chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Hypercapnia, Hyperkalaemia, Laboratory test normal, Left ventricular dysfunction
Clinical narrative: Patient is a 68 y.o. female patient of, DO with history of chronic respiratory failure with hypoxia, anemia, cardiomegaly, duodenal ulcer, convulsions, hypothyroidism, muscle wasting, protein malnutrition presented to Hospital with cough, fatigue, and altered mental status.   Acute on Chronic Hypoxic and Hypercapnic Respiratory Failure Community acquired pneumonia COVID-19 Cough, fatigue, and altered mental status on presentation Requiring 6L O2 on admission, now weaned to 2 L(baseline 2-3L) Initial VBG with pCO2 elevate CT with mild right and trace left posterior lower lobe lung consolidation reflecting atelectasis or pneumonitis Similar presentation about 2 months ago Treat suspected PNA; completed steroids Lactic acid normal Urine antigens negative Tested positive for COVID 1/6. End iso 1/16.  MRSA screen negative. Vanco discontinued 1/07.  Augmentin at discharge.    Acute metabolic encephalopathy Uncertain etiology, possible related to PNA vs decreased respiratory drive with hypercapnia Some mild improvement with treatment in the ED Somnolent on exam VBG: pH 7.40, PCO2 66, HCO3 40.3, consistent with respiratory acidosis with metabolic compensation UDS negative, ammonia normal, other labs grossly normal Continue treatment of pneumonia as above Mental status improving and at baseline   Chronic congestive heart failure Cardiomegaly Echo 10/27 with LVEF 65%,  LV with grade 1 diastolic dysfunction BNP elevated but CXR clear.  Does not appear fluid overloaded on exam Continue home lasix and metoprolol  Holding K supplementation given initial  hyperkalemia TTE LVEF normal   Hyperkalemia - Resolved K 5.8 in the ED Treated in the ER, resolved   Duodenal Ulcer Gastritis Continue home PPI   Convulsions Continue Depakote
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Lung consolidation, Mental status changes, Metabolic encephalopathy, PCO2 increased, Pneumonia
Clinical narrative: Patient is a 68 y.o. female patient of, DO with history of chronic respiratory failure with hypoxia, anemia, cardiomegaly, duodenal ulcer, convulsions, hypothyroidism, muscle wasting, protein malnutrition presented to Hospital with cough, fatigue, and altered mental status.   Acute on Chronic Hypoxic and Hypercapnic Respiratory Failure Community acquired pneumonia COVID-19 Cough, fatigue, and altered mental status on presentation Requiring 6L O2 on admission, now weaned to 2 L(baseline 2-3L) Initial VBG with pCO2 elevate CT with mild right and trace left posterior lower lobe lung consolidation reflecting atelectasis or pneumonitis Similar presentation about 2 months ago Treat suspected PNA; completed steroids Lactic acid normal Urine antigens negative Tested positive for COVID 1/6. End iso 1/16.  MRSA screen negative. Vanco discontinued 1/07.  Augmentin at discharge.    Acute metabolic encephalopathy Uncertain etiology, possible related to PNA vs decreased respiratory drive with hypercapnia Some mild improvement with treatment in the ED Somnolent on exam VBG: pH 7.40, PCO2 66, HCO3 40.3, consistent with respiratory acidosis with metabolic compensation UDS negative, ammonia normal, other labs grossly normal Continue treatment of pneumonia as above Mental status improving and at baseline   Chronic congestive heart failure Cardiomegaly Echo 10/27 with LVEF 65%,  LV with grade 1 diastolic dysfunction BNP elevated but CXR clear.  Does not appear fluid overloaded on exam Continue home lasix and metoprolol  Holding K supplementation given initial  hyperkalemia TTE LVEF normal   Hyperkalemia - Resolved K 5.8 in the ED Treated in the ER, resolved   Duodenal Ulcer Gastritis Continue home PPI   Convulsions Continue Depakote
