chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Adverse reaction, Chills, Immediate post-injection reaction, Injection site pain, Paraesthesia
Clinical narrative: Immediately after the shot I did develop some pain in the shoulder and a little tingling in the left hand. This was not a concern to me . I figured that was normal. Within six hours I started to develop tingling in my feet which moved up to my legs through the night and over the course of the next couple days. I experienced tingling, twitching, mild tremors in my quads. Sunday morning I had two bouts of chills. The tingling and the twitching in my feet and legs were bothersome: Ibuprofen and Tylenol seemed to help.. Last night I decided not to take any medicine to see if I continue to have this response. I took melatonin and while in bed I felt that my symptoms were improving. I woke up with minimal neurological involvement  (still some twitching and tingling , though not painful,  but noticeable. I believe I?m improving.  I did make an appointment virtually with the Ireland Army health clinic today at 11 AM. My doctor was not available so I was lined up with another Primary Care Provider. He told me he believes this was an adverse reaction to the vaccine and since I?m starting to see some improvement he told me to only go back if I started to get worse. He felt that I would continue to improve over time.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: Immediately after the shot I did develop some pain in the shoulder and a little tingling in the left hand. This was not a concern to me . I figured that was normal. Within six hours I started to develop tingling in my feet which moved up to my legs through the night and over the course of the next couple days. I experienced tingling, twitching, mild tremors in my quads. Sunday morning I had two bouts of chills. The tingling and the twitching in my feet and legs were bothersome: Ibuprofen and Tylenol seemed to help.. Last night I decided not to take any medicine to see if I continue to have this response. I took melatonin and while in bed I felt that my symptoms were improving. I woke up with minimal neurological involvement  (still some twitching and tingling , though not painful,  but noticeable. I believe I?m improving.  I did make an appointment virtually with the Ireland Army health clinic today at 11 AM. My doctor was not available so I was lined up with another Primary Care Provider. He told me he believes this was an adverse reaction to the vaccine and since I?m starting to see some improvement he told me to only go back if I started to get worse. He felt that I would continue to improve over time.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia
Clinical narrative: Patient described feeling tingling in the ears and nose. After 15-20 minutes the feeling subsided. Blood pressure was check and was normal
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Vision blurred
Clinical narrative: Patient says she experienced blurry vision. EMS attended and released. Patient recovered.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Psoriasis
Clinical narrative: Psoriasis outbreak on soles of  feet and palms of hands ,never before have I had psoriasis .
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Pain in extremity, Throat tightness
Clinical narrative: The evening she received the vaccines she had some throat tightness, next day had sore arm.  Three days later she described tightness in her chest that has not resolved
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19
Clinical narrative: Hospitalized for COVID illness
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Gastrointestinal disorder, Headache, Pain in extremity
Clinical narrative: Arm pain, crazy stomach, leg pain, and headaches.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Axillary pain, Chills, Epistaxis, Fatigue
Clinical narrative: Fever, chills, body and joint aches, fatigue and lymph node enlargement and tenderness in the axilla on the shot side. Lasting 24 hours except for the lymph nodes which are still enlarged and painful.  Nosebleed x 2 on 9/5.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy, Pain, Pyrexia
Clinical narrative: Fever, chills, body and joint aches, fatigue and lymph node enlargement and tenderness in the axilla on the shot side. Lasting 24 hours except for the lymph nodes which are still enlarged and painful.  Nosebleed x 2 on 9/5.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Food refusal, Mental status changes, SARS-CoV-2 test positive
Clinical narrative: Family calling EMS d/t change in mental status. Pt has been refusing to eat. Temp
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Chest X-ray abnormal, Erythema, Joint swelling, Laboratory test
