■在2019年冠状病毒病(COVID-19)患者中进行结核病(TB)检测的干扰素-γ释放测定(IGRA)的可靠性尚不清楚。本研究旨在系统地回顾SARS-CoV-2感染或疫苗接种后不确定的TB-IGRA的患病率,并回顾相关因素。
■根据PRISMA指南,通过搜索PubMed,Scopus,WebofScience,Clinicalkey,科克伦图书馆报告TB-IGRA测试结果的研究(QuantiFERON[QFT]-TB,T-SPOT。纳入了COVID-19患者或疫苗的TB)。随机效应模型用于评估不确定IGRA结果的患病率。使用T2和95%预测区间评估异质性。
■在筛选的273篇引文中,最终分析包括12篇文章,包括总共2107名患者。不确定QFT-TB结果的总体合并效应大小比例,在使用QFT-TBPlus测定的8项研究中估计,为0.26(95%CI:0.205-0.324,T2=0.158)。平均真实效应大小为0.26(95%预测间隔:[0.110-0.500])。由于研究数量少,未进行亚组分析。不确定的QFT-TB发生率与COVID-19严重程度相关,类固醇治疗,炎症相关参数,嗜中性粒细胞增多症,和淋巴细胞减少症。
■COVID-19患者的不确定的QFT-TB结果发生在几乎四分之一的测试中。需要进一步的研究来评估相关因素。
UNASSIGNED: The reliability of interferon-gamma-release-assays (IGRAs) for tuberculosis (TB) testing in coronavirus disease 2019 (COVID-19) patients is unknown. This study aimed to systematically
review the prevalence of indeterminate TB-IGRA following SARS-CoV-2 infection or vaccination and to
review associated factors.
UNASSIGNED: This systematic literature
review was guided according to the PRISMA guidelines by searching PubMed, Scopus, Web of Science, Clinicalkey, and Cochrane Library. Studies reporting results of TB-IGRA tests (QuantiFERON [QFT]-TB, T-SPOT.TB) in COVID-19 patients or vaccines were included. The random effects model was used to assess the prevalence of indeterminate IGRA results. Heterogeneity was evaluated using the Τ 2 and 95% predictive interval.
UNASSIGNED: Of the 273 citations screened, 12 articles were included in the final analysis including a total of 2107 patients. The overall pooled effect size proportion of indeterminate QFT-TB results, estimated in eight studies using the QFT-TB Plus assay, was 0.26 (95% CI: 0.205-0.324, Τ 2 = 0.158). The mean true effect size was 0.26 (95% predictive interval: [0.110-0.500]). A subgroup analysis was not undertaken due to the small number of studies. Indeterminate QFT-TB rates were associated with COVID-19 severity, steroid treatment, inflammation-related parameters, neutrophilia, and lymphopenia.
UNASSIGNED: Indeterminate QFT-TB results in COVID-19 patients occur in almost one-quarter of tests performed. Further studies are needed to assess associated factors.