Table 1.

Demographic of patient who underwent virtual challenge

Age	Sex	Comorbidities	Inciting medication	Index reaction	Risk of reactiona	Rationale for virtually supervised challenge based on patient–physician shared decision making	Reactions—immediate or delayedb
3	M	Multiple food allergies	Amoxicillin	Generalized urticaria	Intermediate	Convenience–distance	None
3	F		Amoxicillin	Maculopapular rash	Intermediate	Convenience–distance	None
4	M	Cystic fibrosis	Amoxicillin clavulanic acid	Maculopapular rash	Intermediate	Convenience–distance	None
4	M	Asthma, atopic dermatitis	Amoxicillin	Maculopapular rash	Intermediate	Convenience–distance	None
6	F	Recurrent urinary tract infections, allergic rhinoconjuctivitis	Amoxicillin	Generalized urticaria	Intermediate	Convenience–distance	None
6	F	Atopic dermatitis	Amoxicillin	Maculopapular rash	Intermediate	Convenience–distance	None
6	F		Amoxicillin clavulanic acid	Urticaria	Intermediate	Convenience–distance	None
8	F		Amoxicillin	Generalized urticaria and facial angioedema	Intermediate	Convenience–distance	None
8	M	NSAID allergy	Amoxicillin	Urticaria and angioedema	Intermediate	Convenience–distance	None
8	M	Cystic fibrosis	Amoxicillin	Urticaria	Intermediate	Convenience	None
11	F		Amoxicillin	Generalized urticaria	Intermediate	Convenience	None
12	M	Food allergy (peanut), asthma, allergic rhinoconjunctivitis	Penicillin	Maculopapular rash	Intermediate	Convenience, less missed school days	None
12	F		Amoxicillin	Generalized urticaria	Intermediate	Convenience	None
12	M		Amoxicillin	Maculopapular rash	Intermediate	Convenience	None
14	M	Allergic rhinitis, food allergy, asthma	Amoxicillin	Urticaria	Intermediate	Convenience	None
19	F	Asthma	Amoxicillin	Generalized urticaria	Intermediate	Convenience, less missed school days	None
37	M	Relapsing Hodgkin lymphoma, thyroiditis, previous stem cell transplant	Amoxicillin	Rash	Intermediate	Reduce hospital/infectious risk exposure	None
54	F	Interstitial lung disease on oxygen (end stage)	Amoxicillin	Localized rash on arm	Intermediate	Reduce hospital/infectious risk exposure in patient-high risk for severe COVID19 outcomes	None
65	F	Myelodysplastic syndrome, dyslipidemia, hypertension, diabetes	Piperacillin tazobactam	Petechial macules/thin papules coalescing into larger purpuric patches on her upper and lower extremities and including trunk, patient also thrombocytopenic	Intermediate	Reduce hospital/infectious risk exposure in immunosuppressed patient	None
66	F	Multiple myeloma awaiting stem cell transplant, hypertension, diabetes	Amoxicillin	Local rash to chest	Intermediate		None
70	F	Locally advanced thymic tumour, hypertension, diabetes	Penicillin	Urticaria	Intermediate	Reduce hospital/infectious risk exposure in patient-high risk for severe COVID19 outcomes	None
70	F	Diffuse large B-cell lymphoma awaiting bone marrow transplant	Penicillin	Unknown	Intermediate	Convenience	None
71	M	Interstitial lung disease (end stage) awaiting transplant, emphysema, hypothyroidism, hypertension, dyslipidemia	Penicillin	Local rash	Intermediate	Reduce hospital/infectious risk exposure in patient-high risk for severe COVID19 outcomes	None

All patients underwent a one-step oral challenge with 250–500 mg of oral amoxicillin (or weight-based dose if pediatric) at their physician’s discretion. Majority of patients lived over 2 h from the centre and/or had co-morbidities putting them at high risk of severe COVID, thus wishing for limited healthcare interaction

^aRisk of reaction for proposed oral challenge determined as per the algorithm recommended in reference 3

^bReactions—immediate or delayed after the oral challenge took place