chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Gastrointestinal wall thickening, Haemoglobin, Peptic ulcer, SARS-CoV-2 test positive
Clinical narrative: Patient up to date on COVID vaccines who admitted with an incidental COVID test.  Asymtpomatic for COVID.  Provider d/c note:  "90 year old male with a history of CKD stage III, anemia, BPH, hypertension, and osteoarthritis admitted with COVID and black stools. CT two weeks ago revealed proximal duodenal wall thickening, surrounding fat stranding, and a couple areas of suspected ulcer is in the duodenal bulb suspicious for peptic ulcer disease with neoplastic or other duodenitis. He was incidentally found to have COVID.    Hospital Course:  Pt was seen by GI who offered endoscopy. The pt declined endoscopy in favor of medical treatment. A full and detailed discussion of the risks and benefits of this course of action was held. Spouse and other family member (daughter or grandaughter) made aware of this decision as well and they agree. They understand it could be from cancer.  His hemoglobin has stabilized with PPI therapy, which will continue.    He remained asymptomatic in regards to COVID, in fact today he states, ""I feel great."" He has been instructed on quarantine measures. "
Age: 62.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: NO ADVERSE EVENT NOTED OR REPORTED. Jynneos vaccine 0.1 ml was administered ID with no wheal produced and subsequent additional 0.1ml ID given with wheal production.
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Atelectasis, COVID-19, Computerised tomogram abdomen abnormal, Confusional state
Clinical narrative: The patient was brought to Medical Center on 02/18/2022 by her daughter for worsening confusion, generalized weakness, and new urinary incontinence and was refusing to eat/drink, or walk.   The patient tested positive for Covid-19 on 01/19/2022.   CT abdomen pelvis on 02/18/2022 showed moderate bilateral pleural effusion with overlying atelectasis/consolidation.  Due to the patient's multiple comorbidities, palliative care was consulted, and decided that the patient would be discharged home on hospice care.  The patient was discharged on 02/25/2022.  The patient expired on 03/08/2022.
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Fluid intake reduced, Food refusal, Lung consolidation, Multimorbidity
Clinical narrative: The patient was brought to Medical Center on 02/18/2022 by her daughter for worsening confusion, generalized weakness, and new urinary incontinence and was refusing to eat/drink, or walk.   The patient tested positive for Covid-19 on 01/19/2022.   CT abdomen pelvis on 02/18/2022 showed moderate bilateral pleural effusion with overlying atelectasis/consolidation.  Due to the patient's multiple comorbidities, palliative care was consulted, and decided that the patient would be discharged home on hospice care.  The patient was discharged on 02/25/2022.  The patient expired on 03/08/2022.
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Pleural effusion, SARS-CoV-2 test positive, Urinary incontinence
Clinical narrative: The patient was brought to Medical Center on 02/18/2022 by her daughter for worsening confusion, generalized weakness, and new urinary incontinence and was refusing to eat/drink, or walk.   The patient tested positive for Covid-19 on 01/19/2022.   CT abdomen pelvis on 02/18/2022 showed moderate bilateral pleural effusion with overlying atelectasis/consolidation.  Due to the patient's multiple comorbidities, palliative care was consulted, and decided that the patient would be discharged home on hospice care.  The patient was discharged on 02/25/2022.  The patient expired on 03/08/2022.
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, Blood loss anaemia, COVID-19, Condition aggravated, Crohn's disease
Clinical narrative: Patient up to date with COVID vaccinations who admitted with positive COVID test.  Provider d/c note:  "27 yo F with a PMH of Chron's, Anxiety who presented to Urgent Care due to generalized weakness and worsening bloody stools at home. Found to have acute blood loss anemia requiring 3uPRBC in setting of likely crohn's flare and EPEC. She was also COVID +. She was not hypoxic but did have a sore throat. She was initiated on IV solumedrol 20mg q8 per GI and transitioned to home Prednisone 40mg daily upon discharge. She should continue a low residue diet. She had "normal" stools prior to discharge with no further bleeding noted. She was discharged home in stable condition with strict return precautions".
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Gastroenteritis Escherichia coli, Haematochezia, Oropharyngeal pain, Red blood cell transfusion, SARS-CoV-2 test positive
Clinical narrative: Patient up to date with COVID vaccinations who admitted with positive COVID test.  Provider d/c note:  "27 yo F with a PMH of Chron's, Anxiety who presented to Urgent Care due to generalized weakness and worsening bloody stools at home. Found to have acute blood loss anemia requiring 3uPRBC in setting of likely crohn's flare and EPEC. She was also COVID +. She was not hypoxic but did have a sore throat. She was initiated on IV solumedrol 20mg q8 per GI and transitioned to home Prednisone 40mg daily upon discharge. She should continue a low residue diet. She had "normal" stools prior to discharge with no further bleeding noted. She was discharged home in stable condition with strict return precautions".
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Genital rash, Hypersensitivity, Rash
Clinical narrative: Shot was received Sunday evening. The following Friday after school, our son has a pretty substantial rash in the crotch area and on his back. That looked better in the morning with a dose of Benadryl overnight, but more rash had developed on his stomach and under his arms. Another dose of Benadryl was administered Saturday night. All the rash had pretty much resolved by Sunday and was totally gone by Monday. We sent our doctor a message on Monday. She said the timing and appearance would make her more suspicious of a mild allergic reaction to something he came in contact with rather than the vaccine, but she thought it worth noting and reporting to VAERS.
