The presence of fungal super infection, specifically invasive pulmonary aspergillosis (IPA), in patients with COVID-19, has become a cause of great concern. Although this disease occurs in immune-compromised, the isolated reports indicate its increased risk in patients with COVID-19 who are non-immuno-compromised at baseline.

Voriconazole remains the first-line treatment for IPA and must be monitored for neurotoxicity and hepatoxicity and drug-drug interactions.

A study reports no increase in Antifungal use in the early COVID-19 pandemic at an academic medical centre. They also mentioned the importance and role of Antifungal stewardship during the pandemic, which can guide clinicians to optimize the work-up for IPA by identifying high-risk patients and developing local evaluation and empiric treatment protocols.