chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: C-reactive protein, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Endoscopic swallowing evaluation
Clinical narrative: Patient is a 69 y.o. male with h/o- HTN, CKD, prostate cancer, who presented from home on 1/31/2023 with fever, generalized weakness, hypoxia, found to have COVID-19 pneumonia with possible superimposed bacterial pneumonia.  Pulmonology was consulted, patient completed course of remdesivir, started on Decadron and will complete 10-day course outpatient.  He was given Rocephin and azithromycin to cover for possible bacterial pneumonia.  He has been weaned to room air.  He will follow-up with PCP for imaging to ensure resolution of pneumonia.   COVID infection Acute hypoxic respiratory failure - Presented with: fever, generalized weakness - Symptom onset: 1/30/23 - Positive COVID-19: RMH ER on 1/31/23 - Vaccination status: vaccinated and boosted with Pfizer - CXR on admission showed left basal infiltrate - Oxygen status: Increasing oxygen, required non-rebreather then weaned to Oxymizer and now on room air - Decadron: Yes, started 2/1, will complete 10 days - Remdesivir: Yes, started 2/2 after seen by Pulm with renal function at baseline, can be stopped on day - Ceftriaxone, Azithro added 2/2 per Pulm for suspected secondary bacterial infection; sputum culture with gram-positive cocci, no growth, they state okay to discontinue 2/6 - DVT prophylaxis: - Serial COVID labs ordered: Yes- CRP is down trending  - supportive care with limited IV hydration, PRN antipyretics, PRN antitussives, IS - PT/OT and mobility encouraged - Pulmonology signed off   Throat pain, laryngitis - FEES by ST performed 2/3 with pharyngeal and laryngeal structures appearing edematous-see separate procedure images - Suspect this is related to acute COVID infection, treatment as above  - Continue supportive care   Essential HTN - BP acceptable; resumed home med Nifedipine - initially held hydralazine given soft blood pressures, now resumed   Hyperlipidemia - stable, resume statin   CKD- Stage 3 - follows with Dr. - Cr stable range, avoid nephrotoxins as able   Prostate cancer in remission BPH - follows with Urology/Dr. - s/p radiation, now on Xtandi - resumed Flomax
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Gram stain positive, Hypoxia, Laboratory test, Laryngeal oedema, Laryngitis
Clinical narrative: Patient is a 69 y.o. male with h/o- HTN, CKD, prostate cancer, who presented from home on 1/31/2023 with fever, generalized weakness, hypoxia, found to have COVID-19 pneumonia with possible superimposed bacterial pneumonia.  Pulmonology was consulted, patient completed course of remdesivir, started on Decadron and will complete 10-day course outpatient.  He was given Rocephin and azithromycin to cover for possible bacterial pneumonia.  He has been weaned to room air.  He will follow-up with PCP for imaging to ensure resolution of pneumonia.   COVID infection Acute hypoxic respiratory failure - Presented with: fever, generalized weakness - Symptom onset: 1/30/23 - Positive COVID-19: RMH ER on 1/31/23 - Vaccination status: vaccinated and boosted with Pfizer - CXR on admission showed left basal infiltrate - Oxygen status: Increasing oxygen, required non-rebreather then weaned to Oxymizer and now on room air - Decadron: Yes, started 2/1, will complete 10 days - Remdesivir: Yes, started 2/2 after seen by Pulm with renal function at baseline, can be stopped on day - Ceftriaxone, Azithro added 2/2 per Pulm for suspected secondary bacterial infection; sputum culture with gram-positive cocci, no growth, they state okay to discontinue 2/6 - DVT prophylaxis: - Serial COVID labs ordered: Yes- CRP is down trending  - supportive care with limited IV hydration, PRN antipyretics, PRN antitussives, IS - PT/OT and mobility encouraged - Pulmonology signed off   Throat pain, laryngitis - FEES by ST performed 2/3 with pharyngeal and laryngeal structures appearing edematous-see separate procedure images - Suspect this is related to acute COVID infection, treatment as above  - Continue supportive care   Essential HTN - BP acceptable; resumed home med Nifedipine - initially held hydralazine given soft blood pressures, now resumed   Hyperlipidemia - stable, resume statin   CKD- Stage 3 - follows with Dr. - Cr stable range, avoid nephrotoxins as able   Prostate cancer in remission BPH - follows with Urology/Dr. - s/p radiation, now on Xtandi - resumed Flomax
