chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: U
Vaccine: COVID19
Symptoms: Anti-GAD antibody, Antibody test, Blood glucose, Latent autoimmune diabetes in adults, Thrombocytopenia
Clinical narrative: severe thrombocytopenia; Latent autoimmune diabetes of adults; This is a literature report.  A 74-year-old patient received BNT162b2 (BNT162B2), as dose number unknown, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "Type-2 Diabetes" (ongoing). Concomitant medication(s) included: METFORMIN taken for type 2 diabetes mellitus. The following information was reported: THROMBOCYTOPENIA (hospitalization, medically significant, life threatening), 2 weeks after the suspect product(s) administration, outcome "unknown", described as "severe thrombocytopenia"; LATENT AUTOIMMUNE DIABETES IN ADULTS (hospitalization), outcome "unknown", described as "Latent autoimmune diabetes of adults". The patient underwent the following laboratory tests and procedures: Antibody test: confirmed LADA, notes: Progressively rising; Anti-GAD antibody: Unknown results; Blood glucose: remained elevated, notes: after discharge from the hospital; Unknown results. Therapeutic measures were taken as a result of thrombocytopenia, latent autoimmune diabetes in adults.; Sender's Comments: Based on the available information in the case, the causal association between the events thrombocytopenia, latent autoimmune diabetes in adults and the suspect drug cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Error: Dose in Series Given Too Early-
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Dizziness, Tremor
Clinical narrative: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Shakiness-Mild
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Immunisation reaction, Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Additional Details: Patient came in to pick up prescription. Stated she had "covid arm". Observed swelling and redness of muscle area.  Patient states she had not reported it as she read is very common on people who received the covid vaccine.  I explained that it needed to be reported as a severe reaction.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Additional Details: Patient came in to pick up prescription. Stated she had "covid arm". Observed swelling and redness of muscle area.  Patient states she had not reported it as she read is very common on people who received the covid vaccine.  I explained that it needed to be reported as a severe reaction.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Eye swelling, Injection site pruritus, Mouth swelling, Pruritus
Clinical narrative: Site: Itching at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Additional Details: Administered Zyrtec 10mg and monitored patient for 45 mins since vaccination.  Symptoms did not worsen and patient attributed it possibly to an allergy shot she received.  Will follow up later this evening.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Swelling face, Swollen tongue
Clinical narrative: Site: Itching at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Additional Details: Administered Zyrtec 10mg and monitored patient for 45 mins since vaccination.  Symptoms did not worsen and patient attributed it possibly to an allergy shot she received.  Will follow up later this evening.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Asthenia, Flushing, Hyperhidrosis, Hypotension
Clinical narrative: Site: Pain at Injection Site-Mild, Systemic: Abdominal Pain-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Mild, Systemic: Weakness-Medium, Additional Details: pt was advised to lie down with legs elevated.  bp was monitored several times until symptoms of sweating, nausea subsided and pt was feeling better.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Nausea, Vomiting
Clinical narrative: Site: Pain at Injection Site-Mild, Systemic: Abdominal Pain-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Mild, Systemic: Weakness-Medium, Additional Details: pt was advised to lie down with legs elevated.  bp was monitored several times until symptoms of sweating, nausea subsided and pt was feeling better.
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Error: Dose in Series Given Too Early-
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Error: Dose in Series Given Too Early-
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: vaccine breakthrough event  dose 1 1/13/21 Pfizer EL3248 dose 2 2/3/21 Pfizer EL9265
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Asthenia, COVID-19, Chest X-ray normal, Dehydration
Clinical narrative: Pfizer Dose 1 2/10/21 (el3302) Pfizer Dose 2 3/5/21 (EN6199) Pfizer Dose 3 10/12/21 (EW0171) COVID Positive 1/8/22  1/8/22: This is an 83 years old female patient who presented to the emergency department today because of generalized weakness and feeling tired  Patient has a past medical history notable for aortic stenosis status post TAVR procedure, heart failure with reduced ejection fraction, pacemaker in place, hypertension, obesity, neuroendocrine cancer, chronic kidney disease, insulin-dependent diabetes mellitus  For the past 3-4 days she has been having subjective fevers, fatigue, nausea, vomiting and right upper quadrant abdominal pain  She also reports a productive cough with production of yellow/green sputum.  She denies any diarrhea, dysuria, chest pain.  She is vaccinated against COVID-19 and denies any recent COVID-19 exposure.  She is anticoagulated with Eliquis for history of DVT.  In the emergency department she was found to be febrile and hypoxic requiring 2 L of oxygen via nasal cannula.  