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Amr J Halawani,1 Saif Elden B Abdalla,2 Mahmoud M Habibullah,2 Ghalia Shamlan,3 Neil D Avent4 1Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Medical Laboratory Technology, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia; 3Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, 11362, Saudi Arabia; 4Consultant Molecular Biologist, Bristol, UKCorrespondence: Amr J Halawani, Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia, Email ajjhalawani@uqu.edu.saPurpose: Inherited blood disorders as well as malaria are prevalent in southwestern Saudi Arabia. Patients with specific hemoglobinopathies may require frequent blood transfusions. Accordingly, alloimmunization may occur if donors and recipients are incompatible. Therefore, examination of various blood group antigens to provide compatible blood units is essential. Two alleles of the Diego (DI) blood group system, DI*02.03 and DI*02.04 encode the Wright antigens; Wra and Wrb, respectively. Anti-Wra may lead to alloimmunization during transfusion and pregnancy. Furthermore, the Wrb antigen may involve in interaction between protein receptors for Plasmodium falciparum. This study aimed to investigate the allele/genotype frequencies of the Wright blood groups in southwestern Saudi blood donors regarding the blood transfusion and assessed the population of Jazan Province for susceptibility of Plasmodium falciparum invasion.Materials and Methods: One-hundred-fifty Saudi blood donors were enrolled to this study. DNA was extracted from the blood samples. Primer pairs were designed to capture a single nucleotide variation that distinguishes the Wright alleles. Polymerase chain reaction (PCR) was conducted and followed by standard sequencing.Results: Among the 150 genotyped samples, the only observed allele was DI*02.04 (n = 150, 100%). Accordingly, the genotype prevalence of DI*02.04/DI*02.04 was accounted for (n = 150, 100%).Conclusion: This study demonstrated the allele frequencies of DI*02.03 and DI*02.04 of the DI blood group system in Saudi blood donors. The DI*02.04 allele was the only allele that was observed. Furthermore, the prevalence of the genotypes was determined and the only observed genotype was DI*02.04/DI*02.04. Interestingly, this study indicates that the Saudi Arabian population living in Jazan Province may be more susceptible to Plasmodium falciparum invasion. Moreover, adding the Wright alleles for the transfusion screening panel is not recommended.Keywords: wright blood group, blood group genotyping, blood transfusion, malaria, Saudi Arabia

Amr J Halawani,1 Hisham I Abu-Tawil,2,3 Salah Alharbi,4 Bandar S Almalki,5 Fawaz M Majmi,6 Renad A Miny,1 Nada G Alghoribi,1 Sulaiman S Alabsi,7 Saeed M Kabrah,1 Haneen O Alhaj,8 Musaed M Alshahrani,9 Nora Y Hakami10 1Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Laboratory and Blood Bank, Prince Mohammed Bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia; 3Department of Laboratory and Blood Bank, King Faisal Medical City for Southern Regions, Ministry of Health, Abha, Saudi Arabia; 4Armed Forces Hospital in Jazan, Ministry of Defence, Jazan, Saudi Arabia; 5General Medical Committee, tDirectorate General of Health Affairs, Jazan, Saudi Arabia; 6Department of Pharmacy, Ahad Al Masarihah General Hospital, Ministry of Health, Jazan, Saudi Arabia; 7King Abdulaziz Medical City, Jeddah, Saudi Arabia; 8Kholoud Laboratory for Medical Analysis, Makkah, Saudi Arabia; 9Blood Bank Laboratory, Prince Sultan Military Medical City, Saudi Arabia; 10Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Amr J Halawani, Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences Umm Al-Qura University, Makkah, Saudi Arabia, Email ajjhalawani@uqu.edu.saPurpose: Jazan Province in Saudi Arabia is notable for its high prevalence of inherited hemoglobinopathies, including sickle cell disease and thalassemia, necessitating frequent blood transfusions for affected individuals. To mitigate risks such as RBC alloimmunization and hemolytic transfusion reactions, ensuring blood compatibility is crucial. The Kell (KEL) blood group system, pivotal alongside the ABO and RH systems, encompasses multiple antigens implicated in these complications. This study aimed to investigate the frequencies of KEL blood group antigens (K, k, Kpa, and Kpb) and determine KEL phenotypes (K/k and Kpa/Kpb) among Saudi blood donors living in Jazan Province.Methods: A total of 138 anonymous healthy Saudi blood donors from Prince Mohammed bin Nasser Hospital in Jazan Province, Saudi Arabia, were enrolled in this study. Anticoagulated blood was analyzed using the gel card technique to assess K, k, Kpa, and Kpb antigens.Results: The prevalence of KEL antigens was as follows: K (n = 9, 6.52%), k (n = 137, 99.28%), Kpa (n = 1, 0.72%), and Kpb (n = 138, 100%). KEL phenotypes observed were K+k+ (n = 8, 5.80%), K+k− (n = 1 0.72%), K−k+ (n = 129, 93.48%), Kp(a+b+) (n = 1, 0.72%), and Kp(a−b+) (n = 137, 99.28%).Conclusion: This study provides insights into the prevalence of KEL blood group antigens and phenotypes in Jazan Province, Saudi Arabia. These findings may contribute to the establishment of a national blood group database and guide transfusion practices to ensure compatibility and minimize alloimmunization risks.Keywords: Kell blood group, blood transfusion, immunohematology, Saudi Arabia