Age: 58.0
Sex: M
Vaccine: SMALLMNK
Symptoms: No adverse event, Urticaria
Clinical narrative: NO ADVERSE EVENT NOTED OR REPORTED. Jynneos 0.1ml ID administered with no wheal production; therefore subsequent dose administered (0.1ML, ID) with wheal production.
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cerebral infarction, Death, Dyspnoea
Clinical narrative: The patient presented to the ED with c/o SOB and was diagnosed with Covid-19 6 days prior to admission.  The patient was admitted for Covid-19 Was placed on bronchodilators and duo nebs.  The patient was treated with dexamethasone and remdesivir.  She developed left-sided weakness during hospitalization and hypertension urgency.  MRI showed a subacute infarct, several grouped early subacute lacunar infarcts of the right basal ganglia extending to the pericallosal parietal white matter.  The patient was transferred on 02/08/2022.  The patient expired at facility on 02/13/2022.
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Hemiparesis, Hypertensive urgency, Lacunar infarction, Magnetic resonance imaging head abnormal
Clinical narrative: The patient presented to the ED with c/o SOB and was diagnosed with Covid-19 6 days prior to admission.  The patient was admitted for Covid-19 Was placed on bronchodilators and duo nebs.  The patient was treated with dexamethasone and remdesivir.  She developed left-sided weakness during hospitalization and hypertension urgency.  MRI showed a subacute infarct, several grouped early subacute lacunar infarcts of the right basal ganglia extending to the pericallosal parietal white matter.  The patient was transferred on 02/08/2022.  The patient expired at facility on 02/13/2022.
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Angioedema, Blood test normal, Urticaria
Clinical narrative: Three weeks after my last shoot (the booster), I began having urticaria (hives). At first, only a few would appear and disappear throughout the day. Then as the months went on, they became much worse and wouldn't go away with antihistamines. I received treatment from several doctors (including two different allergists/immunologists) over the time span of nine months. I also experienced more severe reactions twice including angioedema and given an EpiPen by my doctor. I still chronic hives and have to take high doses of medicine every day to manage them (Zyrtec, Allegra and Pepcid). At one point in April 2022, I had to go on a ten-day dose of steroids just to manage symptoms. Since December 2021 this has been happening with the worst side effects appearing around April and March 2022. I am still seeking answers and continuing to seek out different and new care/perspectives.
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Angioedema, Chronic spontaneous urticaria, Emotional distress, Pruritus, Urticaria
Clinical narrative: Three weeks after my last shoot (the booster), I began having urticaria (hives). At first, only a few would appear and disappear throughout the day. Then as the months went on, they became much worse and wouldn't go away with antihistamines. I received treatment from several doctors (including two different allergists/immunologists) over the time span of nine months. I also experienced more severe reactions twice including angioedema and given an EpiPen by my doctor. I still chronic hives and have to take high doses of medicine every day to manage them (Zyrtec, Allegra and Pepcid). At one point in April 2022, I had to go on a ten-day dose of steroids just to manage symptoms. Since December 2021 this has been happening with the worst side effects appearing around April and March 2022. I am still seeking answers and continuing to seek out different and new care/perspectives.
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
Clinical narrative: Three weeks after my last shoot (the booster), I began having urticaria (hives). At first, only a few would appear and disappear throughout the day. Then as the months went on, they became much worse and wouldn't go away with antihistamines. I received treatment from several doctors (including two different allergists/immunologists) over the time span of nine months. I also experienced more severe reactions twice including angioedema and given an EpiPen by my doctor. I still chronic hives and have to take high doses of medicine every day to manage them (Zyrtec, Allegra and Pepcid). At one point in April 2022, I had to go on a ten-day dose of steroids just to manage symptoms. Since December 2021 this has been happening with the worst side effects appearing around April and March 2022. I am still seeking answers and continuing to seek out different and new care/perspectives.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Blood test normal, Bradykinesia, Depression, Gait disturbance
Clinical narrative: She got her vaccine, didn't have any reaction at first, didn't even hurt.  Around 7:30 she started feeling pain in her knee area, which she normally sleeps with a pillow between them.  She tossed and turned all night long and only slept about an hour and half.  She went to work, was hobbling, and could not walk, hurt to walk.  Getting in and out of the bed hard to get up to use the bathroom.  She had to sit down first and then had to try to lift her leg, constant pain that would not go away.  It's been that way since then.  She worked the 23rd and 24th and could not stand it anymore.  She went to see a doctor and was sent to the ER to get US to see for blood clots, which was negative.  She was told to use patch for the pain which did not stay on, and she started taking Ibuprofen for the pain.  She then tried to work with that, went back to the doctors office again, her doctors team and did blood work to look for gout and inflammation, which he did not see anything.  The pain was still there and he did not direct her what to do next.  She went to the chiropractor which did help a little bit and could walk better, but did not take are of her pain.  She called back her doctor and she asked if she wanted to do therapy.  She hobbled in and was hard to walk.  She was using a cane that she borrowed, and that is how it has been.  She decided to go back to work, and she walks very slow and gets the job done.  She is still in therapy, has a session at 11:00 today.  She had a scraping with a tool around the knee and massaging, also an ice/water bath connected to her knee which has helped some.  She just wants to walk normal again as it is affecting her back again.   She said that this is depressing, and she works in a nursing home as a nursing assistant and she loves her job and wants to continue doing this.  She did not have any problems with her knees prior to the vaccine.    She only had minimal symptoms of fatigue and body aches with the other COVID vaccines.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Knee operation, Laboratory test, Mobility decreased, Pain, Sleep disorder
