chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 72.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Product storage error
Clinical narrative: TEMP EXCURSION- ROOM TEMP (68*) FOR >12 HOURS. NO SIDE EFFECTS REPORTED
Age: 24.0
Sex: F
Vaccine: COVID19-2, FLUR4
Symptoms: Erythema, Rash pruritic, Skin warm, Urticaria
Clinical narrative: Hot, red, itchy bumps all over my body (Hives). I went to my doctor who prescribed me a steroid, but the hives did not go away. I then saw an allergist who prescribed me Xyzal to take twice a day. I still have hives even with the medication.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 60.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: TEMP EXCURSION- ROOM TEMP (68*) FOR >12 HOURS. NO SIDE EFFECTS REPORTED
Age: 87.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Hypotension, Hypotonia
Clinical narrative: SHORTLY AFTER GETTING HER SHOT, PATIENT SLUMPED OVER IN HER CHAIR AND WAS UNRESPONSIVE.WE LOWERED HER TO THE FLOOR AND ELEVATED HER FEET. IN 2-3 MINUTES SHE STARTED RESONDING TO QUESTIONS. THE PARAMEDICS ARRIVED IN ABOUT 5 MINUTES. THEY TOOK HER BLOOD PRESSURE WHICH WAS NORMAL WHEN SHE WAS LYING DOWN. THEN THEY STOOD HER UP AND TOOK IT AGAIN AND IT WAS VERY LOW AND SHE BECAME VERY DIZZY. THEY TRANSPORTED HER TO THE HOSPITAL. WE DO NOT KNOW WHAT HAPPENED AFTER THAT.
Age: 63.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Product storage error
Clinical narrative: TEMP EXCURSION- ROOM TEMP (68*) FOR >12 HOURS. NO SIDE EFFECTS REPORTED
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 23.0
Sex: F
Vaccine: COVID19-2
Symptoms: Confusional state, Fall, Loss of consciousness, Pallor
Clinical narrative: Patient sat down after getting shot and after sitting a few minutes the person with her yelled help.  When I arrived, she was slumped over on the bench leaning on the person with her.  I called her name and she woke up but was a bit confused and her lips were pale.  After resting for approximately 10 mintues, she felt completely fine and was able to walk away.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Memory impairment
Clinical narrative: 1) Forgetting how to board a ski gondola with skis!  Not something I have EVER had trouble with. 2) Forgetting how to pay for dinner with a credit card!  Not something I have EVER had trouble with.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 66.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hiccups
Clinical narrative: hiccups  11/12/22------8-9 pm 11/13/22------1201 am-1 am.     330am-430 am.    1230 pm. 115 pm.    325pm-4pm.  510 pm- - on going as of 605pm
Age: 98.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Wrong series was given to patient. Patient should have received Pfizer bivalent and not Pfizer monovalent.
Age: 23.0
Sex: M
Vaccine: UNK
Symptoms: Chest discomfort, Chest pain, Dizziness, Electrocardiogram abnormal, Fatigue
Clinical narrative: - Chest Pain, Abnormal EKG Reading, Nausea, Dizziness, Persistent Chest Pressure, Tiredness
Age: 23.0
Sex: M
Vaccine: UNK
Symptoms: Imaging procedure, Laboratory test, Nausea, Troponin I
Clinical narrative: - Chest Pain, Abnormal EKG Reading, Nausea, Dizziness, Persistent Chest Pressure, Tiredness
Age: 13.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness
Clinical narrative: pt felt light headed after administeratoin. felt better by lying down and drinking cold water
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Myalgia
Clinical narrative: Very sore thigh muscles. This has happened after each shot.
Age: 54.0
Sex: M
Vaccine: PNC13
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient was to receive Prevnar 20 but received Prevnar 13 instead.
Age: 17.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Cardiovascular function test, Eye movement disorder, Hyperhidrosis, Immediate post-injection reaction, Musculoskeletal stiffness
Clinical narrative: After administering 2nd vaccine, patient immediately started to faint, eyes rolled back and arms stiffened. It appeared pt had a seizure for about 1 second. Afterwards pt was alert but very pale and felt sweaty.
Age: 17.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Neurological examination, Pallor, Presyncope, Syncope
Clinical narrative: After administering 2nd vaccine, patient immediately started to faint, eyes rolled back and arms stiffened. It appeared pt had a seizure for about 1 second. Afterwards pt was alert but very pale and felt sweaty.
Age: 72.0
Sex: M
Vaccine: COVID19, FLUA4, VARZOS
Symptoms: COVID-19, Nasopharyngitis, Oropharyngeal pain, Paranasal sinus hypersecretion, SARS-CoV-2 test positive
Clinical narrative: Typical cold symptoms.  Sinus drainage, sore throat.  Tested positive for COVID with home test kit.
Age: 54.0
Sex: F
Vaccine: FLU4, VARZOS
Symptoms: Wrong product administered
Clinical narrative: Influenza vaccine administered instead of Tdap. This was the second influenza immunization given to patient in 2022.
