Predictors of interferon-gamma release assay results and their association with COVID-19 infection outcomes

BACKGROUND: An ‘indeterminate’ interferon-gamma release assay (IGRA) result used in the diagnosis of latent TB infection (LTBI) is most commonly due to an inadequate control (or ‘mitogen’) response, which may reflect underlying T-cell dysfunction. METHODS: We performed a single-centre, retrospective...

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Main Authors: S.J.W. Kang, G.W. Eather, F. Qureshi, J.R. Scott
Format: Article
Language:English
Published: International Union Against Tuberculosis and Lung Disease (The Union) 2024-10-01
Series:IJTLD Open
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Online Access:https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000010/art00004
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Summary:BACKGROUND: An ‘indeterminate’ interferon-gamma release assay (IGRA) result used in the diagnosis of latent TB infection (LTBI) is most commonly due to an inadequate control (or ‘mitogen’) response, which may reflect underlying T-cell dysfunction. METHODS: We performed a single-centre, retrospective study on COVID-19 patients admitted to a tertiary referral hospital who had IGRA testing conducted over a 5-month period. The primary outcomes included predictors of indeterminate IGRA results and associations with COVID-19 outcomes. RESULTS: A total of 181 patients were included for analysis. Approximately one-third of patients hospitalised with COVID-19 with IGRA testing performed (60/181) had an indeterminate result. The likelihood of an indeterminate IGRA was increased in patients with a history of solid organ transplant and a higher severity of COVID-19 at the time of testing. An indeterminate IGRA was associated with a higher risk of severe COVID-19 and a higher risk of admission to the ICU during admission to the hospital. No difference in mortality between the two subgroups was found. CONCLUSION: Our study demonstrated that COVID-19 patients on immunosuppression had a high likelihood of an indeterminate IGRA result, which was associated with markers of disease severity and immunosuppression. In this cohort, an indeterminate result was associated with worse COVID-19 outcomes.
ISSN:3005-7590