chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Epstein-Barr virus test, Laboratory test, Lung opacity, Myeloproliferative neoplasm, Pyrexia
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Splenic infarction, Splenomegaly, Ultrasound Doppler abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Bronchial wall thickening, COVID-19, Chest X-ray, Chest X-ray normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram abdomen, Computerised tomogram abdomen abnormal, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cough, Cytomegalovirus test, Echocardiogram, Echocardiogram normal, Epstein-Barr virus test
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Laboratory test, Lung opacity, Myeloproliferative neoplasm, Pyrexia, Rhinorrhoea
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test, SARS-CoV-2 test positive, Splenic infarction, Splenomegaly, Ultrasound Doppler
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Ultrasound Doppler abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/6/2022 Discharge Date: Oct 9, 2022  PRESENTING PROBLEM: Infarction of spleen [D73.5] Splenic infarct [D73.5] Splenic infarct in the setting of COVID infection Splenomegaly History of mild Von Willebrand syndrome Mild persistent asthma with mild exacerbation History of small lung nodule, remote history of smoking Abnormal left thigh lump HOSPITAL COURSE: Patient is a 74 y.o. female with past medical history significant for Von Willebrand syndrome, Lyme disease with chronic arthritis, former smoker, and mild intermittent ashtma on rescue inhaler who presented to emergency department with several months of cough, runny nose, "fevers", presented for abdominal pain and found to have splenic infarct and also COVID 19+. She has only had 1 J&J vaccine 11/2021.   Abdominal CT was done and showed a splenic infarct with splenomegaly.  Splenic infarct was thought to be 2/2 recent covid infection. She was seen by Hematology who felt in the absence of associated vessel thrombus, itself does not require anticoagulation. Data has shown no benefit with anticoagulation over aspirin for organ infarct. Given that she is already on ASA 81 mg daily long term, I recommended a short course of increased dose to 325 mg daily x 1 month, empirically in the setting of COVID+ and associated hypercoagulability with this. She conceded to two baby ASA tablets (= 162 mg) daily.  Echocardiogram was negative for cardio-embolic sources.   Hematology checked for other viral illnesses that can cause splenomegaly (EBV, CMV) and appropriate to screen for some hematologic conditions: 1) myeloproliferative condition with Jak2/MPN and BCR-ABL FISH. 2) PNH.  Most of these labs were pending at the time of discharge and will be followed up by Hematology who plan to see patient in their clinic outpatient.    Chest x-ray did not show evidence of lung infection. She has been on room air with O2 sat above 97%.  During the hospitalization, had a CT chest which showed Stable several a small 1-2 mm solid pulmonary nodule likely benign in etiology. New 3 mm groundglass nodule within the left upper lobe most likely due to infection and inflammation. Mild bronchial wall thickening due to infection or inflammation. No bronchiectasis. No focal airspace consolidation.  She was placed on a short course of prednisone due to her underlying asthma by Pulmonology.    A left UE soft tissue ultrasound shows an  Ill-defined focus of increased echogenicity within the subcutaneous fat of the anterior thigh correlates with the patient's palpable lump. Differential considerations would include a focus of fat inflammation versus a ill-defined hyperechoic mass. MRI LLE was recommended however,the patient opted to have it done outpatient with her PCP.   The patient was discharged in stable condition
Age: 69.0
Sex: M
Vaccine: COVID19, VARZOS
Symptoms: Acute kidney injury, Asthenia, Blood lactic acid, COVID-19, COVID-19 pneumonia
