The presence of secondary IFD primarily in the critical-care COVID-19 patient, while predicted for CAPA, was somewhat unexpected for CAC and CAM. Even at low incidences (Table 1) and with only 2.5% of COVID-19 patients requiring critical-care management the combined burden of IFD exceeds what we would expect to see in the ICU by approximately 35%. With such a broad range of IFD not usually seen in the critical-care patient, outside specific high-risk populations, it highlights the need for comprehensive IFD screening algorithms during the pandemic (https://covidandfungus.org/care-step-pathways/). With an ever-increasing population at risk of fungal disease and the concerning emergence of antifungal resistance, it is time to recognize the increasing need for enhanced mycological diagnosis within microbiology, and outside specialist referral centres.
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Curr Opin Infect Dis. 2021;34(6):573-580. © 2021 Lippincott Williams & Wilkins