Clinical narrative: She got her vaccine, didn't have any reaction at first, didn't even hurt.  Around 7:30 she started feeling pain in her knee area, which she normally sleeps with a pillow between them.  She tossed and turned all night long and only slept about an hour and half.  She went to work, was hobbling, and could not walk, hurt to walk.  Getting in and out of the bed hard to get up to use the bathroom.  She had to sit down first and then had to try to lift her leg, constant pain that would not go away.  It's been that way since then.  She worked the 23rd and 24th and could not stand it anymore.  She went to see a doctor and was sent to the ER to get US to see for blood clots, which was negative.  She was told to use patch for the pain which did not stay on, and she started taking Ibuprofen for the pain.  She then tried to work with that, went back to the doctors office again, her doctors team and did blood work to look for gout and inflammation, which he did not see anything.  The pain was still there and he did not direct her what to do next.  She went to the chiropractor which did help a little bit and could walk better, but did not take are of her pain.  She called back her doctor and she asked if she wanted to do therapy.  She hobbled in and was hard to walk.  She was using a cane that she borrowed, and that is how it has been.  She decided to go back to work, and she walks very slow and gets the job done.  She is still in therapy, has a session at 11:00 today.  She had a scraping with a tool around the knee and massaging, also an ice/water bath connected to her knee which has helped some.  She just wants to walk normal again as it is affecting her back again.   She said that this is depressing, and she works in a nursing home as a nursing assistant and she loves her job and wants to continue doing this.  She did not have any problems with her knees prior to the vaccine.    She only had minimal symptoms of fatigue and body aches with the other COVID vaccines.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound Doppler normal, Walking aid user
Clinical narrative: She got her vaccine, didn't have any reaction at first, didn't even hurt.  Around 7:30 she started feeling pain in her knee area, which she normally sleeps with a pillow between them.  She tossed and turned all night long and only slept about an hour and half.  She went to work, was hobbling, and could not walk, hurt to walk.  Getting in and out of the bed hard to get up to use the bathroom.  She had to sit down first and then had to try to lift her leg, constant pain that would not go away.  It's been that way since then.  She worked the 23rd and 24th and could not stand it anymore.  She went to see a doctor and was sent to the ER to get US to see for blood clots, which was negative.  She was told to use patch for the pain which did not stay on, and she started taking Ibuprofen for the pain.  She then tried to work with that, went back to the doctors office again, her doctors team and did blood work to look for gout and inflammation, which he did not see anything.  The pain was still there and he did not direct her what to do next.  She went to the chiropractor which did help a little bit and could walk better, but did not take are of her pain.  She called back her doctor and she asked if she wanted to do therapy.  She hobbled in and was hard to walk.  She was using a cane that she borrowed, and that is how it has been.  She decided to go back to work, and she walks very slow and gets the job done.  She is still in therapy, has a session at 11:00 today.  She had a scraping with a tool around the knee and massaging, also an ice/water bath connected to her knee which has helped some.  She just wants to walk normal again as it is affecting her back again.   She said that this is depressing, and she works in a nursing home as a nursing assistant and she loves her job and wants to continue doing this.  She did not have any problems with her knees prior to the vaccine.    She only had minimal symptoms of fatigue and body aches with the other COVID vaccines.
Age: 46.0
Sex: M
Vaccine: MMR
Symptoms: Expired product administered, No adverse event
Clinical narrative: Vaccine was administered on 09/01/2022. Expiration date of vaccine was 08/26/2022. No adverse outcomes.
Age: 72.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: NO ADVERSE EVENT NOTED OR REPORTED. Jynneos 0.1 ml administered ID with no production of wheal; therefore an additional dose of Jynneos 0.1ml, ID administered with production of wheal.
Age: 43.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Incorrect route of product administration, Injection site nodule, Injection site pain, Insomnia, Night sweats
Clinical narrative: Excessive night sweats, night terrors, and insomnia for 6 days following the second vaccine (given intradermal route). No side effects other than a nodule and pain at the injection site for my first vaccine given via subcutaneous route.
Age: 43.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Sleep terror
Clinical narrative: Excessive night sweats, night terrors, and insomnia for 6 days following the second vaccine (given intradermal route). No side effects other than a nodule and pain at the injection site for my first vaccine given via subcutaneous route.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Chills, Cough, Death, Dyspnoea
Clinical narrative: The patient presented to hospital on 02/09/2022 with a worsening SOB.  The patient stated progressively worsening chest congestion, cough, SOB, chills, and body aches.  In the ED the patient was placed on 15 L nonrebreather.  The patient was admitted to the hospital for Covid-19 PNA, acute hypoxic respiratory failure, and pancytopeia/microcyticanemia.  The patient was treated with dexamethasone and remdesivir.  The patient expired on 02/22/2022.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pancytopenia, Respiratory tract congestion
Clinical narrative: The patient presented to hospital on 02/09/2022 with a worsening SOB.  The patient stated progressively worsening chest congestion, cough, SOB, chills, and body aches.  In the ED the patient was placed on 15 L nonrebreather.  The patient was admitted to the hospital for Covid-19 PNA, acute hypoxic respiratory failure, and pancytopeia/microcyticanemia.  The patient was treated with dexamethasone and remdesivir.  The patient expired on 02/22/2022.
