The Pitfalls of Mining for QuantiFERON Gold in Severely Ill Patients With COVID-19

Prevalence of indeterminate tuberculosis interferon‐gamma release assays in COVID‐19 patients: Systematic review and meta‐analysis

“…A definition of indeterminate results was mentioned in 8/12 studies (66.6%). 11,12,[17][18][19][20]25 An indeterminate result was defined according to the manufacturers' definition in six studies, 11,12,17,18,22,25 and as (Nil [baseline] >8.0 IU/mL) or [nil ≤8.0 IU/mL and mitogen-nil <0.5 IU/ mL] in two studies. 19,20 The term "low response to the mitogen" was used in two other studies.…”

“…The prevalence of indeterminate QFT-TB results among COVID-19 patients was mentioned in nine studies and varied from 7.14% to 64.58% (Table 2). [10][11][12][18][19][20]22,23,25 For the meta-analysis, the prevalence of indeterminate QFT-TB results was retrieved from eight studies and ranged from 7.14% to 40.33%. 10,12,[18][19][20]22,23,25 We excluded the study of Ward et The overall pooled effect size (equivalent to the pooled proportion of indeterminate QFT-TB Plus results) was 0.26 (95% confidence interval: 0.205−0.324, Τ 2 = 0.158) for QFT-TB Plus.…”

“…[10][11][12][18][19][20]22,23,25 For the meta-analysis, the prevalence of indeterminate QFT-TB results was retrieved from eight studies and ranged from 7.14% to 40.33%. 10,12,[18][19][20]22,23,25 We excluded the study of Ward et The overall pooled effect size (equivalent to the pooled proportion of indeterminate QFT-TB Plus results) was 0.26 (95% confidence interval: 0.205−0.324, Τ 2 = 0.158) for QFT-TB Plus. The mean of true effect size was 0.26 (95% prediction interval: 0.11−0.5) (Figure 2).…”

“…10,11,18,19,24 Five other studies did not report whether their indeterminate results were due to a low mitogen response or an increased baseline response in the Nil tube. 12,20,22,23,25 Three studies reported an increase in the indeterminate QFT-test rates during the COVID-19 pandemic compared to the pre-pandemic period in the same region [10][11][12] (from 1.4%, 8.7%, and 19.4% before the pandemic to 4.2%, 15.5%, and 28.1%, respectively). The results of indeterminate QFT results in COVID-19 patients and mean values of IFNɣ production for Nil, TB1, TB2, and mitogen tubes of the QFT assay were summarized in Table 3.…”

“…COVID-19 patients provided information on the severity of the COVID-19 disease. [10][11][12][18][19][20][22][23][24] QFT-TB indeterminate results in severe COVID-19 reported in four studies, 12,[18][19][20] 12 ), Charlson comorbidity index (Imeneo et al 20 ). -Steroid treatment before QFT testing (Solanich et al 19 ; Granozzi et al 18 ) (the longer the duration of corticosteroid therapy before the QFT testing, the higher the probability of having an indeterminate result [Granozzi et al 18 ]).…”