaccinated CVT cases (43% vs. 17%, respectively, p < 0.001). Blood group A was less prevalent, though still high, in the vaccinated group compared with the unvaccinated group (47% vs. 71%, respectively, p < 0.001). No significant differences were observed in the VITT-CVT non-ChAdOx1-S vaccine group and unvaccinated pre-COVID-19 CVT group for blood group.
Conclusions
Blood group O is more prevalent among patients with VITT-CVT after ChAdOx1-S vaccination compared with unvaccinated cases, independent of well-established CVT risk factors. A larger dataset may be able to determine whether those of blood groups B and/or AB may be safely vaccinated with the low cost, readily available and easily transported ChAdOx1-S rather than adopting a complete ban.