chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 47.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Muscular weakness, Nerve conduction studies, Pain, Pain in extremity, Palpitations
Clinical narrative: Since the evening of the 2nd shot I had a softball sized swollen area on my left arm.  It was heated, itchy and last about a week.  I had a small similar area with the 1st shot however it only lasted a few days and was the size of 50 cent piece.  I have tests showing the spike protein was still present in my body 603 days after the 2nd Moderna vaccine.  My symptoms have been consistent even though they vary daily:  Feel like I'm wearing a lead suit all the time.  Worse on rainy days.  Balance/coordination is off, takes more effort to climb stairs,  etc.  Migraines, 90% of the time within 1-2 hours of waking. Severe 2-3 days a week forcing me to do nothing (reduction in headaches after diet changes), starting get worse Feel like I can't get a full breath/ baby elephant on my chest.  Get winded when talking for a while or walking for extended period.  Dizzy spells when changing positions, a few when standing still. Worse in extreme heat/ cold At times can't regulate my body temperature, no fever when occurring.  Feels like my entire body caught fire inside, not like a hot flash. Other times I'm under blankets.  CAN'T tolerate hot temperatures. In the Summer I would want to drop down to my knees the moment I walked into the heat. Everything would start to go white and I would get dizzy.   Hard to get warm when temps are cold, even with layers,  blankets,  etc. Heart randomly racing with no/ little activity.  Washing dishes is taxing.  Brain fog, can't remember simple words/ tasks Loss of strength in hands. No real appetite for food like I use to, force myself to eat at times.  No real interest in meat.  Depression is worse Anxiety high No focus at all. I feel like a ping pong ball is in my head most of the day. Can't read books right now due to focus issue.  Random vibration in left foot Blurry vision off and on. Clear floaters. Mostly in right eye Achy joints, especially right wrist/ pointer finger   Certain materials annoy me Randomly feels like I'm being poked with a hot poker Tremors in hands Eyes seem to constantly realign Muscle jumps left arm Shooting pains in eyeballs Bones hurt, ear canals, face, legs Shooting pains in hips Losing coordination/leg function back of knees week.  Twitches in neck Feel I've been beat across my ribs. Sometimes kicked in left side
Age: 47.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Peripheral swelling, Pruritus, Pulmonary function test, Reading disorder, Scan with contrast
Clinical narrative: Since the evening of the 2nd shot I had a softball sized swollen area on my left arm.  It was heated, itchy and last about a week.  I had a small similar area with the 1st shot however it only lasted a few days and was the size of 50 cent piece.  I have tests showing the spike protein was still present in my body 603 days after the 2nd Moderna vaccine.  My symptoms have been consistent even though they vary daily:  Feel like I'm wearing a lead suit all the time.  Worse on rainy days.  Balance/coordination is off, takes more effort to climb stairs,  etc.  Migraines, 90% of the time within 1-2 hours of waking. Severe 2-3 days a week forcing me to do nothing (reduction in headaches after diet changes), starting get worse Feel like I can't get a full breath/ baby elephant on my chest.  Get winded when talking for a while or walking for extended period.  Dizzy spells when changing positions, a few when standing still. Worse in extreme heat/ cold At times can't regulate my body temperature, no fever when occurring.  Feels like my entire body caught fire inside, not like a hot flash. Other times I'm under blankets.  CAN'T tolerate hot temperatures. In the Summer I would want to drop down to my knees the moment I walked into the heat. Everything would start to go white and I would get dizzy.   Hard to get warm when temps are cold, even with layers,  blankets,  etc. Heart randomly racing with no/ little activity.  Washing dishes is taxing.  Brain fog, can't remember simple words/ tasks Loss of strength in hands. No real appetite for food like I use to, force myself to eat at times.  No real interest in meat.  Depression is worse Anxiety high No focus at all. I feel like a ping pong ball is in my head most of the day. Can't read books right now due to focus issue.  Random vibration in left foot Blurry vision off and on. Clear floaters. Mostly in right eye Achy joints, especially right wrist/ pointer finger   Certain materials annoy me Randomly feels like I'm being poked with a hot poker Tremors in hands Eyes seem to constantly realign Muscle jumps left arm Shooting pains in eyeballs Bones hurt, ear canals, face, legs Shooting pains in hips Losing coordination/leg function back of knees week.  Twitches in neck Feel I've been beat across my ribs. Sometimes kicked in left side
Age: 47.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Sensory disturbance, Skin warm, Sleep study, Temperature intolerance, Tilt table test
