Risk of COVID-19-associated pulmonary aspergillosis: time for a nuanced approach to antifungal prophylaxis?

COVID-19-associated pulmonary aspergillosis (CAPA) emerged as a serious complication of severe COVID-19 during the early phases of the COVID-19 pandemic.1 Although absolute numbers of CAPA have decreased in the post-vaccination era and during the omicron wave, the risk of developing CAPA has increased in patients requiring intensive care unit (ICU) admission due to COVID-19-associated acute respiratory failure.2,3 This increased risk is driven by changes in patient characteristics in those critically ill with COVID-19.