chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram spine, Cortisol normal
Clinical narrative: Perpetual Assessment: Patient is a 76 y.o. male who presented from home on 1/5/2023 with productive cough, shortness of breath, fevers, acute on chronic neck pain. He tested positive for SARS-CoV-2 on 12/31/22.          Assessment and Plan COVID-19 pneumonia - Presented with: Cough, shortness of breath, generalized weakness, fevers, myalgias  - Symptom onset: Patient is unsure, approximately 12/28 or 12/29  - Positive COVID-19: 12/31/22 at ED - Vaccination status: Vaccinated with Moderna and boosted with Moderna with booster dose on 8/22/22. - CXR on admission showed: There are multifocal areas of diffuse ground-glass opacities in the bilateral mid and lower lung zones, progressed from the study of 12/31/2022.  There is also blunting of the bilateral costophrenic sulci, suggestive of small pleural effusions.   - Oxygen status: 93% on room air although desats with ambulation so arranged for home O2 - Decadron: Does not qualify due to SpO2>94% on RA.  - Remdesivir: Does not qualify due to SpO2>94% on RA, unclear symptom onset.  - DVT prophylaxis:Lovenox - CRP elevated, procalcitonin wnl, blood and sputum cultures NGTD, urine antigens non-contributory - Aggressive pulmonary hygiene - Mucinex, prn Tesslon capsules - Out of isolation 1/10/23   Neck pain, acute on chronic  Cervical spine DDD - Acute worsening over the last few days with new pain radiating down right upper extremity. No weakness on exam. Denies recent trauma/injury. - CT cervical spine on admission: Severe disc space narrowing C5-6, C6-7 and moderate-to-severe disc space narrowing C3-4 and C7-T1. Facet arthropathy to the right of midline C3-4, C4-5 and to the left of midline C3-4, C4-5, C5-6. Foraminal stenosis to the right of midline C3-4, C5-6, C6-7 and to the left of midline C3-4, C4-5, C5-6, C6-7. No evidence of central spinal canal stenosis. - MRI C-spine reveals severe bilateral neural foraminal stenosis C3-C6 levels and severe neuroforaminal stenosis on the left at C6 and 7.  Moderate stenosis C7-T2.  No central canal stenosis or cord signal abnormality. - Pain control with acetaminophen, lidocaine patch, prn Flexeril   Hyponatremia, improving - Acute on chronic; prior Na+ levels ~127-132. Na+ 124 on presentation - TSH and AM Cortisol wnl. - S/p 500 cc 0.9% NS in the ED, with 75cc of NS in the AM 1/6. - Na worsened to 122 1/6/23.  Suspicious for SIADH, possible in setting of COVID - SSRI held, fluid restriction initiated; Na continues to fluctuate although mostly in the upper 120s - Stable at 126 on dc; rec ongoing fluid restriction and followup BMP 1 week  COPD - No current evidence of exacerbation. - Continue home ICS-LABA, prn albuterol  - Aggressive pulmonary hygiene with incentive spirometry, vibratory PEP therapy    Paroxysmal atrial fibrillation - Per history. Not on AC. Currently in sinus rhythm - Continue home BB
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Dyspnoea exertional, Facet joint syndrome, Fluid intake restriction, Hyponatraemia
Clinical narrative: Perpetual Assessment: Patient is a 76 y.o. male who presented from home on 1/5/2023 with productive cough, shortness of breath, fevers, acute on chronic neck pain. He tested positive for SARS-CoV-2 on 12/31/22.          Assessment and Plan COVID-19 pneumonia - Presented with: Cough, shortness of breath, generalized weakness, fevers, myalgias  - Symptom onset: Patient is unsure, approximately 12/28 or 12/29  - Positive COVID-19: 12/31/22 at ED - Vaccination status: Vaccinated with Moderna and boosted with Moderna with booster dose on 8/22/22. - CXR on admission showed: There are multifocal areas of diffuse ground-glass opacities in the bilateral mid and lower lung zones, progressed from the study of 12/31/2022.  There is also blunting of the bilateral costophrenic sulci, suggestive of small pleural effusions.   - Oxygen status: 93% on room air although desats with ambulation so arranged for home O2 - Decadron: Does not qualify due to SpO2>94% on RA.  - Remdesivir: Does not qualify due to SpO2>94% on RA, unclear symptom onset.  - DVT prophylaxis:Lovenox - CRP elevated, procalcitonin wnl, blood and sputum cultures NGTD, urine antigens non-contributory - Aggressive pulmonary hygiene - Mucinex, prn Tesslon capsules - Out of isolation 1/10/23   Neck pain, acute on chronic  Cervical spine DDD - Acute worsening over the last few days with new pain radiating down right upper extremity. No weakness on exam. Denies recent trauma/injury. - CT cervical spine on admission: Severe disc space narrowing C5-6, C6-7 and moderate-to-severe disc space narrowing C3-4 and C7-T1. Facet arthropathy to the right of midline C3-4, C4-5 and to the left of midline C3-4, C4-5, C5-6. Foraminal stenosis to the right of midline C3-4, C5-6, C6-7 and to the left of midline C3-4, C4-5, C5-6, C6-7. No evidence of central spinal canal stenosis. - MRI C-spine reveals severe bilateral neural foraminal stenosis C3-C6 levels and severe neuroforaminal stenosis on the left at C6 and 7.  Moderate stenosis C7-T2.  No central canal stenosis or cord signal abnormality. - Pain control with acetaminophen, lidocaine patch, prn Flexeril   Hyponatremia, improving - Acute on chronic; prior Na+ levels ~127-132. Na+ 124 on presentation - TSH and AM Cortisol wnl. - S/p 500 cc 0.9% NS in the ED, with 75cc of NS in the AM 1/6. - Na worsened to 122 1/6/23.  Suspicious for SIADH, possible in setting of COVID - SSRI held, fluid restriction initiated; Na continues to fluctuate although mostly in the upper 120s - Stable at 126 on dc; rec ongoing fluid restriction and followup BMP 1 week  COPD - No current evidence of exacerbation. - Continue home ICS-LABA, prn albuterol  - Aggressive pulmonary hygiene with incentive spirometry, vibratory PEP therapy    Paroxysmal atrial fibrillation - Per history. Not on AC. Currently in sinus rhythm - Continue home BB