Clinical narrative: Since the evening of the 2nd shot I had a softball sized swollen area on my left arm.  It was heated, itchy and last about a week.  I had a small similar area with the 1st shot however it only lasted a few days and was the size of 50 cent piece.  I have tests showing the spike protein was still present in my body 603 days after the 2nd Moderna vaccine.  My symptoms have been consistent even though they vary daily:  Feel like I'm wearing a lead suit all the time.  Worse on rainy days.  Balance/coordination is off, takes more effort to climb stairs,  etc.  Migraines, 90% of the time within 1-2 hours of waking. Severe 2-3 days a week forcing me to do nothing (reduction in headaches after diet changes), starting get worse Feel like I can't get a full breath/ baby elephant on my chest.  Get winded when talking for a while or walking for extended period.  Dizzy spells when changing positions, a few when standing still. Worse in extreme heat/ cold At times can't regulate my body temperature, no fever when occurring.  Feels like my entire body caught fire inside, not like a hot flash. Other times I'm under blankets.  CAN'T tolerate hot temperatures. In the Summer I would want to drop down to my knees the moment I walked into the heat. Everything would start to go white and I would get dizzy.   Hard to get warm when temps are cold, even with layers,  blankets,  etc. Heart randomly racing with no/ little activity.  Washing dishes is taxing.  Brain fog, can't remember simple words/ tasks Loss of strength in hands. No real appetite for food like I use to, force myself to eat at times.  No real interest in meat.  Depression is worse Anxiety high No focus at all. I feel like a ping pong ball is in my head most of the day. Can't read books right now due to focus issue.  Random vibration in left foot Blurry vision off and on. Clear floaters. Mostly in right eye Achy joints, especially right wrist/ pointer finger   Certain materials annoy me Randomly feels like I'm being poked with a hot poker Tremors in hands Eyes seem to constantly realign Muscle jumps left arm Shooting pains in eyeballs Bones hurt, ear canals, face, legs Shooting pains in hips Losing coordination/leg function back of knees week.  Twitches in neck Feel I've been beat across my ribs. Sometimes kicked in left side
Age: 47.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Tremor, Vision blurred, Visual impairment, Vitreous floaters
Clinical narrative: Since the evening of the 2nd shot I had a softball sized swollen area on my left arm.  It was heated, itchy and last about a week.  I had a small similar area with the 1st shot however it only lasted a few days and was the size of 50 cent piece.  I have tests showing the spike protein was still present in my body 603 days after the 2nd Moderna vaccine.  My symptoms have been consistent even though they vary daily:  Feel like I'm wearing a lead suit all the time.  Worse on rainy days.  Balance/coordination is off, takes more effort to climb stairs,  etc.  Migraines, 90% of the time within 1-2 hours of waking. Severe 2-3 days a week forcing me to do nothing (reduction in headaches after diet changes), starting get worse Feel like I can't get a full breath/ baby elephant on my chest.  Get winded when talking for a while or walking for extended period.  Dizzy spells when changing positions, a few when standing still. Worse in extreme heat/ cold At times can't regulate my body temperature, no fever when occurring.  Feels like my entire body caught fire inside, not like a hot flash. Other times I'm under blankets.  CAN'T tolerate hot temperatures. In the Summer I would want to drop down to my knees the moment I walked into the heat. Everything would start to go white and I would get dizzy.   Hard to get warm when temps are cold, even with layers,  blankets,  etc. Heart randomly racing with no/ little activity.  Washing dishes is taxing.  Brain fog, can't remember simple words/ tasks Loss of strength in hands. No real appetite for food like I use to, force myself to eat at times.  No real interest in meat.  Depression is worse Anxiety high No focus at all. I feel like a ping pong ball is in my head most of the day. Can't read books right now due to focus issue.  Random vibration in left foot Blurry vision off and on. Clear floaters. Mostly in right eye Achy joints, especially right wrist/ pointer finger   Certain materials annoy me Randomly feels like I'm being poked with a hot poker Tremors in hands Eyes seem to constantly realign Muscle jumps left arm Shooting pains in eyeballs Bones hurt, ear canals, face, legs Shooting pains in hips Losing coordination/leg function back of knees week.  Twitches in neck Feel I've been beat across my ribs. Sometimes kicked in left side
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Bradycardia, Cardiac monitoring, Cardiac pacemaker insertion, Computerised tomogram, Expired product administered
Clinical narrative: Bradycardia leading to pacemaker  Neuropathy right side Original Vaccine (1) administered was expired when given
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Neuropathy peripheral
Clinical narrative: Bradycardia leading to pacemaker  Neuropathy right side Original Vaccine (1) administered was expired when given
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Alcohol detoxification, Alcohol withdrawal syndrome, Anxiety, Aspartate aminotransferase increased
Clinical narrative: Patient is a 50 y.o. female patient of Provider Not in System with history of PE/DVT, Alcohol abuse, Anemia, FMS, Hyperaldosteronism, Lymphedema, Neuropathy, presented with alcohol withdrawal and covid.   Covid-19 Virus Infection Date of onset of symptoms: 12/29 Symptoms present on admission: sore throat, cough, rhinorrhea, diarrhea, nausea Date of covid positive test: 12/30 Vaccination status: Incompletely vaccinated Imaging: CXR no acute finding Oxygen requirements on admission: none Current oxygen requirements: none Medical therapy: not indicated.  Patient requesting to be initiated on Paxilovid. States that she had severe COVID a year ago which required her to be hospitalized.  Consult ID for further recommendation. Started on Remdesivir 01/03 Consultants following: ID Anticipated special isolation end date: 1/8   Alcohol withdrawal Pt states she had two "seizures" at home described as shaking although no acidosis on chem Has had phenobarb detox several times before but continues to drink Completed phenobarb taper Also complaining of increased anxiety which likely is triggering her alcohol consumption. BH consulted. Appreciate assistance. Continue Seroquel for anxiety   Hyponatremia Hypokalemia improved   Transaminitis AST 54, ALT 50; likely due to alcohol Improved   Leg pain Hx of lymphedema, neuropathy and DVT Lower extremity Dopplers negative for DVT Continue home dose of torsemide and as needed Norco for pain   Morbid obesity BMI 54.07; LSM recommended Needs sleep study
