Background immunosuppression downregulates the type 1 T-helper pathway responsible for generating IFN-γ directed towards pathogens such as fungi and mycobacteria, which is directly assessed with the mitogen control tube in IGRA testing.15,16 This would also explain the higher likelihood of obtaining an indeterminate IGRA result when testing was performed after immunosuppression was commenced for COVID-19, which was noted in our study. The gene discussed is IFNG; the disease is COVID-19.