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonitis, Respiratory acidosis, Respiratory disorder, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Patient is a 68 y.o. female patient of, DO with history of chronic respiratory failure with hypoxia, anemia, cardiomegaly, duodenal ulcer, convulsions, hypothyroidism, muscle wasting, protein malnutrition presented to Hospital with cough, fatigue, and altered mental status.   Acute on Chronic Hypoxic and Hypercapnic Respiratory Failure Community acquired pneumonia COVID-19 Cough, fatigue, and altered mental status on presentation Requiring 6L O2 on admission, now weaned to 2 L(baseline 2-3L) Initial VBG with pCO2 elevate CT with mild right and trace left posterior lower lobe lung consolidation reflecting atelectasis or pneumonitis Similar presentation about 2 months ago Treat suspected PNA; completed steroids Lactic acid normal Urine antigens negative Tested positive for COVID 1/6. End iso 1/16.  MRSA screen negative. Vanco discontinued 1/07.  Augmentin at discharge.    Acute metabolic encephalopathy Uncertain etiology, possible related to PNA vs decreased respiratory drive with hypercapnia Some mild improvement with treatment in the ED Somnolent on exam VBG: pH 7.40, PCO2 66, HCO3 40.3, consistent with respiratory acidosis with metabolic compensation UDS negative, ammonia normal, other labs grossly normal Continue treatment of pneumonia as above Mental status improving and at baseline   Chronic congestive heart failure Cardiomegaly Echo 10/27 with LVEF 65%,  LV with grade 1 diastolic dysfunction BNP elevated but CXR clear.  Does not appear fluid overloaded on exam Continue home lasix and metoprolol  Holding K supplementation given initial  hyperkalemia TTE LVEF normal   Hyperkalemia - Resolved K 5.8 in the ED Treated in the ER, resolved   Duodenal Ulcer Gastritis Continue home PPI   Convulsions Continue Depakote
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Somnolence, Staphylococcus test negative, Urine antigen test
Clinical narrative: Patient is a 68 y.o. female patient of, DO with history of chronic respiratory failure with hypoxia, anemia, cardiomegaly, duodenal ulcer, convulsions, hypothyroidism, muscle wasting, protein malnutrition presented to Hospital with cough, fatigue, and altered mental status.   Acute on Chronic Hypoxic and Hypercapnic Respiratory Failure Community acquired pneumonia COVID-19 Cough, fatigue, and altered mental status on presentation Requiring 6L O2 on admission, now weaned to 2 L(baseline 2-3L) Initial VBG with pCO2 elevate CT with mild right and trace left posterior lower lobe lung consolidation reflecting atelectasis or pneumonitis Similar presentation about 2 months ago Treat suspected PNA; completed steroids Lactic acid normal Urine antigens negative Tested positive for COVID 1/6. End iso 1/16.  MRSA screen negative. Vanco discontinued 1/07.  Augmentin at discharge.    Acute metabolic encephalopathy Uncertain etiology, possible related to PNA vs decreased respiratory drive with hypercapnia Some mild improvement with treatment in the ED Somnolent on exam VBG: pH 7.40, PCO2 66, HCO3 40.3, consistent with respiratory acidosis with metabolic compensation UDS negative, ammonia normal, other labs grossly normal Continue treatment of pneumonia as above Mental status improving and at baseline   Chronic congestive heart failure Cardiomegaly Echo 10/27 with LVEF 65%,  LV with grade 1 diastolic dysfunction BNP elevated but CXR clear.  Does not appear fluid overloaded on exam Continue home lasix and metoprolol  Holding K supplementation given initial  hyperkalemia TTE LVEF normal   Hyperkalemia - Resolved K 5.8 in the ED Treated in the ER, resolved   Duodenal Ulcer Gastritis Continue home PPI   Convulsions Continue Depakote
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: patient was given Covid Bivalent past its use by date. Patient had no symptoms and was advised to repeat dose.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Injection site paraesthesia, Joint range of motion decreased, Paraesthesia, X-ray normal
Clinical narrative: I had my vaccination in 07/2022. On 11/22/2022 I woke up with tingling on left arm from shoulder to fingers. I could not rotate my shoulder. The tingling and numbness is still present on 01/31/2023. I did physical therapy and I do take a pain reliever.
Age: 48.0
Sex: F
Vaccine: FLUA4
Symptoms: Product storage error
Clinical narrative: Vaccine storage temperature issue, health department advised to repeat.
