chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pneumonia, Red blood cell transfusion, Renal impairment, SARS-CoV-2 test positive, Shock
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: NP  Admission Date: 12/17/2022 Discharge Date: 12/31/2022 COVID positive date: 12/17/2022 HOSPITAL COURSE: Patient is a 65-year-old female with history of type 2 diabetes mellitus, hypertension, recent colonoscopy 12/12 who presented to ED on 12/17 after being found on floor by son.  She reportedly had poor oral intake and diarrhea in the preceding days. In ED she was hypothermic and hypotensive with altered mental status. She became increasingly agitated, ultimately requiring intubation. Laboratory studies were significant for profound acidosis (PH 6.7), lactic acid (25), acute renal failure (BUN 56/creat 10.45), leukocytosis (34,000), and she was influenza A positive. CXR showed possible RLL infiltrate. CT angio abdomen showed mild nonspecific pan colitis, vascular exam unremarkable. CT head and c-spine without acute process/fracture. She received bicarb push x 2, hydrocortisone 100 mg, 4L IVF and Tamiflu. She was transferred to ICU in florid shock, requiring up to four vasopressors and bicarb drip. Given Metformin use and severely elevated lactic acid, it was suspected that she was suffering from Metformin toxicity.  She was started on empiric antibiotics, including Cefepime, Flagyl and Vancomycin.  She was also started on Tamiflu.  She was noted to test positive for COVID-19 as well on admission to ICU, in addition to influenza A.  Vascular catheter was placed and continuous renal replacement therapy was started 12/17.  Her acidosis cleared and vasopressors were slowly weaned down. She was able to be weaned off sedation by 12/21, and was extubated on 12/23. Continuous renal replacement therapy was stopped 12/24 and she was transitioned to hemodialysis.   She had a run of hemodialysis on 12/26, but then had progressive improvement in her renal function with increased urine output, such that dialysis was no longer felt to be required.  Vascular catheter was removed on 12/28.   Patient transferred to the hospitalist service 12/25/2022.  She had completed a full course of antibiotics while in the intensive care unit for pneumonia and completed 5-days of Tamiflu therapy for influenza A.  She developed acute worsening in anemia on 12/28, requiring 1 unit packed red blood cells, with hemoglobin stable around 8-8.5 g/dL thereafter.  Her blood sugars remained stable on low dose corrective Humalog, and A1c was normal at 6.0%.   She was felt stable for discharge home on 12/31/22.  She will need follow-up CBC and CMP in 5 days to recheck renal function and hemoglobin.  I am going to keep her off of chlorthalidone, glipizide, Janumet, metformin and losartan at discharge.  She will continue simvastatin and Ozempic.  She should follow-up her PCP in 1 week.  She should establish care with local nephrologist, given high likelihood for ongoing renal dysfunction/CKD in the setting of her severe AKI.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Vascular catheterisation, Vascular test normal, White blood cell count increased
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: NP  Admission Date: 12/17/2022 Discharge Date: 12/31/2022 COVID positive date: 12/17/2022 HOSPITAL COURSE: Patient is a 65-year-old female with history of type 2 diabetes mellitus, hypertension, recent colonoscopy 12/12 who presented to ED on 12/17 after being found on floor by son.  She reportedly had poor oral intake and diarrhea in the preceding days. In ED she was hypothermic and hypotensive with altered mental status. She became increasingly agitated, ultimately requiring intubation. Laboratory studies were significant for profound acidosis (PH 6.7), lactic acid (25), acute renal failure (BUN 56/creat 10.45), leukocytosis (34,000), and she was influenza A positive. CXR showed possible RLL infiltrate. CT angio abdomen showed mild nonspecific pan colitis, vascular exam unremarkable. CT head and c-spine without acute process/fracture. She received bicarb push x 2, hydrocortisone 100 mg, 4L IVF and Tamiflu. She was transferred to ICU in florid shock, requiring up to four vasopressors and bicarb drip. Given Metformin use and severely elevated lactic acid, it was suspected that she was suffering from Metformin toxicity.  She was started on empiric antibiotics, including Cefepime, Flagyl and Vancomycin.  She was also started on Tamiflu.  She was noted to test positive for COVID-19 as well on admission to ICU, in addition to influenza A.  Vascular catheter was placed and continuous renal replacement therapy was started 12/17.  Her acidosis cleared and vasopressors were slowly weaned down. She was able to be weaned off sedation by 12/21, and was extubated on 12/23. Continuous renal replacement therapy was stopped 12/24 and she was transitioned to hemodialysis.   She had a run of hemodialysis on 12/26, but then had progressive improvement in her renal function with increased urine output, such that dialysis was no longer felt to be required.  Vascular catheter was removed on 12/28.   Patient transferred to the hospitalist service 12/25/2022.  She had completed a full course of antibiotics while in the intensive care unit for pneumonia and completed 5-days of Tamiflu therapy for influenza A.  She developed acute worsening in anemia on 12/28, requiring 1 unit packed red blood cells, with hemoglobin stable around 8-8.5 g/dL thereafter.  Her blood sugars remained stable on low dose corrective Humalog, and A1c was normal at 6.0%.   She was felt stable for discharge home on 12/31/22.  She will need follow-up CBC and CMP in 5 days to recheck renal function and hemoglobin.  I am going to keep her off of chlorthalidone, glipizide, Janumet, metformin and losartan at discharge.  She will continue simvastatin and Ozempic.  She should follow-up her PCP in 1 week.  She should establish care with local nephrologist, given high likelihood for ongoing renal dysfunction/CKD in the setting of her severe AKI.
