Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Immunisation, Leukocytosis, Lumbar spinal stenosis, Lung consolidation, Magnetic resonance imaging spinal abnormal
Clinical narrative: Hospitalized 02/15/2022; COVID-19 positive 02/16/2022; fully vaccinated plus booster  BRIEF OVERVIEW: Primary Care Physician at Discharge: MD Hematologist/Oncologist: Dr. Admission Date: 2/15/2022 Discharge Date: 02/20/2022 Patient's Discharge Disposition:  Home in stable condition. Discharge summary: This is a 62 y.o. year old patient who was admitted on 2/15/2022 with PMH of small cell lung cancer, CHF, cardiomyopathy, chronic obstructive pulmonary disease, and hypertension who presented for a direct admission for left flank pain.  Patient was seen in the same-day clinic for this problem and was admitted for further evaluation treatment of this pain.  X-ray of the lumbar spine as well as ribs were done which showed scoliosis with mild endplate compression at L2 as well as old rib fractures respectively.  MRI of the lumbar spine was done on 02/15/2022 which showed severe left neural foraminal stenosis at L5 through S1.  Ortho Spine was consulted to make recommendations and did not recommend any surgical intervention from their standpoint but recommended interventional radiology team evaluate for nerve block.  Patient did undergo a left L5 SNRB under general anesthesia on 02/18/2022.  Patient's pain was otherwise well controlled on Tylenol as well as Oxy IR.  Patient felt nerve block was taking effect prior to discharge was very hopeful that he would gain great relief from this then would be able to stop the Oxy; patient very concerned about addiction properties.   Incidentally upon routine admission testing, patient tested positive for COVID-19 as well as coronavirus 229E.  CT of the chest abdomen pelvis was done on 02/16/2022 and showed bilateral lower lobe consolidation suspicious for pneumonia.  Remdesivir was started as well as dexamethasone.  Patient did complete remdesivir 5th dose on 2/20/2022.  Patient did not have symptoms of COVID during this admission aside from chronic cough.  Patient remained stable on room air.  Patient did have leukocytosis during this admission though this is secondary to inappropriate that started upon admission given neutropenia.  Patient also was on dexamethasone during this admission was also contribute to leukocytosis.  We expect the leukocytosis will improve upon discharge.  In any case, given exam findings, cough as well as leukocytosis, patient was discharged home on 7 days of Levaquin which he will complete.  It was not felt that further dexamethasone upon discharge would be helpful.  Unfortunately given patient has incidental finding of COVID, we cannot be sure exactly when patient did become 1st positive with this.  Our office will not see him back in the office and tell he has been in isolation for 10 days.  Patient is aware that our office will call him tomorrow morning to reschedule his appointment due this week for sometime after 2-26-22; this was confirmed to be appropriate per discussion with Dr.   Prior to discharge today, patient denies new, worsening or changes in ROS at this time, including no fevers/chills/sweats, no CP/SOB/DOE, no abd pain/N/V/D, and no neuro changes.  Patient eating/drinking/voiding well and ambulating as tolerated.  Patient will plan to follow up in our office as per below.  Patient's discharge medications were discussed and new prescriptions were sent to patient's requested pharmacy prior to discharge as per generated list below.  Patient is aware to call our office should further questions or concerns arise following this discharge.