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Supplemental Material for Impact of chronic comorbidities on hospitalization, intensive care unit admission and death among adult vaccinated and unvaccinated COVID-19 confirmed cases during the Omicron wave by Marc Simard, Véronique Boiteau, Élise Fortin, Sonia Jean, Louis Rochette, Pierre-Luc Trépanier and Rodica Gilca in Journal of Multimorbidity and Comorbidity

Additional file 1: Table S1. International Classification of Diseases (ICD) diagnostic codes for defining systemic autoimmune rheumatic diseases cases and their corresponding numbers of cases. Table S2. Distribution of population weighted concentrations of ambient PM2.5 and ozone in Quebec. SD: standard deviation.

Background In Québec primary care, antimicrobial use is higher in patients with chronic diseases, but it is unclear whether this utilization may be reduced. We aimed to measure the proportion of compliant antimicrobial prescriptions according to the provincial guidelines for the treatment of common respiratory and urinary infections and measure variations in this proportion with certain chronic diseases. Methods Antimicrobial dispensing covered by the public drug insurance plan between April 2010 and March 2017, delivered within 2 days of an outpatient consultation for an infection was included. Infections targeted by provincial guidelines were studied: otitis media, pharyngitis, pneumonia, sinusitis, bronchitis and chronic obstructive pulmonary disease exacerbations, cystitis, and acute pyelonephritis. The proportion of prescriptions compliant with guidelines (right antimicrobial for children, and right antimicrobial and dosage for adults) was computed by age group (children or adults) and per category of chronic disease (respiratory, cardiovascular, diabetes, mental disorder, none of previous). For each infection and age group, multivariate robust Poisson regression was used to measure the impact of categories of chronic diseases on proportions of prescriptions compliant with guidelines. Results Between 14 677 and 312 786 prescriptions were included, for each infection. Compliance to guidelines was above 87% in children and was significantly lower (≤ 3% bellow) in children with asthma. In adults, the choice of agent was compliant for at least 73% of prescriptions, except for cases of pharyngitis (between 53% and 61%). Accounting for dosage led to lower proportions of compliance, which varied between 19% (cystitis with diabetes) and 77% (pyelonephritis with none of the studied chronic disease categories). Compliant prescriptions were 2,4% to 20,4% less frequent in the presence of chronic diseases (statistically significant). Conclusion Non-compliant prescriptions could still be appropriate, but their high frequency suggests there is room for improvement. Dosage seems particularly problematic. Additional support could be offered to clinicians for the prescription of antimicrobials to patients with chronic diseases. Disclosures All Authors: No reported disclosures

Table S1. List of codes used for Elders Risk Assessment (ERA) index. Table S2. List of codes used for Elixhauser comorbidity index. (DOCX 19 kb)

Procedure of exportation from EndNote to Excel, description of how data is exported from EndNote software to an Excel file. (PDF 135Â kb)

Search strategy on PubMed, description of the combination of the keywords and synonyms used in PubMed. (PDF 146Â kb)

Procedure of exportation from EndNote to Excel, description of how data is exported from EndNote software to an Excel file. (PDF 135Â kb)

Table S1. List of codes used for Elders Risk Assessment (ERA) index. Table S2. List of codes used for Elixhauser comorbidity index. (DOCX 19 kb)

Search strategy on PubMed, description of the combination of the keywords and synonyms used in PubMed. (PDF 146Â kb)

PRISMA-P (preferred reporting items for systematic review and meta-analysis, checklist of items that should be found in the manuscript. (PDF 260Â kb)

PRISMA-P (preferred reporting items for systematic review and meta-analysis, checklist of items that should be found in the manuscript. (PDF 260Â kb)