Age: 74.0
Sex: F
Vaccine: VARZOS
Symptoms: Diarrhoea, Fatigue, Nausea, Pain
Clinical narrative: general fatigue and body ache.  Nausea and diarrhea over three days
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Blood creatinine increased, COVID-19, COVID-19 pneumonia
Clinical narrative: Clinical Summary Patient is a 84 y.o. male with a history of T2DM, HTN, dementia who presented to hospital 12/31/2022 with fall, cough and congestion. Found to have COVID-19 pneumonia and acute respiratory failure. Hospital course complicated by placement; however he improved and was discharged home with HHC.    1. COVID 19 pneumonia: partially vaccinated. Symptom onset 12/25/22, COVID-19 test positive on 12/31/22. Completed 5 days of Remdesivir 1/7/23. Stopped Decadron 1/5/23 due to insomnia.  2. Acute hypoxic respiratory failure: no baseline needs, required 4L on admit. Admit CXR with bilateral lower lobe consolidations. Due to COVID infection, weaned to room-air since 1/3/23.  3. Acute Metabolic Acidosis: likely 2/2 minimal PO intake. Given IVFs with bicarb with improvement.  4. Fall: with head trauma. CT head and CT C spine nonacute on admit. Trauma-Surgery signed off.  5. Acute Metabolic Encephalopathy with Chronic Dementia: mild symptoms with recall difficulties at baseline. Worsening due to infection, hospital associated delirium with known dementia. Delirium precautions, supportive care.  6. AKI on CKD2: baseline Cr 0.9--1.1, Cr 1.3 on admit. Held ARB. Resolved since 1/5/23.  7. HTN: Held home ARB due to AKI. Resume as needed.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Computerised tomogram head abnormal, Computerised tomogram spine, Condition aggravated, Cough
Clinical narrative: Clinical Summary Patient is a 84 y.o. male with a history of T2DM, HTN, dementia who presented to hospital 12/31/2022 with fall, cough and congestion. Found to have COVID-19 pneumonia and acute respiratory failure. Hospital course complicated by placement; however he improved and was discharged home with HHC.    1. COVID 19 pneumonia: partially vaccinated. Symptom onset 12/25/22, COVID-19 test positive on 12/31/22. Completed 5 days of Remdesivir 1/7/23. Stopped Decadron 1/5/23 due to insomnia.  2. Acute hypoxic respiratory failure: no baseline needs, required 4L on admit. Admit CXR with bilateral lower lobe consolidations. Due to COVID infection, weaned to room-air since 1/3/23.  3. Acute Metabolic Acidosis: likely 2/2 minimal PO intake. Given IVFs with bicarb with improvement.  4. Fall: with head trauma. CT head and CT C spine nonacute on admit. Trauma-Surgery signed off.  5. Acute Metabolic Encephalopathy with Chronic Dementia: mild symptoms with recall difficulties at baseline. Worsening due to infection, hospital associated delirium with known dementia. Delirium precautions, supportive care.  6. AKI on CKD2: baseline Cr 0.9--1.1, Cr 1.3 on admit. Held ARB. Resolved since 1/5/23.  7. HTN: Held home ARB due to AKI. Resume as needed.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Delirium, Dementia, Fall, Head injury, Hypophagia
Clinical narrative: Clinical Summary Patient is a 84 y.o. male with a history of T2DM, HTN, dementia who presented to hospital 12/31/2022 with fall, cough and congestion. Found to have COVID-19 pneumonia and acute respiratory failure. Hospital course complicated by placement; however he improved and was discharged home with HHC.    1. COVID 19 pneumonia: partially vaccinated. Symptom onset 12/25/22, COVID-19 test positive on 12/31/22. Completed 5 days of Remdesivir 1/7/23. Stopped Decadron 1/5/23 due to insomnia.  2. Acute hypoxic respiratory failure: no baseline needs, required 4L on admit. Admit CXR with bilateral lower lobe consolidations. Due to COVID infection, weaned to room-air since 1/3/23.  3. Acute Metabolic Acidosis: likely 2/2 minimal PO intake. Given IVFs with bicarb with improvement.  4. Fall: with head trauma. CT head and CT C spine nonacute on admit. Trauma-Surgery signed off.  5. Acute Metabolic Encephalopathy with Chronic Dementia: mild symptoms with recall difficulties at baseline. Worsening due to infection, hospital associated delirium with known dementia. Delirium precautions, supportive care.  6. AKI on CKD2: baseline Cr 0.9--1.1, Cr 1.3 on admit. Held ARB. Resolved since 1/5/23.  7. HTN: Held home ARB due to AKI. Resume as needed.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Insomnia, Lung consolidation, Metabolic acidosis, Metabolic encephalopathy, Respiratory tract congestion