Clinical narrative: Admission Date: 10/6/2022 Discharge Date: Oct 17, 2022  PRESENTING PROBLEM: Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE: 69-year-old male with a past medical history significant for metastatic prostate cancer as well as chronic kidney disease stage 3 with bilateral nephrostomy tubes in place who presents due to generalized weakness as well as cough and fevers and was found to have COVID-19.   Although patient briefly required oxygen on admission the hospital, he was quickly able to wean off of oxygen.  His presentation was thought to be related to his COVID-19 infection the setting of his chronic comorbid conditions.  On admission, patient and family had already expressed consideration for hospice in the future but there hope was that the patient would have some improvement in his symptomatology and that he would be stronger to allow for him to return to home which is where he wanted to be.   As the patient had presented with acute on chronic kidney injury, IV fluids were provided and with this, patient's renal function did improve.  Off of fluids his renal function continue to improve.  Consult was placed to IR for consideration of exchange of his bilateral nephrostomy tubes as he normally does undergo monthly exchanges.   Although the patient initially presented hypertensive requiring addition of amlodipine morning 10/10 he was notably more hypotensive.  Etiology behind this was uncertain.  All antihypertensive agents were held and with 1 L of fluid provided, patient's blood pressures began to trend up.  Hemoglobin was stable.  Lactic acid was normal.  Patient was eventually able risk to be restarted on Imdur, hydralazine.  His Coreg continue to be held.   After being seen by PT/OT, patient was thought to warrant transition to subacute rehab.  Transition to subacute rehab was thought to be complicated by his COVID-19 status but eventually, a facility was found that was willing to accept the patient with his isolation precautions in place.  However, this facility was hours away from home.  Patient and wife also did not approve of the ratings the facility received on the Internet.  The refused the transfer to this facility which was the only accepting facility for the patient.  They decided to appeal the discharge initially.  However, they did not want this appeal.  Instead of going to rehab per our recommendations, they decided to go home instead and sign on with hospice in the outpatient setting.
Age: 69.0
Sex: M
Vaccine: COVID19, VARZOS
Symptoms: Cough, Haemoglobin normal, Hypertension, Pyrexia
Clinical narrative: Admission Date: 10/6/2022 Discharge Date: Oct 17, 2022  PRESENTING PROBLEM: Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE: 69-year-old male with a past medical history significant for metastatic prostate cancer as well as chronic kidney disease stage 3 with bilateral nephrostomy tubes in place who presents due to generalized weakness as well as cough and fevers and was found to have COVID-19.   Although patient briefly required oxygen on admission the hospital, he was quickly able to wean off of oxygen.  His presentation was thought to be related to his COVID-19 infection the setting of his chronic comorbid conditions.  On admission, patient and family had already expressed consideration for hospice in the future but there hope was that the patient would have some improvement in his symptomatology and that he would be stronger to allow for him to return to home which is where he wanted to be.   As the patient had presented with acute on chronic kidney injury, IV fluids were provided and with this, patient's renal function did improve.  Off of fluids his renal function continue to improve.  Consult was placed to IR for consideration of exchange of his bilateral nephrostomy tubes as he normally does undergo monthly exchanges.   Although the patient initially presented hypertensive requiring addition of amlodipine morning 10/10 he was notably more hypotensive.  Etiology behind this was uncertain.  All antihypertensive agents were held and with 1 L of fluid provided, patient's blood pressures began to trend up.  Hemoglobin was stable.  Lactic acid was normal.  Patient was eventually able risk to be restarted on Imdur, hydralazine.  His Coreg continue to be held.   After being seen by PT/OT, patient was thought to warrant transition to subacute rehab.  Transition to subacute rehab was thought to be complicated by his COVID-19 status but eventually, a facility was found that was willing to accept the patient with his isolation precautions in place.  However, this facility was hours away from home.  Patient and wife also did not approve of the ratings the facility received on the Internet.  The refused the transfer to this facility which was the only accepting facility for the patient.  They decided to appeal the discharge initially.  However, they did not want this appeal.  Instead of going to rehab per our recommendations, they decided to go home instead and sign on with hospice in the outpatient setting.
