{"id":8990,"date":"2020-11-08T05:16:20","date_gmt":"2020-11-08T05:16:20","guid":{"rendered":"https:\/\/www.rhesusnegative.net\/staynegative\/?p=8990"},"modified":"2020-11-08T05:44:22","modified_gmt":"2020-11-08T05:44:22","slug":"association-of-abo-rh-with-sars%e2%80%90cov%e2%80%902-positivity-the-role-of-race-and-ethnicity-in-a-female-cohort","status":"publish","type":"post","link":"https:\/\/www.rhesusnegative.net\/staynegative\/association-of-abo-rh-with-sars%e2%80%90cov%e2%80%902-positivity-the-role-of-race-and-ethnicity-in-a-female-cohort\/","title":{"rendered":"Association of ABO\/Rh with SARS\u2010CoV\u20102 positivity: The role of race and ethnicity in a female cohort"},"content":{"rendered":"<div style=\"padding-bottom:20px; padding-top:10px;\" class=\"hupso-share-buttons\"><!-- Hupso Share Buttons - https:\/\/www.hupso.com\/share\/ --><a class=\"hupso_toolbar\" href=\"https:\/\/www.hupso.com\/share\/\"><img data-recalc-dims=\"1\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/static.hupso.com\/share\/buttons\/share-medium.png?w=640&#038;ssl=1\" style=\"border:0px; padding-top:5px; float:left;\" alt=\"Share Button\"\/><\/a><script type=\"text\/javascript\">var hupso_services_t=new Array(\"Twitter\",\"Facebook\",\"Pinterest\",\"Linkedin\");var hupso_background_t=\"#EAF4FF\";var hupso_border_t=\"#66CCFF\";var hupso_toolbar_size_t=\"medium\";var hupso_twitter_via = \"datebytype\";var hupso_image_folder_url = \"\";var hupso_twitter_via=\"datebytype\";var hupso_url_t=\"\";var hupso_title_t=\"Association of ABO\/Rh with SARS\u2010CoV\u20102 positivity: The role of race and ethnicity in a female cohort\";<\/script><script type=\"text\/javascript\" src=\"https:\/\/static.hupso.com\/share\/js\/share_toolbar.js\"><\/script><!-- Hupso Share Buttons --><\/div>\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"841\" src=\"https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/ajh.26019-pdf.jpg?resize=640%2C841&#038;ssl=1\" alt=\"\" class=\"wp-image-8995\"\/><figcaption>Access the PDF file:<br><a href=\"https:\/\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/ajh.26019.pdf\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"https:\/\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/ajh.26019.pdf (opens in a new tab)\">https:\/\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/ajh.26019.pdf<\/a><\/figcaption><\/figure><\/div>\n\n\n\n<p>Previous reports have documented an association between ABO blood group and risk for infection with the severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102), the cause of the coronavirus disease 2019 (Covid\u201019) pandemic.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0001\">1<\/a>&#8211;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0003\">3<\/a>&nbsp;Associations between race\/ethnicity and SARS\u2010CoV\u20102 positivity have also been reported.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0004\">4<\/a>,&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0005\">5<\/a>&nbsp;Here we describe the first large\u2010scale observational study investigating the associations between ABO group\/Rh types with SARS\u2010CoV\u20102 positivity, by major race\/ethnicity.<\/p>\n\n\n\n<p>In this retrospective, observational study, test results from a national reference clinical laboratory were assessed to determine the influence of race\/ethnicity on the associations of ABO\/Rh with SARS\u2010CoV\u20102 RNA positivity. Results from SARS\u2010CoV\u20102 RNA nucleic acid amplification tests (NAAT) performed March through July 2020 were matched with ABO\/Rh test results obtained for the same individual since January 2010. Only one SARS\u2010CoV\u20102 result per patient was considered; a patient was considered to have a positive result if any SARS\u2010CoV\u20102 test result was positive. The ABO\/Rh testing is generally performed as part of maternal screening; males were excluded. The influence of race\/ethnicity on the associations of ABO type\/Rh group with SARS CoV\u20102 positivity was assessed in a subset of females with available race\/ethnicity data.<\/p>\n\n\n\n<p>The SARS\u2010CoV\u20102 RNA NAAT was performed using one of four US Food and Drug Administration (FDA) Emergency Use Authorized tests (Quest Diagnostics SARS\u2010CoV\u20102 RNA [Covid\u201019], Qualitative NAAT; Hologic Panther Fusion SARS\u2010CoV\u20102 assay; Roche Diagnostics cobas SARS\u2010CoV\u20102 test; or Hologic Aptima SARS\u2010CoV\u20102 assay). The ABO\/Rh typing was performed using solid\u2010phase technology (Immucor NEO).