Age: 72.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, COVID-19, Cough, Dyspnoea, Malaise
Clinical narrative: I did not have an adverse reaction to the vaccine. On 12/16/2022 I had a scratchy throat; cough and just felt sick. On 12/17/20222, I continued to have a sore throat, shortness of breath and very weak. I tested positive for COVID-19 on 12/17/2022. I contacted my doctor and was advised to take cough medicine and acetaminophen. As of today, I was doing better but I got a horrible sinus infection of which I'm still experiencing and my throat is still scratchy.
Age: 72.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sinusitis, Throat irritation
Clinical narrative: I did not have an adverse reaction to the vaccine. On 12/16/2022 I had a scratchy throat; cough and just felt sick. On 12/17/20222, I continued to have a sore throat, shortness of breath and very weak. I tested positive for COVID-19 on 12/17/2022. I contacted my doctor and was advised to take cough medicine and acetaminophen. As of today, I was doing better but I got a horrible sinus infection of which I'm still experiencing and my throat is still scratchy.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Herpes virus infection, Herpes zoster
Clinical narrative: Before this vax, patient was diagnosed with shingles 11 years prior and has herpes upon taking Zoster. No herpes or shingles outbreak. Valtrex is used for both. Wasn't taking Valtrex for 11 years because she recovered. Patient had Shingrix shot on 8/22 and experienced shingles and herpes outbreak. Takes the medicine and it goes away. When she does not take medication, her outbreak appears. Herpes on the lip, shingles on her back. "This shot is not working!!" Seen doctor and has appointment coming up. Also has part 2 of Shingrix vax coming up.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Acute respiratory failure, Agitation, Aspiration, Behaviour disorder, Blood culture negative
Clinical narrative: Hospitalized with COVID 19 12.9.22 - 12.29.22 (fully vaccinated and booster received)  Discharge Provider: MD  Primary Care Provider: DO    Admitting Service: Internal Medicine Service Admission Date: 12/9/2022 Discharge Date: 12/29/2022 Admitting Diagnoses: Acute respiratory failure due to COVID-19 (HCC) Patient Active Problem List Diagnosis ? Stage 3a chronic kidney disease (HCC) ? Lewy body dementia without behavioral disturbance (HCC) ? Prostate cancer (HCC) - MUSIC ? Other dysphagia ? Moderate episode of recurrent major depressive disorder (HCC) ? Primary osteoarthritis involving multiple joints ? Dementia with behavioral disturbance ? Advance care planning ? Multiple comorbid conditions ? Other constipation Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00] HOSPITAL COURSE: 85-year-old male with history of prostate cancer, CKD stage 3, coronary disease, hyperlipidemia, Lewy body dementia with parkinsonism.  Admitted for hypoxia with COVID.  Patient was started on Remdesivir(4 doses completed on 12/12) and Decadron(10 doses completed on 12/19/2022).  Blood cultures remain negative.  Chest x-ray was negative for acute cardiopulmonary disease. Patient on room air and doing well from respiratory standpoint. Patient did have episodes of confusion and agitation, which improved with the use of Seroquel. SLP evaluated the patient and a video swallow study showed that he is aspirating across all consistencies and they recommended a feeding tube.  Wife wanted a percutaneous tube due to feeling that this might be long-term problem due to progressing dementia.  In the meantime Corpak was placed and he tolerated tube feeds.  IR placed PGJ on 12/19.  Tolerated tube feeds well, initial plan was for long-term care facility, eventually his strength improved, PT and OT recommended home care, Care Management during home PT/OT/SLP and Nutrition Services, instructions discussed in detail with patient's wife, she verbalized understanding, discharge home today in stable condition.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: COVID-19, Chest X-ray normal, Confusional state, Dementia, Gastrointestinal tube insertion