Chest x-ray did not show any acute finding.  She was given empiric IV antibiotics and IV fluid boluses and is admitted to hospitalist service for dehydration  For the history of neuroendocrine cancer she has been having for the past 4 years, she has been undergoing treatment with octreotide injection monthly with the next injection due January 17th approximately  Patient did not take her insulin last night due to decreased oral intake and vomiting.  1/11/22: An 83-year-old woman with a history of carcinoid tumor with metastasis who presented to the emergency room with complaints of generalized weakness and malaise.  Symptoms associated with productive cough and shortness of breath.  Emergency room, she was febrile, hypoxic requiring 2 L of oxygen by nasal cannula.  Clinical exam was consistent with dehydration.  Patient received IV fluids for hydration, she was started on IV remdesivir and dexamethasone due to hypoxia.  She was also start on empiric antibiotic therapy.  Patient had improvement in her symptoms, she reports feeling better, improving oxygen requirement, she had oxygen walk prior to discharge, she does not require oxygen at discharge.  She is being discharged home in a stable condition with VNA services.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Fatigue, Hypophagia, Hypoxia, Inappropriate schedule of product administration
Clinical narrative: Pfizer Dose 1 2/10/21 (el3302) Pfizer Dose 2 3/5/21 (EN6199) Pfizer Dose 3 10/12/21 (EW0171) COVID Positive 1/8/22  1/8/22: This is an 83 years old female patient who presented to the emergency department today because of generalized weakness and feeling tired  Patient has a past medical history notable for aortic stenosis status post TAVR procedure, heart failure with reduced ejection fraction, pacemaker in place, hypertension, obesity, neuroendocrine cancer, chronic kidney disease, insulin-dependent diabetes mellitus  For the past 3-4 days she has been having subjective fevers, fatigue, nausea, vomiting and right upper quadrant abdominal pain  She also reports a productive cough with production of yellow/green sputum.  She denies any diarrhea, dysuria, chest pain.  She is vaccinated against COVID-19 and denies any recent COVID-19 exposure.  She is anticoagulated with Eliquis for history of DVT.  In the emergency department she was found to be febrile and hypoxic requiring 2 L of oxygen via nasal cannula.  Chest x-ray did not show any acute finding.  She was given empiric IV antibiotics and IV fluid boluses and is admitted to hospitalist service for dehydration  For the history of neuroendocrine cancer she has been having for the past 4 years, she has been undergoing treatment with octreotide injection monthly with the next injection due January 17th approximately  Patient did not take her insulin last night due to decreased oral intake and vomiting.  1/11/22: An 83-year-old woman with a history of carcinoid tumor with metastasis who presented to the emergency room with complaints of generalized weakness and malaise.  Symptoms associated with productive cough and shortness of breath.  Emergency room, she was febrile, hypoxic requiring 2 L of oxygen by nasal cannula.  Clinical exam was consistent with dehydration.  Patient received IV fluids for hydration, she was started on IV remdesivir and dexamethasone due to hypoxia.  She was also start on empiric antibiotic therapy.  Patient had improvement in her symptoms, she reports feeling better, improving oxygen requirement, she had oxygen walk prior to discharge, she does not require oxygen at discharge.  She is being discharged home in a stable condition with VNA services.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Nausea, Productive cough, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Pfizer Dose 1 2/10/21 (el3302) Pfizer Dose 2 3/5/21 (EN6199) Pfizer Dose 3 10/12/21 (EW0171) COVID Positive 1/8/22  1/8/22: This is an 83 years old female patient who presented to the emergency department today because of generalized weakness and feeling tired  Patient has a past medical history notable for aortic stenosis status post TAVR procedure, heart failure with reduced ejection fraction, pacemaker in place, hypertension, obesity, neuroendocrine cancer, chronic kidney disease, insulin-dependent diabetes mellitus  For the past 3-4 days she has been having subjective fevers, fatigue, nausea, vomiting and right upper quadrant abdominal pain  She also reports a productive cough with production of yellow/green sputum.  She denies any diarrhea, dysuria, chest pain.  She is vaccinated against COVID-19 and denies any recent COVID-19 exposure.  She is anticoagulated with Eliquis for history of DVT.  In the emergency department she was found to be febrile and hypoxic requiring 2 L of oxygen via nasal cannula.  Chest x-ray did not show any acute finding.  She was given empiric IV antibiotics and IV fluid boluses and is admitted to hospitalist service for dehydration  For the history of neuroendocrine cancer she has been having for the past 4 years, she has been undergoing treatment with octreotide injection monthly with the next injection due January 17th approximately  Patient did not take her insulin last night due to decreased oral intake and vomiting.  1/11/22: An 83-year-old woman with a history of carcinoid tumor with metastasis who presented to the emergency room with complaints of generalized weakness and malaise.  Symptoms associated with productive cough and shortness of breath.  Emergency room, she was febrile, hypoxic requiring 2 L of oxygen by nasal cannula.  Clinical exam was consistent with dehydration.  Patient received IV fluids for hydration, she was started on IV remdesivir and dexamethasone due to hypoxia.  She was also start on empiric antibiotic therapy.  Patient had improvement in her symptoms, she reports feeling better, improving oxygen requirement, she had oxygen walk prior to discharge, she does not require oxygen at discharge.  She is being discharged home in a stable condition with VNA services.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Sputum discoloured, Vomiting