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray normal, Condition aggravated, Cough, Diarrhoea
Clinical narrative: Patient is a 50 y.o. female patient of Provider Not in System with history of PE/DVT, Alcohol abuse, Anemia, FMS, Hyperaldosteronism, Lymphedema, Neuropathy, presented with alcohol withdrawal and covid.   Covid-19 Virus Infection Date of onset of symptoms: 12/29 Symptoms present on admission: sore throat, cough, rhinorrhea, diarrhea, nausea Date of covid positive test: 12/30 Vaccination status: Incompletely vaccinated Imaging: CXR no acute finding Oxygen requirements on admission: none Current oxygen requirements: none Medical therapy: not indicated.  Patient requesting to be initiated on Paxilovid. States that she had severe COVID a year ago which required her to be hospitalized.  Consult ID for further recommendation. Started on Remdesivir 01/03 Consultants following: ID Anticipated special isolation end date: 1/8   Alcohol withdrawal Pt states she had two "seizures" at home described as shaking although no acidosis on chem Has had phenobarb detox several times before but continues to drink Completed phenobarb taper Also complaining of increased anxiety which likely is triggering her alcohol consumption. BH consulted. Appreciate assistance. Continue Seroquel for anxiety   Hyponatremia Hypokalemia improved   Transaminitis AST 54, ALT 50; likely due to alcohol Improved   Leg pain Hx of lymphedema, neuropathy and DVT Lower extremity Dopplers negative for DVT Continue home dose of torsemide and as needed Norco for pain   Morbid obesity BMI 54.07; LSM recommended Needs sleep study
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertransaminasaemia, Hypokalaemia, Hyponatraemia, Laboratory test normal, Malaise
Clinical narrative: Patient is a 50 y.o. female patient of Provider Not in System with history of PE/DVT, Alcohol abuse, Anemia, FMS, Hyperaldosteronism, Lymphedema, Neuropathy, presented with alcohol withdrawal and covid.   Covid-19 Virus Infection Date of onset of symptoms: 12/29 Symptoms present on admission: sore throat, cough, rhinorrhea, diarrhea, nausea Date of covid positive test: 12/30 Vaccination status: Incompletely vaccinated Imaging: CXR no acute finding Oxygen requirements on admission: none Current oxygen requirements: none Medical therapy: not indicated.  Patient requesting to be initiated on Paxilovid. States that she had severe COVID a year ago which required her to be hospitalized.  Consult ID for further recommendation. Started on Remdesivir 01/03 Consultants following: ID Anticipated special isolation end date: 1/8   Alcohol withdrawal Pt states she had two "seizures" at home described as shaking although no acidosis on chem Has had phenobarb detox several times before but continues to drink Completed phenobarb taper Also complaining of increased anxiety which likely is triggering her alcohol consumption. BH consulted. Appreciate assistance. Continue Seroquel for anxiety   Hyponatremia Hypokalemia improved   Transaminitis AST 54, ALT 50; likely due to alcohol Improved   Leg pain Hx of lymphedema, neuropathy and DVT Lower extremity Dopplers negative for DVT Continue home dose of torsemide and as needed Norco for pain   Morbid obesity BMI 54.07; LSM recommended Needs sleep study
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Obesity, Oropharyngeal pain, Pain in extremity, Rhinorrhoea
Clinical narrative: Patient is a 50 y.o. female patient of Provider Not in System with history of PE/DVT, Alcohol abuse, Anemia, FMS, Hyperaldosteronism, Lymphedema, Neuropathy, presented with alcohol withdrawal and covid.   Covid-19 Virus Infection Date of onset of symptoms: 12/29 Symptoms present on admission: sore throat, cough, rhinorrhea, diarrhea, nausea Date of covid positive test: 12/30 Vaccination status: Incompletely vaccinated Imaging: CXR no acute finding Oxygen requirements on admission: none Current oxygen requirements: none Medical therapy: not indicated.  Patient requesting to be initiated on Paxilovid. States that she had severe COVID a year ago which required her to be hospitalized.  Consult ID for further recommendation. Started on Remdesivir 01/03 Consultants following: ID Anticipated special isolation end date: 1/8   Alcohol withdrawal Pt states she had two "seizures" at home described as shaking although no acidosis on chem Has had phenobarb detox several times before but continues to drink Completed phenobarb taper Also complaining of increased anxiety which likely is triggering her alcohol consumption. BH consulted. Appreciate assistance. Continue Seroquel for anxiety   Hyponatremia Hypokalemia improved   Transaminitis AST 54, ALT 50; likely due to alcohol Improved   Leg pain Hx of lymphedema, neuropathy and DVT Lower extremity Dopplers negative for DVT Continue home dose of torsemide and as needed Norco for pain   Morbid obesity BMI 54.07; LSM recommended Needs sleep study
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Seizure, Tremor, Ultrasound Doppler normal