Age: 79.0
Sex: M
Vaccine: VARZOS
Symptoms: Dizziness, Mobility decreased, Pain in extremity
Clinical narrative: patient complaining of arm pain and not being able to fully move arm/extend arm. stated he was also dizzy and lightheaded. states no swelling or redness as injection site
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy, COVID-19, Computerised tomogram abnormal, Condition aggravated, Cough
Clinical narrative: Admission Date: 10/6/2022 Discharge Date: 10/17/2022  PRESENTING PROBLEM: Pneumonia, unspecified organism   HOSPITAL COURSE: 76 y/o male s/p single right lung transplant (4/26/2016) presents with increased DOE, fatigue and cough. COVID positive 9/15, s/p MAB 9/17. Initally felt better and has since progressively worsened. CT consistent with viral process. Initially started on prednisone burst, broad spectrum abx, but Bronch cultures completed 10/6 concerning for mucor. Steroids stopped, ID consulted, recommended posaconazole. Repeat TBBx 10/12 with A1B0, evidence of organizing pna. High dose prednisone started with significant improvement in symptoms. MMF resumed at 250mg BID given A1 biopsy, with goal of 500mg BID. Patient was evaluated by pulmonary rehab and qualified for 2L home oxygen therapy with activity. Will plan to dc home today with home nursing, therapy, follow-up labs Thursday, clinic visit next week.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Culture, Dyspnoea exertional, Fatigue, Organising pneumonia, SARS-CoV-2 test positive
Clinical narrative: Admission Date: 10/6/2022 Discharge Date: 10/17/2022  PRESENTING PROBLEM: Pneumonia, unspecified organism   HOSPITAL COURSE: 76 y/o male s/p single right lung transplant (4/26/2016) presents with increased DOE, fatigue and cough. COVID positive 9/15, s/p MAB 9/17. Initally felt better and has since progressively worsened. CT consistent with viral process. Initially started on prednisone burst, broad spectrum abx, but Bronch cultures completed 10/6 concerning for mucor. Steroids stopped, ID consulted, recommended posaconazole. Repeat TBBx 10/12 with A1B0, evidence of organizing pna. High dose prednisone started with significant improvement in symptoms. MMF resumed at 250mg BID given A1 biopsy, with goal of 500mg BID. Patient was evaluated by pulmonary rehab and qualified for 2L home oxygen therapy with activity. Will plan to dc home today with home nursing, therapy, follow-up labs Thursday, clinic visit next week.
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood test, Computerised tomogram head normal, Dyskinesia, Electrocardiogram normal, Hypertension
Clinical narrative: I received the Pfizer Bivalent booster for COVID-19 and a flu shot at 11 AM on 10/18/2022. At between 8 and 9 PM that night, I experienced an unusual health incident. I was lying on the sofa, and as I got up to go to the bathroom, I lost control of most of my body. My body shuddered and my arms and legs flailed involuntarily. The muscles in my neck and jaw also felt extremely tight. I did not feel weak or faint. Thankfully, I was able to grab hold of the walls and other surfaces on my way to the bathroom, so that I wouldn't fall. After using the bathroom, I called my daughter to tell her about the incident. Between the time I got up to use the bathroom and the time I finished my call to my daughter, at least about 20 minutes had passed, though I'm not sure how long the episode lasted. By the time I finished talking to my daughter, the episode had subsided. I didn't feel well, but I had taken some Tylenol, gotten a heating pad, and gone to bed. By then, I was no longer flailing. I wanted to see my PCP, but he was unavailable, so I ended up going to the ER at about noon on 10/20/2022. While I was at the ER, they checked my vitals at least 3 times and did 3 different blood draws. They also conducted a CAT scan of my brain and an EKG.  No anomalies were found in the CAT scan or the EKG, though my BP was high. The findings were inconclusive; they figured that I had possibly had a seizure, a panic attack, or a transient ischaemic attack. They advised me to see my PCP. Since my PCP was unavailable for more than a week, I decided that I needed to find another PCP.  I plan to do this probably on 10/24/2022. Since 10/18/2022, I have not had another such incident, but I would still like to find out what triggered it and if I need further treatment.