Clinical narrative: Pfizer Dose 1 2/10/21 (el3302) Pfizer Dose 2 3/5/21 (EN6199) Pfizer Dose 3 10/12/21 (EW0171) COVID Positive 1/8/22  1/8/22: This is an 83 years old female patient who presented to the emergency department today because of generalized weakness and feeling tired  Patient has a past medical history notable for aortic stenosis status post TAVR procedure, heart failure with reduced ejection fraction, pacemaker in place, hypertension, obesity, neuroendocrine cancer, chronic kidney disease, insulin-dependent diabetes mellitus  For the past 3-4 days she has been having subjective fevers, fatigue, nausea, vomiting and right upper quadrant abdominal pain  She also reports a productive cough with production of yellow/green sputum.  She denies any diarrhea, dysuria, chest pain.  She is vaccinated against COVID-19 and denies any recent COVID-19 exposure.  She is anticoagulated with Eliquis for history of DVT.  In the emergency department she was found to be febrile and hypoxic requiring 2 L of oxygen via nasal cannula.  Chest x-ray did not show any acute finding.  She was given empiric IV antibiotics and IV fluid boluses and is admitted to hospitalist service for dehydration  For the history of neuroendocrine cancer she has been having for the past 4 years, she has been undergoing treatment with octreotide injection monthly with the next injection due January 17th approximately  Patient did not take her insulin last night due to decreased oral intake and vomiting.  1/11/22: An 83-year-old woman with a history of carcinoid tumor with metastasis who presented to the emergency room with complaints of generalized weakness and malaise.  Symptoms associated with productive cough and shortness of breath.  Emergency room, she was febrile, hypoxic requiring 2 L of oxygen by nasal cannula.  Clinical exam was consistent with dehydration.  Patient received IV fluids for hydration, she was started on IV remdesivir and dexamethasone due to hypoxia.  She was also start on empiric antibiotic therapy.  Patient had improvement in her symptoms, she reports feeling better, improving oxygen requirement, she had oxygen walk prior to discharge, she does not require oxygen at discharge.  She is being discharged home in a stable condition with VNA services.
Age: 1.83
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Febrile convulsion, Lethargy, Palpitations, Pyrexia
Clinical narrative: Patient had a fever of 100.9 degrees F. when I brought her home from school around 5:30. I gave her 5 mL of children's Tylenol. She was acting lethargic and barely ate any dinner. We took her temperature at 6:45 pm and it had not changed. We gave her a quick bath. Her heart was racing and she was upset so we took her out of the bath. When we took her out she had a short convulsion. We were advised to call an ambulance. When they arrived her temperature had gone up to 102. The doctors at the ER later said it was likely a febrile seizure or something similar related to the COVID-19 vaccine she had received 2 days earlier.
Age: 1.83
Sex: F
Vaccine: COVID19
Symptoms: Seizure
Clinical narrative: Patient had a fever of 100.9 degrees F. when I brought her home from school around 5:30. I gave her 5 mL of children's Tylenol. She was acting lethargic and barely ate any dinner. We took her temperature at 6:45 pm and it had not changed. We gave her a quick bath. Her heart was racing and she was upset so we took her out of the bath. When we took her out she had a short convulsion. We were advised to call an ambulance. When they arrived her temperature had gone up to 102. The doctors at the ER later said it was likely a febrile seizure or something similar related to the COVID-19 vaccine she had received 2 days earlier.
Age: 49.0
Sex: F
Vaccine: RAB
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient had possible rabies exposure 5/30. Bat was caught and sent for testing. Upon positive rabies test, patient returned to ED and started PEP. Patient received rabies vaccine and immune globulin 6/2. Patient received another dose of rabies vaccine 6/5, 6/9, and 6/12. The fourth dose was given 13 days post exposure, but only 10 days post the initial vaccine which was 4 days early according to the guidelines.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Blood creatinine increased, Blood glucose increased, Blood pH normal, COVID-19