Clinical narrative: Clinical Summary Patient is a 84 y.o. male with a history of T2DM, HTN, dementia who presented to hospital 12/31/2022 with fall, cough and congestion. Found to have COVID-19 pneumonia and acute respiratory failure. Hospital course complicated by placement; however he improved and was discharged home with HHC.    1. COVID 19 pneumonia: partially vaccinated. Symptom onset 12/25/22, COVID-19 test positive on 12/31/22. Completed 5 days of Remdesivir 1/7/23. Stopped Decadron 1/5/23 due to insomnia.  2. Acute hypoxic respiratory failure: no baseline needs, required 4L on admit. Admit CXR with bilateral lower lobe consolidations. Due to COVID infection, weaned to room-air since 1/3/23.  3. Acute Metabolic Acidosis: likely 2/2 minimal PO intake. Given IVFs with bicarb with improvement.  4. Fall: with head trauma. CT head and CT C spine nonacute on admit. Trauma-Surgery signed off.  5. Acute Metabolic Encephalopathy with Chronic Dementia: mild symptoms with recall difficulties at baseline. Worsening due to infection, hospital associated delirium with known dementia. Delirium precautions, supportive care.  6. AKI on CKD2: baseline Cr 0.9--1.1, Cr 1.3 on admit. Held ARB. Resolved since 1/5/23.  7. HTN: Held home ARB due to AKI. Resume as needed.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Clinical Summary Patient is a 84 y.o. male with a history of T2DM, HTN, dementia who presented to hospital 12/31/2022 with fall, cough and congestion. Found to have COVID-19 pneumonia and acute respiratory failure. Hospital course complicated by placement; however he improved and was discharged home with HHC.    1. COVID 19 pneumonia: partially vaccinated. Symptom onset 12/25/22, COVID-19 test positive on 12/31/22. Completed 5 days of Remdesivir 1/7/23. Stopped Decadron 1/5/23 due to insomnia.  2. Acute hypoxic respiratory failure: no baseline needs, required 4L on admit. Admit CXR with bilateral lower lobe consolidations. Due to COVID infection, weaned to room-air since 1/3/23.  3. Acute Metabolic Acidosis: likely 2/2 minimal PO intake. Given IVFs with bicarb with improvement.  4. Fall: with head trauma. CT head and CT C spine nonacute on admit. Trauma-Surgery signed off.  5. Acute Metabolic Encephalopathy with Chronic Dementia: mild symptoms with recall difficulties at baseline. Worsening due to infection, hospital associated delirium with known dementia. Delirium precautions, supportive care.  6. AKI on CKD2: baseline Cr 0.9--1.1, Cr 1.3 on admit. Held ARB. Resolved since 1/5/23.  7. HTN: Held home ARB due to AKI. Resume as needed.
Age: 63.0
Sex: M
Vaccine: FLU4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse reaction patient was given HIGH Dose Flu instead of age appropriate influenza vaccine
Age: 54.0
Sex: U
Vaccine: FLUA4
Symptoms: Product storage error
Clinical narrative: Vaccine storage temperature issue, health department advised to repeat.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Cough, Diarrhoea, SARS-CoV-2 test positive
Clinical narrative: 01/01/23 presents toED for "diarrhea" "weakness" "cough". PMHx of "hypertension, breast cancer, DM type II"
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Mechanical urticaria, Pruritus, Scratch, Urticaria
Clinical narrative: We went to an allergist and found out he had Dermographia, known a skin writing. Anything that slightly scratches his skin he gets raised welts or hives and marks usual disappear within 30 minutes and it could be triggered by medications and infections. He also has intense itching, itching starts from various things. He was told to take an antihistamine and if he doesn't take it, it gets worse. We were told it could last for years. He also uses hydrocortisone.