Age: 0.5
Sex: M
Vaccine: DTAPIPVHIB, FLU4, HEP, PNC13, RV5
Symptoms: Unevaluable event
Clinical narrative: See attached ER visit note.
Age: 51.0
Sex: M
Vaccine: SMALLMNK
Symptoms: No adverse event, Vaccination error
Clinical narrative: NO ADVERSE EVENT NOTED OR REPORTED. Jynneos 0.1 ml, ID administered with no wheal production; therefore, additional dose administered with wheal production.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Facial discomfort, Swelling of eyelid
Clinical narrative: Right eyelid discomfort within an hour after receiving, swelling of right lid x 2 days
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: After receiving my first booster of Moderna on 10/29/21 I began to notice shakiness and small tremors in my right foot and fingers on both hands (mainly right side) on occasion. I also received a 2nd booster of Pfizer on 6/3/2022 and noticed an increase of the tremors progressively getting worse. I will be seeing a neurologist but I'm concerned because I had no issues before the vaccines and now I do.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, Paranasal sinus discomfort, Respiratory tract congestion
Clinical narrative: The only symptoms is weakness, congestion and sinus pressure. No fever yet and I have a mild cough. I've been taking over the counter medications.
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: The only symptoms is weakness, congestion and sinus pressure. No fever yet and I have a mild cough. I've been taking over the counter medications.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Administered 2nd booster dose prior to recommended interval (30 days early).
Age: 4.0
Sex: F
Vaccine: DTAP
Symptoms: Injection site erythema, Injection site rash, Injection site warmth
Clinical narrative: Patient woke up Saturday morning with a rash on her right thigh near the injection site.  As the day went on it turned into a large (basically her entire right thigh) red ring around the site.  By Saturday night it was a bright red circle.  It stayed this way all Sunday.  On Monday it was much lighter but still noticable for several days.  It never bothered her but was warm to the touch.
Age: 39.0
Sex: F
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: NO ADVERSE EVENT REPORTED OR NOTED.  Jynneos 0.1 ml admimistered ID without production of wheal and Additional dose was given (0.1ml, ID) with production of wheal.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Fatigue, Nasopharyngitis, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I was fine until July 10 when I developed cold symptoms followed by temp of 101.7. Took at home COVID test before the fever started and it was negative. After fever treated symptoms with ibuprofen and Tylenol. Advised to take COVID test early morning of 7/12 and it was positive. PCP prescribed Paxlovid. Symptoms mild - fever was gone by that time.  Fatigue remained an issue for almost 3 weeks.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Death, Exposure to SARS-CoV-2, Unresponsive to stimuli
Clinical narrative: Meets vital records criteria. COVID listed as COD on death certificate.  DIDI COD: ASCVD, DMII, Possible COVID19. The decedent was discovered unresponsive in bed 10/11/21. Pt medical hx: hypertension, diabetes, and a kidney transplant 10 years ago. Pt's daughter had tested positive for COVID the day before and the decedent had been coughing more than usual prior to her death.
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Asymptomatic COVID-19, Blood potassium decreased, Blood sodium normal, Chest X-ray abnormal
Clinical narrative: Patient with 2 COVID vaccines who admitted to hospital with positive COVID test.  Asymptomatic for COVID other than weakness leading to fall.  Provider d/c note:  "93-year-old female who originally presented to Community Hospital yesterday, on 7/25/22, after she fell at home. The patient cannot recall the events that led to her fall, but states that she no ooze (sic) that she fell at home.  The patient apparently called for a neighbor, who then alerted EMS, and brought the patient.  Upon initial evaluation, she was complaining of pain in her right chest.  As is detailed below, radiologic workup revealed for right-sided rib fractures and small pneumothorax   She was observed closely with pain management and incentive spirometry.  Her pneumothorax improved with observation and pain was controlled. Xrays showed fractures of R.2nd-5th ribs.  Transfer to skilled nursing was advised, and COVID screening was positive, despite being asymptomatic.  This delayed her transfer additional 10 days, before she was accepted for transfer.  There are no interval events.  Initial sodium 136 dropped to 129, without improvement upon discharge.  Initial potassium 3.5 dropped to 2.8, but improved to 4.3 with replacement."
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chest pain, Fall, Incentive spirometry, Pneumothorax, Rib fracture
Clinical narrative: Patient with 2 COVID vaccines who admitted to hospital with positive COVID test.  Asymptomatic for COVID other than weakness leading to fall.  Provider d/c note:  "93-year-old female who originally presented to Community Hospital yesterday, on 7/25/22, after she fell at home. The patient cannot recall the events that led to her fall, but states that she no ooze (sic) that she fell at home.  The patient apparently called for a neighbor, who then alerted EMS, and brought the patient.  Upon initial evaluation, she was complaining of pain in her right chest.  As is detailed below, radiologic workup revealed for right-sided rib fractures and small pneumothorax   She was observed closely with pain management and incentive spirometry.  Her pneumothorax improved with observation and pain was controlled. Xrays showed fractures of R.2nd-5th ribs.  Transfer to skilled nursing was advised, and COVID screening was positive, despite being asymptomatic.  This delayed her transfer additional 10 days, before she was accepted for transfer.  There are no interval events.  Initial sodium 136 dropped to 129, without improvement upon discharge.  Initial potassium 3.5 dropped to 2.8, but improved to 4.3 with replacement."