Amr J Halawani,1 Abdullah A Mobarki,2 Ali H Arjan,3 Muhammad Saboor,2 Hassan A Hamali,2 Gasim Dobie,2 Khalaf F Alsharif4 1Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 3Department of Laboratory and Blood Bank, King Fahad Central Hospital, Ministry of Health, Jazan, Saudi Arabia; 4Department of Clinical Laboratory Science, College of Applied Medical Sciences, Taif University, Taif, Saudi ArabiaCorrespondence: Amr J Halawani, Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia, Email ajjhalawani@uqu.edu.saPurpose: Sickle cell disease (SCD) and thalassemia are common inherited blood disorders in Saudi Arabia, especially in Jazan Province. Patients with these disorders require multiple blood transfusions, which may lead to alloimmunization because of mismatched blood group antigens. In this study, we examined the alloimmunization and autoimmunization rates in patients with SCD and thalassemia together with the involved antibodies.Patients and Methods: A cross-sectional study was conducted to review the transfusion history records of patients with SCD and thalassemia at Prince Mohammed bin Nasser Hospital, Jazan Province, Saudi Arabia.Results: Four-hundred thirty-eight patients (385 with SCD, 52 with β-thalassemia, and 1 with α-thalassemia) were received leukoreduced red cell transfusions. The alloimmunization and autoimmunization rates in patients with SCD were 12.98% and 0.52%, respectively. In patients with thalassemia, the alloimmunization and autoimmunization rates were 13.21% and 3.77%, respectively. The most prevalent antibodies in the study population were anti-E (17.19%) and anti-K (14.06%).Conclusion: The alloimmunization and autoimmunization rates were determined in patients with SCD and thalassemia in Jazan Province, Saudi Arabia. The results highlight the need for extended phenotyping to include ABO, RH (D, C, c, E, e), K, Fya, Fyb, Jka and Jkb antigens in the screening panel. This will benefit patients to ensure better transfusion practices.Keywords: red cell alloimmunization, sickle cell disease, thalassemia, autoimmunization

Amr J Halawani,1 Mahmoud M Habibullah,2,3 Gasim Dobie,2 Alaa Alhazmi,2,3 Farkad Bantun,4 Mohammed H Nahari,5 Ibrahim Dawmary,6 Hisham I Abu-Tawil6,7 1Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 2Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 3SMIRES for Consultation in Specialized Medical Laboratories, Jazan University, Jazan, Saudi Arabia; 4Department of Microbiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; 5Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia; 6Department of Laboratory and Blood Bank, Prince Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia; 7Department of Laboratory and Blood Bank, King Faisal Medical City for Southern Regions, Ministry of Health, Abha, Saudi ArabiaCorrespondence: Amr J Halawani Makkah, 24381 8156, Saudi ArabiaEmail ajjhalawani@uqu.edu.saPurpose: Knowledge of the prevalence of blood group antigens in a given population is important for the prevention of hemolytic reactions. The MNS blood group system (002) has four polymorphic antigens—M, N, S, and s. Anti-S and anti-s antibodies may result in immediate and delayed hemolytic transfusion reactions, and hemolytic disease of the fetus and newborn may occur. The present study investigated the frequencies of the main antigens and phenotypes of the MNS blood group system.Subjects and Methods: We randomly obtained 149 samples from anonymous Saudi blood donors living in Jazan Province. Serotyping was conducted using a gel card to investigate (M, N, S, and s) antigens and phenotypes.Results: The frequencies of MNS antigens were as follows: M = 89.26%, N = 51.67%, S = 61.07%, and s = 82.55%. Regarding the MNS phenotypes, nine phenotypes were observed in the study population. The most common phenotype was M+N–S+s+ (n = 36, 24.16%), in contrast to the least common phenotype M+N–S–s– (n = 1, 0.67%). The prevalence of the MNS phenotypes in the current study population was highly and significantly different from that in Europeans (P = 0.044) and African Americans (P = 0.000).Conclusion: In summary, this study reports the frequencies of the MNS antigens and phenotypes in Jazan Province, Saudi Arabia. The most common phenotype was M+N–S+s+, whereas the least observed phenotype was M+N–S–s–. The outcomes of this study may assist the blood banks in Jazan Province to establish an extended phenotyping protocol including the MNS antigens, in particular S and s antigens, to preclude any alloimmunization events.Keywords: MNS blood group, blood donors, transfusion, Saudi Arabia

