Preliminary observations on IGRA testing for TB infection in patients with severe COVID-19 eligible for immunosuppressive therapy

Torre, Alessandro; Aliberti, Stefano; Castellotti, Paola; Cirillo, Daniela María; Grisolia, Antonella; Mangioni, Davide; Marchetti, Giulia; Rossotti, Roberto; Santus, Pierachille; Besozzi, Giorgio; Villa, Simone; Codecasa, Luigi

doi:10.1016/j.rmed.2020.106204

Cited by 19 publications

(40 citation statements)

References 14 publications

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“…Of great concern, the present study found that 35.4% of the hospitalized COVID-19 patients studied had an indeterminate QFT-Plus assay result. This proportion is consistent with the 36.4% rate reported by Torre et al in a recent work from an Italian series [ 10 ]. So, the frequency of indeterminate results might be significantly high in COVID-19 patients.…”

Section: Discussionsupporting

confidence: 93%

“…During the first months of the COVID-19 pandemic, microbiologists observed a surprisingly high rate of QFT-Plus indeterminate results in patients hospitalized with COVID-19 at our hospital. At that time, there was no information about this finding and, nowadays, there is still little information about how COVID-19 itself and the immunosuppressive drugs can impact QFT-Plus performance [ 10 ]. In addition, it is not known if an indeterminate QFT-Plus result might have a relation to COVID-19 severity and mortality.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Significance of Indeterminate QuantiFERON-TB Gold Plus Assay Results in Hospitalized COVID-19 Patients with Severe Hyperinflammatory Syndrome

Solanich

Fernández-Huerta

Basaez³

et al. 2021

JCM

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Performance of the QuantiFERON-TB Gold Plus (QFT-Plus) assay could be affected by conditions of immune dysregulation. Little is known about the reliability of QTF-Plus in COVID-19 patients. Our aim was to determine the prevalence and the factors related to an indeterminate QFT-Plus test in COVID-19 hospitalized patients, and to analyze its relationship with in-hospital mortality. A retrospective analysis of all hospitalized COVID-19 patients on whom a QTF-Plus assay was performed in a tertiary care public hospital during the first epidemic wave in Spain (March–April 2020). Out of a total of 96 patients included, 34 (35.4%) had an indeterminate result, in all cases due to a lack of response in the mitogen control. Factors related to COVID-19 severity, such as higher lactate dehydrogenase (LDH) (odds ratio [OR] 1.005 [95% confidence interval [CI] 1.002–1.008]) and previous administration of corticosteroids (OR 4.477 [95% CI 1.397–14.345]), were independent predictors for indeterminate QFT-Plus assay. Furthermore, indeterminate results were more frequent among COVID-19 patients who died during hospitalization (29.1% vs. 64.7%; p = 0.005). We conclude that QFT-Plus assay yielded an unexpected, high prevalence of indeterminate results in severe COVID-19 patients. Factors related to worse COVID-19 outcome, such as LDH, as well as corticosteroid use before the QFT-Plus assay, seem to be predictors for an indeterminate result. The role of an indeterminate QFT-Plus result in predicting COVID-19 severity and mortality should be evaluated.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Indeterminate QuantiFERON-TB Gold Plus Assay Results in Hospitalized COVID-19 Patients with Severe Hyperinflammatory Syndrome

Solanich

Fernández-Huerta

Basaez³

et al. 2021

JCM

View full text Add to dashboard Cite

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“…A desregulação imunológica causada pela COVID-19 pode afetar o diagnóstico e o manejo da ITBL. (47) Nesse sentido, muitas questões permanecem abertas. Não se sabe, por exemplo, se é necessário realizar a triagem dos pacientes com COVID-19 grave por meio do teste tuberculínico/nsaio de liberação de IFN-γ antes da prescrição de medicamentos imunossupressores e, em caso de resultado positivo no teste tuberculínico/ ensaio de liberação de IFN-γ, se os medicamentos imunossupressores atualmente em uso devem ser suspensos.…”

