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We also fully agree that this is a modest study and that the relationship between the ABO blood group and susceptibility to infection may be influenced by other factors not analysed, as shown in other series.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> One of the main limitations of our study is that it was carried out at the beginning of the pandemic, when diagnostic PCR was only performed on patients admitted with severe respiratory pathology. From May onwards, PCR testing of outpatients, asymptomatic people and contacts increased.</p><p id="par0010" class="elsevierStylePara elsevierViewall">However, the paper explains that the data collected during the first wave shows that group O patients admitted with COVID-19 infection are proportionally less than the population base, and already acknowledges that the difference is not statistically significant. Given the suspicion of a lack of significance due to a low sample size, we urged colleagues from other autonomous communities in Spain to carry out a multicentre study, in which nearly 1400 patients have been analysed, showing a significant increase in the percentage of groups A, B and AB in patients hospitalised with SARS-CoV2, and a decrease in those of group O in comparison with the general population (data pending publication). Recently other colleagues have published their experience in 2 patient cohorts and have found significant results.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">On the other hand, our group has continued its research with patients from the second wave in summer and the third wave at the beginning of winter, adding factors not analysed in the first study. The entire population of our region has been included (n = 651,586) and all diagnosed cases, including clinical, demographic, and social variables. Preliminary analysis would not find an increased risk of transmission or infection but would find an increased risk of hospitalisation and severity (unpublished data). However, although in the published results we found that the AB + B group was statistically significant in terms of the number of thrombotic complications together with a higher rate of admission to intensive care units, in the second wave, probably influenced by the current early application of antithrombotic protocols, this association would no longer be significant. Among the factors with significant risk of admission, we have found migration, a factor that could be related to ethnicity as Dr. Jianghui Cai's group comments, but in our population, these are group O and B more frequently than the general population (personal communication Dr. Librero).</p><p id="par0020" class="elsevierStylePara elsevierViewall">It is known that ABO blood groups present differences in their distribution worldwide and that the ABO polymorphism and host susceptibility to certain pathogens is consolidated, as well as the difference in hemorrhagic or thrombotic risk. For this reason, given the suspicion that SARS-CoV2 may be heading in the same direction, we believe that international studies should be carried out in different areas of the world, in order to research the pathophysiological mechanisms if there is causality. This could contribute to the development of treatments, as well as directing the kinetics of the pandemic. Therefore, in addition to agreeing once again with the comments made by Dr. Jianghui's team, we are willing to extend these studies to the international arena together with them.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Zalba Marcos S, Antelo Caamaño ML, García-Erce JA. Réplica a la carta al editor: «Infección y trombosis asociada al COVID-19: posible papel del grupo sanguíneo ABO». Med Clin (Barc). 2021;157:e283.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lack of association between ABO blood groups and susceptibility to SARS-CoV-2 infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.E. Levi" 1 => "P.R. Telles" 2 => "H. Scrivani" 3 => "G. Campana" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/vox.13015" "Revista" => array:2 [ "tituloSerie" => "Vox Sang" "fecha" => "2020" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship between the ABO blood group and COVID-19 susceptibility, severity and mortality in two cohorts of patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Muñiz-Diaz" 1 => "J. Llopis" 2 => "R. Parra" 3 => "I. Roig" 4 => "G. Ferrer" 5 => "J. Grifols" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2450/2020.0256-20" "Revista" => array:6 [ "tituloSerie" => "Blood Transfus" "fecha" => "2021" "volumen" => "19" "paginaInicial" => "54" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33196417" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015700000005/v1_202109171210/S2387020621004137/v1_202109171210/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015700000005/v1_202109171210/S2387020621004137/v1_202109171210/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621004137?idApp=UINPBA00004N" ]