Muhammad Saboor,1,2 Amtuz Zehra,3 Hassan A Hamali,1 Amr Jamal Halawani,1 Abdullah A Mobarki,1 Aymen M Madkhali,1 Saleh Abdullah1 1Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 2Medical Research Centre (MRC), Jazan University, Jazan, Saudi Arabia; 3Basic Science Department, King Saud Bin Abdulaziz University, Al Ahasa Branch, Saudi ArabiaCorrespondence: Muhammad SaboorDepartment of Medical Laboratory Technology, Faculty of Applied Medical Science, Jazan University, Jazan, Saudi ArabiaTel +966 54 495 9029Email msaboor@jazanu.edu.saPurpose: A2 and A2B are rare phenotypes of the ABO blood group system. Some individuals with A2 and A2B may have anti-A1 antibodies that may be clinically significant or insignificant. The aim of this study was to determine the frequency of A2, A2B phenotypes and anti-A1 antibodies in blood donors in Jazan, Saudi Arabia. This study also evaluated the reactivity potential of anti-A1 antibodies.Materials and Methods: Blood samples collected from 446 blood donors were typed for ABO (cell and serum grouping) and Rh D. Individuals with blood group A and AB were further subtyped by testing with anti-A1 lectin. In addition to the serum grouping using A1 red cells, A2 and A2B individuals were screened for the presence of anti-A1 in their sera against A1 red cells at 4°C, 22°C and 37°C to determine the thermal amplitude of the reacting anti-A1 antibody (if present).Results: Among A and AB, A1 was the commonest phenotype (20.2%, n=90 out of 446) while A1B was found to be 1.8% (n=8) among AB phenotype. A2 and A2B were found to be 2.2% (n=10) and 0.9% (n=4), respectively. Only one individual with A2B blood type showed cold reactive anti-A1 antibody, the strength of which was 32.Conclusion: A2 and A2B were the rarest among ABO phenotypes in the studied population. Although rare, anti-A1 antibody is not so uncommon. Care shall be taken during routine ABO grouping especially in cases of mix-field or weak positive reactions in A and AB phenotypes.Keywords: ABO, anti-A1, subgroups, blood groups, antibodies, Saudi Arabia

Several diseases, including both noninfectious diseases and bacterial and viral diseases, are associated with the ABO and RH blood group systems. Previous studies have shown a link between blood type and the probability of coronavirus disease 2019 (COVID-19) infection. In this study, we aimed to explore the correlation between deaths caused by COVID-19 and ABO and RhD blood types in Saudi Arabia. In this cross-sectional observational study, data from COVID-19 patients were collected from 2 major hospitals treating COVID-19 in Riyadh City, Saudi Arabia, between March 2020 and November 2021. The association between ABO and RhD blood types and COVID-19 outcomes was investigated. A total of 2302 real-time polymerase chain reaction-confirmed COVID-19 patients were enrolled in this study; a chi-square test was used to determine the statistical significance of the data. Of the 2302 enrolled patients, 1008 (43.8%) had blood type O, 677 (29.41%) had blood type A, 502 (21.8%) had blood type B, and 115 (5%) had blood type AB. Of the patients, 2143 (93.1%) were RhD-positive. The O-positive blood type had the highest mortality rate among COVID-19-infected patients, whereas the AB-negative type had the lowest. However, statistical analysis revealed no significant correlation between blood type (ABO or RhD) and COVID-19-based susceptibility or mortality. In conclusion, we found no association between ABO and RhD blood types and either susceptibility to or mortality due to COVID-19 in Saudi Arabia., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Blood supply shortage may affect the health of patients who are transfusion-dependent. Consequently, blood donation plays an important role in the community as it can provide sufficient blood supply at blood bank centers. Medical sciences students can help promote blood donation. The current study aimed to assess the knowledge on, attitude toward, and barriers on blood donation among medical sciences students at the Faculty of Applied Medical Sciences of Jazan University, Saudi Arabia., Methods: An online questionnaire with 23 knowledge and attitude questions was established using Google Forms. Statistical analysis was performed based on gender and blood donation status (never donated, unable to donate, and donated blood)., Results: In total, 601 participants from six different departments responded to the questionnaire. Interestingly, female students had a higher rate of accurate responses toward the knowledge and attitude questions than male students (p < 0.01). Furthermore, students who previously donated had a higher rate of accurate responses to the questions than those who were not able to or never donated blood (p < 0.01)., Conclusions: The questionnaire was designed to assess the general knowledge and attitude of medical sciences students and barriers on blood donation. Female gender and a history of blood donation had a significant impact on responses. Therefore, more efforts are required to educate students regarding the importance of blood donation among patients who are transfusion-dependent.