<\/p>\n\n\n\n<p>Differences in proportions were analyzed using the chi\u2010square test (with results presented as nominal&nbsp;<em>P<\/em>&nbsp;values). For multivariable logistic regression models, race\/ethnicity was grouped into the following categories: Black non\u2010Hispanic, Hispanic, white non\u2010Hispanic, and \u201cother\u201d race\/ethnicity (\u201cother\u201d included females of multiple race\/ethnicities). Analyses were performed using SAS Studio 3.6 on SAS 9.4 (SAS Institute). This Quest Diagnostics Health Trends study was deemed exempt by the Western Institutional Review Board (Puyallup, Washington).<\/p>\n\n\n\n<p>The study cohort comprised 276\u2009536 females with matched SARS\u2010CoV\u20102 and ABO\u2010Rh results from all 50 American states and the District of Columbia. There were 34\u2009178 females who were SARS\u2010CoV\u20102 positive (12.4%, 95% CI 12.2%\u201012.5%).The median patient age at the time of SARS\u2010CoV\u20102 testing was 34.4 (IQR 29.2\u201040.0) years. The SARS\u2010CoV\u20102 positivity rate was higher in both females under 30\u2009years of age (15.1%, 95% CI 14.9%\u201015.4%) and those 30\u201039\u2009years (11.9%, 95% CI 11.7%\u201012.0%) than in females age 40\u2009years or over (10.1%, 95% CI 9.9%\u201010.4%) (<em>P<\/em>\u2009&lt;\u2009.001 for both comparisons). The most common blood type was O+ (123\u2009642; 44.7%), followed by A+ (83\u2009219; 30.1%); B+ (32\u2009961; 11.9%); O\u2010 (12\u2009871; 4.7%); A\u2010 (10 531; 3.8%); AB+ (9048; 3.3%); B\u2010 (3179; 1.2%); and AB\u2010 (1085; 0.4%).<\/p>\n\n\n\n<p>The SARS\u2010CoV\u20102 positivity rate was 38% higher in Rh+ patients (12.7%, 95% CI 12.6%\u201012.8%) than in Rh\u2010 patients (9.2%, 95% CI 8.9%\u20109.5%) (<em>P<\/em>\u2009&lt;\u2009.001). The SARS\u2010CoV\u20102 positivity rate was also significantly higher among type O patients (13.0%, 95% CI 12.8%\u201013.2%) than among type A (11.8%, 95% CI 11.6%\u201012.0%), type B (11.9%, 95% CI 11.5%\u201012.2%), or type AB (11.4%, 95% CI 10.7%\u201012.0%) patients (<em>P<\/em>\u2009&lt;\u2009.001 for all comparisons). No statistically significant differences in SARS\u2010CoV\u20102 positivity between females with type A and B (<em>P<\/em>&nbsp;= .66), type A and AB (<em>P<\/em>&nbsp;= .21), or type B and AB (<em>P<\/em>&nbsp;= .16) were observed. In stratified analyses, the relationship between SARS\u2010CoV\u20102 positivity and Rh type remained significant across ABO blood groups (Figure&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#support-information-section\">S1<\/a>).<\/p>\n\n\n\n<p>Among the 88\u2009975 females with available race\/ethnicity data, the distributions of ABO groups\/Rh types were remarkably similar to findings from a large study of blood donors conducted by the American Red Cross.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0006\">6<\/a>&nbsp;In this study SARS\u2010CoV\u20102 positivity rates, as well as ABO\/Rh distributions, differed significantly between race\/ethnicity groups (Table&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#support-information-section\">S1<\/a>). Hispanic females were significantly more likely to have type O blood (58.3%) than were black non\u2010Hispanic (49.5%), white\u2010non\u2010Hispanic (45.2%), and \u201cother\u201d race\/ethnicity females (<em>P<\/em>\u2009&lt;\u2009.001 for all comparisons). White non\u2010Hispanic females were more than twice as likely to be Rh\u2010 (15.1%) compared to other groups, including \u201cother\u201d race\/ethnicity (6.6%), Hispanic (6.4%), and black non\u2010Hispanic (6.1%) groups (<em>P<\/em>\u2009&lt;\u2009.001 for all comparisons). Hispanic females had the highest SARS\u2010CoV\u20102 positivity rate (21.4%, 95% CI 20.9%\u201021.9%), followed by black non\u2010Hispanic (16.3%, 95% CI 15.7%\u201016.9%), \u201cother\u201d race\/ethnicity (12.8%, 95% CI 12.3%\u201013.4%), and white non\u2010Hispanic (7.2%, 95% CI 6.9%\u20107.4%) females.<\/p>\n\n\n\n<p>Unadjusted logistic regression analyses demonstrated similar associations between ABO\/Rh variables and SARS\u2010CoV\u20102 positivity in the subset of females with race\/ethnicity data as in the overall cohort (Figure&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-fig-0001\">1<\/a>). However, when race\/ethnicity groups were included in an adjusted model, there were two important changes. First, the increased risk of SARS\u2010CoV\u20102 positivity in Rh+ patients fell from 1.44 (95% CI 1.34\u20101.54) in the unadjusted model to 1.15 (95% CI 1.06\u20101.23) in the adjusted model. Second, the association between type O and SARS\u2010CoV\u20102 positivity changed from being significantly predictive in the unadjusted model (OR 1.07, 95% CI 1.03\u20101.11), to significantly protective in the adjusted model (OR 0.95, 95% CI 0.92\u20100.99).