Section: Prioridades Para O Manejo Clínicounclassified

Tuberculosis and COVID-19, the new cursed duet: what differs between Brazil and Europe?

et al. 2021

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Em 1º de abril de 2020, a COVID-19 ultrapassou a tuberculose em número de óbitos por dia no mundo. A associação da tuberculose com a COVID-19 apresenta grande potencial de morbidade e mortalidade. Além disso, a pandemia de COVID-19 tem tido um impacto significativo no diagnóstico e tratamento da tuberculose. Neste artigo de revisão, abordamos tuberculose e COVID-19 concomitantes, com particular atenção às diferenças entre Brasil e Europa. Além disso, discutimos as prioridades em atendimento clínico, saúde pública e pesquisa. Descritores: Tuberculose; Infecções por coronavirus; Betacoronavirus; Coronavirus.

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“…It has been shown that COVID-19 can occur before, after or simultaneously with the diagnosis of TB and that mortality is likely to be increased in elderly individuals with these co-infections ( 4 ). A recent study showed that indeterminate result in Interferon Gamma Release Assays was associated with severe lymphocytopenia in COVID-19 patients ( 5 ). In addition, LTBI was not shown to affect the ability to in vitro respond to SARS-CoV-2 ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Latent tuberculosis co-infection is associated with heightened levels of humoral, cytokine and acute phase responses in seropositive SARS-CoV-2 infection

Ray

Kumar

Padmapriyadarsini

et al. 2021

Journal of Infection

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Objectives : Latent Tuberculosis infection (LTBI) is postulated to modulate immune responses and alter disease severity in SARS-CoV-2 co-infection. However, no data exist on the effect of LTBI on the immune responses in SARS-CoV-2 co-infected individuals. Methods : We examined the SARS-CoV-2 specific antibody responses, plasma cytokines, chemokines, acute phase proteins and growth factor levels in LTBI positive and negative individuals with SARS-CoV-2 infection. Results : Our results demonstrated that individuals with LTBI (LTBI+) and seropositive for SARS-CoV-2 infection were associated with elevated SARS-CoV-2 specific IgM, IgG and IgA antibodies, as well as enhanced neutralization activity compared to those negative for LTBI (LTBI-) individuals. Our results also demonstrate that LTBI+ individuals exhibited significantly higher plasma levels of IFNγ, IL-2, TNFα, IL-1α, IL-1β, IL-6, IL-12, IL-15, IL-17, IL-3, GM-CSF, IL-10, IL-25, IL-33, CCL3 and CXCL10 compared to LTBI- individuals. Finally, our results show that LTBI+ individuals exhibit significantly higher levels of C-reactive protein, alpha-2 macroglobulin, VEGF and TGFα compared to LTBI- individuals. Conclusions : Thus, our data clearly demonstrates that LTBI+ individuals seropositive for SARS-CoV2 infection exhibit heightened levels of humoral, cytokine and acute phase responses compared to LTBI- individuals. Thus, LTBI is associated with modulation of antibody and cytokine responses as well as systemic inflammation in individuals seropositive for SARS-CoV2 infection.

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Preliminary observations on IGRA testing for TB infection in patients with severe COVID-19 eligible for immunosuppressive therapy

Cited by 19 publications

References 14 publications

Clinical Significance of Indeterminate QuantiFERON-TB Gold Plus Assay Results in Hospitalized COVID-19 Patients with Severe Hyperinflammatory Syndrome

Clinical Significance of Indeterminate QuantiFERON-TB Gold Plus Assay Results in Hospitalized COVID-19 Patients with Severe Hyperinflammatory Syndrome

Tuberculosis and COVID-19, the new cursed duet: what differs between Brazil and Europe?

Latent tuberculosis co-infection is associated with heightened levels of humoral, cytokine and acute phase responses in seropositive SARS-CoV-2 infection

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