Clinical narrative: Pfizer Dose 1 4/15/21 (EW0153) Pfizer Dose 2 5/7/22 (ER8736) Pfizer Dose 3 8/14/22 (lot NA) COVID Postive 2/3/22  2/2/22: Patient is 63-year-old male with history of kidney transplant in 2018 on prednisone, mycophenolate, and tacrolimus , insulin-dependent diabetes mellitus, presented to the emergency department with a complaint of burning epigastric abdominal pain nausea, and vomiting with poor oral intake of 3 weeks duration.  Patient reports that symptoms started 3-4 weeks ago, symptoms are pursue stent, he has been having epigastric and substernal burning abdominal pain that is constant described as reflux, he has been nauseous and vomiting at times, reports that vomitus is bloody, reported black tarry stool, reported very poor oral intake for the last 3 weeks, poor urine output. Denied any history of bleeding in the past, he is not on any blood thinners and takes only low-dose aspirin, denies excess alcohol use, no recent illness fever or chills.  In the emergency department, Patient was with sinus tachycardia, slightly hypertensive, lab work showed CO2 of 12 in 17 on repeat, blood glucose of 303 but with normal pH and no concern of DKA, creatinine 3.9, lipase of 32, troponin of 0.04, hemoglobin 12, platelets 90 K, patient was given 2 L normal saline.  ED provider discussed accepted the patient as level to but expect bed to be available within 24 hours.  2/10/22: Pt with a renal transplant developed NV, dehydration, tested positive for COVID, no hypoxemia, admitted for IV fluids and BP control.  He has improved, Nephrology consulted for renal function and medications, ortho consulted for foot pressure sores, no sign of active infection.  He was uncomfortable, wanted to go home, follow up with PCP, nephrology and wound clinic
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Carbon dioxide decreased, Chest pain, Decubitus ulcer, Dehydration, Discomfort
Clinical narrative: Pfizer Dose 1 4/15/21 (EW0153) Pfizer Dose 2 5/7/22 (ER8736) Pfizer Dose 3 8/14/22 (lot NA) COVID Postive 2/3/22  2/2/22: Patient is 63-year-old male with history of kidney transplant in 2018 on prednisone, mycophenolate, and tacrolimus , insulin-dependent diabetes mellitus, presented to the emergency department with a complaint of burning epigastric abdominal pain nausea, and vomiting with poor oral intake of 3 weeks duration.  Patient reports that symptoms started 3-4 weeks ago, symptoms are pursue stent, he has been having epigastric and substernal burning abdominal pain that is constant described as reflux, he has been nauseous and vomiting at times, reports that vomitus is bloody, reported black tarry stool, reported very poor oral intake for the last 3 weeks, poor urine output. Denied any history of bleeding in the past, he is not on any blood thinners and takes only low-dose aspirin, denies excess alcohol use, no recent illness fever or chills.  In the emergency department, Patient was with sinus tachycardia, slightly hypertensive, lab work showed CO2 of 12 in 17 on repeat, blood glucose of 303 but with normal pH and no concern of DKA, creatinine 3.9, lipase of 32, troponin of 0.04, hemoglobin 12, platelets 90 K, patient was given 2 L normal saline.  ED provider discussed accepted the patient as level to but expect bed to be available within 24 hours.  2/10/22: Pt with a renal transplant developed NV, dehydration, tested positive for COVID, no hypoxemia, admitted for IV fluids and BP control.  He has improved, Nephrology consulted for renal function and medications, ortho consulted for foot pressure sores, no sign of active infection.  He was uncomfortable, wanted to go home, follow up with PCP, nephrology and wound clinic
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspepsia, Faeces discoloured, Gastrooesophageal reflux disease, Haematemesis, Haemoglobin decreased
Clinical narrative: Pfizer Dose 1 4/15/21 (EW0153) Pfizer Dose 2 5/7/22 (ER8736) Pfizer Dose 3 8/14/22 (lot NA) COVID Postive 2/3/22  2/2/22: Patient is 63-year-old male with history of kidney transplant in 2018 on prednisone, mycophenolate, and tacrolimus , insulin-dependent diabetes mellitus, presented to the emergency department with a complaint of burning epigastric abdominal pain nausea, and vomiting with poor oral intake of 3 weeks duration.  Patient reports that symptoms started 3-4 weeks ago, symptoms are pursue stent, he has been having epigastric and substernal burning abdominal pain that is constant described as reflux, he has been nauseous and vomiting at times, reports that vomitus is bloody, reported black tarry stool, reported very poor oral intake for the last 3 weeks, poor urine output. Denied any history of bleeding in the past, he is not on any blood thinners and takes only low-dose aspirin, denies excess alcohol use, no recent illness fever or chills.  In the emergency department, Patient was with sinus tachycardia, slightly hypertensive, lab work showed CO2 of 12 in 17 on repeat, blood glucose of 303 but with normal pH and no concern of DKA, creatinine 3.9, lipase of 32, troponin of 0.04, hemoglobin 12, platelets 90 K, patient was given 2 L normal saline.  ED provider discussed accepted the patient as level to but expect bed to be available within 24 hours.  2/10/22: Pt with a renal transplant developed NV, dehydration, tested positive for COVID, no hypoxemia, admitted for IV fluids and BP control.  He has improved, Nephrology consulted for renal function and medications, ortho consulted for foot pressure sores, no sign of active infection.  He was uncomfortable, wanted to go home, follow up with PCP, nephrology and wound clinic
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Hypertension, Hypophagia, Inappropriate schedule of product administration, Lipase normal, Melaena
