PMC:7108609 / 3671-4715 JSONTXT

Various genetic factors influencing the susceptibility to or the outcome of SARS have been described (Gu and Korteweg 2007). The ABO gene stands out among the genes involved since O blood group individuals were shown to have very low odds of infection compared to non-O individuals in a hospital outbreak that occurred in March 2003 in Hong Kong (Cheng et al. 2005). Histo-blood group antigens are present not only on erythrocytes but also on many epithelial cells, which are their main site of expression (Marionneau et al. 2001). Since SARS-CoV replicates in epithelial cells of the respiratory and digestive tracts that have the ability to synthesize ABH carbohydrate epitopes, we hypothesized that the S protein of virions produced by either A or B individuals could be decorated with A or B carbohydrate epitopes, respectively. Natural anti-A or -B antibodies from blood group O, B, and A individuals could bind to the S protein and block its interaction with ACE2, thereby preventing infection in accordance with the rules of transfusion.