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Lung infiltration, Oropharyngeal pain, Pharyngeal oedema, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Patient is a 69 y.o. male with h/o- HTN, CKD, prostate cancer, who presented from home on 1/31/2023 with fever, generalized weakness, hypoxia, found to have COVID-19 pneumonia with possible superimposed bacterial pneumonia.  Pulmonology was consulted, patient completed course of remdesivir, started on Decadron and will complete 10-day course outpatient.  He was given Rocephin and azithromycin to cover for possible bacterial pneumonia.  He has been weaned to room air.  He will follow-up with PCP for imaging to ensure resolution of pneumonia.   COVID infection Acute hypoxic respiratory failure - Presented with: fever, generalized weakness - Symptom onset: 1/30/23 - Positive COVID-19: RMH ER on 1/31/23 - Vaccination status: vaccinated and boosted with Pfizer - CXR on admission showed left basal infiltrate - Oxygen status: Increasing oxygen, required non-rebreather then weaned to Oxymizer and now on room air - Decadron: Yes, started 2/1, will complete 10 days - Remdesivir: Yes, started 2/2 after seen by Pulm with renal function at baseline, can be stopped on day - Ceftriaxone, Azithro added 2/2 per Pulm for suspected secondary bacterial infection; sputum culture with gram-positive cocci, no growth, they state okay to discontinue 2/6 - DVT prophylaxis: - Serial COVID labs ordered: Yes- CRP is down trending  - supportive care with limited IV hydration, PRN antipyretics, PRN antitussives, IS - PT/OT and mobility encouraged - Pulmonology signed off   Throat pain, laryngitis - FEES by ST performed 2/3 with pharyngeal and laryngeal structures appearing edematous-see separate procedure images - Suspect this is related to acute COVID infection, treatment as above  - Continue supportive care   Essential HTN - BP acceptable; resumed home med Nifedipine - initially held hydralazine given soft blood pressures, now resumed   Hyperlipidemia - stable, resume statin   CKD- Stage 3 - follows with Dr. - Cr stable range, avoid nephrotoxins as able   Prostate cancer in remission BPH - follows with Urology/Dr. - s/p radiation, now on Xtandi - resumed Flomax
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Sputum culture positive
Clinical narrative: Patient is a 69 y.o. male with h/o- HTN, CKD, prostate cancer, who presented from home on 1/31/2023 with fever, generalized weakness, hypoxia, found to have COVID-19 pneumonia with possible superimposed bacterial pneumonia.  Pulmonology was consulted, patient completed course of remdesivir, started on Decadron and will complete 10-day course outpatient.  He was given Rocephin and azithromycin to cover for possible bacterial pneumonia.  He has been weaned to room air.  He will follow-up with PCP for imaging to ensure resolution of pneumonia.   COVID infection Acute hypoxic respiratory failure - Presented with: fever, generalized weakness - Symptom onset: 1/30/23 - Positive COVID-19: RMH ER on 1/31/23 - Vaccination status: vaccinated and boosted with Pfizer - CXR on admission showed left basal infiltrate - Oxygen status: Increasing oxygen, required non-rebreather then weaned to Oxymizer and now on room air - Decadron: Yes, started 2/1, will complete 10 days - Remdesivir: Yes, started 2/2 after seen by Pulm with renal function at baseline, can be stopped on day - Ceftriaxone, Azithro added 2/2 per Pulm for suspected secondary bacterial infection; sputum culture with gram-positive cocci, no growth, they state okay to discontinue 2/6 - DVT prophylaxis: - Serial COVID labs ordered: Yes- CRP is down trending  - supportive care with limited IV hydration, PRN antipyretics, PRN antitussives, IS - PT/OT and mobility encouraged - Pulmonology signed off   Throat pain, laryngitis - FEES by ST performed 2/3 with pharyngeal and laryngeal structures appearing edematous-see separate procedure images - Suspect this is related to acute COVID infection, treatment as above  - Continue supportive care   Essential HTN - BP acceptable; resumed home med Nifedipine - initially held hydralazine given soft blood pressures, now resumed   Hyperlipidemia - stable, resume statin   CKD- Stage 3 - follows with Dr. - Cr stable range, avoid nephrotoxins as able   Prostate cancer in remission BPH - follows with Urology/Dr. - s/p radiation, now on Xtandi - resumed Flomax
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Electrocardiogram abnormal, Peripheral swelling, Pyrexia, Rash, Tachycardia
Clinical narrative: Swollen arm and rash  Fever  40+ 5 days  Tachycardia and still suffering with symptoms
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Anticoagulant therapy, Atelectasis, Atrial flutter, Blood creatinine increased
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Blood urea increased, COVID-19, Computerised tomogram head normal, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Coronary artery disease, Dehydration, Disorientation, Echocardiogram normal, Ejection fraction normal
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Fall, Hypokalaemia, Hyponatraemia, Hypophagia
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Hypothyroidism, Intervertebral disc operation, Medical device removal, Metabolic encephalopathy, Myasthenia gravis
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Neck pain, Orthosis user, Pain in extremity, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Septic shock, Sinus rhythm, Spinal decompression, Spinal fusion surgery, Troponin increased
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Ventricular tachycardia
Clinical narrative: Patient is a 72 y.o. female patient with history of chronic pain syndrome, back pain, arthritis, fibromyalgia, GERD, HTN, HLD, hypothyroid, RLS, OSA, CVA, TIA, presented to Hospital with altered.   Covid-19 Virus Infection Acute metabolic encephalopathy POA, resolved Septic shock POA, resolved Date of onset of symptoms: 1/29 Symptoms present on admission: Encephalopathy. Disoriented in ED, oriented to person only. Resolved Date of covid positive test: 1/31 Vaccination status: vaccinated Imaging: CT chest showed Bibasilar atelectasis. No pneumonia or effusion is seen. Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: not indicated Anticipated special isolation end date: 2/9  CT head nonacute  IVF given for sepsis, started on abx on admission which was discontinued once pt improved and found to have COVID.  Patient improved with treatment Patient was discharged in stable condition.   Atrial flutter  NSVT Tachycardia with ventricular rates up to 170s  Family reports intermittent tachycardia over the last couple months Initial EKG showed NSR. Cardio following, transitioned from heparin drip to Eliquis 5 mg twice daily. Was initiated on diltiazem drip. Transitioned to p.o. amiodarone. Continue metoprolol. Plan for EP study as an outpatient with likely ablation. Patient remains in normal sinus rhythm. Patient will follow up with cardiology at discharge.   Neck and arm pain, resolved  Degenerative disc disease, cervical  History of cervical laminectomy decompression fusion on 1/3/2023 Had subsequent fall and hardware failure with hardware removal on 1/19 Followed by discectomy, fusion anterior on 1/21 Pt requiring neck brace when moving PT/OT   AKI Likely secondary to dehydration, poor PO intake Creatinine of 1.60 on admission, baseline is normal Resolved. Creatinine 0.89 with a BUN of 26 by the time of discharge.   Elevated troponin  Baseline troponin unknown  Troponin of 133 -> 71 on admission  No chest pain or SOB at this time  EKG shows no acute ischemic ST changes  CT chest shows CAD, but shows no acute processes  Suspect troponin elevated 2/2 tachycardia vs AKI  Cardiology called in ED, will follow along  Echo showed EF of 56%, with no wall motion abnormalities mentioned   Hypokalemia Resolved.   Hyponatremia Resolved.   Myasthenia gravis  Continue pyrodostigmine    Hypothyroid Continue Synthroid