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Intervertebral disc degeneration, Intervertebral disc space narrowing, Lung opacity, Magnetic resonance imaging spinal abnormal, Myalgia
Clinical narrative: Perpetual Assessment: Patient is a 76 y.o. male who presented from home on 1/5/2023 with productive cough, shortness of breath, fevers, acute on chronic neck pain. He tested positive for SARS-CoV-2 on 12/31/22.          Assessment and Plan COVID-19 pneumonia - Presented with: Cough, shortness of breath, generalized weakness, fevers, myalgias  - Symptom onset: Patient is unsure, approximately 12/28 or 12/29  - Positive COVID-19: 12/31/22 at ED - Vaccination status: Vaccinated with Moderna and boosted with Moderna with booster dose on 8/22/22. - CXR on admission showed: There are multifocal areas of diffuse ground-glass opacities in the bilateral mid and lower lung zones, progressed from the study of 12/31/2022.  There is also blunting of the bilateral costophrenic sulci, suggestive of small pleural effusions.   - Oxygen status: 93% on room air although desats with ambulation so arranged for home O2 - Decadron: Does not qualify due to SpO2>94% on RA.  - Remdesivir: Does not qualify due to SpO2>94% on RA, unclear symptom onset.  - DVT prophylaxis:Lovenox - CRP elevated, procalcitonin wnl, blood and sputum cultures NGTD, urine antigens non-contributory - Aggressive pulmonary hygiene - Mucinex, prn Tesslon capsules - Out of isolation 1/10/23   Neck pain, acute on chronic  Cervical spine DDD - Acute worsening over the last few days with new pain radiating down right upper extremity. No weakness on exam. Denies recent trauma/injury. - CT cervical spine on admission: Severe disc space narrowing C5-6, C6-7 and moderate-to-severe disc space narrowing C3-4 and C7-T1. Facet arthropathy to the right of midline C3-4, C4-5 and to the left of midline C3-4, C4-5, C5-6. Foraminal stenosis to the right of midline C3-4, C5-6, C6-7 and to the left of midline C3-4, C4-5, C5-6, C6-7. No evidence of central spinal canal stenosis. - MRI C-spine reveals severe bilateral neural foraminal stenosis C3-C6 levels and severe neuroforaminal stenosis on the left at C6 and 7.  Moderate stenosis C7-T2.  No central canal stenosis or cord signal abnormality. - Pain control with acetaminophen, lidocaine patch, prn Flexeril   Hyponatremia, improving - Acute on chronic; prior Na+ levels ~127-132. Na+ 124 on presentation - TSH and AM Cortisol wnl. - S/p 500 cc 0.9% NS in the ED, with 75cc of NS in the AM 1/6. - Na worsened to 122 1/6/23.  Suspicious for SIADH, possible in setting of COVID - SSRI held, fluid restriction initiated; Na continues to fluctuate although mostly in the upper 120s - Stable at 126 on dc; rec ongoing fluid restriction and followup BMP 1 week  COPD - No current evidence of exacerbation. - Continue home ICS-LABA, prn albuterol  - Aggressive pulmonary hygiene with incentive spirometry, vibratory PEP therapy    Paroxysmal atrial fibrillation - Per history. Not on AC. Currently in sinus rhythm - Continue home BB
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Neck pain, Oxygen saturation decreased, Pain, Pain in extremity, Pleural effusion
Clinical narrative: Perpetual Assessment: Patient is a 76 y.o. male who presented from home on 1/5/2023 with productive cough, shortness of breath, fevers, acute on chronic neck pain. He tested positive for SARS-CoV-2 on 12/31/22.          Assessment and Plan COVID-19 pneumonia - Presented with: Cough, shortness of breath, generalized weakness, fevers, myalgias  - Symptom onset: Patient is unsure, approximately 12/28 or 12/29  - Positive COVID-19: 12/31/22 at ED - Vaccination status: Vaccinated with Moderna and boosted with Moderna with booster dose on 8/22/22. - CXR on admission showed: There are multifocal areas of diffuse ground-glass opacities in the bilateral mid and lower lung zones, progressed from the study of 12/31/2022.  There is also blunting of the bilateral costophrenic sulci, suggestive of small pleural effusions.   - Oxygen status: 93% on room air although desats with ambulation so arranged for home O2 - Decadron: Does not qualify due to SpO2>94% on RA.  - Remdesivir: Does not qualify due to SpO2>94% on RA, unclear symptom onset.  - DVT prophylaxis:Lovenox - CRP elevated, procalcitonin wnl, blood and sputum cultures NGTD, urine antigens non-contributory - Aggressive pulmonary hygiene - Mucinex, prn Tesslon capsules - Out of isolation 1/10/23   Neck pain, acute on chronic  Cervical spine DDD - Acute worsening over the last few days with new pain radiating down right upper extremity. No weakness on exam. Denies recent trauma/injury. - CT cervical spine on admission: Severe disc space narrowing C5-6, C6-7 and moderate-to-severe disc space narrowing C3-4 and C7-T1. Facet arthropathy to the right of midline C3-4, C4-5 and to the left of midline C3-4, C4-5, C5-6. Foraminal stenosis to the right of midline C3-4, C5-6, C6-7 and to the left of midline C3-4, C4-5, C5-6, C6-7. No evidence of central spinal canal stenosis. - MRI C-spine reveals severe bilateral neural foraminal stenosis C3-C6 levels and severe neuroforaminal stenosis on the left at C6 and 7.  Moderate stenosis C7-T2.  No central canal stenosis or cord signal abnormality. - Pain control with acetaminophen, lidocaine patch, prn Flexeril   Hyponatremia, improving - Acute on chronic; prior Na+ levels ~127-132. Na+ 124 on presentation - TSH and AM Cortisol wnl. - S/p 500 cc 0.9% NS in the ED, with 75cc of NS in the AM 1/6. - Na worsened to 122 1/6/23.  Suspicious for SIADH, possible in setting of COVID - SSRI held, fluid restriction initiated; Na continues to fluctuate although mostly in the upper 120s - Stable at 126 on dc; rec ongoing fluid restriction and followup BMP 1 week  COPD - No current evidence of exacerbation. - Continue home ICS-LABA, prn albuterol  - Aggressive pulmonary hygiene with incentive spirometry, vibratory PEP therapy    Paroxysmal atrial fibrillation - Per history. Not on AC. Currently in sinus rhythm - Continue home BB