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Blood creatinine increased, Blood folate normal, Blood iron decreased
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of Afib, CAD, COPD, HTN and cancer of L kidney presented to Hospital with cough and SOB.     Acute Hypoxemic Respiratory Failure COPD Exacerbation COVID-19 Cough, SOB, fever, chills and congestion x 4 days COVID positive, Flu negative Pt vaccinated and boosted Febrile with T max 101 on admission CXR No acute cardiopulmonary process based on AP image alone SpO2 88 on admission, improved to 98% on 3 L NC; weaned to RA this morning Received 4 days of  Remdisivir and  will continue Decadron as po to complete 10 day course.  Clinically  improving, on room air with O2 saturation 95%, ambulatory in room.  Okay medically for discharge to home today.  Discussed wearing a mask for 5 more days to complete his isolation protocol.     AKI, improving Cr 1.48 on admission improved to 1.24 this AM, baseline 1.16 No IVFs  given due to LE edema and COVID infection   HTN BP 136/72 on admission Lopressor 25 mg at home, restart but hold for SBP<100 or DBP<60 Monitor   Pancytopenia WBC 4.26, Hb 13.4 and Platelets 85 on admission Iron study consistent with iron deficiency B12/Folate wnl Start daily PO iron supplement Follow-up with PCP  A-Fib Currently asymptomatic  Continue home Coumadin, pharmacy to dose while in hospital.  INR 1.9 this morning   Hypothyroidism Pt on Synthroid at home TSH 0.04, T4 wnl Continue home meds.  Follow-up with PCP
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood thyroid stimulating hormone decreased, COVID-19, Chest X-ray normal, Chills, Chronic obstructive pulmonary disease
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of Afib, CAD, COPD, HTN and cancer of L kidney presented to Hospital with cough and SOB.     Acute Hypoxemic Respiratory Failure COPD Exacerbation COVID-19 Cough, SOB, fever, chills and congestion x 4 days COVID positive, Flu negative Pt vaccinated and boosted Febrile with T max 101 on admission CXR No acute cardiopulmonary process based on AP image alone SpO2 88 on admission, improved to 98% on 3 L NC; weaned to RA this morning Received 4 days of  Remdisivir and  will continue Decadron as po to complete 10 day course.  Clinically  improving, on room air with O2 saturation 95%, ambulatory in room.  Okay medically for discharge to home today.  Discussed wearing a mask for 5 more days to complete his isolation protocol.     AKI, improving Cr 1.48 on admission improved to 1.24 this AM, baseline 1.16 No IVFs  given due to LE edema and COVID infection   HTN BP 136/72 on admission Lopressor 25 mg at home, restart but hold for SBP<100 or DBP<60 Monitor   Pancytopenia WBC 4.26, Hb 13.4 and Platelets 85 on admission Iron study consistent with iron deficiency B12/Folate wnl Start daily PO iron supplement Follow-up with PCP  A-Fib Currently asymptomatic  Continue home Coumadin, pharmacy to dose while in hospital.  INR 1.9 this morning   Hypothyroidism Pt on Synthroid at home TSH 0.04, T4 wnl Continue home meds.  Follow-up with PCP
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Condition aggravated, Cough, Dyspnoea, Haemoglobin decreased, Hypertension
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of Afib, CAD, COPD, HTN and cancer of L kidney presented to Hospital with cough and SOB.     Acute Hypoxemic Respiratory Failure COPD Exacerbation COVID-19 Cough, SOB, fever, chills and congestion x 4 days COVID positive, Flu negative Pt vaccinated and boosted Febrile with T max 101 on admission CXR No acute cardiopulmonary process based on AP image alone SpO2 88 on admission, improved to 98% on 3 L NC; weaned to RA this morning Received 4 days of  Remdisivir and  will continue Decadron as po to complete 10 day course.  Clinically  improving, on room air with O2 saturation 95%, ambulatory in room.  Okay medically for discharge to home today.  Discussed wearing a mask for 5 more days to complete his isolation protocol.     AKI, improving Cr 1.48 on admission improved to 1.24 this AM, baseline 1.16 No IVFs  given due to LE edema and COVID infection   HTN BP 136/72 on admission Lopressor 25 mg at home, restart but hold for SBP<100 or DBP<60 Monitor   Pancytopenia WBC 4.26, Hb 13.4 and Platelets 85 on admission Iron study consistent with iron deficiency B12/Folate wnl Start daily PO iron supplement Follow-up with PCP  A-Fib Currently asymptomatic  Continue home Coumadin, pharmacy to dose while in hospital.  INR 1.9 this morning   Hypothyroidism Pt on Synthroid at home TSH 0.04, T4 wnl Continue home meds.  Follow-up with PCP
