Evaluating the impact of COVID-19 or SARS-CoV-2 vaccination on TB infection testing in the context of TB elimination

O B J E C T I V E S: The impact of COVID19 and SARSCoV2vaccination on interferongamma release assay (IGRA) indeterminate results is unclear. This minireview aims to examine whether COVID19 or SARSCoV2vaccination affects the accuracy of IGRAs by increasing the indeterminate rate. M E T H O D S: Nonsystematic literature review based on a PubMed search using specific keywords, including various combinations of ‘TB’, ‘quantiferon’, ‘indeterminate or negative results’ and ‘covid’ without any time limits. R E S U L T S: A systematic review found an overall pooled effect size (equivalent to the indeterminate results) of 0.26(95% confidence: 0.205—0.32) for QuantiFERON TB Plus (QFTTB) with a mean true effect size of 0.26 (95% prediction interval: 0.11—0.5), and other studies confirmed the link with disease severity. SARSCoV2 vaccination does not affect IGRA interpretation. C O N C L U S I O N S: The use of IGRAs is not significantly affected by the COVID19 pandemic or vaccinations, except in a small number of severe cases observed during the pandemic’s peak. IGRAs’ reliability remains consistent with their prepandemic performance.