Clinical narrative: Hospitalized with COVID 19 12.9.22 - 12.29.22 (fully vaccinated and booster received)  Discharge Provider: MD  Primary Care Provider: DO    Admitting Service: Internal Medicine Service Admission Date: 12/9/2022 Discharge Date: 12/29/2022 Admitting Diagnoses: Acute respiratory failure due to COVID-19 (HCC) Patient Active Problem List Diagnosis ? Stage 3a chronic kidney disease (HCC) ? Lewy body dementia without behavioral disturbance (HCC) ? Prostate cancer (HCC) - MUSIC ? Other dysphagia ? Moderate episode of recurrent major depressive disorder (HCC) ? Primary osteoarthritis involving multiple joints ? Dementia with behavioral disturbance ? Advance care planning ? Multiple comorbid conditions ? Other constipation Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00] HOSPITAL COURSE: 85-year-old male with history of prostate cancer, CKD stage 3, coronary disease, hyperlipidemia, Lewy body dementia with parkinsonism.  Admitted for hypoxia with COVID.  Patient was started on Remdesivir(4 doses completed on 12/12) and Decadron(10 doses completed on 12/19/2022).  Blood cultures remain negative.  Chest x-ray was negative for acute cardiopulmonary disease. Patient on room air and doing well from respiratory standpoint. Patient did have episodes of confusion and agitation, which improved with the use of Seroquel. SLP evaluated the patient and a video swallow study showed that he is aspirating across all consistencies and they recommended a feeding tube.  Wife wanted a percutaneous tube due to feeling that this might be long-term problem due to progressing dementia.  In the meantime Corpak was placed and he tolerated tube feeds.  IR placed PGJ on 12/19.  Tolerated tube feeds well, initial plan was for long-term care facility, eventually his strength improved, PT and OT recommended home care, Care Management during home PT/OT/SLP and Nutrition Services, instructions discussed in detail with patient's wife, she verbalized understanding, discharge home today in stable condition.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Hypoxia, Swallow study abnormal
Clinical narrative: Hospitalized with COVID 19 12.9.22 - 12.29.22 (fully vaccinated and booster received)  Discharge Provider: MD  Primary Care Provider: DO    Admitting Service: Internal Medicine Service Admission Date: 12/9/2022 Discharge Date: 12/29/2022 Admitting Diagnoses: Acute respiratory failure due to COVID-19 (HCC) Patient Active Problem List Diagnosis ? Stage 3a chronic kidney disease (HCC) ? Lewy body dementia without behavioral disturbance (HCC) ? Prostate cancer (HCC) - MUSIC ? Other dysphagia ? Moderate episode of recurrent major depressive disorder (HCC) ? Primary osteoarthritis involving multiple joints ? Dementia with behavioral disturbance ? Advance care planning ? Multiple comorbid conditions ? Other constipation Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00] HOSPITAL COURSE: 85-year-old male with history of prostate cancer, CKD stage 3, coronary disease, hyperlipidemia, Lewy body dementia with parkinsonism.  Admitted for hypoxia with COVID.  Patient was started on Remdesivir(4 doses completed on 12/12) and Decadron(10 doses completed on 12/19/2022).  Blood cultures remain negative.  Chest x-ray was negative for acute cardiopulmonary disease. Patient on room air and doing well from respiratory standpoint. Patient did have episodes of confusion and agitation, which improved with the use of Seroquel. SLP evaluated the patient and a video swallow study showed that he is aspirating across all consistencies and they recommended a feeding tube.  Wife wanted a percutaneous tube due to feeling that this might be long-term problem due to progressing dementia.  In the meantime Corpak was placed and he tolerated tube feeds.  IR placed PGJ on 12/19.  Tolerated tube feeds well, initial plan was for long-term care facility, eventually his strength improved, PT and OT recommended home care, Care Management during home PT/OT/SLP and Nutrition Services, instructions discussed in detail with patient's wife, she verbalized understanding, discharge home today in stable condition.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Asthenia, COVID-19, Condition aggravated, Cough, Drug hypersensitivity