<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"2128\" height=\"1569\" src=\"https:\/\/i1.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?fit=640%2C472&amp;ssl=1\" alt=\"\" class=\"wp-image-8992\" srcset=\"https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?w=2128&amp;ssl=1 2128w, https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?resize=300%2C221&amp;ssl=1 300w, https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?resize=768%2C566&amp;ssl=1 768w, https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?resize=1024%2C755&amp;ssl=1 1024w, https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?w=1280&amp;ssl=1 1280w, https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?w=1920&amp;ssl=1 1920w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption> Logistic regression models, associations with SARS\u2010CoV\u20102 positivity. Reference Groups: 1, Rh negative; 2, Blood types A, B, and AB; 3, White non\u2010Hispanic; 4, Age\u2009&gt;\u2009=40\u2009years. \u201cLCL\u201d, lower confidence limit; \u201cOR\u201d, odds ratio; \u201cUCL\u201d, upper confidence limit. The bars represent the 95% Wald Confidence Limits. Multivariable adjusted model n = 88\u2009970 of 88\u2009975 females with race\/ethnicity data (five were missing age)<br><br> <\/figcaption><\/figure><\/div>\n\n\n\n<p>This is the largest reported study to date assessing SARS\u2010CoV\u20102 positivity rates by ABO\/Rh and race\/ethnicity. In line with prior studies,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0002\">2<\/a>,&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0003\">3<\/a>&nbsp;our findings demonstrated that Rh positivity, independent of ABO blood group and race\/ethnicity, was a statistically significant risk factor for SARS\u2010CoV\u20102 positivity. In contrast to findings from smaller studies,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0001\">1<\/a>&nbsp;our unadjusted analysis showed a significantly higher SARS\u2010CoV\u20102 positivity rate among individuals with type O blood than in those with other blood types. However, after adjusting for race\/ethnicity, the relationship between type O and SARS\u2010CoV\u20102 reversed from predictive to protective. Type O and Rh\u2009+\u2009blood is more prevalent in Hispanics and black non\u2010Hispanics, two groups in our study with the highest proportions of positive SARS\u2010CoV\u20102 tests. Thus we conclude, in concordance with findings from other studies,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0001\">1<\/a>&nbsp;that type O blood is slightly protective against SARS\u2010CoV\u20102 positivity once race\/ethnicity has been considered. The multivariable model also demonstrated that the influence of Rh+ blood type was attenuated when adjusted for race\/ethnicity, suggesting that the association between ABO\/Rh and SARS\u2010CoV\u20102 positivity is strongly influenced by race\/ethnicity.<\/p>\n\n\n\n<p>Much attention has been paid to the disproportionate rates of SARS\u2010CoV\u20102 infection in Hispanic and black non\u2010Hispanic populations in the United States.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0004\">4<\/a>,&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0005\">5<\/a>&nbsp;The reasons for this relationship are not fully understood. Theories include increased exposure to the virus among Hispanic and black non\u2010Hispanic populations owing to employment, economic hardship, dense living conditions, and other general disparities.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0004\">4<\/a>,&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0005\">5<\/a>&nbsp;Here, we demonstrated additional racial\/ethnic influences on relationship between ABO group\/Rh type and SARS\u2010CoV\u20102 positivity.<\/p>\n\n\n\n<p>One explanation for variations among studies is differences in the underlying distributions of blood groups\/types by race\/ethnicity in the populations studied. The race\/ethnicity distribution for the subset of females with available data in this study was remarkably similar to estimates for the total U.S. population.