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Procalcitonin normal, Productive cough, Pyrexia, SARS-CoV-2 test positive, Sinus rhythm
Clinical narrative: Perpetual Assessment: Patient is a 76 y.o. male who presented from home on 1/5/2023 with productive cough, shortness of breath, fevers, acute on chronic neck pain. He tested positive for SARS-CoV-2 on 12/31/22.          Assessment and Plan COVID-19 pneumonia - Presented with: Cough, shortness of breath, generalized weakness, fevers, myalgias  - Symptom onset: Patient is unsure, approximately 12/28 or 12/29  - Positive COVID-19: 12/31/22 at ED - Vaccination status: Vaccinated with Moderna and boosted with Moderna with booster dose on 8/22/22. - CXR on admission showed: There are multifocal areas of diffuse ground-glass opacities in the bilateral mid and lower lung zones, progressed from the study of 12/31/2022.  There is also blunting of the bilateral costophrenic sulci, suggestive of small pleural effusions.   - Oxygen status: 93% on room air although desats with ambulation so arranged for home O2 - Decadron: Does not qualify due to SpO2>94% on RA.  - Remdesivir: Does not qualify due to SpO2>94% on RA, unclear symptom onset.  - DVT prophylaxis:Lovenox - CRP elevated, procalcitonin wnl, blood and sputum cultures NGTD, urine antigens non-contributory - Aggressive pulmonary hygiene - Mucinex, prn Tesslon capsules - Out of isolation 1/10/23   Neck pain, acute on chronic  Cervical spine DDD - Acute worsening over the last few days with new pain radiating down right upper extremity. No weakness on exam. Denies recent trauma/injury. - CT cervical spine on admission: Severe disc space narrowing C5-6, C6-7 and moderate-to-severe disc space narrowing C3-4 and C7-T1. Facet arthropathy to the right of midline C3-4, C4-5 and to the left of midline C3-4, C4-5, C5-6. Foraminal stenosis to the right of midline C3-4, C5-6, C6-7 and to the left of midline C3-4, C4-5, C5-6, C6-7. No evidence of central spinal canal stenosis. - MRI C-spine reveals severe bilateral neural foraminal stenosis C3-C6 levels and severe neuroforaminal stenosis on the left at C6 and 7.  Moderate stenosis C7-T2.  No central canal stenosis or cord signal abnormality. - Pain control with acetaminophen, lidocaine patch, prn Flexeril   Hyponatremia, improving - Acute on chronic; prior Na+ levels ~127-132. Na+ 124 on presentation - TSH and AM Cortisol wnl. - S/p 500 cc 0.9% NS in the ED, with 75cc of NS in the AM 1/6. - Na worsened to 122 1/6/23.  Suspicious for SIADH, possible in setting of COVID - SSRI held, fluid restriction initiated; Na continues to fluctuate although mostly in the upper 120s - Stable at 126 on dc; rec ongoing fluid restriction and followup BMP 1 week  COPD - No current evidence of exacerbation. - Continue home ICS-LABA, prn albuterol  - Aggressive pulmonary hygiene with incentive spirometry, vibratory PEP therapy    Paroxysmal atrial fibrillation - Per history. Not on AC. Currently in sinus rhythm - Continue home BB
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Sputum culture, Urine antigen test, Vertebral foraminal stenosis
Clinical narrative: Perpetual Assessment: Patient is a 76 y.o. male who presented from home on 1/5/2023 with productive cough, shortness of breath, fevers, acute on chronic neck pain. He tested positive for SARS-CoV-2 on 12/31/22.          Assessment and Plan COVID-19 pneumonia - Presented with: Cough, shortness of breath, generalized weakness, fevers, myalgias  - Symptom onset: Patient is unsure, approximately 12/28 or 12/29  - Positive COVID-19: 12/31/22 at ED - Vaccination status: Vaccinated with Moderna and boosted with Moderna with booster dose on 8/22/22. - CXR on admission showed: There are multifocal areas of diffuse ground-glass opacities in the bilateral mid and lower lung zones, progressed from the study of 12/31/2022.  There is also blunting of the bilateral costophrenic sulci, suggestive of small pleural effusions.   - Oxygen status: 93% on room air although desats with ambulation so arranged for home O2 - Decadron: Does not qualify due to SpO2>94% on RA.  - Remdesivir: Does not qualify due to SpO2>94% on RA, unclear symptom onset.  - DVT prophylaxis:Lovenox - CRP elevated, procalcitonin wnl, blood and sputum cultures NGTD, urine antigens non-contributory - Aggressive pulmonary hygiene - Mucinex, prn Tesslon capsules - Out of isolation 1/10/23   Neck pain, acute on chronic  Cervical spine DDD - Acute worsening over the last few days with new pain radiating down right upper extremity. No weakness on exam. Denies recent trauma/injury. - CT cervical spine on admission: Severe disc space narrowing C5-6, C6-7 and moderate-to-severe disc space narrowing C3-4 and C7-T1. Facet arthropathy to the right of midline C3-4, C4-5 and to the left of midline C3-4, C4-5, C5-6. Foraminal stenosis to the right of midline C3-4, C5-6, C6-7 and to the left of midline C3-4, C4-5, C5-6, C6-7. No evidence of central spinal canal stenosis. - MRI C-spine reveals severe bilateral neural foraminal stenosis C3-C6 levels and severe neuroforaminal stenosis on the left at C6 and 7.  Moderate stenosis C7-T2.  No central canal stenosis or cord signal abnormality. - Pain control with acetaminophen, lidocaine patch, prn Flexeril   Hyponatremia, improving - Acute on chronic; prior Na+ levels ~127-132. Na+ 124 on presentation - TSH and AM Cortisol wnl. - S/p 500 cc 0.9% NS in the ED, with 75cc of NS in the AM 1/6. - Na worsened to 122 1/6/23.  Suspicious for SIADH, possible in setting of COVID - SSRI held, fluid restriction initiated; Na continues to fluctuate although mostly in the upper 120s - Stable at 126 on dc; rec ongoing fluid restriction and followup BMP 1 week  COPD - No current evidence of exacerbation. - Continue home ICS-LABA, prn albuterol  - Aggressive pulmonary hygiene with incentive spirometry, vibratory PEP therapy    Paroxysmal atrial fibrillation - Per history. Not on AC. Currently in sinus rhythm - Continue home BB