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Influenza virus test negative, International normalised ratio increased, Iron deficiency, Oedema peripheral, Pancytopenia
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of Afib, CAD, COPD, HTN and cancer of L kidney presented to Hospital with cough and SOB.     Acute Hypoxemic Respiratory Failure COPD Exacerbation COVID-19 Cough, SOB, fever, chills and congestion x 4 days COVID positive, Flu negative Pt vaccinated and boosted Febrile with T max 101 on admission CXR No acute cardiopulmonary process based on AP image alone SpO2 88 on admission, improved to 98% on 3 L NC; weaned to RA this morning Received 4 days of  Remdisivir and  will continue Decadron as po to complete 10 day course.  Clinically  improving, on room air with O2 saturation 95%, ambulatory in room.  Okay medically for discharge to home today.  Discussed wearing a mask for 5 more days to complete his isolation protocol.     AKI, improving Cr 1.48 on admission improved to 1.24 this AM, baseline 1.16 No IVFs  given due to LE edema and COVID infection   HTN BP 136/72 on admission Lopressor 25 mg at home, restart but hold for SBP<100 or DBP<60 Monitor   Pancytopenia WBC 4.26, Hb 13.4 and Platelets 85 on admission Iron study consistent with iron deficiency B12/Folate wnl Start daily PO iron supplement Follow-up with PCP  A-Fib Currently asymptomatic  Continue home Coumadin, pharmacy to dose while in hospital.  INR 1.9 this morning   Hypothyroidism Pt on Synthroid at home TSH 0.04, T4 wnl Continue home meds.  Follow-up with PCP
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Platelet count decreased, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Thyroxine normal
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of Afib, CAD, COPD, HTN and cancer of L kidney presented to Hospital with cough and SOB.     Acute Hypoxemic Respiratory Failure COPD Exacerbation COVID-19 Cough, SOB, fever, chills and congestion x 4 days COVID positive, Flu negative Pt vaccinated and boosted Febrile with T max 101 on admission CXR No acute cardiopulmonary process based on AP image alone SpO2 88 on admission, improved to 98% on 3 L NC; weaned to RA this morning Received 4 days of  Remdisivir and  will continue Decadron as po to complete 10 day course.  Clinically  improving, on room air with O2 saturation 95%, ambulatory in room.  Okay medically for discharge to home today.  Discussed wearing a mask for 5 more days to complete his isolation protocol.     AKI, improving Cr 1.48 on admission improved to 1.24 this AM, baseline 1.16 No IVFs  given due to LE edema and COVID infection   HTN BP 136/72 on admission Lopressor 25 mg at home, restart but hold for SBP<100 or DBP<60 Monitor   Pancytopenia WBC 4.26, Hb 13.4 and Platelets 85 on admission Iron study consistent with iron deficiency B12/Folate wnl Start daily PO iron supplement Follow-up with PCP  A-Fib Currently asymptomatic  Continue home Coumadin, pharmacy to dose while in hospital.  INR 1.9 this morning   Hypothyroidism Pt on Synthroid at home TSH 0.04, T4 wnl Continue home meds.  Follow-up with PCP
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Vitamin B12 normal, White blood cell count decreased
Clinical narrative: Patient is a 85 y.o. male patient of MD with history of Afib, CAD, COPD, HTN and cancer of L kidney presented to Hospital with cough and SOB.     Acute Hypoxemic Respiratory Failure COPD Exacerbation COVID-19 Cough, SOB, fever, chills and congestion x 4 days COVID positive, Flu negative Pt vaccinated and boosted Febrile with T max 101 on admission CXR No acute cardiopulmonary process based on AP image alone SpO2 88 on admission, improved to 98% on 3 L NC; weaned to RA this morning Received 4 days of  Remdisivir and  will continue Decadron as po to complete 10 day course.  Clinically  improving, on room air with O2 saturation 95%, ambulatory in room.  