The considerable impact of the SARS-CoV-2 pandemic and COVID-19 on the UK National Mycology Reference Laboratory activities and workload

Andrew M. Borman*, Mark Fraser, Zoe Patterson, Sue McLachlan, Michael D. Palmer, Ciara Mann, Debra Oliver, Phillipa Brown, Christopher J. Linton, Agnieszka Dzietczyk, Michelle Hedley, Martin Gough, Elizabeth M. Johnson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1068-1075
Number of pages8
JournalMedical Mycology
Volume59
Issue number11
Early online date14 Jul 2021
DOIs
Publication statusPublished - 1 Nov 2021

Bibliographical note

Funding Information: No funding information.

Open Access: Free to read, but no Open Access licence.

Publisher Copyright: © Crown copyright 2021. This article contains public sector information licensed under the Open Government Licence v3.0
(http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/).

Citation: Andrew M Borman, Mark Fraser, Zoe Patterson, Sue McLachlan, Michael D Palmer, Ciara Mann, Debra Oliver, Phillipa Brown, Christopher J Linton, Agnieszka Dzietczyk, Michelle Hedley, Martin Gough, Elizabeth M Johnson, The considerable impact of the SARS-CoV-2 pandemic and COVID-19 on the UK National Mycology Reference Laboratory activities and workload, Medical Mycology, Volume 59, Issue 11, November 2021, Pages 1068–1075,

DOI: https://doi.org/10.1093/mmy/myab039.

Keywords

  • COVID-19
  • Mycology Reference laboratory
  • SARS-CoV-2
  • candidemia
  • diagnosis
  • impact
  • invasive pulmonary aspergillosis

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