Introduction: Iron deficiency anemia is the most common type of anemia according to the World Health Organization. Females are more likely to be affected than males. There are several factors causing iron deficiency anemia, such as increased loss of iron, decreased intake of iron, and increased utilization of iron. There are limited research studies evaluating the risk factors that cause anemia among female medical students in Saudi Arabia. For this, the study aimed to identify the prevalence of undiagnosed iron deficiency anemia (IDA) among young female university students and to identify if there is any correlation between IDA and several factors including dietary habits, psychological stress, anxiety status, and body mass index., Materials and Methods: A cross-sectional observational study was performed between October 2022 and December 2022 with a sample of 100 healthy female students aged between 19 and 23 years, who were studying at the medical colleges of Umm Al-Qura University, Saudi Arabia. Blood samples were collected to perform complete blood count and iron profile tests. Also, a survey was done to find correlation between iron deficiency anemia and dietary intake, drinks, stress, anxiety, and body mass index (BMI). Independent t-test or Mann-Whitney U test were used to compare values for non-anemic with anemic participants, and linear regression tests were used to analyze differences between non-anemic and anemic participants' dietary intake factors and stress and anxiety scores. The level of significance was set at p<0.05., Results: The findings represent an overall prevalence of iron deficiency anemia in female medical students based on the lab finding results. Thus, students were divided into two following groups: anemic (13%) with hemoglobin (Hb) concentration <12 g/dL and non-anemic (84%) with Hb concentration ≥12 g/dL. When comparing the two groups, results showed significant differences in the majority of RBC indices (hematocrit {HCT}, mean corpuscular volume {MCV}, mean corpuscular hemoglobin {MCH}, red cell distribution width {RDW}) and iron profiles, p-value was <0.05. On evaluation of the different types of food consumption, the mean iron intake was around 7 mg/day, and in 65% of the participants, it was below the estimated average requirement (EAR) of iron (8.1 mg/dL). The perceived stress scale (PSS) shows that 63% of the participants experienced moderate stress and 58% reported severe anxiety by the generalized anxiety disorder (GAD) scale. In multiple linear regression, iron was positively associated with hemoglobin concentrations, whereas stress scores were negatively associated with hemoglobin concentrations., Conclusion: There is a relatively low prevalence of anemia and most of it was found of the microcytic type, indicating that this condition is a common health issue among local female college students. There was no independent association between stress or anxiety and hemoglobin levels., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Almasmoum et al.)

Background: Inherited hemoglobinopathies are common in Jazan Province, Saudi Arabia, and some patients may frequently require a blood transfusion. Therefore, the provision of compatible units using extended phenotypes is necessary to preclude the risk of alloimmunization. This study aimed to investigate the frequencies of the Lewis (LE), Lutheran (LU), and P1 antigens, as well as determine the prevalence of LE and LU phenotypes., Methods: This study collected 150 blood samples from Saudi Arabian anonymous volunteering blood donors at Prince Muhammed bin Nasser Hospital in Jazan Province, Saudi Arabia. Serotyping was performed using antigen profile-II based on gel card technology to determine LE, LU, and P1 antigens., Results: The prevalence of antigens was as follows: Lea (n = 37, 24.6%), Leb (n = 87, 58%), Lua (n = 6, 4%), Lub (n = 150, 100%), and P1 (n = 120, 80%). Regarding the LE phenotypes, Le (a+b-) was 24.7%, Le (a-b+) was 58%, and Le (a-b-) was 17.3%. The frequencies of only observed LU phenotypes Lu (a-b+) and Lu (a+b+) were 96% and 4%, respectively., Conclusions: In summary, this study reports LE, LU, and P1 antigen prevalence. Moreover, LE and LU phenotype frequencies were investigated. This study may help establish a national database of blood group antigens in Jazan Province, Saudi Arabia. Additionally, it may provide better transfusion practice to avoid the alloimmunization risk.

