Starting late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a devastating global pandemic of coronavirus-19 disease (COVID-19) with ∼179 million cases and ∼3.9 million deaths to date. COVID-19 ranges from asymptomatic infection to severe illness with acute respiratory distress requiring critical care in up to 40% of hospitalized patients. Numerous reports have identified COVID-19-associated pulmonary aspergillosis (CAPA) as an important infective complication of COVID-19. In the UK, the pandemic has had unprecedented impacts on the National Health Service (NHS'): each wave of infections required hospitals to reconfigure for large surges in patients requiring intensive care, to the detriment of most aspects of non-COVID care including planned operations, outpatient appointments, general practitioner consultations and referrals. The UK National Mycology Reference Laboratory (MRL) offers a comprehensive service for the diagnosis and management of fungal disease nationwide, with a test portfolio that includes: diagnosis of allergies to fungal and other respiratory allergens; diagnosis of superficial and invasive/systemic fungal infections using traditional mycological, serological and molecular approaches; identification and susceptibility testing of the causative fungi; therapeutic drug monitoring of patients receiving antifungal therapy. Here, we describe the impact of the first 14 months of the COVID-19 pandemic on MRL activities. Changes to MRL workload closely mirrored many of the NHS-wide challenges, with marked reductions in ‘elective’ mycological activities unrelated to the pandemic and dramatic surges in tests that contributed to the diagnosis and management of COVID-19-related secondary fungal infections, in particular CAPA and candidemia in COVID-19 patients in intensive care. Lay summary The COVID-19 pandemic has had an unprecedented impact on the UK National Health Service, with hospitals forced to repeatedly reconfigure to prepare for large surges in COVID-19 patients. Here we describe the impact of the first 14 months of the UK pandemic on the workload of the National Mycology Reference Laboratory.

中文翻译：

---

SARS-CoV-2 大流行和 COVID-19 对英国国家真菌学参考实验室活动和工作量的巨大影响

从 2019 年底开始，严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 已导致冠状病毒 19 病 (COVID-19) 的毁灭性全球大流行，迄今已造成约 1.79 亿例病例和约 390 万人死亡。COVID-19 的范围从无症状感染到伴有急性呼吸窘迫的严重疾病，多达 40% 的住院患者需要重症监护。许多报告已将 COVID-19 相关肺曲霉病 (CAPA) 确定为 COVID-19 的重要感染并发症。在英国，这种流行病对国家卫生服务 (NHS) 产生了前所未有的影响：每一波感染都需要医院重新配置，以应对需要重症监护的患者激增，这损害了非 COVID 护理的大部分方面，包括计划中的手术、门诊预约、全科医生咨询和转诊。英国国家真菌学参考实验室 (MRL) 为全国真菌病的诊断和管理提供综合服务，其测试组合包括：对真菌和其他呼吸道过敏原过敏的诊断；使用传统的真菌学、血清学和分子学方法诊断浅表性和侵袭性/全身性真菌感染；致病真菌的鉴定和药敏试验；对接受抗真菌治疗的患者进行治疗药物监测。在这里，我们描述了 COVID-19 大流行的前 14 个月对 MRL 活动的影响。MRL 工作量的变化密切反映了 NHS 范围内的许多挑战，与大流行无关的“选择性”真菌学活动显着减少，以及有助于诊断和管理 COVID-19 相关继发性真菌感染的测试急剧增加，特别是重症监护中 COVID-19 患者的 CAPA 和念珠菌血症。总结 COVID-19 大流行对英国国家卫生服务局产生了前所未有的影响，医院被迫反复重新配置以准备应对 COVID-19 患者的大量激增。在这里，我们描述了英国大流行的前 14 个月对国家真菌学参考实验室工作量的影响。总结 COVID-19 大流行对英国国家卫生服务局产生了前所未有的影响，医院被迫反复重新配置以准备应对 COVID-19 患者的大量激增。在这里，我们描述了英国大流行的前 14 个月对国家真菌学参考实验室工作量的影响。总结 COVID-19 大流行对英国国家卫生服务局产生了前所未有的影响，医院被迫反复重新配置以准备应对 COVID-19 患者的大量激增。在这里，我们描述了英国大流行的前 14 个月对国家真菌学参考实验室工作量的影响。