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Adrenal adenoma, Adrenal mass, Angiogram pulmonary abnormal, Atelectasis
Clinical narrative: Patient is a 96 y.o. female with a past medical history of dementia who presented from assisted living on 2/9/23 with dyspnea and cough, found to have COVID-19 and acute respiratory failure with hypoxemia. Treated with decadron and remdesivir with clinical improvement. Required low flow nasal cannula which was weaned to room air. Course complicated by hospital delirium. Patient to be discharged back to assisted living under hospice care.    Comments/Problems to be Addressed after Discharge Not applicable, patient is under hospice care.   COVID-19 infection -Vaccinated x 3 with Moderna (last dose 11/2021). Symptom onset 2/8. Positive COVID-19 test at assisted living on 2/9. -CTPA on admit without pneumonia and mild bilateral lower lobe atelectasis.  -Required low flow nasal cannula during stay. Treated with prednisone 60 mg once (2/9) followed by dexamethasone 6 mg daily (2/10-2/13).  -Weaned down to room air, dexamethasone and remdesivir to be discontinued upon discharge.    Acute hypoxemic hypercapnic respiratory failure, resolved -In the setting of COVID-19. No baseline oxygen requirements.  -Mild hypercapnia up to pCO2 of 59 noted on VBG.  -Treated with low flow nasal cannula, weaned down to room air.    Acute encephalopathy  -Likely hospital delirium in the setting of known dementia and hospitalization.  -Optimized sleep/wake cycle. Steroids discontinued upon discharge.    Asthma  -Continue albuterol nebulizer prn.    Dementia Anxiety  -Resides at local assisted living (and memory care unit).  -Continue home seroquel and celexa.    Incidental CT findings  -CTPA 2/9/23 with age-indeterminate T11 compression fracture and left adrenal nodule (most likely adenoma).
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Blood gases abnormal, COVID-19, Cough, Delirium, Dyspnoea
Clinical narrative: Patient is a 96 y.o. female with a past medical history of dementia who presented from assisted living on 2/9/23 with dyspnea and cough, found to have COVID-19 and acute respiratory failure with hypoxemia. Treated with decadron and remdesivir with clinical improvement. Required low flow nasal cannula which was weaned to room air. Course complicated by hospital delirium. Patient to be discharged back to assisted living under hospice care.    Comments/Problems to be Addressed after Discharge Not applicable, patient is under hospice care.   COVID-19 infection -Vaccinated x 3 with Moderna (last dose 11/2021). Symptom onset 2/8. Positive COVID-19 test at assisted living on 2/9. -CTPA on admit without pneumonia and mild bilateral lower lobe atelectasis.  -Required low flow nasal cannula during stay. Treated with prednisone 60 mg once (2/9) followed by dexamethasone 6 mg daily (2/10-2/13).  -Weaned down to room air, dexamethasone and remdesivir to be discontinued upon discharge.    Acute hypoxemic hypercapnic respiratory failure, resolved -In the setting of COVID-19. No baseline oxygen requirements.  -Mild hypercapnia up to pCO2 of 59 noted on VBG.  -Treated with low flow nasal cannula, weaned down to room air.    Acute encephalopathy  -Likely hospital delirium in the setting of known dementia and hospitalization.  -Optimized sleep/wake cycle. Steroids discontinued upon discharge.    Asthma  -Continue albuterol nebulizer prn.    Dementia Anxiety  -Resides at local assisted living (and memory care unit).  -Continue home seroquel and celexa.    Incidental CT findings  -CTPA 2/9/23 with age-indeterminate T11 compression fracture and left adrenal nodule (most likely adenoma).