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Malaise, Motor dysfunction, Muscle tightness, Tremor
Clinical narrative: I received the Pfizer Bivalent booster for COVID-19 and a flu shot at 11 AM on 10/18/2022. At between 8 and 9 PM that night, I experienced an unusual health incident. I was lying on the sofa, and as I got up to go to the bathroom, I lost control of most of my body. My body shuddered and my arms and legs flailed involuntarily. The muscles in my neck and jaw also felt extremely tight. I did not feel weak or faint. Thankfully, I was able to grab hold of the walls and other surfaces on my way to the bathroom, so that I wouldn't fall. After using the bathroom, I called my daughter to tell her about the incident. Between the time I got up to use the bathroom and the time I finished my call to my daughter, at least about 20 minutes had passed, though I'm not sure how long the episode lasted. By the time I finished talking to my daughter, the episode had subsided. I didn't feel well, but I had taken some Tylenol, gotten a heating pad, and gone to bed. By then, I was no longer flailing. I wanted to see my PCP, but he was unavailable, so I ended up going to the ER at about noon on 10/20/2022. While I was at the ER, they checked my vitals at least 3 times and did 3 different blood draws. They also conducted a CAT scan of my brain and an EKG.  No anomalies were found in the CAT scan or the EKG, though my BP was high. The findings were inconclusive; they figured that I had possibly had a seizure, a panic attack, or a transient ischaemic attack. They advised me to see my PCP. Since my PCP was unavailable for more than a week, I decided that I needed to find another PCP.  I plan to do this probably on 10/24/2022. Since 10/18/2022, I have not had another such incident, but I would still like to find out what triggered it and if I need further treatment.
Age: 14.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Hyperhidrosis, Loss of consciousness, Pallor
Clinical narrative: Patient received 2 vaccinations and passed out during administration of second vaccination, which was the influenza vaccine. Patient regained consciousness within about 1 minute. Patient remained in upright position with feet up and was pale and experiencing diaphoresis for about 5 to 10 minutes. Pt seemed to make full recovery after about 15 minutes, during which time mother administered water and candy
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired vaccine administered to patient. No adverse signs or symptoms
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Given novavax, patient was supposed to receive bivalent booster
Age: 0.58
Sex: F
Vaccine: COVID19
Symptoms: Dermatitis diaper, Diarrhoea, Nasal mucosal discolouration
Clinical narrative: Patient showed no noticeable side effects the day after vaccination. Starting on 10/7, she had very thick, green snot for approximately one week. Starting on 10/12, she started getting a serious diaper rash after multiple bouts of diarrhea. She experienced at least 6 diarrhea episodes each day until 10/21. We took patient to the doctor on 10/18 to get her checked out and to ensure that she was as healthy as possible despite the diarrhea and diaper rash. The doctor saw no other issues and told us to come back in one week if she was still experiencing the same amount of diarrhea. Dr. gave us a prescription for some medicated diaper cream, although it was mainly to treat diaper rash due to a yeast infection, which was not observed.
Age: 62.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Feeling abnormal, Pharyngeal swelling
Clinical narrative: Patient stated after administration of both vaccines his throat felt weird and swollen.
Age: 86.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Extra dose administered
Clinical narrative: PATIENT RECEIVED TWO SETS OF IDENTICAL VACCINES. RECEIVED FLUZONE HD AND PFIZER BIVALENT ON 10/14/22; AND THEN AGAIN ON 10/20/22; WAS PART OF A VACCINE CLINIC HOSTED AT ASSISTED LIVING FACILITY. NO ADVERSE REACTION HAD BEEN REPORTED. PHARMACY REALIZED ERROR WHEN BILLING THE SHOTS FROM 10/20/22 AND NOTIFIED ASSISSTED LIVING FACILITY AND PATIENTS PRIMARY CARE PHYSICIAN.
Age: 19.0
Sex: F
Vaccine: FLUR4
Symptoms: Syncope
Clinical narrative: Patient collapsed shortly after given vaccination; has a history of syncope due to needle phobia and stated that this has happened in the past during blood draws. EMS was called and patient had normal vitals upon being checked. Epinephrine was not administered.
Age: 60.0
Sex: F
Vaccine: COVID19, VARZOS
Symptoms: Vaccination site pain
Clinical narrative: My arm was hurting on my vaccination site. I already had migraines and knee problems. Two days after the pain got way worse.
Age: 14.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Dizziness, Immunisation reaction, Laboratory test, Loss of consciousness, Malaise
Clinical narrative: Pt arose to get ready for work at 6:30 in the morning and didnt feel well. She went to get ready for work and went to  bathroom and became dizzy and passed out. Mom and dad came in and mom became dizzy as well and passed out. Pt, mom and dad went to ER.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Given Novavax instead of bivalent pfizer vaccine.
Age: 17.0
Sex: F
Vaccine: FLUC4
Symptoms: Throat tightness, Urticaria
Clinical narrative: patient had hives and tightness of throat, went to ER twice. will follow up with allergist
Age: 45.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product preparation issue
Clinical narrative: The patient received 0.3 ml of undiluted Pediatric Pfizer (orange cap) vaccine instead of the Pfizer (gray cap).