Clinical narrative: Intense Swelling in both legs, ankles, feet with severe pain, itching, burning, which resulted in Red knots/nodules under the skin on both lower legs that were hot to the touch. I went to the Emergency Room on March 22nd only to be given an X-ray. I attempted to go and get my 2nd Dose of Moderna at the Community Vaccine Site on March 30th, 2021 and was told they recommend me not move forward with the 2nd dose due to the swelling, tenderness and redness that 2 different staff observed because they couldn't guarantee that what was going on wasn't blood clots that could prove to be fatal due to my body's reaction to the 1st dose.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Nodule, Pain, Peripheral swelling, Pruritus, Skin discolouration
Clinical narrative: Intense Swelling in both legs, ankles, feet with severe pain, itching, burning, which resulted in Red knots/nodules under the skin on both lower legs that were hot to the touch. I went to the Emergency Room on March 22nd only to be given an X-ray. I attempted to go and get my 2nd Dose of Moderna at the Community Vaccine Site on March 30th, 2021 and was told they recommend me not move forward with the 2nd dose due to the swelling, tenderness and redness that 2 different staff observed because they couldn't guarantee that what was going on wasn't blood clots that could prove to be fatal due to my body's reaction to the 1st dose.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Skin warm, Tenderness, Ultrasound Doppler normal, X-ray
Clinical narrative: Intense Swelling in both legs, ankles, feet with severe pain, itching, burning, which resulted in Red knots/nodules under the skin on both lower legs that were hot to the touch. I went to the Emergency Room on March 22nd only to be given an X-ray. I attempted to go and get my 2nd Dose of Moderna at the Community Vaccine Site on March 30th, 2021 and was told they recommend me not move forward with the 2nd dose due to the swelling, tenderness and redness that 2 different staff observed because they couldn't guarantee that what was going on wasn't blood clots that could prove to be fatal due to my body's reaction to the 1st dose.
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: My documentation indicates that this 13 year old boy got Moderna vaccine dose #1 (0.5 ml, lot # 005C21A, left arm, intramuscular injection) as part of a drive-through mobile vaccine event.  Given I know well that children are able to receive only the Pfizer vaccine, I believe it likely that he received the Pfizer vaccine and that somehow my error was a mix-up in the documentation (perhaps an adult in the same car received Moderna and I mixed up the consents).
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea
Clinical narrative: Chest pain and shortness of breath.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Headache, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: HEADACHE, NASAL DRAINAGE
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: POSITIVE FOR COVID
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Arthritis, Fatigue, Headache, Inflammation
Clinical narrative: Had one dose in each shoulder, 1st in Feb, 2nd in Mar. Had mild fever, tiredness, headache, joint pain. Arm was sore for 5 days after 2nd shot.  Afterward developed persistent inflammation and discomfort in both shoulder joints.  Arm painful to raise above shoulder height. Has partially resolved but discomfort remains.
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Musculoskeletal discomfort, Pain, Pain in extremity, Pyrexia, X-ray abnormal
Clinical narrative: Had one dose in each shoulder, 1st in Feb, 2nd in Mar. Had mild fever, tiredness, headache, joint pain. Arm was sore for 5 days after 2nd shot.  Afterward developed persistent inflammation and discomfort in both shoulder joints.  Arm painful to raise above shoulder height. Has partially resolved but discomfort remains.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Epilepsy, Generalised tonic-clonic seizure
Clinical narrative: Grand Mal Seizure, unknown, follow up needed.
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Syncope
Clinical narrative: Patient filled out her VAR and stated she has had no reaction to vaccines before. She states that she has a needle phobia. After receiving her vaccine, she felt dizzy and fainted twice. EMS was called and took over the situation. The patient was walked away at her own free will.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Cardiac disorder, Dizziness, Heart rate increased
Clinical narrative: Heart problems, rapid heart beat, dizziness, weakness.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Exposure during pregnancy, Hypoaesthesia
Clinical narrative: Patient refers with numbness in the left arm then it manifested to the right arm it continues after the first dose since day 17/08/21. Patient with 5 months of pregnancy is recommended to visit her medical doctor to tell him a her symptoms.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Deafness, Ear discomfort, Tinnitus, Vertigo
Clinical narrative: Vertigo, fullness in ears, hearing loss, tinnitus  Vertigo -- has been "strong" to slight --  have had 17 different episodes now Fullness in ears -- I have not been able to clear my ears since 4-29-21...