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Encephalopathy, Hypercapnia, Malaise, PCO2 increased, Respiratory failure
Clinical narrative: Patient is a 96 y.o. female with a past medical history of dementia who presented from assisted living on 2/9/23 with dyspnea and cough, found to have COVID-19 and acute respiratory failure with hypoxemia. Treated with decadron and remdesivir with clinical improvement. Required low flow nasal cannula which was weaned to room air. Course complicated by hospital delirium. Patient to be discharged back to assisted living under hospice care.    Comments/Problems to be Addressed after Discharge Not applicable, patient is under hospice care.   COVID-19 infection -Vaccinated x 3 with Moderna (last dose 11/2021). Symptom onset 2/8. Positive COVID-19 test at assisted living on 2/9. -CTPA on admit without pneumonia and mild bilateral lower lobe atelectasis.  -Required low flow nasal cannula during stay. Treated with prednisone 60 mg once (2/9) followed by dexamethasone 6 mg daily (2/10-2/13).  -Weaned down to room air, dexamethasone and remdesivir to be discontinued upon discharge.    Acute hypoxemic hypercapnic respiratory failure, resolved -In the setting of COVID-19. No baseline oxygen requirements.  -Mild hypercapnia up to pCO2 of 59 noted on VBG.  -Treated with low flow nasal cannula, weaned down to room air.    Acute encephalopathy  -Likely hospital delirium in the setting of known dementia and hospitalization.  -Optimized sleep/wake cycle. Steroids discontinued upon discharge.    Asthma  -Continue albuterol nebulizer prn.    Dementia Anxiety  -Resides at local assisted living (and memory care unit).  -Continue home seroquel and celexa.    Incidental CT findings  -CTPA 2/9/23 with age-indeterminate T11 compression fracture and left adrenal nodule (most likely adenoma).
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Spinal compression fracture, Thoracic vertebral fracture
Clinical narrative: Patient is a 96 y.o. female with a past medical history of dementia who presented from assisted living on 2/9/23 with dyspnea and cough, found to have COVID-19 and acute respiratory failure with hypoxemia. Treated with decadron and remdesivir with clinical improvement. Required low flow nasal cannula which was weaned to room air. Course complicated by hospital delirium. Patient to be discharged back to assisted living under hospice care.    Comments/Problems to be Addressed after Discharge Not applicable, patient is under hospice care.   COVID-19 infection -Vaccinated x 3 with Moderna (last dose 11/2021). Symptom onset 2/8. Positive COVID-19 test at assisted living on 2/9. -CTPA on admit without pneumonia and mild bilateral lower lobe atelectasis.  -Required low flow nasal cannula during stay. Treated with prednisone 60 mg once (2/9) followed by dexamethasone 6 mg daily (2/10-2/13).  -Weaned down to room air, dexamethasone and remdesivir to be discontinued upon discharge.    Acute hypoxemic hypercapnic respiratory failure, resolved -In the setting of COVID-19. No baseline oxygen requirements.  -Mild hypercapnia up to pCO2 of 59 noted on VBG.  -Treated with low flow nasal cannula, weaned down to room air.    Acute encephalopathy  -Likely hospital delirium in the setting of known dementia and hospitalization.  -Optimized sleep/wake cycle. Steroids discontinued upon discharge.    Asthma  -Continue albuterol nebulizer prn.    Dementia Anxiety  -Resides at local assisted living (and memory care unit).  -Continue home seroquel and celexa.    Incidental CT findings  -CTPA 2/9/23 with age-indeterminate T11 compression fracture and left adrenal nodule (most likely adenoma).