Clinical narrative: Patient is a 50 y.o. female patient of Provider Not in System with history of PE/DVT, Alcohol abuse, Anemia, FMS, Hyperaldosteronism, Lymphedema, Neuropathy, presented with alcohol withdrawal and covid.   Covid-19 Virus Infection Date of onset of symptoms: 12/29 Symptoms present on admission: sore throat, cough, rhinorrhea, diarrhea, nausea Date of covid positive test: 12/30 Vaccination status: Incompletely vaccinated Imaging: CXR no acute finding Oxygen requirements on admission: none Current oxygen requirements: none Medical therapy: not indicated.  Patient requesting to be initiated on Paxilovid. States that she had severe COVID a year ago which required her to be hospitalized.  Consult ID for further recommendation. Started on Remdesivir 01/03 Consultants following: ID Anticipated special isolation end date: 1/8   Alcohol withdrawal Pt states she had two "seizures" at home described as shaking although no acidosis on chem Has had phenobarb detox several times before but continues to drink Completed phenobarb taper Also complaining of increased anxiety which likely is triggering her alcohol consumption. BH consulted. Appreciate assistance. Continue Seroquel for anxiety   Hyponatremia Hypokalemia improved   Transaminitis AST 54, ALT 50; likely due to alcohol Improved   Leg pain Hx of lymphedema, neuropathy and DVT Lower extremity Dopplers negative for DVT Continue home dose of torsemide and as needed Norco for pain   Morbid obesity BMI 54.07; LSM recommended Needs sleep study
Age: 12.0
Sex: M
Vaccine: HPV9, MNQ
Symptoms: Nausea, Streptococcus test negative, Urticaria
Clinical narrative: Received vaccines at PCP on morning of 1/27/23. Developed Hives on 1/27/23 in the evening. Took Benadryl. Had nausea and hives the morning of 1/28/23. Went to Urgent Care. Was given a prescription of Prednisone. Had one 20mg tablet of Prednisone. Hives proceeded to worsen. Came to our center at 1830 on 1/28/23. Nausea has resolved, but still having hives.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Brain natriuretic peptide normal, Bronchitis, COVID-19, Cough
Clinical narrative: Patient is a 66 y.o. female with history of CAD, COPD, DVT requiring thrombectomy, HTN, OSA, DM II presented to Medical Center with fever, BLE swelling and pain .   Lower extremity edema BL pain in LE Symptoms for a few days, no claudication symptoms or calf/thigh pain D-Dimer 0.72; pBNP wnl, CTPA 12/31 negative, no symptoms of claudication, symptoms improved significantly since admission. Venous dopplers neg for DVT.  A1C of 6.3%.      Covid-19 Virus Infection Date of onset of symptoms: 12/27 Symptoms present on admission: cough, fevers, dyspnea Date of covid positive test: 12/31 Vaccination status: vaccinated Imaging: CTPA mild bronchitis Oxygen requirements on admission: None Current oxygen requirements: 2L Medical therapy: starting remdesevir and dexamethasone 1/1 Consultants following:   Anticipated special isolation end date:  Underwent walking 02 assessment by primary RN taking care of patient.  Found to not require any oxygen  Discharge home.      HTN, controlled Hypokalemia Cont home Norvasc, Lasix, Lisinopril, hydrochlorothiazide Would hold diuretics if getting volume depleted with COVID Dose with KCl today, may need long term treatment while on diuretics  DM II; controlled A1C chronically ~6.6 Home Metformin held On correctional humalog   Morbid obesity BMI 56, outpatient follow up
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Diuretic therapy, Dyspnoea, Fibrin D dimer, Glycosylated haemoglobin increased, Malaise
Clinical narrative: Patient is a 66 y.o. female with history of CAD, COPD, DVT requiring thrombectomy, HTN, OSA, DM II presented to Medical Center with fever, BLE swelling and pain .   Lower extremity edema BL pain in LE Symptoms for a few days, no claudication symptoms or calf/thigh pain D-Dimer 0.72; pBNP wnl, CTPA 12/31 negative, no symptoms of claudication, symptoms improved significantly since admission. Venous dopplers neg for DVT.  A1C of 6.3%.      Covid-19 Virus Infection Date of onset of symptoms: 12/27 Symptoms present on admission: cough, fevers, dyspnea Date of covid positive test: 12/31 Vaccination status: vaccinated Imaging: CTPA mild bronchitis Oxygen requirements on admission: None Current oxygen requirements: 2L Medical therapy: starting remdesevir and dexamethasone 1/1 Consultants following:   Anticipated special isolation end date:  Underwent walking 02 assessment by primary RN taking care of patient.  Found to not require any oxygen  Discharge home.      HTN, controlled Hypokalemia Cont home Norvasc, Lasix, Lisinopril, hydrochlorothiazide Would hold diuretics if getting volume depleted with COVID Dose with KCl today, may need long term treatment while on diuretics  DM II; controlled A1C chronically ~6.6 Home Metformin held On correctional humalog   Morbid obesity BMI 56, outpatient follow up
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Oedema peripheral, Pain in extremity, Peripheral swelling, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Patient is a 66 y.o. female with history of CAD, COPD, DVT requiring thrombectomy, HTN, OSA, DM II presented to Medical Center with fever, BLE swelling and pain .   Lower extremity edema BL pain in LE Symptoms for a few days, no claudication symptoms or calf/thigh pain D-Dimer 0.72; pBNP wnl, CTPA 12/31 negative, no symptoms of claudication, symptoms improved significantly since admission. Venous dopplers neg for DVT.  A1C of 6.3%.      Covid-19 Virus Infection Date of onset of symptoms: 12/27 Symptoms present on admission: cough, fevers, dyspnea Date of covid positive test: 12/31 Vaccination status: vaccinated Imaging: CTPA mild bronchitis Oxygen requirements on admission: None Current oxygen requirements: 2L Medical therapy: starting remdesevir and dexamethasone 1/1 Consultants following:   Anticipated special isolation end date:  Underwent walking 02 assessment by primary RN taking care of patient.  Found to not require any oxygen  Discharge home.      HTN, controlled Hypokalemia Cont home Norvasc, Lasix, Lisinopril, hydrochlorothiazide Would hold diuretics if getting volume depleted with COVID Dose with KCl today, may need long term treatment while on diuretics  DM II; controlled A1C chronically ~6.6 Home Metformin held On correctional humalog   Morbid obesity BMI 56, outpatient follow up