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Aspergillus test, Atelectasis, Bacterial test, Blood albumin, Blood beta-D-glucan
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Blood immunoglobulin G decreased, Blood lactate dehydrogenase, Blood lactic acid normal, C-reactive protein increased, COVID-19
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram abdomen, Computerised tomogram thorax abnormal, Cytomegalovirus test
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Differential white blood cell count, Dyspnoea, Fibrin D dimer, Fungal test, Gram stain
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: HIV test, Hyperhidrosis, Inflammation, Interferon gamma level, Legionella test
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Lymphadenopathy, Mycobacterium test negative, Pleural effusion, Pneumocystis test
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia, Polymerase chain reaction, Procalcitonin, Productive cough, Prothrombin time
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory viral panel, SARS-CoV-2 test positive, Scan with contrast abnormal, Sepsis
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Serum ferritin, Sputum culture, Tachycardia, Tachypnoea, Viral test
Clinical narrative: 52 Y male with PMHx of chronic lymphoid leukemia (in remission since 2/2021), gout, anxiety, COVID-19 positive on 8/5/2021, who presented to ED on 8/31/2021 with worsening cough, fever, and SOB. Patient has had these progressive symptoms over the last 1-2 months. Patient met sepsis criteria presenting with fever 100.7F, tachycardia HR 138, and tachypnea RR 48, lactate 2.1-- >0.8 (after IV NaCl). He was positive for COVID-19 on 8/5/2021 after ~1 month of persistent productive cough, SOB, fevers (having tested negative on 7/16/21). Patient recently completed 2 courses of levofloxacin in July and August (8/26-8/30) for presumed CAP. On exam however patient is non-toxic and breathing comfortably on RA. Patient is fully vaccinated with Moderna COVID-19 vaccine since 4/2021 and has been in remission from CLL since 2/2021. CXR 8/31 with increasing opacity primarily in the right upper lung. Extensive workup initiated to r/o infectious vs malignant sources. Workup consisted of sputum cultures, sputum gram stain, AFB smear and culture, beta-d-glucan, aspergillus antigen, legionella antigen urine, procalcinotin, coccidiodes AB serum, TB gamma interferon, albumin, CRP, D-Dimer, PT, LDH, ferritin, HIV, CMV, PJP.    CAP coverage started on 8/31 with ceftriaxone and doxycycline. Case was discussed with with ID, Pulm, and Onc. Imaging findings suggested COVID-19 process rather than opportunistic infection, so recommended CT contrast of chest/abd/pelvis. 9/1 CT showed progression with 1. Overall worsening multifocal groundglass infiltrates/pneumonia, particularly in the upper lobes compared with the previous chest CT. 2. New finding of trace bilateral pleural effusions with some relatively of modest suspected adjacent compressive atelectasis in the dependent left lung base. 3. No new developing intrathoracic or abdominal bulky adenopathy. No new localized intra-abdominal inflammatory process demonstrated. Patient has allergy to contrast but consented to CT with benadryl for relief of symptoms (had had multiple CTs done in past).  9/1 COVID-19 test returned positive, cycle threshold 30.7 and 33.1 per ID. Given still COVID-19 positive, it is possible he has not fully cleared the virus. Per Onc, less concerned for recurrent CLL. Patient continued to be non toxic on exam, breathing on room air, but had sweats and fevers overnight 9/1-9/2. Still unclear what is leading to prolonged symptoms. Differential includes viral, fungal, bacterial - less likely HSP or COP. Respiratory viral panel negative. AFB smear negative. Remaining workup pending.    # COVID-19 Pneumonia vs Community-Acquired Pneumonia - Complete abx course for possible bacterial co-infection: Vantin/Doxycycline - Repeat CXR in 3-4 weeks to document resolution, if not clear, refer to Pulm   # h/o Chronic Lymphocytic Leukemia (remission since 2/2021) # Low IgG  Reason for Hospital Admission (Admitting Diagnosis):  PNEUMONIA
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Painful respiration
Clinical narrative: Pt complained of mild SOB and chest pain within about 10 min post vaccination. Chest pain with breathing, A&Ox3, VS on EMS arrival T-N/A, P- 110-120, R 14-16, BP-157/88. Taken to EMD.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Communication disorder, Confusional state, Cough, Dyspnoea
Clinical narrative: SOB and cough x 4 weeks. EMS found pt to be saturating 79% on room air with a fever of 101. Pt confused/ poor historian
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: SOB and cough x 4 weeks. EMS found pt to be saturating 79% on room air with a fever of 101. Pt confused/ poor historian
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Headache, Musculoskeletal stiffness
Clinical narrative: Headache...muscle stiffness
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Injected limb mobility decreased, Muscular weakness, Pain in extremity
Clinical narrative: After my vaccination and  leaving Pharmacy, I was experiencing pain in my left arm . I assumed it was from the injection, and that the pain would go away. I noticed the pain wasn't going away and that it was hard to raise my left arm. I'm experiencing dull pain, weakness in my arm, and a reduced range of motion. I have not contacted a health care provider because I keep thinking it's going to get better, but I realize it's still the same.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Pharyngeal paraesthesia
Clinical narrative: Patient reported she felt "tingling of the throat" a "few minutes" after her vaccination. Patient reported she did not  report it while in observation. Patient reported the tingling went away on its own.