Introduction The COVID-19 pandemic has been a major public health and economic issue worldwide. Even though vaccines have been developed to reduce the spread of the infection, treating patients remains a significant challenge. This study aims to measure the perceptions of Saudis toward participating in the COVID-19 Convalescent Plasma Clinical Trial. Method A cross-sectional study measuring the perceptions of Saudis toward participating in the COVID-19 Convalescent Plasma Clinical Trial was conducted with participants who had recovered from COVID-19. The study used an online questionnaire covering variables related to demographics, awareness, attitudes, perceptions, and plans for improvement. Results A sample of 1,051 participants participated in the questionnaire. A total of 85% had recovered from COVID-19, only 2.76% had participated in clinical trials before, and 83.44% would participate if they were advised or knew about them. The participants showed a high level of education, with 88% having obtained a degree and most used social media. The results can be biased toward the participants who get their knowledge from social media and hope to learn about things on social media. The gap in knowledge about clinical trials among the participants indicated that certain age groups could be targeted through channels where they communicate the most. Conclusion Engaging the community in clinical trials and educating others about their value by sharing experiences would help promote clinical trials and activate donations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Al Eissa et al.)

The current cross-sectional study was conducted to determine the quality of blood donation services and its association with blood donors' trust and loyalty at Makkah blood donation centers in Saudi Arabia. A total of 373 healthy blood donors aged ≥18 years who visited blood donation centers in Makkah, Saudi Arabia, between 1st and 28th February 2023 were recruited using a census sampling method. A pre-tested and validated Arabic language questionnaire was employed. The study survey included a checklist of sociodemographic variables (seven items), as well as seven-point Likert-scale questions on the quality of blood donation services (21 items), questions to assess the participant's level of trust in blood donation centers (4 items), and questions to evaluate the level of loyalty to blood donations (4 items). SPSS (version 24) was used for data analysis. A total of 373 blood donors were included in this study. Of them, 240 (64.3%) were males and 133 (35.7%) were females. The vast majority of the study participants, 330 (88.5%), had a high educational level. The overall average agreement score for the quality of blood donation services was 71.7%. Furthermore, the overall average item agreement score for trust in blood donation centers and places was 83.0%, while the overall average item agreement score for loyalty to blood donation was 72.1%. Moreover, after adjustment for potential confounding factors, high levels of quality in blood donation services were associated with high levels of trust and loyalty among the blood donors (OR: 1.518, CI 95%: 0.321-0.864 and OR: 2.466, CI 95%: 0.285-0.763, respectively) ( p -value < 0.05 for all). The overall quality of, trust in, and loyalty to blood donation services were 71.7%, 83.0%, and 72.1%, respectively. In addition, high levels of quality in blood donation services could improve blood donors' trust and loyalty levels at Makkah blood donation centers in Saudi Arabia.

The Dombrock (DO) blood group system has two primary antigens, Do a and Do b , which can cause delayed hemolytic transfusion reactions. The paucity of specific monospecific antibodies can hamper the typing based on these antigens. Thus, blood group genotyping (BGG) was investigated as a possible solution. Sequence-specific primers were designed to target a single nucleotide polymorphism (rs11276) on the ART4 gene encoding the DO*A and DO*B alleles. Blood samples ( n = 150) from randomly selected volunteer donors were used. DNA was extracted and resulting PCR products were purified and sequenced. The allelic frequencies of DO*A and DO*B were ( n = 122, 40.67%) and ( n = 178, 59.33%), respectively. The distributions of DO genotypes were as follows: DO*A / DO*A ( n = 20), 13.33%; DO*B / DO*B ( n = 48), 32.00%; and DO*A / DO*B ( n = 82), 54.67%. In conclusion, this study reports on the allelic frequencies of DO*A and DO*B of the DO blood group system in Jazan Province, Kingdom of Saudi Arabia. Furthermore, this study reports on the prevalence of each genotype, of which DO*A/DO*B was the most abundant. This study contributes significantly to build the current blood donor database in Southwestern Saudi Arabia. Moreover, it may assist in providing safe blood to polytransfused patients and reduce the risk of the red cell alloimmunization.