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound Doppler normal
Clinical narrative: Patient is a 66 y.o. female with history of CAD, COPD, DVT requiring thrombectomy, HTN, OSA, DM II presented to Medical Center with fever, BLE swelling and pain .   Lower extremity edema BL pain in LE Symptoms for a few days, no claudication symptoms or calf/thigh pain D-Dimer 0.72; pBNP wnl, CTPA 12/31 negative, no symptoms of claudication, symptoms improved significantly since admission. Venous dopplers neg for DVT.  A1C of 6.3%.      Covid-19 Virus Infection Date of onset of symptoms: 12/27 Symptoms present on admission: cough, fevers, dyspnea Date of covid positive test: 12/31 Vaccination status: vaccinated Imaging: CTPA mild bronchitis Oxygen requirements on admission: None Current oxygen requirements: 2L Medical therapy: starting remdesevir and dexamethasone 1/1 Consultants following:   Anticipated special isolation end date:  Underwent walking 02 assessment by primary RN taking care of patient.  Found to not require any oxygen  Discharge home.      HTN, controlled Hypokalemia Cont home Norvasc, Lasix, Lisinopril, hydrochlorothiazide Would hold diuretics if getting volume depleted with COVID Dose with KCl today, may need long term treatment while on diuretics  DM II; controlled A1C chronically ~6.6 Home Metformin held On correctional humalog   Morbid obesity BMI 56, outpatient follow up
Age: 33.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient received 2nd dose too early.  First dose 1/7/23, second dose 1/28/23.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Atrial fibrillation, Blood creatinine increased, Blood gases
Clinical narrative: Assessment and Plan Patient is a 70 y.o. female patient of local DO with history of COPD/asthma, hypertension, CAD status post CABG, hyperlipidemia presented to a local Hospital with shortness of breath.    Shortness of breath Acute hypoxemic respiratory failure On 2 L nasal cannula in no acute respiratory distress VBG; 7.38/48.6/30 X-ray with increased distal markings suggesting pulmonary edema small bilateral pleural effusion proBNP 962 increased from baseline 545 a year ago Etiology of acute hypoxemic respiratory failure likely multifactorial. Presumed heart failure with preserved ejection fraction and in the setting of COVID pneumonia.   Continued oxygen therapy and titrate as tolerated Evaluated for home oxygen, she qualifies for home oxygen. Face-to-face evaluation performed for home oxygen.   Covid-19 Virus Infection Date of onset of symptoms: 1/8/2023 Symptoms present on admission: Shortness of breath Date of covid positive test: 1/9/2023 Vaccination status: vaccinated Imaging: Chest x-ray?vascular congestion with increased interstitial lung markings, small bilateral pleural effusions Oxygen requirements on admission: 2 L Current oxygen requirements: 2L Medical therapy: steroids Consultants following: Infectious disease Continue dexamethasone 6 mg daily to complete a 10-day course   New onset A. fib with RVR. Heart rate fairly controlled at rest but was for a short on 1/11 in the 140s to 150 range with activities 2D echocardiogram showed EF of 40% which is unchanged from July 2021. Consulted cardiology for input. TSH is normal. Cardiology recommended Eliquis. Continue current dose of carvedilol.   Acute on chronic HFrEF CAD status post CABG Essential hypertension Echo 3/21 with EF 40% with grade 2 diastolic dysfunction On home carvedilol and Lasix  Started on Lasix 40 mg IV twice daily Resume home carvedilol and losartan at discharge Resume home ASA, ezetimibe, statin Hold Aldactone at discharge due to hyperkalemia Follow-up with cardiology as outpatient.  AKI on CKD 3B Creatinine on admission 2.80, now 2.66  Baseline creatinine 1.37 about a year ago Etiology likely multifactorial in the setting of nephrotoxic medications, acute HFrEF, COVID-19  Management as above Avoid nephrotoxins?holding home spironolactone and losartan Creatinine slightly increased because of diuresis. Follow-up with PCP for close monitoring.   Hyperkalemia-resolved Potassium 5.4--- >4.9 Patient was on losartan and Aldactone at home. Will discontinue Aldactone at discharge.    COPD/asthma Without exacerbation Denies any smoking currently Resume home inhalers   Gout Resume home allopurinol   Hyperlipidemia Resume home ezetimibe and statin   Morbid obesity Body mass index is 41.27 kg/m². Lifestyle modification
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium increased, Blood thyroid stimulating hormone normal, COVID-19, COVID-19 pneumonia, Cardiac failure
Clinical narrative: Assessment and Plan Patient is a 70 y.o. female patient of local DO with history of COPD/asthma, hypertension, CAD status post CABG, hyperlipidemia presented to a local Hospital with shortness of breath.    Shortness of breath Acute hypoxemic respiratory failure On 2 L nasal cannula in no acute respiratory distress VBG; 7.38/48.6/30 X-ray with increased distal markings suggesting pulmonary edema small bilateral pleural effusion proBNP 962 increased from baseline 545 a year ago Etiology of acute hypoxemic respiratory failure likely multifactorial. Presumed heart failure with preserved ejection fraction and in the setting of COVID pneumonia.   Continued oxygen therapy and titrate as tolerated Evaluated for home oxygen, she qualifies for home oxygen. Face-to-face evaluation performed for home oxygen.   