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary normal, Blood creatinine increased, Blood culture negative, Blood lactic acid increased
Clinical narrative: Patient is a 56 y.o. female patient with history of CAD, hypothyroidism, HLD, HTN, anxiety, type 1 DM, obesity, who presented to Hospital with SOB.   Acute hypoxemic respiratory failure due COVID PNA: Viral sepsis: Viral PNA: Fever, improved CTPA with no evidence of pulmonary embolism. Date of onset of symptoms: 1/28/2023 Symptoms present on admission: fever, chills, SOB, cough Date of covid positive test: 01/29/23 Vaccination status: vaccinated Imaging: CT with LLL PNA Oxygen requirements on admission: 2 Lpm by NC Current oxygen requirements:room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 2/7/2023 Legionella and strep pneumonia antigens negative.  Influenza negative. Follow-up blood cultures and urine culture.  No growth to date Patient was started on IV ceftriaxone for secondary bacterial pneumonia we will switch to p.o. Keflex for 5 more days on discharge   Chest pain, noncardiac 1/30/2023, the patient developed chest pain.  Midsternal.  Tender to touch.  Gets worse with deep breathing.  Not related to exertion.  Not relieved by rest.  EKG with no new changes from baseline EKG.  Troponin negative. Tylenol as needed   CKD stage III Creatinine 1.35 on presentation.  Around baseline.  Continue to monitor   Elevated lactate, clinically undetermined Lactate 3.2 on presentation with no acidosis on BMP.  No intervention needed at this time   Type 1 DM: Insulin dose adjusted Continue Lantus  Lispro AC/HS   GERD: Continue pantoprazole   HTN: Continue Lopressor   CAD: Continue current SA, Plavix, Lopressor  Hypothyroidism: Continue levothyroxine   Morbid obesity, BMI 40.29: Encourage diet modification, active lifestyle, and weight reduction   Anxiety and depression -Continue doxepin and Ativan -Continue Ambien at night to help with sleep -Evaluated by inpatient psych who recommend outpatient follow-up
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest pain, Chills, Computerised tomogram thorax abnormal, Cough
Clinical narrative: Patient is a 56 y.o. female patient with history of CAD, hypothyroidism, HLD, HTN, anxiety, type 1 DM, obesity, who presented to Hospital with SOB.   Acute hypoxemic respiratory failure due COVID PNA: Viral sepsis: Viral PNA: Fever, improved CTPA with no evidence of pulmonary embolism. Date of onset of symptoms: 1/28/2023 Symptoms present on admission: fever, chills, SOB, cough Date of covid positive test: 01/29/23 Vaccination status: vaccinated Imaging: CT with LLL PNA Oxygen requirements on admission: 2 Lpm by NC Current oxygen requirements:room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 2/7/2023 Legionella and strep pneumonia antigens negative.  Influenza negative. Follow-up blood cultures and urine culture.  No growth to date Patient was started on IV ceftriaxone for secondary bacterial pneumonia we will switch to p.o. Keflex for 5 more days on discharge   Chest pain, noncardiac 1/30/2023, the patient developed chest pain.  Midsternal.  Tender to touch.  Gets worse with deep breathing.  Not related to exertion.  Not relieved by rest.  EKG with no new changes from baseline EKG.  Troponin negative. Tylenol as needed   CKD stage III Creatinine 1.35 on presentation.  Around baseline.  Continue to monitor   Elevated lactate, clinically undetermined Lactate 3.2 on presentation with no acidosis on BMP.  No intervention needed at this time   Type 1 DM: Insulin dose adjusted Continue Lantus  Lispro AC/HS   GERD: Continue pantoprazole   HTN: Continue Lopressor   CAD: Continue current SA, Plavix, Lopressor  Hypothyroidism: Continue levothyroxine   Morbid obesity, BMI 40.29: Encourage diet modification, active lifestyle, and weight reduction   Anxiety and depression -Continue doxepin and Ativan -Continue Ambien at night to help with sleep -Evaluated by inpatient psych who recommend outpatient follow-up