Clinical narrative: Pfizer Dose 1 4/15/21 (EW0153) Pfizer Dose 2 5/7/22 (ER8736) Pfizer Dose 3 8/14/22 (lot NA) COVID Postive 2/3/22  2/2/22: Patient is 63-year-old male with history of kidney transplant in 2018 on prednisone, mycophenolate, and tacrolimus , insulin-dependent diabetes mellitus, presented to the emergency department with a complaint of burning epigastric abdominal pain nausea, and vomiting with poor oral intake of 3 weeks duration.  Patient reports that symptoms started 3-4 weeks ago, symptoms are pursue stent, he has been having epigastric and substernal burning abdominal pain that is constant described as reflux, he has been nauseous and vomiting at times, reports that vomitus is bloody, reported black tarry stool, reported very poor oral intake for the last 3 weeks, poor urine output. Denied any history of bleeding in the past, he is not on any blood thinners and takes only low-dose aspirin, denies excess alcohol use, no recent illness fever or chills.  In the emergency department, Patient was with sinus tachycardia, slightly hypertensive, lab work showed CO2 of 12 in 17 on repeat, blood glucose of 303 but with normal pH and no concern of DKA, creatinine 3.9, lipase of 32, troponin of 0.04, hemoglobin 12, platelets 90 K, patient was given 2 L normal saline.  ED provider discussed accepted the patient as level to but expect bed to be available within 24 hours.  2/10/22: Pt with a renal transplant developed NV, dehydration, tested positive for COVID, no hypoxemia, admitted for IV fluids and BP control.  He has improved, Nephrology consulted for renal function and medications, ortho consulted for foot pressure sores, no sign of active infection.  He was uncomfortable, wanted to go home, follow up with PCP, nephrology and wound clinic
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Platelet count decreased, SARS-CoV-2 test positive, Sinus tachycardia, Troponin
Clinical narrative: Pfizer Dose 1 4/15/21 (EW0153) Pfizer Dose 2 5/7/22 (ER8736) Pfizer Dose 3 8/14/22 (lot NA) COVID Postive 2/3/22  2/2/22: Patient is 63-year-old male with history of kidney transplant in 2018 on prednisone, mycophenolate, and tacrolimus , insulin-dependent diabetes mellitus, presented to the emergency department with a complaint of burning epigastric abdominal pain nausea, and vomiting with poor oral intake of 3 weeks duration.  Patient reports that symptoms started 3-4 weeks ago, symptoms are pursue stent, he has been having epigastric and substernal burning abdominal pain that is constant described as reflux, he has been nauseous and vomiting at times, reports that vomitus is bloody, reported black tarry stool, reported very poor oral intake for the last 3 weeks, poor urine output. Denied any history of bleeding in the past, he is not on any blood thinners and takes only low-dose aspirin, denies excess alcohol use, no recent illness fever or chills.  In the emergency department, Patient was with sinus tachycardia, slightly hypertensive, lab work showed CO2 of 12 in 17 on repeat, blood glucose of 303 but with normal pH and no concern of DKA, creatinine 3.9, lipase of 32, troponin of 0.04, hemoglobin 12, platelets 90 K, patient was given 2 L normal saline.  ED provider discussed accepted the patient as level to but expect bed to be available within 24 hours.  2/10/22: Pt with a renal transplant developed NV, dehydration, tested positive for COVID, no hypoxemia, admitted for IV fluids and BP control.  He has improved, Nephrology consulted for renal function and medications, ortho consulted for foot pressure sores, no sign of active infection.  He was uncomfortable, wanted to go home, follow up with PCP, nephrology and wound clinic
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Urine output decreased, Vomiting
Clinical narrative: Pfizer Dose 1 4/15/21 (EW0153) Pfizer Dose 2 5/7/22 (ER8736) Pfizer Dose 3 8/14/22 (lot NA) COVID Postive 2/3/22  2/2/22: Patient is 63-year-old male with history of kidney transplant in 2018 on prednisone, mycophenolate, and tacrolimus , insulin-dependent diabetes mellitus, presented to the emergency department with a complaint of burning epigastric abdominal pain nausea, and vomiting with poor oral intake of 3 weeks duration.  Patient reports that symptoms started 3-4 weeks ago, symptoms are pursue stent, he has been having epigastric and substernal burning abdominal pain that is constant described as reflux, he has been nauseous and vomiting at times, reports that vomitus is bloody, reported black tarry stool, reported very poor oral intake for the last 3 weeks, poor urine output. Denied any history of bleeding in the past, he is not on any blood thinners and takes only low-dose aspirin, denies excess alcohol use, no recent illness fever or chills.  In the emergency department, Patient was with sinus tachycardia, slightly hypertensive, lab work showed CO2 of 12 in 17 on repeat, blood glucose of 303 but with normal pH and no concern of DKA, creatinine 3.9, lipase of 32, troponin of 0.04, hemoglobin 12, platelets 90 K, patient was given 2 L normal saline.  ED provider discussed accepted the patient as level to but expect bed to be available within 24 hours.  2/10/22: Pt with a renal transplant developed NV, dehydration, tested positive for COVID, no hypoxemia, admitted for IV fluids and BP control.  He has improved, Nephrology consulted for renal function and medications, ortho consulted for foot pressure sores, no sign of active infection.  He was uncomfortable, wanted to go home, follow up with PCP, nephrology and wound clinic
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Acute myocardial infarction, Anticoagulant therapy, Atrial fibrillation, COVID-19