Covid-19 Virus Infection Date of onset of symptoms: 1/8/2023 Symptoms present on admission: Shortness of breath Date of covid positive test: 1/9/2023 Vaccination status: vaccinated Imaging: Chest x-ray?vascular congestion with increased interstitial lung markings, small bilateral pleural effusions Oxygen requirements on admission: 2 L Current oxygen requirements: 2L Medical therapy: steroids Consultants following: Infectious disease Continue dexamethasone 6 mg daily to complete a 10-day course   New onset A. fib with RVR. Heart rate fairly controlled at rest but was for a short on 1/11 in the 140s to 150 range with activities 2D echocardiogram showed EF of 40% which is unchanged from July 2021. Consulted cardiology for input. TSH is normal. Cardiology recommended Eliquis. Continue current dose of carvedilol.   Acute on chronic HFrEF CAD status post CABG Essential hypertension Echo 3/21 with EF 40% with grade 2 diastolic dysfunction On home carvedilol and Lasix  Started on Lasix 40 mg IV twice daily Resume home carvedilol and losartan at discharge Resume home ASA, ezetimibe, statin Hold Aldactone at discharge due to hyperkalemia Follow-up with cardiology as outpatient.  AKI on CKD 3B Creatinine on admission 2.80, now 2.66  Baseline creatinine 1.37 about a year ago Etiology likely multifactorial in the setting of nephrotoxic medications, acute HFrEF, COVID-19  Management as above Avoid nephrotoxins?holding home spironolactone and losartan Creatinine slightly increased because of diuresis. Follow-up with PCP for close monitoring.   Hyperkalemia-resolved Potassium 5.4--- >4.9 Patient was on losartan and Aldactone at home. Will discontinue Aldactone at discharge.    COPD/asthma Without exacerbation Denies any smoking currently Resume home inhalers   Gout Resume home allopurinol   Hyperlipidemia Resume home ezetimibe and statin   Morbid obesity Body mass index is 41.27 kg/m². Lifestyle modification
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic kidney disease, Diastolic dysfunction, Diuretic therapy, Dyspnoea
Clinical narrative: Assessment and Plan Patient is a 70 y.o. female patient of local DO with history of COPD/asthma, hypertension, CAD status post CABG, hyperlipidemia presented to a local Hospital with shortness of breath.    Shortness of breath Acute hypoxemic respiratory failure On 2 L nasal cannula in no acute respiratory distress VBG; 7.38/48.6/30 X-ray with increased distal markings suggesting pulmonary edema small bilateral pleural effusion proBNP 962 increased from baseline 545 a year ago Etiology of acute hypoxemic respiratory failure likely multifactorial. Presumed heart failure with preserved ejection fraction and in the setting of COVID pneumonia.   Continued oxygen therapy and titrate as tolerated Evaluated for home oxygen, she qualifies for home oxygen. Face-to-face evaluation performed for home oxygen.   Covid-19 Virus Infection Date of onset of symptoms: 1/8/2023 Symptoms present on admission: Shortness of breath Date of covid positive test: 1/9/2023 Vaccination status: vaccinated Imaging: Chest x-ray?vascular congestion with increased interstitial lung markings, small bilateral pleural effusions Oxygen requirements on admission: 2 L Current oxygen requirements: 2L Medical therapy: steroids Consultants following: Infectious disease Continue dexamethasone 6 mg daily to complete a 10-day course   New onset A. fib with RVR. Heart rate fairly controlled at rest but was for a short on 1/11 in the 140s to 150 range with activities 2D echocardiogram showed EF of 40% which is unchanged from July 2021. Consulted cardiology for input. TSH is normal. Cardiology recommended Eliquis. Continue current dose of carvedilol.   Acute on chronic HFrEF CAD status post CABG Essential hypertension Echo 3/21 with EF 40% with grade 2 diastolic dysfunction On home carvedilol and Lasix  Started on Lasix 40 mg IV twice daily Resume home carvedilol and losartan at discharge Resume home ASA, ezetimibe, statin Hold Aldactone at discharge due to hyperkalemia Follow-up with cardiology as outpatient.  AKI on CKD 3B Creatinine on admission 2.80, now 2.66  Baseline creatinine 1.37 about a year ago Etiology likely multifactorial in the setting of nephrotoxic medications, acute HFrEF, COVID-19  Management as above Avoid nephrotoxins?holding home spironolactone and losartan Creatinine slightly increased because of diuresis. Follow-up with PCP for close monitoring.   Hyperkalemia-resolved Potassium 5.4--- >4.9 Patient was on losartan and Aldactone at home. Will discontinue Aldactone at discharge.    COPD/asthma Without exacerbation Denies any smoking currently Resume home inhalers   Gout Resume home allopurinol   Hyperlipidemia Resume home ezetimibe and statin   Morbid obesity Body mass index is 41.27 kg/m². Lifestyle modification
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Ejection fraction decreased, Hyperkalaemia, Interstitial lung disease, Pleural effusion
Clinical narrative: Assessment and Plan Patient is a 70 y.o. female patient of local DO with history of COPD/asthma, hypertension, CAD status post CABG, hyperlipidemia presented to a local Hospital with shortness of breath.    Shortness of breath Acute hypoxemic respiratory failure On 2 L nasal cannula in no acute respiratory distress VBG; 7.38/48.6/30 X-ray with increased distal markings suggesting pulmonary edema small bilateral pleural effusion proBNP 962 increased from baseline 545 a year ago Etiology of acute hypoxemic respiratory failure likely multifactorial. Presumed heart failure with preserved ejection fraction and in the setting of COVID pneumonia.   Continued oxygen therapy and titrate as tolerated Evaluated for home oxygen, she qualifies for home oxygen. Face-to-face evaluation performed for home oxygen.   