Background and Objectives: Blood transfusion is a lifesaving procedure for transfusion-dependent patients. Therefore, maintaining blood supply is extremely crucial. The coronavirus disease 2019 (COVID-19) pandemic has negatively affected blood supply by affecting donor attendance. This study aimed to investigate blood supply and demand during the pandemic and demonstrate the positive impact of blood donation campaigns through mobile blood drives., Materials and Methods: A cross-sectional study was conducted based on data of the blood bank at Prince Muhammad bin Nasser Hospital (PMBNH) in southwestern Saudi Arabia. Data on the attendance of blood donors at PMBNH were retrieved and retrospectively reviewed to assess the impact of mobile blood drives during the COVID-19 pandemic., Results: Blood supply and donor attendance during the COVID-19 pandemic dropped by 17.32 %. However, blood supply increased between March and May 2020 due to national blood donation campaigns conducted through mobile blood drives. The drop in blood supply after 3 months of mobile blood drives significantly decreased to 0.17 % (P < 0.01). This means the blood supply was increased as follows; (March 2020 = 32.67 %, April 2020 = 45.54 %, and May 2020 = 19.47 %). On the other hand, blood demand decreased by 12.83 %., Conclusion: This study demonstrated the significant impact of establishing blood donation campaigns through mobile blood drives. Our results showed that the strategy can contribute to sufficient blood units to patients during pandemics and emergencies., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: The World Health Organization declared coronavirus disease 2019 (COVID-19) responsible for a catastrophic global pandemic. The complexity of COVID-19 is centred on the unpredictable course of the disease, which can rapidly develop from patients being asymptomatic to having life-threatening symptoms. The unpredictable disease severity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a major problem facing the healthcare system during the pandemic. Identifying the laboratory biomarkers would help predict SARS-CoV-2 pathogenicity. This study focused on the previous literature regarding three laboratory biomarker profiles: haematological, inflammatory, and biochemical biomarkers., Methods: A retrospective study of COVID-19 patients was conducted between May 2020 and September 2020 to determine the predictors of hospitalization (severity) in COVID-19 patients. Patients were divided into two groups: those admitted to an intensive care unit (ICU, severe) and those admitted to a non-ICU (stable). Patients' data were obtained from their medical records at Al Noor Specialist Hospital and East Arafat Hospital in Saudi Arabia., Results: A total of 487 patients with COVID-19, including 304 males and 183 females, were investigated in this study. A total of 217 patients were admitted to the ICU. Patients admitted to the ICU had a higher prevalence of chronic comorbidities than non-ICU patients. D-dimer, white blood cells (WBC), neutrophils, ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were more elevated in patients admitted to the ICU compared to non-ICU patients., Conclusion: Chronic comorbidities are a significant predictor for admission to the ICU. Moreover, tests for D-dimer, WBC, neutrophils, lymphocytes, CRP, LDH, and ALT could be used to predict patients' admission to the ICU., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alsafi et al.)