Okay medically for discharge to home today.  Discussed wearing a mask for 5 more days to complete his isolation protocol.     AKI, improving Cr 1.48 on admission improved to 1.24 this AM, baseline 1.16 No IVFs  given due to LE edema and COVID infection   HTN BP 136/72 on admission Lopressor 25 mg at home, restart but hold for SBP<100 or DBP<60 Monitor   Pancytopenia WBC 4.26, Hb 13.4 and Platelets 85 on admission Iron study consistent with iron deficiency B12/Folate wnl Start daily PO iron supplement Follow-up with PCP  A-Fib Currently asymptomatic  Continue home Coumadin, pharmacy to dose while in hospital.  INR 1.9 this morning   Hypothyroidism Pt on Synthroid at home TSH 0.04, T4 wnl Continue home meds.  Follow-up with PCP
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood potassium decreased, COVID-19, Cardiac index increased, Catheterisation cardiac abnormal
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray normal, Chest pain, Chronic respiratory failure, Computerised tomogram thorax normal, Coronary artery disease
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cough, Echocardiogram abnormal, Ejection fraction normal, Hypokalaemia, Hypothyroidism
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Left atrial enlargement, Malaise, Percutaneous coronary intervention, SARS-CoV-2 test positive, Sinus bradycardia
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Tricuspid valve incompetence, Wall motion score index normal
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood potassium, Blood potassium decreased, COVID-19, Cardiac index
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cardiac index increased, Catheterisation cardiac, Catheterisation cardiac abnormal, Chest X-ray, Chest X-ray normal
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest pain, Chronic respiratory failure, Computerised tomogram thorax, Computerised tomogram thorax normal, Coronary artery disease
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cough, Echocardiogram, Echocardiogram abnormal, Ejection fraction, Ejection fraction normal
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypokalaemia, Hypothyroidism, Left atrial enlargement, Malaise, Percutaneous coronary intervention
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid
Age: 43.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test, SARS-CoV-2 test positive, Sinus bradycardia, Tricuspid valve incompetence, Wall motion score index
Clinical narrative: Patient is a 44 y.o. male patient of MD with a history of CAD, OSA, HTN.   See below for summary by diagnosis.   Discharge Diagnoses:   1. Chest pain             -Echo: Ejection fraction 63%, left atrium mildly enlarged, other cardiac chambers are normal, left ventricular mass index is increased, left ventricular segmental wall motion is normal, normal diastolic function, mild tricuspid valve regurgitation, no pericardial effusion             -Sinus bradycardia at night likely related to underlying obstructive sleep apnea.  We will order a Holter monitor as outpatient.             -CT pulmonary artery study is ordered- negative for PE.             -Cardiology is following- imdur started    2. COVID 19             -.Covid-19 Virus Infection Date of onset of symptoms:  12/30/22 Symptoms present on admission: Cough Date of covid positive test:  12/31/22 Vaccination status:  J&J x2 Imaging:   CXR negative Oxygen requirements on admission:   RA Current oxygen requirements:  RA Medical therapy: Decadron Consultants following:  cardiology Anticipated special isolation end date: 10 days from test      3. Sinus bradycardia             -Avoid calcium channel blocker and beta-blocker.             -Outpatient Holter monitor.  Likely related to obstructive sleep apnea   4. OSA, chronic respiratory failure             -4 L at night.   5. Hypokalemia              -Patient potassium 3.3, 40 mEq provided   6. CAD             -History of with recent heart cath 2/2/2022.  Patient's heart cath was severe 1 vessel CAD of the LAD with nonobstructive RCA disease, successful PCI of the LAD.  To be on aspirin 81 mg indefinitely and Plavix for 1 year.   7. Subclinical hypothyroidism             -Repeat after COVID and is symptomatic start low-dose Synthroid