Increased rates of indeterminate results in QuantiFERON-TB gold in-tube during the COVID-19 epidemic in Hunan province, China

Wanchan Peng; Rihui Deng; Siyu Wu; Juan Zhao; Jinfang Fu; Yunli Zhang; Wei Chen; Wei Wang

doi:10.1016/j.diagmicrobio.2023.116131

Increased rates of indeterminate results in QuantiFERON-TB gold in-tube during the COVID-19 epidemic in Hunan province, China

Diagn Microbiol Infect Dis. 2024 Feb;108(2):116131. doi: 10.1016/j.diagmicrobio.2023.116131. Epub 2023 Nov 10.

Authors

Wanchan Peng¹, Rihui Deng², Siyu Wu¹, Juan Zhao¹, Jinfang Fu¹, Yunli Zhang¹, Wei Chen¹, Wei Wang³

Affiliations

¹ Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China.
² Department of Clinical Laboratory, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ Department of Clinical Laboratory, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China. Electronic address: weiweiwang1983@163.com.

PMID: 37976555
DOI: 10.1016/j.diagmicrobio.2023.116131

Abstract

Increased rates of indeterminate QuantiFERON-TB Gold In-Tube (QFT-GIT) results have been reported since the COVID-19 epidemic in Hunan Province, China. The indeterminate result (ITR) rate of QFT increased from an average of 5.2% to 12.4%, paralleling the first COVID-19 pandemic wave in the region. QFT-GIT results of 243 hospitalized patients with COVID-19 from January 2022 to April 2023 at Xiangya Hospital of Central South University were analyzed. Of the 243 patients, 71 (29.2%) had ITRs due to reduced interferon-gamma production in the positive control. Multiple factors are associated with ITRs, such as disease severity, respiratory failure incidence, immunosuppressant use, and prognosis. Additionally, interferon-gamma (Mitogen-Nil) levels differed significantly depending upon disease severity, prognosis, immunosuppressant use, sepsis symptoms, respiratory failure, or hyperlipidemia. An abnormal increase in the ITR rate in the QFT was observed after the COVID-19 pandemic, and an optimal machine learning predictive model for indeterminate QFT results was established.

Keywords: COVID-19; Indeterminate results; Machine learning; QFT-GIT.

MeSH terms

COVID-19*
China / epidemiology
Humans
Immunosuppressive Agents / therapeutic use
Interferon-gamma
Interferon-gamma Release Tests / methods
Latent Tuberculosis* / diagnosis
Pandemics
Respiratory Insufficiency*
Tuberculin Test / methods
Tuberculosis* / diagnosis

Substances

Interferon-gamma
Immunosuppressive Agents