Age: 55.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: The patient received Pfizer BIVALANT instead of Pfizer MONOVALENT; no reaction observed
Age: 17.0
Sex: F
Vaccine: HPV9, IPV
Symptoms: Exposure during pregnancy
Clinical narrative: Minor was pregnant at the time of vaccination. Estimated delivery date is 05/21/2023.
Age: 33.0
Sex: F
Vaccine: FLUR4
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth
Clinical narrative: Patient reports morning following injection a quarter size reaction manifested below injection site. Reaction site described as hot to touch and painful, with no change in mobility or arm function. Patient indicated following day reaction site was raised, patient was seen by urgent care facility and prescribed an antibiotic for possible cellulitis. Patient reports improvement in redness and pain.
Age: 77.0
Sex: F
Vaccine: UNK
Symptoms: Asthenia, Headache, Pain
Clinical narrative: Very weak for the next 12hours. Body aches, headache
Age: 55.0
Sex: F
Vaccine: FLUC4
Symptoms: Injection site erythema, Injection site pruritus, Injection site scab, Injection site swelling
Clinical narrative: Small red raised area around the site of injection.  Injection puncture has a scab.  The patient noticed the next day.  She reports it does not hurt but itches a bit.  She has been self treating by rubbing an alcohol swab on it.  I told her to wash the area with soap and warm water instead because the alcohol may be contributing to dryness and itchiness.
Age: 25.0
Sex: M
Vaccine: COVID19-2, FLUC4
Symptoms: Periorbital swelling
Clinical narrative: Patient says left eye is getting puffy. Recommended Benadryl to see if it is relieved with it. Instructed patient to contact health care provider tomorrow if it does not get better, and if symptoms get worse to see medical attention tonight or call emergency services if trouble breathing
Age: 17.0
Sex: F
Vaccine: HPV9
Symptoms: Exposure during pregnancy
Clinical narrative: Minor pregnant at the time of vaccine administration. Estimated delivery date 06/29/2023.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chills, Headache, Myofascial pain syndrome, Nausea, Neck pain
Clinical narrative: Intense headache, neck ache, body aches (myofascial) and nausea for ~Spiked a fever twice. Chills. The most intense headache I've ever had, about 7/10
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain, Pyrexia
Clinical narrative: Intense headache, neck ache, body aches (myofascial) and nausea for ~Spiked a fever twice. Chills. The most intense headache I've ever had, about 7/10
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Aneurysm, Blood immunoglobulin M increased, Blood phosphorus decreased, Blood potassium decreased, Blood sodium decreased
Clinical narrative: After first shot, I had severe fatigue, exercise intolerance, migraines, dizziness.  Afrer second shot, I had the same fatigue, exercise intolerance, migraine, dizziness, tachycardia, electrolyte imbalances, pins and needles all over my skin, light and sound sensitivity, GERD.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dizziness, Electrolyte imbalance, Exercise tolerance decreased, Fatigue, Gastrooesophageal reflux disease
Clinical narrative: After first shot, I had severe fatigue, exercise intolerance, migraines, dizziness.  Afrer second shot, I had the same fatigue, exercise intolerance, migraine, dizziness, tachycardia, electrolyte imbalances, pins and needles all over my skin, light and sound sensitivity, GERD.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hyperacusis, Idiopathic intracranial hypertension, Intracranial pressure increased, Magnetic resonance imaging, Migraine
Clinical narrative: After first shot, I had severe fatigue, exercise intolerance, migraines, dizziness.  Afrer second shot, I had the same fatigue, exercise intolerance, migraine, dizziness, tachycardia, electrolyte imbalances, pins and needles all over my skin, light and sound sensitivity, GERD.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Palpitations, Paraesthesia, Photophobia, Postural orthostatic tachycardia syndrome, Scan with contrast
Clinical narrative: After first shot, I had severe fatigue, exercise intolerance, migraines, dizziness.  Afrer second shot, I had the same fatigue, exercise intolerance, migraine, dizziness, tachycardia, electrolyte imbalances, pins and needles all over my skin, light and sound sensitivity, GERD.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Tachycardia, Transverse sinus stenosis