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0006\">6<\/a>&nbsp;ABO blood types are known to influence susceptibility to other infectious agents, including the severe acute respiratory syndrome\u2010associated coronavirus\u20101 (SARS\u2010CoV\u20101), where similar associations with blood group have been described.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0001\">1<\/a>,&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0002\">2<\/a>&nbsp;The ABO antigens are carbohydrate\u2010enriched epitopes present on erythrocytes, endothelial cells, and other specialized tissues and secreted within certain body fluids of some individuals. These antigens induce a potent immune response, triggering isoagglutinin antibodies against non\u2010expressed ABO antigens. The spike proteins of SARS viruses also express carbohydrate\u2010rich moieties, as well as ABO antigens borrowed from the infected host. In this way, type O individuals, whose blood naturally contains both anti\u2010A and anti\u2010B isoagglutinin antibodies, are thought to have an inherent immune advantage against SARS viral infections.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0001\">1<\/a>,&nbsp;<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019#ajh26019-bib-0002\">2<\/a><\/p>\n\n\n\n<p>The Rh blood type consists of more than 50 protein antigens, the most clinically relevant of which are D, C, c, E, and e. The RH locus encodes two genes&nbsp;<em>RHD<\/em>&nbsp;and&nbsp;<em>RHCE<\/em>. An individual&#8217;s Rh type is largely determined by the presence or absence of the D antigen on erythrocytes, Rh+ or Rh\u2010, respectively. The Rh antigens complex with associated glycoproteins on the red blood cell surface, but physiologic roles of RhD and RhE have yet to be elucidated. The association between Rh\u2009+\u2009blood and SARS\u2010CoV\u20102 positivity merits further investigation.<\/p>\n\n\n\n<p>This study was limited by several factors. The majority of those studied were likely pregnant at the time of ABO\/Rh testing, but not necessarily pregnant at the time of SARS\u2010CoV\u20102 testing. It is unclear how pregnancy and its associated immunotolerance affect SARS\u2010CoV\u20102 positivity rates. People with symptoms, or high exposure risk, for example, healthcare workers, are theoretically more likely to be tested for SARS\u2010CoV\u20102. In addition, race\/ethnicity data were reported by the ordering clinician and were only available for 32.2% of the study cohort. However, the group of females with race\/ethnicity available (n = 88\u2009975) still represents one of the largest known studies to date comparing the association between ABO\/Rh and SARS\u2010CoV\u20102 positivity. No clinical information was available to corroborate test results, correlate outcome, or assess clinical course.<\/p>\n\n\n\n<p>In summary, an association between ABO\/Rh and SARS\u2010CoV\u20102 positivity was confirmed but greatly attenuated after factoring in race\/ethnicity. Future studies to evaluate the influence of race\/ethnicity on COVID\u201019 risk and clinical course are necessary for comprehensive assessment of the impact of blood group\/Rh type on infection and disease.<\/p>\n\n\n\n<p><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.26019\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Association of ABO\/Rh with SARS\u2010CoV\u20102 positivity: The role of race and ethnicity in a female cohort (opens in a new tab)\">Association of ABO\/Rh with SARS\u2010CoV\u20102 positivity: The role of race and ethnicity in a female cohort<\/a><\/p>\n<div style=\"padding-bottom:20px; padding-top:10px;\" class=\"hupso-share-buttons\"><!-- Hupso Share Buttons - https:\/\/www.hupso.com\/share\/ --><a class=\"hupso_toolbar\" href=\"https:\/\/www.hupso.com\/share\/\"><img data-recalc-dims=\"1\" decoding=\"async\" src=\"https:\/\/i0.wp.com\/static.hupso.com\/share\/buttons\/share-medium.png?w=640&#038;ssl=1\" style=\"border:0px; padding-top:5px; float:left;\" alt=\"Share Button\"\/><\/a><script type=\"text\/javascript\">var hupso_services_t=new Array(\"Twitter\",\"Facebook\",\"Pinterest\",\"Linkedin\");var hupso_background_t=\"#EAF4FF\";var hupso_border_t=\"#66CCFF\";var hupso_toolbar_size_t=\"medium\";var hupso_twitter_via = \"datebytype\";var hupso_image_folder_url = \"\";var hupso_twitter_via=\"datebytype\";var hupso_url_t=\"\";var hupso_title_t=\"Association of ABO\/Rh with SARS\u2010CoV\u20102 positivity: The role of race and ethnicity in a female cohort\";<\/script><script type=\"text\/javascript\" src=\"https:\/\/static.hupso.com\/share\/js\/share_toolbar.js\"><\/script><!