Clinical narrative: Hospitalized with COVID 19 12.9.22 - 12.29.22 (fully vaccinated and booster received)  Discharge Provider: MD  Primary Care Provider: DO    Admitting Service: Internal Medicine Service Admission Date: 12/9/2022 Discharge Date: 12/29/2022 Admitting Diagnoses: Acute respiratory failure due to COVID-19 (HCC) Patient Active Problem List Diagnosis ? Stage 3a chronic kidney disease (HCC) ? Lewy body dementia without behavioral disturbance (HCC) ? Prostate cancer (HCC) - MUSIC ? Other dysphagia ? Moderate episode of recurrent major depressive disorder (HCC) ? Primary osteoarthritis involving multiple joints ? Dementia with behavioral disturbance ? Advance care planning ? Multiple comorbid conditions ? Other constipation Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00] HOSPITAL COURSE: 85-year-old male with history of prostate cancer, CKD stage 3, coronary disease, hyperlipidemia, Lewy body dementia with parkinsonism.  Admitted for hypoxia with COVID.  Patient was started on Remdesivir(4 doses completed on 12/12) and Decadron(10 doses completed on 12/19/2022).  Blood cultures remain negative.  Chest x-ray was negative for acute cardiopulmonary disease. Patient on room air and doing well from respiratory standpoint. Patient did have episodes of confusion and agitation, which improved with the use of Seroquel. SLP evaluated the patient and a video swallow study showed that he is aspirating across all consistencies and they recommended a feeding tube.  Wife wanted a percutaneous tube due to feeling that this might be long-term problem due to progressing dementia.  In the meantime Corpak was placed and he tolerated tube feeds.  IR placed PGJ on 12/19.  Tolerated tube feeds well, initial plan was for long-term care facility, eventually his strength improved, PT and OT recommended home care, Care Management during home PT/OT/SLP and Nutrition Services, instructions discussed in detail with patient's wife, she verbalized understanding, discharge home today in stable condition.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Hypervolaemia, Hypoxia, Lethargy, Malnutrition, Mental status changes
Clinical narrative: Hospitalized with COVID 19 12.9.22 - 12.29.22 (fully vaccinated and booster received)  Discharge Provider: MD  Primary Care Provider: DO    Admitting Service: Internal Medicine Service Admission Date: 12/9/2022 Discharge Date: 12/29/2022 Admitting Diagnoses: Acute respiratory failure due to COVID-19 (HCC) Patient Active Problem List Diagnosis ? Stage 3a chronic kidney disease (HCC) ? Lewy body dementia without behavioral disturbance (HCC) ? Prostate cancer (HCC) - MUSIC ? Other dysphagia ? Moderate episode of recurrent major depressive disorder (HCC) ? Primary osteoarthritis involving multiple joints ? Dementia with behavioral disturbance ? Advance care planning ? Multiple comorbid conditions ? Other constipation Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00] HOSPITAL COURSE: 85-year-old male with history of prostate cancer, CKD stage 3, coronary disease, hyperlipidemia, Lewy body dementia with parkinsonism.  Admitted for hypoxia with COVID.  Patient was started on Remdesivir(4 doses completed on 12/12) and Decadron(10 doses completed on 12/19/2022).  Blood cultures remain negative.  Chest x-ray was negative for acute cardiopulmonary disease. Patient on room air and doing well from respiratory standpoint. Patient did have episodes of confusion and agitation, which improved with the use of Seroquel. SLP evaluated the patient and a video swallow study showed that he is aspirating across all consistencies and they recommended a feeding tube.  Wife wanted a percutaneous tube due to feeling that this might be long-term problem due to progressing dementia.  In the meantime Corpak was placed and he tolerated tube feeds.  IR placed PGJ on 12/19.  Tolerated tube feeds well, initial plan was for long-term care facility, eventually his strength improved, PT and OT recommended home care, Care Management during home PT/OT/SLP and Nutrition Services, instructions discussed in detail with patient's wife, she verbalized understanding, discharge home today in stable condition.