Clinical narrative: Pfizer Dose 1 2/25/21 (EN6200) Pfizer Dose 2 3/19/21 (EN6208) Pfizer Dose 3 12/4/21 (FH8027) COVID Positive 1/5/22  1/12/22: A 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm and chronic HFpEF comes to ED complaining of chest pain.  Patient complains of left-sided chest pain radiating across to the right, started this morning, not associated with shortness of breath or palpitations or nausea or vomiting.  Denies cough or fever or chills.  States that she had some abdominal pain with nausea and vomiting and diarrhea a couple of days ago which is resolved.  Patient had recent upper respiratory infection, was tested positive for COVID-19 on 01/05/2022.   In the ED, she was afebrile, vital signs stable, pulse ox 98% on room air.  Troponin is positive 0.12.  EKG showed atrial fibrillation, rate controlled.  ED provider has discussed the case with on-call cardiologist, patient is started on nitro drip.  She is seen by me on the medical floor, states that she does not have any chest pain at this time.  1/15/22:  Patient is a 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm, chronic HFpEF adn recent diagnosis of COVID 19 came to ED complaining of chest pain.  Patient admitted for NSTEMI.  Patient was noted to have elevated troponin with no acute EKG changes. Patient was started on heparin drip.  Cardiology was consulted.  Patient had cardiac catheterization but did not require any intervention.  Continue medical management.  On discharge patient is chest pain-free.  Patient will follow-up with Cardiology as needed.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Catheterisation cardiac normal, Chest pain, Condition aggravated, Diarrhoea, Electrocardiogram abnormal
Clinical narrative: Pfizer Dose 1 2/25/21 (EN6200) Pfizer Dose 2 3/19/21 (EN6208) Pfizer Dose 3 12/4/21 (FH8027) COVID Positive 1/5/22  1/12/22: A 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm and chronic HFpEF comes to ED complaining of chest pain.  Patient complains of left-sided chest pain radiating across to the right, started this morning, not associated with shortness of breath or palpitations or nausea or vomiting.  Denies cough or fever or chills.  States that she had some abdominal pain with nausea and vomiting and diarrhea a couple of days ago which is resolved.  Patient had recent upper respiratory infection, was tested positive for COVID-19 on 01/05/2022.   In the ED, she was afebrile, vital signs stable, pulse ox 98% on room air.  Troponin is positive 0.12.  EKG showed atrial fibrillation, rate controlled.  ED provider has discussed the case with on-call cardiologist, patient is started on nitro drip.  She is seen by me on the medical floor, states that she does not have any chest pain at this time.  1/15/22:  Patient is a 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm, chronic HFpEF adn recent diagnosis of COVID 19 came to ED complaining of chest pain.  Patient admitted for NSTEMI.  Patient was noted to have elevated troponin with no acute EKG changes. Patient was started on heparin drip.  Cardiology was consulted.  Patient had cardiac catheterization but did not require any intervention.  Continue medical management.  On discharge patient is chest pain-free.  Patient will follow-up with Cardiology as needed.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain, SARS-CoV-2 test positive, Troponin increased, Upper respiratory tract infection
Clinical narrative: Pfizer Dose 1 2/25/21 (EN6200) Pfizer Dose 2 3/19/21 (EN6208) Pfizer Dose 3 12/4/21 (FH8027) COVID Positive 1/5/22  1/12/22: A 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm and chronic HFpEF comes to ED complaining of chest pain.  Patient complains of left-sided chest pain radiating across to the right, started this morning, not associated with shortness of breath or palpitations or nausea or vomiting.  Denies cough or fever or chills.  States that she had some abdominal pain with nausea and vomiting and diarrhea a couple of days ago which is resolved.  Patient had recent upper respiratory infection, was tested positive for COVID-19 on 01/05/2022.   In the ED, she was afebrile, vital signs stable, pulse ox 98% on room air.  Troponin is positive 0.12.  EKG showed atrial fibrillation, rate controlled.  ED provider has discussed the case with on-call cardiologist, patient is started on nitro drip.  She is seen by me on the medical floor, states that she does not have any chest pain at this time.  1/15/22:  Patient is a 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm, chronic HFpEF adn recent diagnosis of COVID 19 came to ED complaining of chest pain.  Patient admitted for NSTEMI.  Patient was noted to have elevated troponin with no acute EKG changes. Patient was started on heparin drip.  Cardiology was consulted.  Patient had cardiac catheterization but did not require any intervention.  Continue medical management.  On discharge patient is chest pain-free.  Patient will follow-up with Cardiology as needed.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Pfizer Dose 1 2/25/21 (EN6200) Pfizer Dose 2 3/19/21 (EN6208) Pfizer Dose 3 12/4/21 (FH8027) COVID Positive 1/5/22  1/12/22: A 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm and chronic HFpEF comes to ED complaining of chest pain.  Patient complains of left-sided chest pain radiating across to the right, started this morning, not associated with shortness of breath or palpitations or nausea or vomiting.  Denies cough or fever or chills.  States that she had some abdominal pain with nausea and vomiting and diarrhea a couple of days ago which is resolved.  Patient had recent upper respiratory infection, was tested positive for COVID-19 on 01/05/2022.   In the ED, she was afebrile, vital signs stable, pulse ox 98% on room air.  Troponin is positive 0.12.  EKG showed atrial fibrillation, rate controlled.  ED provider has discussed the case with on-call cardiologist, patient is started on nitro drip.  She is seen by me on the medical floor, states that she does not have any chest pain at this time.  1/15/22:  Patient is a 75-year-old female with a past medical history of paroxysmal atrial fibrillation on anticoagulation with Eliquis, COPD, chronic hypoxic respiratory failure on home oxygen, hypertension, hyperthyroidism, thoracic aortic aneurysm, chronic HFpEF adn recent diagnosis of COVID 19 came to ED complaining of chest pain.  Patient admitted for NSTEMI.  Patient was noted to have elevated troponin with no acute EKG changes. Patient was started on heparin drip.  Cardiology was consulted.  Patient had cardiac catheterization but did not require any intervention.  Continue medical management.  On discharge patient is chest pain-free.  Patient will follow-up with Cardiology as needed.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Anticoagulant therapy, Asthenia, Atrial fibrillation, COVID-19
