chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Activated partial thromboplastin time shortened, Acute respiratory failure, Alanine aminotransferase normal, Albumin globulin ratio decreased, Allen's test
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Anion gap, Anogenital warts, Anticoagulant therapy, Aspartate aminotransferase increased
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Atelectasis, Back pain, Base excess negative, Basophil count normal, Basophil percentage
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood albumin decreased, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood calcium normal
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood chloride normal, Blood creatinine normal, Blood disorder, Blood gases, Blood glucose normal
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood pH normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Blood urea nitrogen/creatinine ratio increased
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide normal, COVID-19, Carbon dioxide decreased, Chest X-ray abnormal, Chest pain
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cough, Differential white blood cell count, Dyspnoea, Echocardiogram, Ejection fraction
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Eosinophil percentage decreased, Fall, Full blood count, Genital lesion, Globulin
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Glomerular filtration rate normal, Glycosylated haemoglobin normal, Haematocrit decreased, Haemoglobin decreased, Hyperglycaemia
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Immature granulocyte count, Increased tendency to bruise, International normalised ratio normal, Lung infiltration, Lung opacity
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lymphocyte count, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin increased, Mean cell volume increased
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Mean platelet volume normal, Metabolic function test, Monocyte count increased, Monocyte percentage increased, Musculoskeletal chest pain
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Neutrophil count increased, Neutrophil percentage increased, Oxygen saturation decreased, PCO2 normal, PO2 decreased
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Platelet count normal, Pleural effusion, Pneumonia, Pneumonia bacterial, Protein total normal
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch
Age: 84.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Prothrombin time prolonged, Red blood cell analysis normal, Red blood cell count decreased, Red blood cell nucleated morphology, Red cell distribution width normal
Clinical narrative: 1/31/22 The patient presents for shortness of breath.  He tested positive for Covid yesterday.  EMS reported O2 sats in the 70s when they transported the patient today.  The patient tells me his shortness of breath has been chronic but worse over the last 3 weeks.  He has had a cough but no fever and no chest pain.  On my assessment, he is awake and alert.  Skin color is normal.  There is no scleral icterus.  He is nontoxic-appearing Pt states he is always short of breath but has worsen since fall on Saturday. Pt has hx of falling for unknown reasons. Pt has been worked up for this. Pt fell Saturday where he broke ribs on his right side. Pt was seen at local hospital. Pt went home and had home health nurse do a covid swab on him which was positive. Pt has had vaccine but not booster. Pt has had a cough. Pt denies fever, sore throat, HA, sneezing/tearing from eyes, body aches, V/D, dysuria, or rash. Pt does bruise easily due to being on aspirin. Pt does smoke. Pt has hx of COPD. No home oxygen. Pt denies hitting head or other injuries from fall. Review of Systems  Constitutional: Negative for fever.  HENT: Negative for sore throat and sneezing.   Eyes: Negative for discharge.  Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Positive for chest pain (ribs).  Gastrointestinal: Negative for diarrhea, nausea and vomiting.  Genitourinary: Negative for dysuria.  Musculoskeletal: Positive for back pain (posterior ribs).  Skin: Positive for color change.  Neurological: Negative for headaches.  Hematological: Bruises/bleeds easily.  2/2/22  Hospital Course:   From admission HPI: "85 y/o male with hx of COPD/emphysema, DM II, HTN, and a recent fall causing right sided rib fractures, presents to ED for evaluation of increasing SOB and cough.  Of note, patient is vaccinated and boostered, but did test + for COVID-19 last week.  He doesn't wear oxygen at home.  Denies fevers or chills. He still has pain in right lateral chest wall."   The following issues were addressed:   1) Acute hypoxic respiratory failure 2/2 community-acquired PNA: - COVID-19 positive but infiltrates on CT chest appear more consistent with bacterial PNA that what we typically see with COVID-19.  - s/p IV abx, discharge on PO to complete course - s/p IV dexamethasone for COVID, home on PO to complete 10 day total course - weaned off oxygen, does not qualify for home O2 per 6 min walk - WBC chronically elevated.   2) Prior R rib fractures: - pain seems to be improving   3) Uncontrolled T2DM with steroid-induced hyperglycemia: - resume metformin - A1c 6.0 so typically well controlled at home   4) Groin lesions: - appear consistent with condyloma acuminata, unclear chronicity - can f/u with PCP after discharge, she can pursue biopsy or removal if desired   5) Tobacco abuse: - requests Rx for nicotine patch