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Nurse only drew up half a dose so patient had to come back for the other half
Age: 87.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Nurse only drew up half a dose so patient had to come back for the other half
Age: 61.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: COVID-19, Chills, Cough, Fatigue, Headache
Clinical narrative: Began not feeling well on 12/24 and had a minor cough. 12/25 still had cough and tested for COVID-19 but was negative. Later that day I began having extreme fatigue and chills. It felt as if I had a bad cold. The next morning the symptoms persisted and I developed congestion, headache, and sore throat. I tested positive for COVID-19 and called PCP. PCP prescribed Paxlovid, steroid pack, and cough suppressant. Symptoms improved over the next 5 days, day 7 I was feeling much better, and then my symptoms returned. Took 2.5 weeks for me to completely recover from COVID-19.
Age: 61.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Began not feeling well on 12/24 and had a minor cough. 12/25 still had cough and tested for COVID-19 but was negative. Later that day I began having extreme fatigue and chills. It felt as if I had a bad cold. The next morning the symptoms persisted and I developed congestion, headache, and sore throat. I tested positive for COVID-19 and called PCP. PCP prescribed Paxlovid, steroid pack, and cough suppressant. Symptoms improved over the next 5 days, day 7 I was feeling much better, and then my symptoms returned. Took 2.5 weeks for me to completely recover from COVID-19.
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Nurse only drew up half a dose so patient had to come back for the other half
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Back pain, Chest X-ray, Chest pain, Echocardiogram, Electrocardiogram
Clinical narrative: 1617: Patient arrives to ED via pov with c/o chest pain for the last hour. States 10/10 starting in back between shoulder blades and radiates to center of chest. Reports he got sweaty. Denies nausea or shortness of breath. States nothing makes it better or worse. States it initially started this morning in his back between shoulder blades but resolved on it's own. States it's been intermittent and severe for the last hour. Reports hx of PE on Warfarin, DM2, HTN and HLD. Denies prior cardiac history
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Full blood count, Hyperhidrosis, International normalised ratio, Metabolic function test, Pain
Clinical narrative: 1617: Patient arrives to ED via pov with c/o chest pain for the last hour. States 10/10 starting in back between shoulder blades and radiates to center of chest. Reports he got sweaty. Denies nausea or shortness of breath. States nothing makes it better or worse. States it initially started this morning in his back between shoulder blades but resolved on it's own. States it's been intermittent and severe for the last hour. Reports hx of PE on Warfarin, DM2, HTN and HLD. Denies prior cardiac history
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Prothrombin time, Troponin
Clinical narrative: 1617: Patient arrives to ED via pov with c/o chest pain for the last hour. States 10/10 starting in back between shoulder blades and radiates to center of chest. Reports he got sweaty. Denies nausea or shortness of breath. States nothing makes it better or worse. States it initially started this morning in his back between shoulder blades but resolved on it's own. States it's been intermittent and severe for the last hour. Reports hx of PE on Warfarin, DM2, HTN and HLD. Denies prior cardiac history
Age: 32.0
Sex: F
Vaccine: FLU4
Symptoms: Fatigue, Headache, Malaise, Nausea
Clinical narrative: Fatigue, H/A, Nausea, Malaise.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Arteriosclerosis, Arteriosclerosis coronary artery, Brain natriuretic peptide increased
Clinical narrative: Patient is a 74 y.o. female patient of PRIVATE, MD with history of hypertension, hyperlipidemia, COPD, brain aneurysm, cervical cancer, degenerative disc disease with lumbar radicular pain presented to Doctors Hospital with worsening shortness of breath.   Acute respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 1/4/2023- 3 days prior to admission  Symptoms present on admission: Shortness of breath cough yellow phlegm production malaise Date of covid positive test: 1/7/2023 Vaccination status: vaccinated Imaging: CTPA?No evidence for acute pulmonary embolism.  Mild bilateral perihilar airway wall thickening reflect sequela of infectious or inflammatory bronchiolitis.  No focal lobar lung consolidation.  Multiple mildly prominent bilateral hilar lymph nodes measuring up to 1 cm thick at the right hilum, likely reactive or inflammatory etiology. Cardiomegaly with extensive left and right coronary artery calcifications.  Extensive bilateral upper lobe centrilobular emphysema. Moderate bilateral peripheral upper and lower lung interstitial lung disease. Heavy atherosclerotic calcifications at the celiac and superior mesenteric arteries origin Oxygen requirements on admission: 4 L Current oxygen requirements: RA however desats down to 74% on rest after 2 passes to door 1/11. Takes some time to recover back to 85-91%. Will give another day to finish 5 day remdesivir course. On 2L NC 1/12, no significant desats with ambulation  Medical therapy: Decadron and remdesivir started 1/8/2023- last remdesivir dose 1/12 Consultants following: None Anticipated special isolation end date: 1/14/2023 Continue to wean O2 as able   Hypertension Restart home doses of lisinopril Monitor closely and give as needed labetalol as needed for systolic blood pressure more than 180 or diastolic more than 110 SBP controlled  COPD Not in acute exacerbation Continue Advair, albuterol Remote history of using oxygen?patient has not use oxygen at home for the last 8 years, previously with API with CPAP?  Elevated BNP In setting of cardiomegaly, increased calcification in coronary arteries noted on CTPA Follow-up 2D echo-EF 60-65% with grade 2 diastolic dysfunction and elevated LV filling pressures with no significant valvulopathy, no pericardial effusions no evidence of pulmonary hypertension.  There is a prominent fat pad.   Hyperlipidemia Continue home doses of statin   Depression Continue home doses of citalopram Qtc check 1/9 well under 500 in low 400s. Ok to continue at current dose   Patient seen and examined in full PPE on day of discharge.  Breathing continues to improve.  On 2 L nasal cannula.  She did walk with me in the room 2 passes from the bed to the door and back only dropped briefly to 89 but quickly recovered.  SBP was more consistently in the high 80s?low 90s.  O2 evaluation was completed qualified for 2 L nasal cannula.  Case management was consulted to help get this set up