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/20/2022 Discharge Date: Jul 2, 2022  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 75 y.o. female with past medical history of recurrent DVTs on Eliquis, Alzheimer's dementia, schizophrenia, insulin-dependent diabetes mellitus type 2, and chronic pain on tramadol who presented for generalized weakness and frequent falls. She was subsequently diagnosed with COVID-19 pneumonia with respiratory failure. CXR consistent with COVID-19. She was started on decadron and remdesivir. She was seen by PT/OT who recommended SAR. She developed new onset atrial fibrillation and was already on Eliquis. Echocardiogram showed normal LV function without valvular pathology and a normal sized IVC. Eliquis was increased to 5mg twice daily and metoprolol was added for rate control.  She was weaned from oxygen.  She completed her course of decadron and Remdesivir during admission. Insulin adjusted due to steroid induced hyperglycemia. She was discharged to subacute rehab in stable condition.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest X-ray abnormal, Echocardiogram normal, Fall, Hyperglycaemia
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/20/2022 Discharge Date: Jul 2, 2022  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 75 y.o. female with past medical history of recurrent DVTs on Eliquis, Alzheimer's dementia, schizophrenia, insulin-dependent diabetes mellitus type 2, and chronic pain on tramadol who presented for generalized weakness and frequent falls. She was subsequently diagnosed with COVID-19 pneumonia with respiratory failure. CXR consistent with COVID-19. She was started on decadron and remdesivir. She was seen by PT/OT who recommended SAR. She developed new onset atrial fibrillation and was already on Eliquis. Echocardiogram showed normal LV function without valvular pathology and a normal sized IVC. Eliquis was increased to 5mg twice daily and metoprolol was added for rate control.  She was weaned from oxygen.  She completed her course of decadron and Remdesivir during admission. Insulin adjusted due to steroid induced hyperglycemia. She was discharged to subacute rehab in stable condition.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory failure
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/20/2022 Discharge Date: Jul 2, 2022  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] AKI (acute kidney injury) [N17.9] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 75 y.o. female with past medical history of recurrent DVTs on Eliquis, Alzheimer's dementia, schizophrenia, insulin-dependent diabetes mellitus type 2, and chronic pain on tramadol who presented for generalized weakness and frequent falls. She was subsequently diagnosed with COVID-19 pneumonia with respiratory failure. CXR consistent with COVID-19. She was started on decadron and remdesivir. She was seen by PT/OT who recommended SAR. She developed new onset atrial fibrillation and was already on Eliquis. Echocardiogram showed normal LV function without valvular pathology and a normal sized IVC. Eliquis was increased to 5mg twice daily and metoprolol was added for rate control.  She was weaned from oxygen.  She completed her course of decadron and Remdesivir during admission. Insulin adjusted due to steroid induced hyperglycemia. She was discharged to subacute rehab in stable condition.
Age: 1.17
Sex: M
Vaccine: MMRV
Symptoms: Rash
Clinical narrative: HPI  Hx of eczema on L thigh at last office visit earlier this month.  No fevers  but mom gave tylenol last night.   He had shrimp for dinner last night, but rash first started yesterday AM and has been progressively worsening. He had his MMRV vaccine within the last 2 weeks. Rash started with a few spots on face, then broke out more on face, then onto torso and extremities today    Water makes rash worse. He is not itching at him. No difficulty breathing or eating, no swelling in mouth
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Dyspnoea, Electrocardiogram abnormal, Feeling jittery, Nervousness
Clinical narrative: Presents to ED after reaction to Covid vaccine. Patient states she received her injection and was waiting up between 5 to 10 minutes after the injection. She acutely felt tingling in her throat short of breath and describes "wave of purple halos around lights". She had 2 significant episodes of this and was provided epinephrine injection at the vaccine facility and sent to ED for further evaluation. She is still feeling extremely shaky and jittery and is complaining of mild dyspnea. Patient provided Benadryl, fluids, Pepcid. Chest x-ray is unremarkable and EKG is sinus tachycardia. Patient observed for several hours without recurrence or worsening of symptoms. Patient stable for discharge home and close follow-up with PCP in the next 1 to 2 days. Patient discharged with steroids, Benadryl and EpiPen and counseled regarding biphasic reaction precautions. Treating physician was (withheld).
