ABO blood group associated with cerebral venous thrombosis after Oxford-AstraZeneca COVID-19 vaccination: a case–control study
Authors: Ken-Dror Gie , Sharma Pankaj ,   on behalf of the international Bio-Repository to Establish the Aetiology of Sinovenous Thrombosis (BEAST) collaborators and Cerebral Venous Sinus Thrombosis With Thrombocytopenia Syndrome Study Group, van de Munckhof Anita , Krzywicka Katarzyna , van Kammen Mayte Sánchez , Ghoreishi Abdoreza , Borhani-Haghighi Afshin , Negro Alberto , Günther Albrecht , Cervera Alvaro , Tuladhar Anil Man , Devroye Annemie , Mengel Annerose , Aujayeb Avinash , Casolla Barbara , Chew Beng Lim Alvin , Zanferrari Carla , Garcia-Esperon Carlos , Wahl Christoph M. , Alonso Daniel Guisado , Bougon David , Zimatore Domenico Sergio , Michalski Dominik , Blacquiere Dylan , Johansson Elias , Cuadrado-Godia Elisa , de Maistre Emmanuel , Kristoffersen Espen Saxhaug , Bonneville Fabrice , Giammello Fabrizio , D'Onofrio Florindo , Grillo Francesco , Tsivgoulis Georgios , Sibon Igor , Masjuan Jaime , Duan Jiangang , Burrow Jim , Pelz Johann , Mbroh Joshua , Ng Karl , Garambois Katia , Lagarde Kevin , Lanthier Sylvain , Pérez María Hernández , Sharma Aarti R , Sharma Shyam S , Morín Mar , Petruzzellis Marco , Cotelli Maria Sofia , Zedde Marialuisa , Carvalho Marta , Wittstock Matthias , Roozbeh Mehrdad , Miranda Miguel , Wronski Miriam , Skjelland Mona , di Poggio Monica Bandettini , Almasi-Dooghaee Mostafa , Raposo Nicolas , Fadakar Nima , Kruyt Nyika , Candelaresi Paolo , Vieira Ricardo , Acampora Roberto , Lemmens Robin , Kern Rolf , Murphy Seán , Nagel Simon , Hiltunen Sini , Chatterton Sophie , Karapanayiotides Theodoros , Cox Thomas , Gattringer Thomas , Geeraerts Thomas , Bartsch Thorsten , Mirzaasgari Zahra , Ziaadini Bentalhoda , Zamani Zohreh , Field Thalia S , Cordonnier Charlotte , Kleinig Timothy J , Putaala Jukka , Poli Sven , Scutelnic Adrian , Heldner Mirjam R , Lindgren Erik , Tatlisumak Turgut , Jood Katarina , Arnold Marcel , de Sousa Diana Aguiar , Ferro Jose M , Coutinho Jonathan M 
Published: December 2023

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.