Document Type
Article
Publication Date
1-1-2022
Abstract
Background
Elevated cytokine release and T cell exhaustion have been associated with COVID-19 disease severity. T cell activity may be indirectly measured through interferon gamma release assays (IGRAs), which use mitogen stimulation of T lymphocytes as a positive control. In our institution, an unexpectedly high rate of indeterminate IGRAs was noted in COVID-19–positive patients. We aimed to evaluate the clinical characteristics associated with indeterminate IGRA results and the difference in mitogen responses between COVID-19–positive and COVID-19–negative patients.
Methods
We reviewed all patients, regardless of COVID status, who were admitted between March 1, 2020, and May 31, 2020, and for whom an IGRA was collected. For COVID-19–positive individuals, we evaluated the statistical association of their IGRA results and clinical characteristics, including demographics, laboratory values, comorbidities, and hospitalization-related outcomes. For both COVID-19–positive and COVID-19–negative individuals, we evaluated IGRA mitogen control values relative to COVID-19 status as stratified by absolute lymphocyte count.
Results
In COVID-19–positive patients, indeterminate IGRA results were statistically associated with white blood cell count and other markers of inflammation. When comparing COVID-19–positive and COVID-19–negative patients, we noted a statistically significant difference in IGRA mitogen control values when stratified by absolute lymphocyte count.
Conclusions
Indeterminate IGRA results were associated with higher levels of inflammatory markers. Furthermore, when comparing mitogen responses between COVID-19–positive and COVID-19–negative patients, there was an observed difference in T cell reactivity between the groups. The mitogen response in IGRAs may serve as a surrogate for T cell function and a marker of disease severity in COVID-19.
Recommended Citation
Coppock, Dagan; Zurlo, Claire E.; Meloni, Jenna M.; Goss, Sara L.; Zurlo, John J.; and Pettengill, Matthew A., "Interferon Gamma Release Assay Mitogen Responses in COVID-19" (2022). Department of Pathology, Anatomy, and Cell Biology Faculty Papers. Paper 348.
https://jdc.jefferson.edu/pacbfp/348
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
Included in
Infectious Disease Commons, Medical Anatomy Commons, Medical Cell Biology Commons, Medical Pathology Commons
Comments
This article is the author's final published version in Infectious Diseases in Clinical Practice, Volume 30, Issue 1, January 2022, Article number e1085
The published version is available at https://doi.org/10.1097/IPC.0000000000001085.
Copyright © 2021 The Author(s).
Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CC-BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.