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Pharyngeal paraesthesia, Sinus tachycardia, Visual impairment
Clinical narrative: Presents to ED after reaction to Covid vaccine. Patient states she received her injection and was waiting up between 5 to 10 minutes after the injection. She acutely felt tingling in her throat short of breath and describes "wave of purple halos around lights". She had 2 significant episodes of this and was provided epinephrine injection at the vaccine facility and sent to ED for further evaluation. She is still feeling extremely shaky and jittery and is complaining of mild dyspnea. Patient provided Benadryl, fluids, Pepcid. Chest x-ray is unremarkable and EKG is sinus tachycardia. Patient observed for several hours without recurrence or worsening of symptoms. Patient stable for discharge home and close follow-up with PCP in the next 1 to 2 days. Patient discharged with steroids, Benadryl and EpiPen and counseled regarding biphasic reaction precautions. Treating physician was (withheld).
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Decreased appetite, Fatigue, Influenza virus test, Oropharyngeal pain, Pyrexia
Clinical narrative: Fever of 102+ for more than 3 days. Fatigue. Sore throat. Hasn't eaten a meal since the vaccine.
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test, Streptococcus test
Clinical narrative: Fever of 102+ for more than 3 days. Fatigue. Sore throat. Hasn't eaten a meal since the vaccine.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Aspartate aminotransferase increased, Asthenia, Blood magnesium normal, COVID-19
Clinical narrative: Admission Date: 6/27/2022 Discharge Date: Jun 28, 2022  PRESENTING PROBLEM: COVID   HOSPITAL COURSE: 48 y.o. female with past medical history of adrenal insufficiency, depression, anxiety, chronic pain on methadone who presented to the ED per recommendation of her endocrinologist d/t concern for adrenal crisis. Patient was recently treated for covid. She completed a 5 day course of paxovid with last treatment date this morning (6/27).  Since her diagnosis of COVID, patient endorses diarrhea which has increased in frequency over the last several days. States she has been having 8-9 stools daily associated with poor oral intake and wt loss of 6 lbs. She has been eating very little and feeling tired and weak. She has lost a significant amount of weight, 10lbs over the past week d/t the GI loss and not eating or drinking much. She admitted to feeling dizzy at times but no syncope or falls. She initially had tripled her home steroid/hydrocortisone dose for a couple days and then went back to her home dose. She has also been taking scheduled tylenol d/t ongoing fevers and chills. She denies any respiratory issues such as cough, SOB, or chest pain.    Upon arrival to the ED, patient was afebrile and hemodynamically stable. Labs were grossly unremarkable aside for AST  57, mag 1.5, hgb 10.1. No imaging was performed. On call Endocrinologist was contacted who recommended admission for scheduled IV hydrocortisone. Patient received hydrocortisone 100 mg IV while in the ED in addition to 1L IVF and tylenol   Patient stayed in hospital for 24 hours.   During hospital stay patient received IV hydrocortisone every 8 hours for 3 doses.  She remained stable throughout hospital stay.  Her diarrhea and vomiting had resolved.  She was given Lovenox prophylaxis for her COVID.  Her D-dimer was elevated at 1090.  With patient stable, she was discharged home with resumption of her oral hydrocortisone regimen at home.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Diarrhoea, Dizziness, Fatigue, Fibrin D dimer increased
Clinical narrative: Admission Date: 6/27/2022 Discharge Date: Jun 28, 2022  PRESENTING PROBLEM: COVID   HOSPITAL COURSE: 48 y.o. female with past medical history of adrenal insufficiency, depression, anxiety, chronic pain on methadone who presented to the ED per recommendation of her endocrinologist d/t concern for adrenal crisis. Patient was recently treated for covid. She completed a 5 day course of paxovid with last treatment date this morning (6/27).  Since her diagnosis of COVID, patient endorses diarrhea which has increased in frequency over the last several days. States she has been having 8-9 stools daily associated with poor oral intake and wt loss of 6 lbs. She has been eating very little and feeling tired and weak. She has lost a significant amount of weight, 10lbs over the past week d/t the GI loss and not eating or drinking much. She admitted to feeling dizzy at times but no syncope or falls. She initially had tripled her home steroid/hydrocortisone dose for a couple days and then went back to her home dose. She has also been taking scheduled tylenol d/t ongoing fevers and chills. She denies any respiratory issues such as cough, SOB, or chest pain.    Upon arrival to the ED, patient was afebrile and hemodynamically stable. Labs were grossly unremarkable aside for AST  57, mag 1.5, hgb 10.1. No imaging was performed. On call Endocrinologist was contacted who recommended admission for scheduled IV hydrocortisone. Patient received hydrocortisone 100 mg IV while in the ED in addition to 1L IVF and tylenol   Patient stayed in hospital for 24 hours.   During hospital stay patient received IV hydrocortisone every 8 hours for 3 doses.  She remained stable throughout hospital stay.  Her diarrhea and vomiting had resolved.  She was given Lovenox prophylaxis for her COVID.  Her D-dimer was elevated at 1090.  With patient stable, she was discharged home with resumption of her oral hydrocortisone regimen at home.