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Bronchial wall thickening, COVID-19, Cardiomegaly, Diastolic dysfunction, Dyspnoea
Clinical narrative: Patient is a 74 y.o. female patient of PRIVATE, MD with history of hypertension, hyperlipidemia, COPD, brain aneurysm, cervical cancer, degenerative disc disease with lumbar radicular pain presented to Doctors Hospital with worsening shortness of breath.   Acute respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 1/4/2023- 3 days prior to admission  Symptoms present on admission: Shortness of breath cough yellow phlegm production malaise Date of covid positive test: 1/7/2023 Vaccination status: vaccinated Imaging: CTPA?No evidence for acute pulmonary embolism.  Mild bilateral perihilar airway wall thickening reflect sequela of infectious or inflammatory bronchiolitis.  No focal lobar lung consolidation.  Multiple mildly prominent bilateral hilar lymph nodes measuring up to 1 cm thick at the right hilum, likely reactive or inflammatory etiology. Cardiomegaly with extensive left and right coronary artery calcifications.  Extensive bilateral upper lobe centrilobular emphysema. Moderate bilateral peripheral upper and lower lung interstitial lung disease. Heavy atherosclerotic calcifications at the celiac and superior mesenteric arteries origin Oxygen requirements on admission: 4 L Current oxygen requirements: RA however desats down to 74% on rest after 2 passes to door 1/11. Takes some time to recover back to 85-91%. Will give another day to finish 5 day remdesivir course. On 2L NC 1/12, no significant desats with ambulation  Medical therapy: Decadron and remdesivir started 1/8/2023- last remdesivir dose 1/12 Consultants following: None Anticipated special isolation end date: 1/14/2023 Continue to wean O2 as able   Hypertension Restart home doses of lisinopril Monitor closely and give as needed labetalol as needed for systolic blood pressure more than 180 or diastolic more than 110 SBP controlled  COPD Not in acute exacerbation Continue Advair, albuterol Remote history of using oxygen?patient has not use oxygen at home for the last 8 years, previously with API with CPAP?  Elevated BNP In setting of cardiomegaly, increased calcification in coronary arteries noted on CTPA Follow-up 2D echo-EF 60-65% with grade 2 diastolic dysfunction and elevated LV filling pressures with no significant valvulopathy, no pericardial effusions no evidence of pulmonary hypertension.  There is a prominent fat pad.   Hyperlipidemia Continue home doses of statin   Depression Continue home doses of citalopram Qtc check 1/9 well under 500 in low 400s. Ok to continue at current dose   Patient seen and examined in full PPE on day of discharge.  Breathing continues to improve.  On 2 L nasal cannula.  She did walk with me in the room 2 passes from the bed to the door and back only dropped briefly to 89 but quickly recovered.  SBP was more consistently in the high 80s?low 90s.  O2 evaluation was completed qualified for 2 L nasal cannula.  Case management was consulted to help get this set up
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Ejection fraction, Emphysema, Lymphadenopathy, Malaise
Clinical narrative: Patient is a 74 y.o. female patient of PRIVATE, MD with history of hypertension, hyperlipidemia, COPD, brain aneurysm, cervical cancer, degenerative disc disease with lumbar radicular pain presented to Doctors Hospital with worsening shortness of breath.   Acute respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 1/4/2023- 3 days prior to admission  Symptoms present on admission: Shortness of breath cough yellow phlegm production malaise Date of covid positive test: 1/7/2023 Vaccination status: vaccinated Imaging: CTPA?No evidence for acute pulmonary embolism.  Mild bilateral perihilar airway wall thickening reflect sequela of infectious or inflammatory bronchiolitis.  No focal lobar lung consolidation.  Multiple mildly prominent bilateral hilar lymph nodes measuring up to 1 cm thick at the right hilum, likely reactive or inflammatory etiology. Cardiomegaly with extensive left and right coronary artery calcifications.  Extensive bilateral upper lobe centrilobular emphysema. Moderate bilateral peripheral upper and lower lung interstitial lung disease. Heavy atherosclerotic calcifications at the celiac and superior mesenteric arteries origin Oxygen requirements on admission: 4 L Current oxygen requirements: RA however desats down to 74% on rest after 2 passes to door 1/11. Takes some time to recover back to 85-91%. Will give another day to finish 5 day remdesivir course. On 2L NC 1/12, no significant desats with ambulation  Medical therapy: Decadron and remdesivir started 1/8/2023- last remdesivir dose 1/12 Consultants following: None Anticipated special isolation end date: 1/14/2023 Continue to wean O2 as able   Hypertension Restart home doses of lisinopril Monitor closely and give as needed labetalol as needed for systolic blood pressure more than 180 or diastolic more than 110 SBP controlled  COPD Not in acute exacerbation Continue Advair, albuterol Remote history of using oxygen?patient has not use oxygen at home for the last 8 years, previously with API with CPAP?  