-- Hupso Share Buttons --><\/div>","protected":false},"excerpt":{"rendered":"<div style=\"padding-bottom:20px; padding-top:10px;\" class=\"hupso-share-buttons\"><!-- Hupso Share Buttons - https:\/\/www.hupso.com\/share\/ --><a class=\"hupso_toolbar\" href=\"https:\/\/www.hupso.com\/share\/\"><img src=\"https:\/\/static.hupso.com\/share\/buttons\/share-medium.png\" style=\"border:0px; padding-top:5px; float:left;\" alt=\"Share Button\"\/><\/a><script type=\"text\/javascript\">var hupso_services_t=new Array(\"Twitter\",\"Facebook\",\"Pinterest\",\"Linkedin\");var hupso_background_t=\"#EAF4FF\";var hupso_border_t=\"#66CCFF\";var hupso_toolbar_size_t=\"medium\";var hupso_twitter_via = \"datebytype\";var hupso_image_folder_url = \"\";var hupso_twitter_via=\"datebytype\";var hupso_url_t=\"\";var hupso_title_t=\"Association of ABO\/Rh with SARS\u2010CoV\u20102 positivity: The role of race and ethnicity in a female cohort\";<\/script><script type=\"text\/javascript\" src=\"https:\/\/static.hupso.com\/share\/js\/share_toolbar.js\"><\/script><!-- Hupso Share Buttons --><\/div>Previous reports have documented an association between ABO blood group and risk for infection with the severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102), the cause of the coronavirus disease 2019 (Covid\u201019) pandemic.1&#8211;3&nbsp;Associations between race\/ethnicity and SARS\u2010CoV\u20102 positivity have also been reported.4,&nbsp;5&nbsp;Here we describe the first large\u2010scale observational study investigating the associations between ABO group\/Rh types with SARS\u2010CoV\u20102 positivity, by major race\/ethnicity. In this retrospective, observational study, test results from a national reference clinical laboratory were assessed to determine the influence of race\/ethnicity on the associations of ABO\/Rh with SARS\u2010CoV\u20102 RNA positivity. Results from SARS\u2010CoV\u20102 RNA nucleic acid amplification tests (NAAT) performed March through July 2020 were matched with ABO\/Rh test results obtained for the same individual since January 2010. Only <div style=\"padding-bottom:20px; padding-top:10px;\" class=\"hupso-share-buttons\"><!-- Hupso Share Buttons - https:\/\/www.hupso.com\/share\/ --><a class=\"hupso_toolbar\" href=\"https:\/\/www.hupso.com\/share\/\"><img src=\"https:\/\/static.hupso.com\/share\/buttons\/share-medium.png\" style=\"border:0px; padding-top:5px; float:left;\" alt=\"Share Button\"\/><\/a><script type=\"text\/javascript\">var hupso_services_t=new Array(\"Twitter\",\"Facebook\",\"Pinterest\",\"Linkedin\");var hupso_background_t=\"#EAF4FF\";var hupso_border_t=\"#66CCFF\";var hupso_toolbar_size_t=\"medium\";var hupso_twitter_via = \"datebytype\";var hupso_image_folder_url = \"\";var hupso_twitter_via=\"datebytype\";var hupso_url_t=\"\";var hupso_title_t=\"Association of ABO\/Rh with SARS\u2010CoV\u20102 positivity: The role of race and ethnicity in a female cohort\";<\/script><script type=\"text\/javascript\" src=\"https:\/\/static.hupso.com\/share\/js\/share_toolbar.js\"><\/script><!-- Hupso Share Buttons --><\/div>","protected":false},"author":1,"featured_media":8992,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"amp_status":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-8990","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-facts"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.rhesusnegative.net\/staynegative\/wp-content\/uploads\/2020\/11\/rh-factor-covid.jpg?fit=2128%2C1569&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p5DV68-2l0","_links":{"self":[{"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/posts\/8990","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/comments?post=8990"}],"version-history":[{"count":5,"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/posts\/8990\/revisions"}],"predecessor-version":[{"id":8997,"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/posts\/8990\/revisions\/8997"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/media\/8992"}],"wp:attachment":[{"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/media?parent=8990"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/categories?post=8990"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.rhesusnegative.net\/staynegative\/wp-json\/wp\/v2\/tags?post=8990"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}