Solanich Xavier, Fernández-Huerta Miguel, Basaez Celeste, Antolí Arnau, Rocamora-Blanch Gemma, Corbella Xavier, Santin Miguel, Alcaide Fernando
Department of Internal Medicine, Bellvitge University Hospital, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
Bellvitge Biomedical Research Institute (IDIBELL), 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
J Clin Med. 2021 Feb 26;10(5):918. doi: 10.3390/jcm10050918.
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%; = 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.
结核感染T细胞检测PLUS（QFT-Plus）检测的性能可能会受到免疫失调状况的影响。关于QTF-Plus在新冠肺炎患者中的可靠性，目前所知甚少。我们的目的是确定新冠肺炎住院患者中QFT-Plus检测结果不确定的患病率及相关因素，并分析其与院内死亡率的关系。对西班牙第一波疫情期间（2020年3月至4月）在一家三级护理公立医院接受QTF-Plus检测的所有新冠肺炎住院患者进行回顾性分析。在纳入的96例患者中，34例（35.4%）结果不确定，所有病例均因丝裂原对照无反应所致。与新冠肺炎严重程度相关的因素，如较高的乳酸脱氢酶（LDH）（比值比[OR]1.005[95%置信区间[CI]1.002-1.008]）和先前使用过皮质类固醇（OR 4.477[95%CI 1.397-14.345]），是QFT-Plus检测结果不确定的独立预测因素。此外，在住院期间死亡的新冠肺炎患者中，不确定结果更为常见（29.1%对64.7%；P=0.005）。我们得出结论，在重症新冠肺炎患者中，QFT-Plus检测出现不确定结果这一情况的患病率意外地高。与新冠肺炎预后较差相关的因素，如LDH，以及在QFT-Plus检测前使用皮质类固醇，似乎是结果不确定的预测因素。应评估QFT-Plus检测结果不确定在预测新冠肺炎严重程度和死亡率方面的作用。