Elevated BNP In setting of cardiomegaly, increased calcification in coronary arteries noted on CTPA Follow-up 2D echo-EF 60-65% with grade 2 diastolic dysfunction and elevated LV filling pressures with no significant valvulopathy, no pericardial effusions no evidence of pulmonary hypertension.  There is a prominent fat pad.   Hyperlipidemia Continue home doses of statin   Depression Continue home doses of citalopram Qtc check 1/9 well under 500 in low 400s. Ok to continue at current dose   Patient seen and examined in full PPE on day of discharge.  Breathing continues to improve.  On 2 L nasal cannula.  She did walk with me in the room 2 passes from the bed to the door and back only dropped briefly to 89 but quickly recovered.  SBP was more consistently in the high 80s?low 90s.  O2 evaluation was completed qualified for 2 L nasal cannula.  Case management was consulted to help get this set up
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Mesenteric arteriosclerosis, Productive cough, Respiration abnormal, SARS-CoV-2 test positive, Sputum discoloured
Clinical narrative: Patient is a 74 y.o. female patient of PRIVATE, MD with history of hypertension, hyperlipidemia, COPD, brain aneurysm, cervical cancer, degenerative disc disease with lumbar radicular pain presented to Doctors Hospital with worsening shortness of breath.   Acute respiratory failure with hypoxia Covid-19 Virus Infection Date of onset of symptoms: 1/4/2023- 3 days prior to admission  Symptoms present on admission: Shortness of breath cough yellow phlegm production malaise Date of covid positive test: 1/7/2023 Vaccination status: vaccinated Imaging: CTPA?No evidence for acute pulmonary embolism.  Mild bilateral perihilar airway wall thickening reflect sequela of infectious or inflammatory bronchiolitis.  No focal lobar lung consolidation.  Multiple mildly prominent bilateral hilar lymph nodes measuring up to 1 cm thick at the right hilum, likely reactive or inflammatory etiology. Cardiomegaly with extensive left and right coronary artery calcifications.  Extensive bilateral upper lobe centrilobular emphysema. Moderate bilateral peripheral upper and lower lung interstitial lung disease. Heavy atherosclerotic calcifications at the celiac and superior mesenteric arteries origin Oxygen requirements on admission: 4 L Current oxygen requirements: RA however desats down to 74% on rest after 2 passes to door 1/11. Takes some time to recover back to 85-91%. Will give another day to finish 5 day remdesivir course. On 2L NC 1/12, no significant desats with ambulation  Medical therapy: Decadron and remdesivir started 1/8/2023- last remdesivir dose 1/12 Consultants following: None Anticipated special isolation end date: 1/14/2023 Continue to wean O2 as able   Hypertension Restart home doses of lisinopril Monitor closely and give as needed labetalol as needed for systolic blood pressure more than 180 or diastolic more than 110 SBP controlled  COPD Not in acute exacerbation Continue Advair, albuterol Remote history of using oxygen?patient has not use oxygen at home for the last 8 years, previously with API with CPAP?  Elevated BNP In setting of cardiomegaly, increased calcification in coronary arteries noted on CTPA Follow-up 2D echo-EF 60-65% with grade 2 diastolic dysfunction and elevated LV filling pressures with no significant valvulopathy, no pericardial effusions no evidence of pulmonary hypertension.  There is a prominent fat pad.   Hyperlipidemia Continue home doses of statin   Depression Continue home doses of citalopram Qtc check 1/9 well under 500 in low 400s. Ok to continue at current dose   Patient seen and examined in full PPE on day of discharge.  Breathing continues to improve.  On 2 L nasal cannula.  She did walk with me in the room 2 passes from the bed to the door and back only dropped briefly to 89 but quickly recovered.  SBP was more consistently in the high 80s?low 90s.  O2 evaluation was completed qualified for 2 L nasal cannula.  Case management was consulted to help get this set up
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Nurse only drew up half a dose so patient had to come back for the other half
Age: 1.0
Sex: F
Vaccine: HEPA, MMRV, UNK
Symptoms: Extra dose administered, No adverse event
Clinical narrative: patient was given this xtra dose by mistake of the kinrix, her brother was getting vaccines also and the ma grabbed the wrong set of shots, the child is fine and has been checked on by the crnp , no adverse reactions
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Nurse only drew up half a dose so patient had to come back for the other half
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: Nurse only drew up half a dose so patient had to come back for the other half
Age: 68.0
Sex: F
Vaccine: PPV
Symptoms: Arthralgia, Erythema, Joint swelling, Loss of personal independence in daily activities, Pain
Clinical narrative: She got her vaccine, it hurt and had pain and then it started swelling.  The next day her whole arm half way down was swelling.  She ignored it as she had it the last time. The third day her whole arm was hard to put on her clothes to her elbow.  When you touched her skin it stung and it was swelling very bad to her elbow (looked like Popeye's arm).  She did not call her doctor, but did call her pharmacist who told her to put ice on it for the swelling, which she did.  It went away, but the swelling is still at the elbow, has pain in that area in the joint, which she had this with her first pneumonia vaccine.    The arm that is swelling is scaring her as she has never had that before.  Her arm was red in the front, the entire area was red.  She has some itching with this vaccine, but it was more stingy.    She did have reactions with her COVID vaccines, but nothing serious.  She called her doctor after her first pneumonia vaccine and told her to take Tylenol and Benadryl which she has used as she also has allergies to other things and takes that.