Clinical narrative: After first shot, I had severe fatigue, exercise intolerance, migraines, dizziness.  Afrer second shot, I had the same fatigue, exercise intolerance, migraine, dizziness, tachycardia, electrolyte imbalances, pins and needles all over my skin, light and sound sensitivity, GERD.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Bell's palsy, Blood test, Computerised tomogram head normal
Clinical narrative: Bell's Palsy - Emergency Room Visit - still in treatment (physical therapy, PO steroids, anti-viral)
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Paraesthesia, Rash pruritic
Clinical narrative: Tingling sensation moving up the arm/shoulder, itching rash on upper arm/shoulder/neck, improved with one dose 25mg diphenhydramine
Age: 2.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product preparation issue
Clinical narrative: No adverse events, was an error in dilution, so the patient received more dose. They administer 0.2ml of the vial, without dilution
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: This client  had vaccines registered on the local website as being given on January 2022  so we confirmed this with the client  Client verified that he did not have  a vaccine since that date  So we were ok to vaccinate  After vaccine was given  a new record became available which shown client last vaccine date was 9/22/22 one month prior?  Client did not remember getting this vaccine  Client?s provider also did not remember this senior citizen receiving this last dose on 9/22/2022 This Client was observed for 30 minutes with no adverse response
Age: 7.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product preparation issue
Clinical narrative: patient was injected with vaccine from undiluted vial.  patient got approximated 3 times the recommended dose.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Hypertension
Clinical narrative: Dizzy and high blood pressure
Age: 42.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Dyspnoea, Oxygen saturation decreased, Productive cough, Pyrexia
Clinical narrative: I tested positive for Covid-19. I had shortness of breath, with a HR of 135 with walking up my stairs. My O2 dropped to 91%.  I am an avid backcountry hiker, so these vitals were not typical. Lots of sinus congestion and sneezing. Sputum production was regular. I had a fever for 4 days straight. I finally didn't get awakened by coughing at night on the night of 10/19/22.
Age: 42.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sinus congestion, Sleep disorder, Sneezing
Clinical narrative: I tested positive for Covid-19. I had shortness of breath, with a HR of 135 with walking up my stairs. My O2 dropped to 91%.  I am an avid backcountry hiker, so these vitals were not typical. Lots of sinus congestion and sneezing. Sputum production was regular. I had a fever for 4 days straight. I finally didn't get awakened by coughing at night on the night of 10/19/22.
Age: 57.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site bruising
Clinical narrative: A lot of bleeding at time of immunization and black and blue bruising that has lasted for more than 7 days.   The patient will follow-up with her primary doctor.
Age: 10.0
Sex: F
Vaccine: UNK
Symptoms: Incorrect route of product administration
Clinical narrative: Tubersol 0.1 ml was inadvertently injected IM into patient's right deltoid.
Age: 28.0
Sex: M
Vaccine: FLUC4
Symptoms: Dizziness, Pallor, Presyncope
Clinical narrative: When screening the patient, patient reported that he previously have experienced dizziness/fainting with other vaccines in the past (meningitis and influenza). After administering vaccine, the patient experienced dizziness and nearly fainted; the patient's skin became pale.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, COVID-19, COVID-19 pneumonia, Cardiac arrest, Death
Clinical narrative: tested positive for covid on       2-4-22      , deceased on        3-2-22    .  Admitted at local hospital on     2-13-22     with resp failure, covid pneumonia and abd pain.    Notes show she was transferred to alternate hospital by air ambulance and underwent cardiac arrest.  on mech ventilation, hyperkalema and for dialysis.  sx resp failure, cardiac arrest and hyperkalemia.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Dialysis, Hyperkalaemia, Mechanical ventilation, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: tested positive for covid on       2-4-22      , deceased on        3-2-22    .  Admitted at local hospital on     2-13-22     with resp failure, covid pneumonia and abd pain.    Notes show she was transferred to alternate hospital by air ambulance and underwent cardiac arrest.  on mech ventilation, hyperkalema and for dialysis.  sx resp failure, cardiac arrest and hyperkalemia.