TABLE 2.

Recommendations for the management of fungal co-infections in COVID-19 patients.

Fungal infection	First-line treatment	Second-line treatment	Alternative or salvage therapy	References
Candida auris	Echinocandins: ANI-loading dose 200 mg, followed by 100 mg/day; or CAS-loading dose 70 mg, followed by 50 mg/day; or MICA-100 mg/day	Liposomal AMB-5 mg/kg/day	Combination regime* against pan-resistant strains (e.g., AMB + flucytosin)	Centers for Disease Control and Prevention, 2021
Aspergillosis	VOR-loading dose 6 mg/kg twice a day, followed by 4 mg/kg twice a day; or ISZ-loading dose 200 mg three times a day for six doses, followed by 200 mg once a day	liposomal AMB-3 mg/kg/day (except for patients with renal insufficiency)	POS or echinocandin + azole (e.g., ANI + VOR)	Koehler et al., 2021
Mucormycosis	surgical debridement of necrotic tissue + liposomal AMB-5 mg/kg/day (in severe cases higher dose, 10 mg/kg/day is recommended)	POS-300 mg twice a day on day 1, followed by 300 mg/day; or ISZ-200 mg on day 1-2, followed by 200 mg/day	POS/ISZ or AMB in combination with POS or ISZ	Cornely et al., 2019; Chao et al., 2022; Hoenigl et al., 2022

ANI, anidulafungin; CAS, caspofungin; MICA, micafungin; AMB, amphotericin B; VOR, voriconazole; ISZ, isavuconazole; POS, posaconazole. *In vitro studies.