Background: The patients who require transfusion are prevalent in the Jazan Province, Saudi Arabia. Therefore, it is essential to know the frequency of blood group antigens in such a population. The Kidd blood group system (JK) has two antithetical antigens, Jk a and Jk b . Antibodies to these antigens may result in delayed hemolytic transfusion reactions. The present study investigated the frequencies of Jk a and Jk b and the phenotypes among Saudi blood donors living in the Jazan Province., Methods: One hundred and forty-three samples from anonymous Saudi volunteer blood donors in the Jazan Province were serotype to detect Jk a and Jk b using gel card technology and determine the phenotypes of the JK blood group system., Results: The prevalence of Jk a and Jk b antigens were 90.64% (n = 126) and 69.40% (n = 93), respectively. The JK phenotypes were 34.96% Jk(a + b - ) (n = 51), 12.59% Jk(a - b + ) (n = 18), 52.45% Jk(a + b + ) (n = 75), and 0% Jk(a - b - ). The frequencies of the JK phenotypes in the Jazan population were significantly different from those in the Asian population ( P  < 0.05)., Conclusions: We reported the frequencies of the Jk a and Jk b antigens and the distribution of the JK phenotypes in a group of Saudi blood donors in the Jazan Province, Saudi Arabia. The phenotype Jk(a + b + ) was the most common among the study population. Furthermore, this study emphasizes the significance of identifying the frequency of JK antigens and phenotypes in the provinces of Saudi Arabia., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Abstract: In the wake of the COVID-19 pandemic, research indicates that the COVID-19 disease susceptibility varies among individuals depending on their ABO blood groups. Researchers globally commenced investigating potential methods to stratify cases according to prognosis depending on several clinical parameters. Since there is evidence of a link between ABO blood groups and disease susceptibility, it could be argued that there is a link between blood groups and disease manifestation and progression. The current study investigates whether clinical manifestation, laboratory, and imaging findings vary among ABO blood groups of hospitalized confirmed COVID-19 patients.This retrospective cohort study was conducted between March 1, 2020 and March 31, 2021 in King Faisal Specialist Hospital and Research Centre Riyadh and Jeddah, Saudi Arabia. Demographic information, clinical information, laboratory findings, and imaging investigations were extracted from the data warehouse for all confirmed COVID-19 patients.A total of 285 admitted patients were included in the study. Of these, 81 (28.4%) were blood group A, 43 (15.1%) were blood group B, 11 (3.9%) were blood group AB, and 150 (52.6%) were blood group O. This was almost consistent with the distribution of blood groups among the Saudi Arabia community. The majority of the study participants (79.6% [n = 227]) were asymptomatic. The upper respiratory tract infection (P = .014) and shortness of breath showed statistically significant differences between the ABO blood group (P = .009). Moreover, the incidence of the symptoms was highly observed in blood group O followed by A then B except for pharyngeal exudate observed in blood group A. The one-way ANOVA test indicated that among the studied hematological parameters, glucose (P = .004), absolute lymphocyte count (P = .001), and IgA (P = .036) showed statistically significant differences between the means of the ABO blood group. The differences in both X-ray and computed tomography scan findings were statistically nonsignificant among the ABO age group. Only 86 (30.3%) patients were admitted to an intensive care unit, and the majority of them were blood groups O 28.7% (n = 43) and A 37.0% (n = 30). However, the differences in complications' outcomes were statistically nonsignificant among the ABO age group.ABO blood groups among hospitalized COVID-19 patients are not associated with clinical, hematological, radiological, and complications abnormality., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Over the past years, the vast majority of blood grouping research in Saudi Arabia has been noted to be mainly focusing on ABO and D antigens. Consequently, knowledge on other clinically significant antigens regarding the RH and KEL blood group systems is required. Therefore, an experimental study using serotyping of ABO antigens, five main antigens (D, C, c, E and e) of the RH blood group system and the KEL1 antigen of the KEL blood group system will be carried out., Methods: A total number of 3,563 blood samples obtained from Saudi volunteer blood donors in Jazan Province were investigated. The following antigens were included in this study: A, B, AB, O, and D type (D VI) and C, c, E, e, and KEL1 antigens. Moreover, RH phenotypes and haplotypes were also determined. Serological analysis was performed using ID System gel cards. DiaClon ABO/D + Reverse grouping and DiaClon Rh subgroups + K were used. Statistical analysis was used to determine the frequency of all antigens, phenotypes, and RH haplotypes., Results: Regarding the ABO blood group system, observations were as follows: A, 29.44%; B, 10.44%; AB, 1.15%; and O, 58.97%. Antigens of RH blood group systems demonstrated as follows: D, 93.32%; C, 70.97%; E, 18.91%; c, 75.38% and e, 97.95%. The frequency of KEL1 antigen is 4.54%. The frequencies of RH haplotypes are as follows: Dce, 0.0078; DCe, 0.4723; DcE, 0.2736; DCE, 0.0051; dce, 0.2410; dCe, 0; dcE, 0.0001; and dCE, 0., Conclusions: We established the frequencies of ABO, RH, and KEL1 antigens in Jazan Province of Saudi Arabia. In addition, RH phenotypes and haplotypes were determined. This blood donor screening may help provide compatible blood units for transfusion and patient safety. Therefore, this might be recommended to other provinces of Saudi Arabia to investigate the prevalence of these antigens for better transfusion practice.

Objective: To evaluate the frequency of alpha thalassemia and detect mutations in the alpha genes in individuals undergoing premarital screening., Methods: The cross-sectional study was conducted at King Fahad Central Hospital, Jazan, Saudi Arabia, from January 2018 to May 2019, and comprised blood samples of individuals visiting the premarital screening clinic. The samples were analyzed for complete blood counts and haemoglobin electrophoresis. Molecular analysis of samples suspected for alpha thalassemia was done using alpha-globin StripAssay kit. Data was anlaysed using SPSS 20., Results: Of the 3,970 samples analysed, 1,859(46.83%) were from males and 2,111(53.17%) from females. The overall frequency of suspected alpha thalassemia was 4.43% based upon haematological parameters including complete blood count and haemoglobin electrophoresis. Overall, 80 suspected samples were selected for genetic analyses, and, of them, 76 (95%) were positive for deletional and non-deletional mutations of alpha-globin genes, while 4 (5%) were negative for any of the 21 mutations tested., Conclusions: Alpha thalassemia was found to be highly prevalent in the study area.

