Prophylactic Antifungal Treatment in Critically Ill Patients with COVID-19: A Systematic Review and Meta-Analysis

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Critically ill COVID-19 patients are at high risk for invasive fungal infections, particularly CAPA, with a prevalence of 10-33% and mortality exceeding 50% in ICU settings.
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Prophylactic antifungal treatment may significantly reduce CAPA incidence, but current evidence is limited by small sample sizes and lack of randomized controlled trials.
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The POSACOVID trial supports the use of posaconazole for prophylaxis in mechanically ventilated patients, though efficacy varies with baseline CAPA incidence.
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Systematic reviews and meta-analyses on antifungal prophylaxis for CAPA in COVID-19 patients are lacking, highlighting the need for more robust evidence.
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This meta-analysis included 9 studies with 1,321 patients, primarily from ICU centers in Europe, to evaluate the effectiveness of antifungal prophylaxis.

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