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient with 2 COVID vaccines who admitted to hospital with positive COVID test.  Asymptomatic for COVID other than weakness leading to fall.  Provider d/c note:  "93-year-old female who originally presented to Community Hospital yesterday, on 7/25/22, after she fell at home. The patient cannot recall the events that led to her fall, but states that she no ooze (sic) that she fell at home.  The patient apparently called for a neighbor, who then alerted EMS, and brought the patient.  Upon initial evaluation, she was complaining of pain in her right chest.  As is detailed below, radiologic workup revealed for right-sided rib fractures and small pneumothorax   She was observed closely with pain management and incentive spirometry.  Her pneumothorax improved with observation and pain was controlled. Xrays showed fractures of R.2nd-5th ribs.  Transfer to skilled nursing was advised, and COVID screening was positive, despite being asymptomatic.  This delayed her transfer additional 10 days, before she was accepted for transfer.  There are no interval events.  Initial sodium 136 dropped to 129, without improvement upon discharge.  Initial potassium 3.5 dropped to 2.8, but improved to 4.3 with replacement."
Age: 5.0
Sex: M
Vaccine: DTAP
Symptoms: Asthma, Condition aggravated, Heart rate increased, Laboratory test, Pyrexia
Clinical narrative: Seizures, high fever of 105.6, extreme vomiting, high heart rate .   * before vaccine on 8/8/22 his asthma was getting betttsince he?s needing more breathing treatments as of now 9/2/2022
Age: 5.0
Sex: M
Vaccine: DTAP
Symptoms: Seizure, Vomiting
Clinical narrative: Seizures, high fever of 105.6, extreme vomiting, high heart rate .   * before vaccine on 8/8/22 his asthma was getting betttsince he?s needing more breathing treatments as of now 9/2/2022
Age: 31.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Bacterial infection, Blood culture positive, COVID-19, Decreased appetite, Device malfunction
Clinical narrative: Patient with 2 COVID vaccinations who admitted to hospital with positive COVID test.  Some GI issues, not hypoxic.  Provdier d/c note:  "32-year-old male with history of DM 1 with insulin pump/sensor with right BKA who was advised to come back to hospital for GPC bacteremia for which patient was monitored and blood culture grew micrococcus which ID assessed as being a contaminant.  However during hospitalization patient developed DKA secondary to malfunctioning insulin pump which resolved after insulin pump placed back on patient correctly.  Patient with poor appetite during this hospitalization secondary to COVID as well as history of gastroparesis but patient feels that he is safe for discharge home and that he should be able to eat well upon discharge to home.  Patient discharged to home."
Age: 31.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Diabetic ketoacidosis, Gastrointestinal disorder, Micrococcus test positive, SARS-CoV-2 test positive
Clinical narrative: Patient with 2 COVID vaccinations who admitted to hospital with positive COVID test.  Some GI issues, not hypoxic.  Provdier d/c note:  "32-year-old male with history of DM 1 with insulin pump/sensor with right BKA who was advised to come back to hospital for GPC bacteremia for which patient was monitored and blood culture grew micrococcus which ID assessed as being a contaminant.  However during hospitalization patient developed DKA secondary to malfunctioning insulin pump which resolved after insulin pump placed back on patient correctly.  Patient with poor appetite during this hospitalization secondary to COVID as well as history of gastroparesis but patient feels that he is safe for discharge home and that he should be able to eat well upon discharge to home.  Patient discharged to home."
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Nasal congestion, SARS-CoV-2 test positive
Clinical narrative: I got head congestion; cough and tiredness lasting 10 days and I took PAXLOVID and felt better. I tested negative COVID 19 on 08/11/2022.