Covid-19 Virus Infection Date of onset of symptoms: 1/8/2023 Symptoms present on admission: Shortness of breath Date of covid positive test: 1/9/2023 Vaccination status: vaccinated Imaging: Chest x-ray?vascular congestion with increased interstitial lung markings, small bilateral pleural effusions Oxygen requirements on admission: 2 L Current oxygen requirements: 2L Medical therapy: steroids Consultants following: Infectious disease Continue dexamethasone 6 mg daily to complete a 10-day course   New onset A. fib with RVR. Heart rate fairly controlled at rest but was for a short on 1/11 in the 140s to 150 range with activities 2D echocardiogram showed EF of 40% which is unchanged from July 2021. Consulted cardiology for input. TSH is normal. Cardiology recommended Eliquis. Continue current dose of carvedilol.   Acute on chronic HFrEF CAD status post CABG Essential hypertension Echo 3/21 with EF 40% with grade 2 diastolic dysfunction On home carvedilol and Lasix  Started on Lasix 40 mg IV twice daily Resume home carvedilol and losartan at discharge Resume home ASA, ezetimibe, statin Hold Aldactone at discharge due to hyperkalemia Follow-up with cardiology as outpatient.  AKI on CKD 3B Creatinine on admission 2.80, now 2.66  Baseline creatinine 1.37 about a year ago Etiology likely multifactorial in the setting of nephrotoxic medications, acute HFrEF, COVID-19  Management as above Avoid nephrotoxins?holding home spironolactone and losartan Creatinine slightly increased because of diuresis. Follow-up with PCP for close monitoring.   Hyperkalemia-resolved Potassium 5.4--- >4.9 Patient was on losartan and Aldactone at home. Will discontinue Aldactone at discharge.    COPD/asthma Without exacerbation Denies any smoking currently Resume home inhalers   Gout Resume home allopurinol   Hyperlipidemia Resume home ezetimibe and statin   Morbid obesity Body mass index is 41.27 kg/m². Lifestyle modification
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Prohormone brain natriuretic peptide increased, Pulmonary congestion, Pulmonary oedema, SARS-CoV-2 test positive
Clinical narrative: Assessment and Plan Patient is a 70 y.o. female patient of local DO with history of COPD/asthma, hypertension, CAD status post CABG, hyperlipidemia presented to a local Hospital with shortness of breath.    Shortness of breath Acute hypoxemic respiratory failure On 2 L nasal cannula in no acute respiratory distress VBG; 7.38/48.6/30 X-ray with increased distal markings suggesting pulmonary edema small bilateral pleural effusion proBNP 962 increased from baseline 545 a year ago Etiology of acute hypoxemic respiratory failure likely multifactorial. Presumed heart failure with preserved ejection fraction and in the setting of COVID pneumonia.   Continued oxygen therapy and titrate as tolerated Evaluated for home oxygen, she qualifies for home oxygen. Face-to-face evaluation performed for home oxygen.   Covid-19 Virus Infection Date of onset of symptoms: 1/8/2023 Symptoms present on admission: Shortness of breath Date of covid positive test: 1/9/2023 Vaccination status: vaccinated Imaging: Chest x-ray?vascular congestion with increased interstitial lung markings, small bilateral pleural effusions Oxygen requirements on admission: 2 L Current oxygen requirements: 2L Medical therapy: steroids Consultants following: Infectious disease Continue dexamethasone 6 mg daily to complete a 10-day course   New onset A. fib with RVR. Heart rate fairly controlled at rest but was for a short on 1/11 in the 140s to 150 range with activities 2D echocardiogram showed EF of 40% which is unchanged from July 2021. Consulted cardiology for input. TSH is normal. Cardiology recommended Eliquis. Continue current dose of carvedilol.   Acute on chronic HFrEF CAD status post CABG Essential hypertension Echo 3/21 with EF 40% with grade 2 diastolic dysfunction On home carvedilol and Lasix  Started on Lasix 40 mg IV twice daily Resume home carvedilol and losartan at discharge Resume home ASA, ezetimibe, statin Hold Aldactone at discharge due to hyperkalemia Follow-up with cardiology as outpatient.  AKI on CKD 3B Creatinine on admission 2.80, now 2.66  Baseline creatinine 1.37 about a year ago Etiology likely multifactorial in the setting of nephrotoxic medications, acute HFrEF, COVID-19  Management as above Avoid nephrotoxins?holding home spironolactone and losartan Creatinine slightly increased because of diuresis. Follow-up with PCP for close monitoring.   Hyperkalemia-resolved Potassium 5.4--- >4.9 Patient was on losartan and Aldactone at home. Will discontinue Aldactone at discharge.    COPD/asthma Without exacerbation Denies any smoking currently Resume home inhalers   Gout Resume home allopurinol   Hyperlipidemia Resume home ezetimibe and statin   Morbid obesity Body mass index is 41.27 kg/m². Lifestyle modification
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Imaging procedure, Impaired self-care, Mobility decreased, Pain in extremity
Clinical narrative: patient states that after she received the vaccine her upper arm was sore and that pain has affected how much she can raise her arm/move shoulder to the point of having difficulty getting dressed and washing back. She states that she went and saw a doctor a few months afterwards since the pain was ongoing. She said that they did some type of imaging and told her it was a problem with her muscle. she came in today looking for pain relief for arm (ongoing since her vaccine administration)
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Pt given pfizer monovalent covid vaccine instead of Pfizer bivalent booster. No adverse events noted. Pt left in stable condition.
Age: 1.0
Sex: F
Vaccine: FLU4
Symptoms: Incorrect dose administered
Clinical narrative: One year old female was vaccinated with 0.5ml of Influenza D2 vaccine instead of receiving age appropriate dose of 0.25ml.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: PATIENT WAS GIVEN O.3ML BIVALENT PFIZER FOR 5-11YR OLD INSTEAD OF THE ADULT BIVALENT BUT NO ADR REPORTED YET
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse events or reactions noted. Pt was given Pfizer monovalent covid vaccine instead of Pfizer bivalent booster. Pt left in stable condition.