Age: 0.17
Sex: M
Vaccine: UNK
Symptoms: Asthma, Hypersensitivity
Clinical narrative: I started to have asthma and allergies around one year old, and I believe it was caused by one of the vaccinations I received prior to that.
Age: 17.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Fall, Loss of consciousness, Posture abnormal, Tremor
Clinical narrative: Before any shots were given, the patient was asked if they experienced any reactions to any previous Covid and Flu vaccines. The patient answered that she felt fine after each of her previous shots, so the vaccines were administered. The Flu shot was given on the left ahoulder and then the Covid shot was given on the right shoulder. There was no reaction immediately after each shot was given, but after 1-2 minutes the patient began to lose consciousness. Patient's head began to fall back and she began to slide down the chair as she started to shake. After getting the pharmacist, the mother comforted the patient. The patient was now awake and given water along with a glucose tablet (per mother's request). Patient's mother was asked if this was an issue before with any other vaccines, but we were told that she has a history of fainting (this was not indicated in the VAR form though). Patient was then laid down on the chair with feet elevated and was given space. Patient and mother were checked on periodically and given a plastic bag (in case needed to throw up) and more water. After about 20 minutes, we were informed that the patient was now feeling better and was walked outside by her mother.
Age: 93.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Extra dose administered
Clinical narrative: PATIENT RECEIVED 2ND DOSE OF INFLUENZA AFTER UNKNOWINGLY RECEIVING A 1ST FLU SHOT AT DOCTOR'S OFFICE ON 9/2/22
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID case w/ Symptons starting on 8/16/22.
Age: 16.0
Sex: M
Vaccine: UNK
Symptoms: Hyperacusis, Oropharyngeal pain
Clinical narrative: I have had a variety of chronic symptoms in various areas. They include sound sensitivity and throat pain.
Age: 76.0
Sex: F
Vaccine: FLU4
Symptoms: Underdose, Wrong product administered
Clinical narrative: Regular dose flu shot administered instead of high dose.
Age: 50.0
Sex: F
Vaccine: COVID19-2
Symptoms: Tinnitus
Clinical narrative: tinnitus in right ear - constant since a few days after vaccination
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Cholelithiasis, Ear infection, Haemorrhoids, Hiatus hernia, Infectious mononucleosis
Clinical narrative: - double ear infection - oral thrush - mono - gallstones - sliding hitial hernia - internal hemoroids - UTI
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Oral candidiasis, Urinary tract infection
Clinical narrative: - double ear infection - oral thrush - mono - gallstones - sliding hitial hernia - internal hemoroids - UTI
Age: 44.0
Sex: F
Vaccine: COVID19-2
Symptoms: Back pain, Dysuria, Fatigue, Headache, Lymphadenopathy
Clinical narrative: Fever, swollen lymph nodes, sore throat, headache, back pain, urine urgency and pain, fatigue.
Age: 44.0
Sex: F
Vaccine: COVID19-2
Symptoms: Micturition urgency, Oropharyngeal pain, Pyrexia, Urine analysis normal
Clinical narrative: Fever, swollen lymph nodes, sore throat, headache, back pain, urine urgency and pain, fatigue.
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Pfizer COVID 5-11 yo  administered instead of bivalent dose.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dizziness, Fatigue, Hypersomnia, Injection site erythema
Clinical narrative: Large raised red circle around injection site approximately 2 inches across. Very warm to the touch & very itchy.  Red circle has been observed for 2.5 days at time of this entry.  I have felt very dizzy for the past 2.5 days.  The first night after I received the injection, I experienced chills & fever all night. I was extremely tired and slept most of the first full day and night after receiving the injection. On the 2nd day, I felt a lot better and wasn't so tired. The raised red circle around the injection site is still there. It is still hot & itchy.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site swelling, Injection site warmth, Pyrexia
Clinical narrative: Large raised red circle around injection site approximately 2 inches across. Very warm to the touch & very itchy.  Red circle has been observed for 2.5 days at time of this entry.  I have felt very dizzy for the past 2.5 days.  The first night after I received the injection, I experienced chills & fever all night. I was extremely tired and slept most of the first full day and night after receiving the injection. On the 2nd day, I felt a lot better and wasn't so tired. The raised red circle around the injection site is still there. It is still hot & itchy.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: patient was administered undiluted childrens pfizer in error 0.3ml. Instead of pfizer bivalent 0.3ml.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fatigue, Incorrect dose administered, Product administered to patient of inappropriate age, Product preparation error
Clinical narrative: Patient was administered an undiluted children's Pfizer bivalent dose instead of the Pfizer adult dose-Bivalent. Dose administered was 85mcg instead of 30mcg. Patient was followed up the next day and just exhibited symptoms of fatigue.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Acoustic stimulation tests, Ear discomfort, Ear pain, Hyperacusis, Muscle spasms
Clinical narrative: Leg cramps, tingling feet  Tinnitus, sound sensitivity, pressure in ears, pain in ears, vision changed
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia, Tinnitus, Visual impairment
Clinical narrative: Leg cramps, tingling feet  Tinnitus, sound sensitivity, pressure in ears, pain in ears, vision changed
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fatigue, Product preparation issue
Clinical narrative: Patient was administered an undiluted children's Pfizer bivalent dose instead of the Pfizer adult dose-Bivalent. Dose administered was 85mcg instead of 30mcg. Patient was followed up the next day and just exhibited symptoms of fatigue.