Background: Knowing the prevalence of blood group antigens in a given population is important to prevent hemolytic reactions. The Duffy blood group system (FY) has two main antigens, Fya and Fyb. Antibodies binding these antigens can cause immediate/delayed hemolytic transfusion reactions as well as hemolytic disease of the fetus and newborn. In this study, frequencies of Fya and Fyb antigen expression and FY phenotypes were determined in a cohort of Saudi blood donors., Methods: For this study, 143 samples were collected from randomly selected volunteer Saudi blood donors living in Jazan Province. Serological analysis, using gel card technology, was performed to detect Fya and Fyb antigens among the samples., Results: The frequencies of Fya and Fyb antigens were 12.58% and 11.18%, respectively. The numbers and frequencies of FY phenotypes were as follows: Fy(a+b-), 15 (10.48%); Fy(a-b+), 13 (9.10%); Fy(a+b+), 3 (2.10%), and Fy(a-b-), 112 (78.32%). The frequencies of the FY phenotypes were highly and significantly different in Jazan Saudis compared to other ethnicities (< 0.01)., Conclusions: This study reports the frequencies of the Fya and Fyb antigens and phenotypes of the FY blood group system in the Kingdom of Saudi Arabia's Jazan Province. The null phenotype Fy(a-b-) was the most prevalent among this population. This study highlights the importance of investigating FY alleles in different provinces of the Kingdom of Saudi Arabia.

Purpose: A 2 and A 2 B are rare phenotypes of the ABO blood group system. Some individuals with A 2 and A 2 B may have anti-A 1 antibodies that may be clinically significant or insignificant. The aim of this study was to determine the frequency of A 2 , A 2 B phenotypes and anti-A 1 antibodies in blood donors in Jazan, Saudi Arabia. This study also evaluated the reactivity potential of anti-A 1 antibodies., Materials and Methods: Blood samples collected from 446 blood donors were typed for ABO (cell and serum grouping) and Rh D. Individuals with blood group A and AB were further subtyped by testing with anti-A 1 lectin. In addition to the serum grouping using A 1 red cells, A 2 and A 2 B individuals were screened for the presence of anti-A 1 in their sera against A 1 red cells at 4°C, 22°C and 37°C to determine the thermal amplitude of the reacting anti-A 1 antibody (if present)., Results: Among A and AB, A 1 was the commonest phenotype (20.2%, n=90 out of 446) while A 1 B was found to be 1.8% (n=8) among AB phenotype. A 2 and A 2 B were found to be 2.2% (n=10) and 0.9% (n=4), respectively. Only one individual with A 2 B blood type showed cold reactive anti-A 1 antibody, the strength of which was 32., Conclusion: A 2 and A 2 B were the rarest among ABO phenotypes in the studied population. Although rare, anti-A 1 antibody is not so uncommon. Care shall be taken during routine ABO grouping especially in cases of mix-field or weak positive reactions in A and AB phenotypes., Competing Interests: The authors report no conflicts of interest in this work., (© 2020 Saboor et al.)

Background: Paternal zygosity testing is used for determining homo- or hemizygosity of RHD in pregnancies that are at a risk of hemolytic disease of the fetus and newborn. At present, this is achieved by using real-time PCR or the Rhesus box PCR, which can be difficult to interpret and unreliable, particularly for black African populations., Methods: DNA samples extracted from 53 blood donors were analyzed using 2 multiplex reactions for RHD -specific targets against a reference ( AGO1 ) 2 to determine gene dosage by digital PCR. Results were compared with serological data, and the correct genotype for 2 discordant results was determined by long-range PCR (LR-PCR), next-generation sequencing, and conventional Sanger sequencing., Results: The results showed clear and reliable determination of RHD zygosity using digital PCR and revealed that 4 samples did not match the serologically predicted genotype. Sanger sequencing and long-range PCR followed by next-generation sequencing revealed that the correct genotypes for samples 729M and 351D, which were serologically typed as R 1 R 2 (DCe/DcE), were R 2 r' (DcE/dCe) for 729M and R 1 r″ (DCe/dcE), R 0 r y (Dce/dCE), or R Z r (DCE/dce) for 351D, in concordance with the digital PCR data., Conclusions: Digital PCR provides a highly accurate method to rapidly define blood group zygosity and has clinical application in the analysis of Rh phenotyped or genotyped samples. The vast majority of current blood group genotyping platforms are not designed to define zygosity, and thus, this technique may be used to define paternal RH zygosity in pregnancies that are at a risk of hemolytic disease of the fetus and newborn and can distinguish between homo- and hemizygous RHD -positive individuals., (© 2017 American Association for Clinical Chemistry.)