Age: 11.0
Sex: F
Vaccine: HPV9, MENB, TDAP
Symptoms: Fatigue, Headache, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Patient was here for her 11 yr check, she was due for her Tdap, Hpv9 and MCV4, the patient was given Men-B.  This was found upon doing the transfer report.  I notified our Nurse Manager as well as the  provider who Pt saw on 09/02, NP.  NP contacted mom around 2:17pm on 09/03 to let her know she was given the wrong vaccine. Mom reported soreness of the injection site.  Around 4pm on 09/03 the Health Department contacted our office to let us know mom called to report Pt wasn't feeling well, no specific symptoms were reported.  I spoke with mother today, she states Pt was feeling a little more tired than normal, had a headache, and redness and swelling at the injection site. Pt is feeling better now.
Age: 11.0
Sex: F
Vaccine: HPV9, MENB, TDAP
Symptoms: Malaise, Wrong product administered
Clinical narrative: Patient was here for her 11 yr check, she was due for her Tdap, Hpv9 and MCV4, the patient was given Men-B.  This was found upon doing the transfer report.  I notified our Nurse Manager as well as the  provider who Pt saw on 09/02, NP.  NP contacted mom around 2:17pm on 09/03 to let her know she was given the wrong vaccine. Mom reported soreness of the injection site.  Around 4pm on 09/03 the Health Department contacted our office to let us know mom called to report Pt wasn't feeling well, no specific symptoms were reported.  I spoke with mother today, she states Pt was feeling a little more tired than normal, had a headache, and redness and swelling at the injection site. Pt is feeling better now.
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dry throat
Clinical narrative: 6mins post vaccination, pt c/o dry throat and chest pain.   Vitals: @10:05 BP 130/85, HR 67, RR 15, Sat 100% on RA Pt brought to triage area.  Pt sat in chair, no swelling or SOB.  NP at chairside.  Pt sat in triage for 15min.  symptoms resolved.  Pt stable and released from the vaccination site.
Age: 40.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Parosmia
Clinical narrative: I smell what smells like cigarettes smoke when no-one else can. multiple times a day, different time, settings, and locations. a few days of this are logged waiting for my PCM to make a decision on next step.
Age: 47.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Balance disorder, Blood urea decreased, Disorientation, Dizziness, Fatigue
Clinical narrative: 11 days after first injection, awoke with vertigo, nausea, nystagmus.  Dizzy, lightheaded, brain fog, disorientation, blurry vision and fatigue. Saw family physician, prescribed antivert and referral to vestibular therapy.  Nearly resolved by the beginning of week 4.  Received the second dose on May 5, 2021 and exactly 11 days later, all the above symptoms returned and have been persisting since this time on a daily basis.  Brain fog and fatigue have diminished but the dizziness and imbalance as well as the blurry vision have persisted. Continue with vestibular rehab, treat with Dr. and taken various supplements and medications.
Age: 47.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Feeling abnormal, Full blood count normal, Metabolic function test, Nausea, Nystagmus
Clinical narrative: 11 days after first injection, awoke with vertigo, nausea, nystagmus.  Dizzy, lightheaded, brain fog, disorientation, blurry vision and fatigue. Saw family physician, prescribed antivert and referral to vestibular therapy.  Nearly resolved by the beginning of week 4.  Received the second dose on May 5, 2021 and exactly 11 days later, all the above symptoms returned and have been persisting since this time on a daily basis.  Brain fog and fatigue have diminished but the dizziness and imbalance as well as the blurry vision have persisted. Continue with vestibular rehab, treat with Dr. and taken various supplements and medications.