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Culture urine negative, Dyspnoea, Electrocardiogram normal, Influenza virus test negative, Legionella test
Clinical narrative: Patient is a 56 y.o. female patient with history of CAD, hypothyroidism, HLD, HTN, anxiety, type 1 DM, obesity, who presented to Hospital with SOB.   Acute hypoxemic respiratory failure due COVID PNA: Viral sepsis: Viral PNA: Fever, improved CTPA with no evidence of pulmonary embolism. Date of onset of symptoms: 1/28/2023 Symptoms present on admission: fever, chills, SOB, cough Date of covid positive test: 01/29/23 Vaccination status: vaccinated Imaging: CT with LLL PNA Oxygen requirements on admission: 2 Lpm by NC Current oxygen requirements:room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 2/7/2023 Legionella and strep pneumonia antigens negative.  Influenza negative. Follow-up blood cultures and urine culture.  No growth to date Patient was started on IV ceftriaxone for secondary bacterial pneumonia we will switch to p.o. Keflex for 5 more days on discharge   Chest pain, noncardiac 1/30/2023, the patient developed chest pain.  Midsternal.  Tender to touch.  Gets worse with deep breathing.  Not related to exertion.  Not relieved by rest.  EKG with no new changes from baseline EKG.  Troponin negative. Tylenol as needed   CKD stage III Creatinine 1.35 on presentation.  Around baseline.  Continue to monitor   Elevated lactate, clinically undetermined Lactate 3.2 on presentation with no acidosis on BMP.  No intervention needed at this time   Type 1 DM: Insulin dose adjusted Continue Lantus  Lispro AC/HS   GERD: Continue pantoprazole   HTN: Continue Lopressor   CAD: Continue current SA, Plavix, Lopressor  Hypothyroidism: Continue levothyroxine   Morbid obesity, BMI 40.29: Encourage diet modification, active lifestyle, and weight reduction   Anxiety and depression -Continue doxepin and Ativan -Continue Ambien at night to help with sleep -Evaluated by inpatient psych who recommend outpatient follow-up
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Metabolic function test abnormal, Musculoskeletal chest pain, Non-cardiac chest pain, Painful respiration, Pneumonia bacterial
Clinical narrative: Patient is a 56 y.o. female patient with history of CAD, hypothyroidism, HLD, HTN, anxiety, type 1 DM, obesity, who presented to Hospital with SOB.   Acute hypoxemic respiratory failure due COVID PNA: Viral sepsis: Viral PNA: Fever, improved CTPA with no evidence of pulmonary embolism. Date of onset of symptoms: 1/28/2023 Symptoms present on admission: fever, chills, SOB, cough Date of covid positive test: 01/29/23 Vaccination status: vaccinated Imaging: CT with LLL PNA Oxygen requirements on admission: 2 Lpm by NC Current oxygen requirements:room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 2/7/2023 Legionella and strep pneumonia antigens negative.  Influenza negative. Follow-up blood cultures and urine culture.  No growth to date Patient was started on IV ceftriaxone for secondary bacterial pneumonia we will switch to p.o. Keflex for 5 more days on discharge   Chest pain, noncardiac 1/30/2023, the patient developed chest pain.  Midsternal.  Tender to touch.  Gets worse with deep breathing.  Not related to exertion.  Not relieved by rest.  EKG with no new changes from baseline EKG.  Troponin negative. Tylenol as needed   CKD stage III Creatinine 1.35 on presentation.  Around baseline.  Continue to monitor   Elevated lactate, clinically undetermined Lactate 3.2 on presentation with no acidosis on BMP.  No intervention needed at this time   Type 1 DM: Insulin dose adjusted Continue Lantus  Lispro AC/HS   GERD: Continue pantoprazole   HTN: Continue Lopressor   CAD: Continue current SA, Plavix, Lopressor  Hypothyroidism: Continue levothyroxine   Morbid obesity, BMI 40.29: Encourage diet modification, active lifestyle, and weight reduction   Anxiety and depression -Continue doxepin and Ativan -Continue Ambien at night to help with sleep -Evaluated by inpatient psych who recommend outpatient follow-up