Age: 69.0
Sex: F
Vaccine: FLU4
Symptoms: Gait disturbance, Musculoskeletal stiffness, Myalgia
Clinical narrative: difficulty walking-muscle pain, stiffness
Age: 41.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Blood pressure increased, Exophthalmos, Nausea, Vertigo, Vomiting
Clinical narrative: head spinning, nausea, vomiting, blood pressure went up, felt like eyes were going to bulge out
Age: 22.0
Sex: M
Vaccine: COVID19
Symptoms: Loss of consciousness
Clinical narrative: patient passed out a few times .  Ambulance was  called and confirmed he only passed out . Patient reveled that he has a history of passing out with vaccines.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood culture, Blood lactic acid increased, Breath sounds abnormal
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 8/14/2022   PRESENTING PROBLEM: Hyponatremia [E87.1] Sepsis (HCC) [A41.9] Severe sepsis (HCC) [A41.9, R65.20] AKI (acute kidney injury) (HCC) [N17.9] COVID-19 virus test result unknown [Z20.822]   HOSPITAL COURSE:   This is a 78 y.o. patient with a past medical history significant for Hepatocellular carcinoma, enrolled in a study; HTN, NICM, DM, persistent Afib, CAD, OSA, who presented to the ED with symptoms of fever, n/v and diarrhea, weakness and shortness of breath. In the ED he was afebrile. His lactic acid was elevated at 5.4, he received 4L IVF bolus in the ED. Blood cultures x 2 and UA obtained, and pt was treated with IV zosyn. Patient was admitted to the oncology service for further workup and treatment of sepsis with fevers.   During this admission, patient's initial infectious work up was negative though given persistent fevers, ID was consulted and ultimately ordered a Karius test 8/17/22 which was positive for EBV, CMV so patient was treated for viremia with gancyclovir though 8/27/22.  ID also felt patient had HLH, so that work up was initiated.  Dr. and ID did conclude patient developed checkpoint inhibitor (treatment) induced HLH given criteria met including but not limited to fevers, pancytopenia, BMBx on 8/24/22 with Hemophagocytosis, IL2 >29,000 and liver bx 8/26/22 consistent with HLH.  Patient was started on dex 10mg IV BID and then increased to 20mg IV BID which was suspected to have lead to encephalopathy and nightly dilerium.  Patient began to show progressive liver injury.  Immunology was consulted and was not convinced patient had HLH but did recommend IVIG BID started 8/26 and Anakinra TID, started 8/27 and cyclosporin started 8/29.  Unfortunately, patient continued to have liver failure and progressive decline.  Given no improvement in HLH, patient determined he did not want further care; however, he was deemed by then incompetent to make medical decisions and his daughter/DPOA was activated.  Patient/family decided to proceed with sign on plans for hospice.  In the meantime, while awaiting hospice placement, he was made comfort care overnight last night.  He passed aware today with daughters, partner and Hospice at bedside.       Patient was seen per nursing request as patient had expired.   Upon evaluation, patient was unresponsive with daughters at bedside.   Patient's pupils were fixed and nonreactive to light.  Patient was without heart or lung sounds upon ascultation.    Patient was without pulses x4 extremities.   Patient was pronounced as having expired today, 09/01/2022, at 1058.   Attending was notified.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Cytomegalovirus test positive, Death, Diarrhoea, Dyspnoea, Epstein-Barr virus test positive
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 8/14/2022   PRESENTING PROBLEM: Hyponatremia [E87.1] Sepsis (HCC) [A41.9] Severe sepsis (HCC) [A41.9, R65.20] AKI (acute kidney injury) (HCC) [N17.9] COVID-19 virus test result unknown [Z20.822]   HOSPITAL COURSE:   This is a 78 y.o. patient with a past medical history significant for Hepatocellular carcinoma, enrolled in a study; HTN, NICM, DM, persistent Afib, CAD, OSA, who presented to the ED with symptoms of fever, n/v and diarrhea, weakness and shortness of breath. In the ED he was afebrile. His lactic acid was elevated at 5.4, he received 4L IVF bolus in the ED. Blood cultures x 2 and UA obtained, and pt was treated with IV zosyn. Patient was admitted to the oncology service for further workup and treatment of sepsis with fevers.   During this admission, patient's initial infectious work up was negative though given persistent fevers, ID was consulted and ultimately ordered a Karius test 8/17/22 which was positive for EBV, CMV so patient was treated for viremia with gancyclovir though 8/27/22.  ID also felt patient had HLH, so that work up was initiated.  Dr. and ID did conclude patient developed checkpoint inhibitor (treatment) induced HLH given criteria met including but not limited to fevers, pancytopenia, BMBx on 8/24/22 with Hemophagocytosis, IL2 >29,000 and liver bx 8/26/22 consistent with HLH.  Patient was started on dex 10mg IV BID and then increased to 20mg IV BID which was suspected to have lead to encephalopathy and nightly dilerium.  Patient began to show progressive liver injury.  Immunology was consulted and was not convinced patient had HLH but did recommend IVIG BID started 8/26 and Anakinra TID, started 8/27 and cyclosporin started 8/29.  Unfortunately, patient continued to have liver failure and progressive decline.  Given no improvement in HLH, patient determined he did not want further care; however, he was deemed by then incompetent to make medical decisions and his daughter/DPOA was activated.  Patient/family decided to proceed with sign on plans for hospice.  In the meantime, while awaiting hospice placement, he was made comfort care overnight last night.  He passed aware today with daughters, partner and Hospice at bedside.       Patient was seen per nursing request as patient had expired.   Upon evaluation, patient was unresponsive with daughters at bedside.   Patient's pupils were fixed and nonreactive to light.  Patient was without heart or lung sounds upon ascultation.    Patient was without pulses x4 extremities.   Patient was pronounced as having expired today, 09/01/2022, at 1058.   Attending was notified.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: General physical health deterioration, Haemophagocytic lymphohistiocytosis, Heart sounds abnormal, Hepatic failure, Hyponatraemia
