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A narrative review of the epidemiological and mechanistic associations between ABO blood groups and diseases: focusing on cardiovascular diseases, cancers, diabetes, malaria, COVID-19 and rheumatic diseases.

Created on 11 Aug 2026

Authors

Ying Liu, Yuan Zhu, Guanghua Luo

Published in

Annals of medicine. Volume 58. Issue 1. Pages 2710922. Epub Aug 10, 2026.

Abstract

The ABO blood group system is one of the most clinically significant human blood group systems and is closely associated with pathogenesis, progression, and prognosis of numerous diseases. This narrative review synthesizes recent epidemiological evidence and explores potential mechanisms linking ABO to cardiovascular diseases, malignancies, diabetes, Plasmodium falciparum malaria, COVID‑19, and rheumatic diseases.
We searched PubMed and CNKI up to September 2025.
Epidemiological studies consistently show non‑O blood groups have significantly elevated cardiovascular risk, with venous thromboembolism risk about two to four times higher than in type O. In oncology, ABO influences susceptibility and prognosis in various cancers, with type A linked to increased gastric cancer risk (pooled OR≈1.2). Type O individuals show relative resistance to severe malaria. During COVID‑19, type A was linked to higher susceptibility and severity, whereas type O appeared mildly protective, though associations exhibited substantial heterogeneity across populations, viral variants, and vaccination contexts. ABO polymorphisms may also modulate risk and manifestations of rheumatic diseases such as systemic lupus erythematosus and rheumatoid arthritis.
Accumulating evidence suggests ABO status is associated with susceptibility and outcomes for a range of diseases. These findings are primarily hypothesis‑generating and underscore the need for further research to elucidate causal mechanisms. The potential of ABO typing as a biomarker for risk stratification in personalized medicine warrants investigation in large, multi‑ethnic prospective studies.

PMID:
42574721
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

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