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonia viral, Pyrexia, SARS-CoV-2 test positive, Streptococcus test negative, Troponin normal
Clinical narrative: Patient is a 56 y.o. female patient with history of CAD, hypothyroidism, HLD, HTN, anxiety, type 1 DM, obesity, who presented to Hospital with SOB.   Acute hypoxemic respiratory failure due COVID PNA: Viral sepsis: Viral PNA: Fever, improved CTPA with no evidence of pulmonary embolism. Date of onset of symptoms: 1/28/2023 Symptoms present on admission: fever, chills, SOB, cough Date of covid positive test: 01/29/23 Vaccination status: vaccinated Imaging: CT with LLL PNA Oxygen requirements on admission: 2 Lpm by NC Current oxygen requirements:room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 2/7/2023 Legionella and strep pneumonia antigens negative.  Influenza negative. Follow-up blood cultures and urine culture.  No growth to date Patient was started on IV ceftriaxone for secondary bacterial pneumonia we will switch to p.o. Keflex for 5 more days on discharge   Chest pain, noncardiac 1/30/2023, the patient developed chest pain.  Midsternal.  Tender to touch.  Gets worse with deep breathing.  Not related to exertion.  Not relieved by rest.  EKG with no new changes from baseline EKG.  Troponin negative. Tylenol as needed   CKD stage III Creatinine 1.35 on presentation.  Around baseline.  Continue to monitor   Elevated lactate, clinically undetermined Lactate 3.2 on presentation with no acidosis on BMP.  No intervention needed at this time   Type 1 DM: Insulin dose adjusted Continue Lantus  Lispro AC/HS   GERD: Continue pantoprazole   HTN: Continue Lopressor   CAD: Continue current SA, Plavix, Lopressor  Hypothyroidism: Continue levothyroxine   Morbid obesity, BMI 40.29: Encourage diet modification, active lifestyle, and weight reduction   Anxiety and depression -Continue doxepin and Ativan -Continue Ambien at night to help with sleep -Evaluated by inpatient psych who recommend outpatient follow-up
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Viral sepsis
Clinical narrative: Patient is a 56 y.o. female patient with history of CAD, hypothyroidism, HLD, HTN, anxiety, type 1 DM, obesity, who presented to Hospital with SOB.   Acute hypoxemic respiratory failure due COVID PNA: Viral sepsis: Viral PNA: Fever, improved CTPA with no evidence of pulmonary embolism. Date of onset of symptoms: 1/28/2023 Symptoms present on admission: fever, chills, SOB, cough Date of covid positive test: 01/29/23 Vaccination status: vaccinated Imaging: CT with LLL PNA Oxygen requirements on admission: 2 Lpm by NC Current oxygen requirements:room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 2/7/2023 Legionella and strep pneumonia antigens negative.  Influenza negative. Follow-up blood cultures and urine culture.  No growth to date Patient was started on IV ceftriaxone for secondary bacterial pneumonia we will switch to p.o. Keflex for 5 more days on discharge   Chest pain, noncardiac 1/30/2023, the patient developed chest pain.  Midsternal.  Tender to touch.  Gets worse with deep breathing.  Not related to exertion.  Not relieved by rest.  EKG with no new changes from baseline EKG.  Troponin negative. Tylenol as needed   CKD stage III Creatinine 1.35 on presentation.  Around baseline.  Continue to monitor   Elevated lactate, clinically undetermined Lactate 3.2 on presentation with no acidosis on BMP.  No intervention needed at this time   Type 1 DM: Insulin dose adjusted Continue Lantus  Lispro AC/HS   GERD: Continue pantoprazole   HTN: Continue Lopressor   CAD: Continue current SA, Plavix, Lopressor  Hypothyroidism: Continue levothyroxine   Morbid obesity, BMI 40.29: Encourage diet modification, active lifestyle, and weight reduction   Anxiety and depression -Continue doxepin and Ativan -Continue Ambien at night to help with sleep -Evaluated by inpatient psych who recommend outpatient follow-up