Age: 47.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Vertigo, Vision blurred
Clinical narrative: 11 days after first injection, awoke with vertigo, nausea, nystagmus.  Dizzy, lightheaded, brain fog, disorientation, blurry vision and fatigue. Saw family physician, prescribed antivert and referral to vestibular therapy.  Nearly resolved by the beginning of week 4.  Received the second dose on May 5, 2021 and exactly 11 days later, all the above symptoms returned and have been persisting since this time on a daily basis.  Brain fog and fatigue have diminished but the dizziness and imbalance as well as the blurry vision have persisted. Continue with vestibular rehab, treat with Dr. and taken various supplements and medications.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Patient presented to the hospital on 9/5/21 with worsening dyspnea that had been going on for a month. He tested positive for COVID on 9/5/21. He is currently still hospitalized and on 7L of Oxygen
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Dyspnoea, Hypertension, Pain, SARS-CoV-2 test positive
Clinical narrative: dyspnea, positive COVID test, HTN, aches, non-small cell CA, taking chemo
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal hernia, Abdominal pain, Abdominal wall oedema, Acute respiratory failure, Anticoagulant therapy
Clinical narrative: Patient hospitalized with COVID-19;  Still hospitalized (ICU);  Fully vaccinated.   Admission Note H&P:  HISTORY OF PRESENT ILLNESS: Patient is a 73-year-old female with past medical history of diastolic CHF, hypertension, hyperlipidemia, seizure disorder s/p VNS, coronary artery disease status post CABG, sick sinus syndrome status post permanent pacemaker, CKD 3, diabetes type 2, GERD. Patient was recently hospitalized from 06/11/2021 to 6/20 3/21 for acute congestive heart failure found to have chronic diastolic CHF.  Patient during this visit was suicidal and was EN route to facility when she developed chest pain and taken to Hospital.  During hospitalization patient was noted to have chronic abdominal pain, a possible seizure that was followed up with an EEG and neuro evaluation all unremarkable.  Patient denies suicidal ideations once admitted therefore no further psych placement needed and she was discharged to subacute rehab. Today patient is coming from facility with complaints of altered mental status from baseline, increased fatigue, fevers, and hypoxia.  On 08/23 patient was diagnosed with COVID-19. Patient complains of some shortness of breath, cough, severe headache, abdominal pain but this appears chronic, numbness testing into her left lower leg.  States having reduced appetite but no loss of taste or smell. ASSESSMENT/PLAN: Severe COVID-19 infection with acute hypoxic respiratory failure - First onset of symptoms: unknown, roughly week - Tested Positive: 8/23 - Decadron: 6mg PO daily, day #1 - continue home PPI - Give Remdesivir      *Daily renal and liver function monitoring for kidney and liver toxicity due to Remdesvir is required. - Oxygen Requirements: 2L, wean as tolerated - COVID lab panel:              - D-Dimer = ordered              - CRP = ordered              - alkaline phosphatase = 244 - DVT Prophylaxis: Heparin - treat CHF keeping euvolemic, encourage proning, IS - PRN albuterol, tessalon, tylenol   Superimposed Bacterial CAP - procal mildly elevated at 0.29 - ER started Rocephin day 1/5 and Azithromycin day 1/3 - sputum culture, legionella, strep pneumoniae, blood cultures ordered    Acute exacerbation of chronic diastolic CHF  -last echo 6/12/21 EF 57%, diastolic dysfunction grade 2, right ventricle mildly to moderately decreased, mild MR, moderate TR right ventricular systolic pressure 43.1 mmHg -chest x-ray shows findings of mild congestion; BNP 17,476 -start Lasix 40 mg IV push 2 times a day    *The patient is on IV Lasix which requires daily monitoring of electrolyte and renal function to monitor for the following toxicities:  renal failure, hyper/hyponatremia, hypokalemia, metabolic alkalosis. -2 L fluid restriction, strict I&Os, daily weights   Indeterminate high sensitivity troponins -trope 61 with a 2 hour delta of +3 -demand ischemia from CHF exacerbation and in the presence of CKD