Age: 68.0
Sex: F
Vaccine: PPV
Symptoms: Peripheral swelling, Pruritus, Swelling
Clinical narrative: She got her vaccine, it hurt and had pain and then it started swelling.  The next day her whole arm half way down was swelling.  She ignored it as she had it the last time. The third day her whole arm was hard to put on her clothes to her elbow.  When you touched her skin it stung and it was swelling very bad to her elbow (looked like Popeye's arm).  She did not call her doctor, but did call her pharmacist who told her to put ice on it for the swelling, which she did.  It went away, but the swelling is still at the elbow, has pain in that area in the joint, which she had this with her first pneumonia vaccine.    The arm that is swelling is scaring her as she has never had that before.  Her arm was red in the front, the entire area was red.  She has some itching with this vaccine, but it was more stingy.    She did have reactions with her COVID vaccines, but nothing serious.  She called her doctor after her first pneumonia vaccine and told her to take Tylenol and Benadryl which she has used as she also has allergies to other things and takes that.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: The nurse drawing up the vaccine only drew up a half a dose so this patient needs to come back in 8 weeks for the other half
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: The nurse drawing up the vaccine only drew up a half a dose so this patient needs to come back in 8 weeks for the other half
Age: 31.0
Sex: F
Vaccine: TDAP
Symptoms: No adverse event, Wrong product administered
Clinical narrative: TDAP adacel 0.5 mL administered IM in L deltoid. Pt tolerated well. Lot u7561aa Exp 11/09/2024 NDC 492140089.   Tdap vaccine was given instead of the flu vaccine. NO adverse effects to patient or fetus at this time.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Anaemia, Anticoagulant therapy, Asthenia, COVID-19, Clostridium difficile infection
Clinical narrative: Report on admission: Patient is a 78 y.o. year-old female, who presented with weakness to ER. Patient admitted to ICU for pneumonia and anemia. Covid +. She did receive blood transfusion. Chronically on Coumadin. CT scan reveals ground glass opacities in upper lobes. Did have episodes of hypotension in ED with decreased responsiveness. She is chronically on midodrine    Infectious disease followed during stay for COVID and C. difficile.  Home Ambien discontinued in setting of falls.  Patient received blood transfusion for anemia.  Coumadin was safely restarted once guaiac was negative.  Palliative care followed during stay.  Patient improved with medical treatment and was discharged home in stable condition.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Fall, Hyporesponsive to stimuli, Hypotension, Intensive care
Clinical narrative: Report on admission: Patient is a 78 y.o. year-old female, who presented with weakness to ER. Patient admitted to ICU for pneumonia and anemia. Covid +. She did receive blood transfusion. Chronically on Coumadin. CT scan reveals ground glass opacities in upper lobes. Did have episodes of hypotension in ED with decreased responsiveness. She is chronically on midodrine    Infectious disease followed during stay for COVID and C. difficile.  Home Ambien discontinued in setting of falls.  Patient received blood transfusion for anemia.  Coumadin was safely restarted once guaiac was negative.  Palliative care followed during stay.  Patient improved with medical treatment and was discharged home in stable condition.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Lung opacity, Occult blood positive, Pneumonia, SARS-CoV-2 test positive, Transfusion
Clinical narrative: Report on admission: Patient is a 78 y.o. year-old female, who presented with weakness to ER. Patient admitted to ICU for pneumonia and anemia. Covid +. She did receive blood transfusion. Chronically on Coumadin. CT scan reveals ground glass opacities in upper lobes. Did have episodes of hypotension in ED with decreased responsiveness. She is chronically on midodrine    Infectious disease followed during stay for COVID and C. difficile.  Home Ambien discontinued in setting of falls.  Patient received blood transfusion for anemia.  Coumadin was safely restarted once guaiac was negative.  Palliative care followed during stay.  Patient improved with medical treatment and was discharged home in stable condition.
Age: 57.0
Sex: F
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: The nurse drawing up the vaccine only drew up a half a dose so this patient needs to come back in 8 weeks for the other half
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Cough, Pyrexia
Clinical narrative: Pt has a PMH of rheumatoid arthritis and is steroid dependent. Pt presents to the ER with fever, weakness, and a one day history of a cough. Chest xray revealed possible pneumonia and pt was found to be COVID positive.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Pt has a PMH of rheumatoid arthritis and is steroid dependent. Pt presents to the ER with fever, weakness, and a one day history of a cough. Chest xray revealed possible pneumonia and pt was found to be COVID positive.