Age: 65.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Wrong product administered
Clinical narrative: Patient was supposed to get Covid 2nd dose (Moderna), No adverse reactions, however the Rph administered a booster dose
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood test, Deep vein thrombosis, Pain, Pain in extremity
Clinical narrative: On 03/31/2022, I was diagnosed with 2 DVTs. One was in my calf and one in my thigh. Acute thrombosis in proximal femoral vein and paleal vein. On 08/10/2022, I was diagnosed with a third DVT in the Gastrocnemius vein. Was prescribed ELIQUIS. I am still taking SYNTHROID.
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Swelling, Ultrasound scan
Clinical narrative: On 03/31/2022, I was diagnosed with 2 DVTs. One was in my calf and one in my thigh. Acute thrombosis in proximal femoral vein and paleal vein. On 08/10/2022, I was diagnosed with a third DVT in the Gastrocnemius vein. Was prescribed ELIQUIS. I am still taking SYNTHROID.
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Laboratory test, Ultrasound Doppler abnormal
Clinical narrative: On 03/31/2022, I was diagnosed with 2 DVTs. One was in my calf and one in my thigh. Acute thrombosis in proximal femoral vein and paleal vein. On 08/10/2022, I was diagnosed with a third DVT in the Gastrocnemius vein. Was prescribed ELIQUIS. I am still taking SYNTHROID.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Anaemia, Anticoagulant therapy, Bloody discharge, COVID-19
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Chronic left ventricular failure, Chronic obstructive pulmonary disease
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Condition aggravated, Dyspnoea, Endotracheal intubation, Extubation, Gastrointestinal haemorrhage
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Gastrointestinal tube insertion, Gastrointestinal tube removal, Haemoglobin decreased, Hypercapnia, Injury
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Intensive care, Mechanical ventilation, Oedema, Oxygen saturation decreased, Pleural effusion
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Polyuria, Positive airway pressure therapy, Product use issue, Pulmonary congestion, Pulmonary oedema
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Treatment failure, Treatment noncompliance, Ulcer
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Blood gases abnormal, Blood pH decreased, COVID-19, Cardiac failure acute
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cardiac failure congestive, Chronic obstructive pulmonary disease, Condition aggravated, Confusional state, Endotracheal intubation
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Extubation, Intensive care, Mental status changes, PCO2 increased, Positive airway pressure therapy
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pulmonary mass, Respiratory failure, SARS-CoV-2 test positive, Somnolence, Splenectomy
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Treatment noncompliance
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Anaemia, Blood bicarbonate increased, Blood gases, Blood pH decreased
Clinical narrative: COVID+ -no date listed.  Vaccination status - pfizer x3 BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 10/30/2022 Discharge Date: Nov 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Respiratory failure (HCC) 10/30/2022 Unknown ? H/O splenectomy 10/30/2022 Unknown ? COPD with acute exacerbation (HCC) 09/21/2022 Yes ? OSA on CPAP 02/19/2020 Yes ? Chronic diastolic congestive heart failure (HCC) 12/07/2018 Yes ? Lung nodules    DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Respiratory failure (HCC) [J96.90] Chronic obstructive pulmonary disease with acute exacerbation (HCC) [J44.1] Chronic respiratory failure with hypoxia and hypercapnia (HCC) [J96.11, J96.12] Acute on chronic congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic respiratory failure with hypoxia (HCC) [J96.21]   HOSPITAL COURSE: 78-year-old patient in our facility 10/4-10/14 with respiratory failure requiring intubation, COVID, CHF exacerbation, COPD exacerbation.  Intubated 10/4-10/5.  Completed five days Remdesivir 10/8.  Received steroids during the hospitalization.  After extubation she was very resistant to wearing BiPAP. Patient had not been wearing her CPAP or Bipap since she got home because it hurts her neck.  She got confused and was brought to the ER. She was awake and talking on arrival but became progressively more somnolent.  She was given Lasix, nebulizer and BiPAP but mental status worsened.  ABG showed pCO2 > 110 with pH 7.32.  She was intubated and started on propofol drip. She was admitted to the ICU intubated. She was able to be extubated on 10/31. She continued on nebulizers and steroids. She did continue to test + for COVID-19 but had not active symptoms, this was felt to all be related to COPD and hypercarbia from lack of OSA treatment. She continued to improve and was breathing well on her home O2. Her O2 was kept between 89-93% due to her severe COPD. She was fitted with nasal pillows for her Bipap and improved with this. She tolerated this well. PT/OT recommended subacute rehab which the patient agreed. Patient was then discharged to SAR in stable condition. She MUST wear her bipap or will be high risk for re-admission. She will continue on a long steroid taper. Patient discharged to rehab in stable condition.  PT d/c'd to Skilled nursing & rehab facility (rehab 11/4/22-11/12/22)