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 8/14/2022   PRESENTING PROBLEM: Hyponatremia [E87.1] Sepsis (HCC) [A41.9] Severe sepsis (HCC) [A41.9, R65.20] AKI (acute kidney injury) (HCC) [N17.9] COVID-19 virus test result unknown [Z20.822]   HOSPITAL COURSE:   This is a 78 y.o. patient with a past medical history significant for Hepatocellular carcinoma, enrolled in a study; HTN, NICM, DM, persistent Afib, CAD, OSA, who presented to the ED with symptoms of fever, n/v and diarrhea, weakness and shortness of breath. In the ED he was afebrile. His lactic acid was elevated at 5.4, he received 4L IVF bolus in the ED. Blood cultures x 2 and UA obtained, and pt was treated with IV zosyn. Patient was admitted to the oncology service for further workup and treatment of sepsis with fevers.   During this admission, patient's initial infectious work up was negative though given persistent fevers, ID was consulted and ultimately ordered a Karius test 8/17/22 which was positive for EBV, CMV so patient was treated for viremia with gancyclovir though 8/27/22.  ID also felt patient had HLH, so that work up was initiated.  Dr. and ID did conclude patient developed checkpoint inhibitor (treatment) induced HLH given criteria met including but not limited to fevers, pancytopenia, BMBx on 8/24/22 with Hemophagocytosis, IL2 >29,000 and liver bx 8/26/22 consistent with HLH.  Patient was started on dex 10mg IV BID and then increased to 20mg IV BID which was suspected to have lead to encephalopathy and nightly dilerium.  Patient began to show progressive liver injury.  Immunology was consulted and was not convinced patient had HLH but did recommend IVIG BID started 8/26 and Anakinra TID, started 8/27 and cyclosporin started 8/29.  Unfortunately, patient continued to have liver failure and progressive decline.  Given no improvement in HLH, patient determined he did not want further care; however, he was deemed by then incompetent to make medical decisions and his daughter/DPOA was activated.  Patient/family decided to proceed with sign on plans for hospice.  In the meantime, while awaiting hospice placement, he was made comfort care overnight last night.  He passed aware today with daughters, partner and Hospice at bedside.       Patient was seen per nursing request as patient had expired.   Upon evaluation, patient was unresponsive with daughters at bedside.   Patient's pupils were fixed and nonreactive to light.  Patient was without heart or lung sounds upon ascultation.    Patient was without pulses x4 extremities.   Patient was pronounced as having expired today, 09/01/2022, at 1058.   Attending was notified.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Pancytopenia, Pulse absent, Pupil fixed, Pyrexia
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 8/14/2022   PRESENTING PROBLEM: Hyponatremia [E87.1] Sepsis (HCC) [A41.9] Severe sepsis (HCC) [A41.9, R65.20] AKI (acute kidney injury) (HCC) [N17.9] COVID-19 virus test result unknown [Z20.822]   HOSPITAL COURSE:   This is a 78 y.o. patient with a past medical history significant for Hepatocellular carcinoma, enrolled in a study; HTN, NICM, DM, persistent Afib, CAD, OSA, who presented to the ED with symptoms of fever, n/v and diarrhea, weakness and shortness of breath. In the ED he was afebrile. His lactic acid was elevated at 5.4, he received 4L IVF bolus in the ED. Blood cultures x 2 and UA obtained, and pt was treated with IV zosyn. Patient was admitted to the oncology service for further workup and treatment of sepsis with fevers.   During this admission, patient's initial infectious work up was negative though given persistent fevers, ID was consulted and ultimately ordered a Karius test 8/17/22 which was positive for EBV, CMV so patient was treated for viremia with gancyclovir though 8/27/22.  ID also felt patient had HLH, so that work up was initiated.  Dr. and ID did conclude patient developed checkpoint inhibitor (treatment) induced HLH given criteria met including but not limited to fevers, pancytopenia, BMBx on 8/24/22 with Hemophagocytosis, IL2 >29,000 and liver bx 8/26/22 consistent with HLH.  Patient was started on dex 10mg IV BID and then increased to 20mg IV BID which was suspected to have lead to encephalopathy and nightly dilerium.  Patient began to show progressive liver injury.  Immunology was consulted and was not convinced patient had HLH but did recommend IVIG BID started 8/26 and Anakinra TID, started 8/27 and cyclosporin started 8/29.  Unfortunately, patient continued to have liver failure and progressive decline.  Given no improvement in HLH, patient determined he did not want further care; however, he was deemed by then incompetent to make medical decisions and his daughter/DPOA was activated.  Patient/family decided to proceed with sign on plans for hospice.  In the meantime, while awaiting hospice placement, he was made comfort care overnight last night.  He passed aware today with daughters, partner and Hospice at bedside.       Patient was seen per nursing request as patient had expired.   Upon evaluation, patient was unresponsive with daughters at bedside.   Patient's pupils were fixed and nonreactive to light.  Patient was without heart or lung sounds upon ascultation.    Patient was without pulses x4 extremities.   Patient was pronounced as having expired today, 09/01/2022, at 1058.   Attending was notified.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Sepsis, Urine analysis, Viraemia, Vomiting