Age: 92.0
Sex: M
Vaccine: COVID19-2
Symptoms: Underdose
Clinical narrative: The nurse drawing up the vaccine only drew up a half a dose so this patient needs to come back in 8 weeks for the other half
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Fatigue, Headache, Pain, Rhinorrhoea
Clinical narrative: On 19JAN2023 COVID-19 Test- Positive, I had a headache, fatigue, runny nose and body aches.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: On 19JAN2023 COVID-19 Test- Positive, I had a headache, fatigue, runny nose and body aches.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Angular cheilitis, Erythema, Herpes zoster, Herpes zoster oticus, Induration
Clinical narrative: Spots in eye diagnosed as Shingles / Mild shingles on face after 1st shot; Mild shingles on face after 1st shot; Spots in ear diagnosed as Shingles; Redness, red spots on face, eye, ear, hairline; Hard spots; Arm was sore; Hard red spot in her eye; Sore in the corner of mouth; This case was reported by a nurse and described the occurrence of ophthalmic herpes zoster in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Concurrent medical conditions included disability. Additional patient notes included patient never had shingles outbreak before.   On 17th January 2023, the patient received the 1st dose of Shingrix. In January 2023, unknown after receiving Shingrix, the patient experienced soreness corner mouth, injection site pain and eye red. On 19th January 2023, the patient experienced ophthalmic herpes zoster (serious criteria GSK medically significant), shingles, herpes zoster otitis externa (serious criteria GSK medically significant), localized erythema and induration. On an unknown date, the outcome of the ophthalmic herpes zoster, shingles, herpes zoster otitis externa, soreness corner mouth, localized erythema, induration and eye red were unknown and the outcome of the injection site pain was recovered/resolved.   The reporter considered the ophthalmic herpes zoster, shingles and herpes zoster otitis externa to be possibly related to Shingrix. It was unknown if the reporter considered the soreness corner mouth, localized erythema, induration, injection site pain and eye red to be related to Shingrix.     Additional Information: GSK receipt date: 25 Jan 2023 and 26 Jan 2023 Reporters comment: The case was reported by the nurse for herself. The nurse reported that the she developed mild case of shingles in left side of face after taking her Shingrix shot she took last Tuesday from reporting day which had been verified by her doctor. On 19th January 2023 Thursday the shingles outbreak started. It started as a sore in corner of mouth. By Thursday evening there was redness. By the weekend there were red spots on her face and upside of face and in eye and ears along hairline. The patient went to the physician and was diagnosed with shingles. Patient also reported that arm was sore (arm pain in injected arm). The patient though that Shingrix caused the shingles outbreak and stated it caused her to had shingles. The patient was plan on taking the second shot as she hopes it would keep her from hopefully every having full blown shingles. She had questions about when she takes it again what she might expect if it could even be worse, what had been other people experience. She had waited for years to take this but could never afford it now could take it free she jumped at the chance to take it and having been in the nursing field she know how bad shingles could get. She did not want a full-blown case. The reporter did not have the lot number of Shingrix shot which she was given but that information should be on record at pharmacy. The reporter consented to follow up.
Age: 60.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site pain, Ocular hyperaemia, Ophthalmic herpes zoster
Clinical narrative: Spots in eye diagnosed as Shingles / Mild shingles on face after 1st shot; Mild shingles on face after 1st shot; Spots in ear diagnosed as Shingles; Redness, red spots on face, eye, ear, hairline; Hard spots; Arm was sore; Hard red spot in her eye; Sore in the corner of mouth; This case was reported by a nurse and described the occurrence of ophthalmic herpes zoster in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis.   Concurrent medical conditions included disability. Additional patient notes included patient never had shingles outbreak before.   On 17th January 2023, the patient received the 1st dose of Shingrix. In January 2023, unknown after receiving Shingrix, the patient experienced soreness corner mouth, injection site pain and eye red. On 19th January 2023, the patient experienced ophthalmic herpes zoster (serious criteria GSK medically significant), shingles, herpes zoster otitis externa (serious criteria GSK medically significant), localized erythema and induration. On an unknown date, the outcome of the ophthalmic herpes zoster, shingles, herpes zoster otitis externa, soreness corner mouth, localized erythema, induration and eye red were unknown and the outcome of the injection site pain was recovered/resolved.   The reporter considered the ophthalmic herpes zoster, shingles and herpes zoster otitis externa to be possibly related to Shingrix. It was unknown if the reporter considered the soreness corner mouth, localized erythema, induration, injection site pain and eye red to be related to Shingrix.     Additional Information: GSK receipt date: 25 Jan 2023 and 26 Jan 2023 Reporters comment: The case was reported by the nurse for herself. The nurse reported that the she developed mild case of shingles in left side of face after taking her Shingrix shot she took last Tuesday from reporting day which had been verified by her doctor. On 19th January 2023 Thursday the shingles outbreak started. It started as a sore in corner of mouth. By Thursday evening there was redness. By the weekend there were red spots on her face and upside of face and in eye and ears along hairline. The patient went to the physician and was diagnosed with shingles. Patient also reported that arm was sore (arm pain in injected arm). The patient though that Shingrix caused the shingles outbreak and stated it caused her to had shingles. The patient was plan on taking the second shot as she hopes it would keep her from hopefully every having full blown shingles. She had questions about when she takes it again what she might expect if it could even be worse, what had been other people experience. She had waited for years to take this but could never afford it now could take it free she jumped at the chance to take it and having been in the nursing field she know how bad shingles could get. She did not want a full-blown case. The reporter did not have the lot number of Shingrix shot which she was given but that information should be on record at pharmacy. The reporter consented to follow up.