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: No adverse events or reactions noted. Pt given Pfizer monovalent covid vaccine instead of desired Pfizer bivalent booster. Pt already received Pfizer monovalent primary series with no adverse reactions reported by pt. Pt left in stable condition.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Angiogram pulmonary abnormal, Aortic aneurysm, Bacterial test positive, Blood creatinine increased
Clinical narrative: The patient is a 82 y.o. female with history of cad, cardiomyopathy, dm2, ckd3 presented to the Hospital with exertional dyspnea .   Exertional dyspnea and hypoxia - resolved  Covid 19 virus infection Date of onset of symptoms: 1/3/23 Symptoms present on admission: Cough, nasal congestion, exertional dyspnea Date of covid positive test: 1/5/2023 Vaccination status: vaccinated Imaging: CTPA showed no acute PE, showed borderline aortic aneurysm and ascending aorta, stable mildly enlarged mediastinal and bilateral hilar lymph nodes.  Minimal scarring in RML.  Cholelithiasis also noted Oxygen requirements on admission: None at rest, 2 L with exertion Current oxygen requirements: Room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 1/13/2023   AKI on CKD 3 - resolved  Most likely due to diuresis Cr 1.9 on arrival Baseline Cr.  Around 1.4 Hold home diuretics and Entresto Avoid nephrotoxins Monitor renal function   Acute UTI UA with moderate leuk esterase, WBC 9500 bacteria Patient does endorse urinary frequency but is also on diuretic Given Keflex in ER Urine culture grew E-coli  Will discharge home with 2 more days of Keflex   Elevated troponin Troponin 27 and then 24 Likely related to CKD EKG without any acute ST changes Patient denies chest pain Continue telemetry monitoring   Chronic HFrEF Does not appear clinically fluid overloaded Hold home Lasix and Aldactone given AKI Monitor volume status BNP 509, near baseline of 500 Echo 12/12 with EF 45%  Hilar lymphadenopathy, chronic stable, likely benign.    DM type 2 with current long term insulin use and CKD 3 A1c 8.8 on 12/16/2022 Home regimen: levemir 50 units qpm and novlog 7-10 with meals Lantus 25 units nightly plus sliding scale ordered for now   Acquired hypothyroidism Continue levothroid   Depression Continue sertraline
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, Cardiac telemetry, Cholelithiasis, Chronic kidney disease
Clinical narrative: The patient is a 82 y.o. female with history of cad, cardiomyopathy, dm2, ckd3 presented to the Hospital with exertional dyspnea .   Exertional dyspnea and hypoxia - resolved  Covid 19 virus infection Date of onset of symptoms: 1/3/23 Symptoms present on admission: Cough, nasal congestion, exertional dyspnea Date of covid positive test: 1/5/2023 Vaccination status: vaccinated Imaging: CTPA showed no acute PE, showed borderline aortic aneurysm and ascending aorta, stable mildly enlarged mediastinal and bilateral hilar lymph nodes.  Minimal scarring in RML.  Cholelithiasis also noted Oxygen requirements on admission: None at rest, 2 L with exertion Current oxygen requirements: Room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 1/13/2023   AKI on CKD 3 - resolved  Most likely due to diuresis Cr 1.9 on arrival Baseline Cr.  Around 1.4 Hold home diuretics and Entresto Avoid nephrotoxins Monitor renal function   Acute UTI UA with moderate leuk esterase, WBC 9500 bacteria Patient does endorse urinary frequency but is also on diuretic Given Keflex in ER Urine culture grew E-coli  Will discharge home with 2 more days of Keflex   Elevated troponin Troponin 27 and then 24 Likely related to CKD EKG without any acute ST changes Patient denies chest pain Continue telemetry monitoring   Chronic HFrEF Does not appear clinically fluid overloaded Hold home Lasix and Aldactone given AKI Monitor volume status BNP 509, near baseline of 500 Echo 12/12 with EF 45%  Hilar lymphadenopathy, chronic stable, likely benign.    DM type 2 with current long term insulin use and CKD 3 A1c 8.8 on 12/16/2022 Home regimen: levemir 50 units qpm and novlog 7-10 with meals Lantus 25 units nightly plus sliding scale ordered for now   Acquired hypothyroidism Continue levothroid   Depression Continue sertraline
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Culture urine positive, Diuretic therapy, Dyspnoea exertional
Clinical narrative: The patient is a 82 y.o. female with history of cad, cardiomyopathy, dm2, ckd3 presented to the Hospital with exertional dyspnea .   Exertional dyspnea and hypoxia - resolved  Covid 19 virus infection Date of onset of symptoms: 1/3/23 Symptoms present on admission: Cough, nasal congestion, exertional dyspnea Date of covid positive test: 1/5/2023 Vaccination status: vaccinated Imaging: CTPA showed no acute PE, showed borderline aortic aneurysm and ascending aorta, stable mildly enlarged mediastinal and bilateral hilar lymph nodes.  Minimal scarring in RML.  Cholelithiasis also noted Oxygen requirements on admission: None at rest, 2 L with exertion Current oxygen requirements: Room air Medical therapy: steroids Consultants following: ID Anticipated special isolation end date: 1/13/2023   AKI on CKD 3 - resolved  Most likely due to diuresis Cr 1.9 on arrival Baseline Cr.  Around 1.4 Hold home diuretics and Entresto Avoid nephrotoxins Monitor renal function   Acute UTI UA with moderate leuk esterase, WBC 9500 bacteria Patient does endorse urinary frequency but is also on diuretic Given Keflex in ER Urine culture grew E-coli  Will discharge home with 2 more days of Keflex   Elevated troponin Troponin 27 and then 24 Likely related to CKD EKG without any acute ST changes Patient denies chest pain Continue telemetry monitoring   Chronic HFrEF Does not appear clinically fluid overloaded Hold home Lasix and Aldactone given AKI Monitor volume status BNP 509, near baseline of 500 Echo 12/12 with EF 45%  Hilar lymphadenopathy, chronic stable, likely benign.    DM type 2 with current long term insulin use and CKD 3 A1c 8.8 on 12/16/2022 Home regimen: levemir 50 units qpm and novlog 7-10 with meals Lantus 25 units nightly plus sliding scale ordered for now   Acquired hypothyroidism Continue levothroid   Depression Continue sertraline