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: MD  Admission Date: 8/14/2022   PRESENTING PROBLEM: Hyponatremia [E87.1] Sepsis (HCC) [A41.9] Severe sepsis (HCC) [A41.9, R65.20] AKI (acute kidney injury) (HCC) [N17.9] COVID-19 virus test result unknown [Z20.822]   HOSPITAL COURSE:   This is a 78 y.o. patient with a past medical history significant for Hepatocellular carcinoma, enrolled in a study; HTN, NICM, DM, persistent Afib, CAD, OSA, who presented to the ED with symptoms of fever, n/v and diarrhea, weakness and shortness of breath. In the ED he was afebrile. His lactic acid was elevated at 5.4, he received 4L IVF bolus in the ED. Blood cultures x 2 and UA obtained, and pt was treated with IV zosyn. Patient was admitted to the oncology service for further workup and treatment of sepsis with fevers.   During this admission, patient's initial infectious work up was negative though given persistent fevers, ID was consulted and ultimately ordered a Karius test 8/17/22 which was positive for EBV, CMV so patient was treated for viremia with gancyclovir though 8/27/22.  ID also felt patient had HLH, so that work up was initiated.  Dr. and ID did conclude patient developed checkpoint inhibitor (treatment) induced HLH given criteria met including but not limited to fevers, pancytopenia, BMBx on 8/24/22 with Hemophagocytosis, IL2 >29,000 and liver bx 8/26/22 consistent with HLH.  Patient was started on dex 10mg IV BID and then increased to 20mg IV BID which was suspected to have lead to encephalopathy and nightly dilerium.  Patient began to show progressive liver injury.  Immunology was consulted and was not convinced patient had HLH but did recommend IVIG BID started 8/26 and Anakinra TID, started 8/27 and cyclosporin started 8/29.  Unfortunately, patient continued to have liver failure and progressive decline.  Given no improvement in HLH, patient determined he did not want further care; however, he was deemed by then incompetent to make medical decisions and his daughter/DPOA was activated.  Patient/family decided to proceed with sign on plans for hospice.  In the meantime, while awaiting hospice placement, he was made comfort care overnight last night.  He passed aware today with daughters, partner and Hospice at bedside.       Patient was seen per nursing request as patient had expired.   Upon evaluation, patient was unresponsive with daughters at bedside.   Patient's pupils were fixed and nonreactive to light.  Patient was without heart or lung sounds upon ascultation.    Patient was without pulses x4 extremities.   Patient was pronounced as having expired today, 09/01/2022, at 1058.   Attending was notified.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Chest X-ray abnormal, Cough
Clinical narrative: I started with a scratchy throat, headache, body aches, and then the next day I still had the headaches, sore throat, cough, loss of appetite, no taste of smell. I contacted my doctor on Monday and she put me on PAXLOVID. I started taking that on the 9th of August for five days twice a day. I tested positive at home for 11 days straight.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Headache, Oropharyngeal pain, Pain, Pulmonary congestion
Clinical narrative: I started with a scratchy throat, headache, body aches, and then the next day I still had the headaches, sore throat, cough, loss of appetite, no taste of smell. I contacted my doctor on Monday and she put me on PAXLOVID. I started taking that on the 9th of August for five days twice a day. I tested positive at home for 11 days straight.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Throat irritation
Clinical narrative: I started with a scratchy throat, headache, body aches, and then the next day I still had the headaches, sore throat, cough, loss of appetite, no taste of smell. I contacted my doctor on Monday and she put me on PAXLOVID. I started taking that on the 9th of August for five days twice a day. I tested positive at home for 11 days straight.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Abortion spontaneous, Anencephaly, Exposure during pregnancy, Foetal heart rate abnormal, Prenatal screening test
Clinical narrative: Miscarriage- baby had no heartbeat- at 9 weeks (May 2021),  Miscarriage- baby had a heartbeat at 8 and 10 weeks, none at 12 weeks (September 2021)- testing done, Trisomy 15. Miscarriage at 20 weeks (May 2022)- baby had Anencephaly and wouldn't survive. Successful twin pregnancy and birth- 5/29/18 at 38 weeks. Successful singleton pregnancy and birth- 12/XX/19 at 39 weeks.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Trisomy 15
Clinical narrative: Miscarriage- baby had no heartbeat- at 9 weeks (May 2021),  Miscarriage- baby had a heartbeat at 8 and 10 weeks, none at 12 weeks (September 2021)- testing done, Trisomy 15. Miscarriage at 20 weeks (May 2022)- baby had Anencephaly and wouldn't survive. Successful twin pregnancy and birth- 5/29/18 at 38 weeks. Successful singleton pregnancy and birth- 12/XX/19 at 39 weeks.
Age: 22.0
Sex: F
Vaccine: HEP
Symptoms: Peripheral swelling, Pruritus
Clinical narrative: Patient experienced itching in hands and feet, progressed to swelling within an hour despite oral benadryl at home and Epi Pen.  Went to ER and was admitted overnight
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Agitation, Angiogram abnormal, Anticoagulant therapy, Basal ganglia infarction
Clinical narrative: Patient with COVID vaccinations who admitted with incidental positive COVID test.  Provider d/c note:  ""73 YO M with hx afib, HTN, CKD, hx SAH, dementia, who was admitted for acute on chronic right sided weakness. He had distant history of stroke with R sided weakness, but was more weak than usual. Admitted for stroke workup. He was also found to have incidental COVID-19 infection.  He was found on MRI to have acute to subacute infarct at the left corona radiata extending to the left basal ganglia.  CT angiogram showed multilevel stenosis without large vessel occlusion.  Neurology was consulted.  He was restarted on Eliquis, aspirin and statin.   His course was complicated by acute on chronic CHF and acute kidney injury.  Cardiology and Nephrology were consulted early in his hospital course for assistance managing those issues with improvement.  He also developed prolonged episode of confusion and agitation thought to be due to delirium in setting of advanced dementia.  Over time and with assistance of Seroquel this also improved significantly.  Discharge was delayed primarily due to agitation and mental status changes.  As these issues resolved he was thought to be a candidate for transition to SNF with therapy.  Discharged in good condition."