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Multiple organ dysfunction syndrome, Pneumonia, Resuscitation, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Hospitalized with COVID 19 12.9.22 - 12.29.22 (fully vaccinated and booster received)  Discharge Provider: MD  Primary Care Provider: DO    Admitting Service: Internal Medicine Service Admission Date: 12/9/2022 Discharge Date: 12/29/2022 Admitting Diagnoses: Acute respiratory failure due to COVID-19 (HCC) Patient Active Problem List Diagnosis ? Stage 3a chronic kidney disease (HCC) ? Lewy body dementia without behavioral disturbance (HCC) ? Prostate cancer (HCC) - MUSIC ? Other dysphagia ? Moderate episode of recurrent major depressive disorder (HCC) ? Primary osteoarthritis involving multiple joints ? Dementia with behavioral disturbance ? Advance care planning ? Multiple comorbid conditions ? Other constipation Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00] HOSPITAL COURSE: 85-year-old male with history of prostate cancer, CKD stage 3, coronary disease, hyperlipidemia, Lewy body dementia with parkinsonism.  Admitted for hypoxia with COVID.  Patient was started on Remdesivir(4 doses completed on 12/12) and Decadron(10 doses completed on 12/19/2022).  Blood cultures remain negative.  Chest x-ray was negative for acute cardiopulmonary disease. Patient on room air and doing well from respiratory standpoint. Patient did have episodes of confusion and agitation, which improved with the use of Seroquel. SLP evaluated the patient and a video swallow study showed that he is aspirating across all consistencies and they recommended a feeding tube.  Wife wanted a percutaneous tube due to feeling that this might be long-term problem due to progressing dementia.  In the meantime Corpak was placed and he tolerated tube feeds.  IR placed PGJ on 12/19.  Tolerated tube feeds well, initial plan was for long-term care facility, eventually his strength improved, PT and OT recommended home care, Care Management during home PT/OT/SLP and Nutrition Services, instructions discussed in detail with patient's wife, she verbalized understanding, discharge home today in stable condition.
Age: 85.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Tachycardia
Clinical narrative: Hospitalized with COVID 19 12.9.22 - 12.29.22 (fully vaccinated and booster received)  Discharge Provider: MD  Primary Care Provider: DO    Admitting Service: Internal Medicine Service Admission Date: 12/9/2022 Discharge Date: 12/29/2022 Admitting Diagnoses: Acute respiratory failure due to COVID-19 (HCC) Patient Active Problem List Diagnosis ? Stage 3a chronic kidney disease (HCC) ? Lewy body dementia without behavioral disturbance (HCC) ? Prostate cancer (HCC) - MUSIC ? Other dysphagia ? Moderate episode of recurrent major depressive disorder (HCC) ? Primary osteoarthritis involving multiple joints ? Dementia with behavioral disturbance ? Advance care planning ? Multiple comorbid conditions ? Other constipation Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure due to COVID-19 (HCC) [U07.1, J96.00] HOSPITAL COURSE: 85-year-old male with history of prostate cancer, CKD stage 3, coronary disease, hyperlipidemia, Lewy body dementia with parkinsonism.  Admitted for hypoxia with COVID.  Patient was started on Remdesivir(4 doses completed on 12/12) and Decadron(10 doses completed on 12/19/2022).  Blood cultures remain negative.  Chest x-ray was negative for acute cardiopulmonary disease. Patient on room air and doing well from respiratory standpoint. Patient did have episodes of confusion and agitation, which improved with the use of Seroquel. SLP evaluated the patient and a video swallow study showed that he is aspirating across all consistencies and they recommended a feeding tube.  Wife wanted a percutaneous tube due to feeling that this might be long-term problem due to progressing dementia.  In the meantime Corpak was placed and he tolerated tube feeds.  IR placed PGJ on 12/19.  Tolerated tube feeds well, initial plan was for long-term care facility, eventually his strength improved, PT and OT recommended home care, Care Management during home PT/OT/SLP and Nutrition Services, instructions discussed in detail with patient's wife, she verbalized understanding, discharge home today in stable condition.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Blister, COVID-19, Cough, Herpes zoster, Hypoaesthesia
Clinical narrative: I received my Pfizer COVID-19 booster on 1/2/2022. On 1/12/2022 or 1/14/2022, I woke up early in the morning with an itch on my right calf. When I turned on the light, I saw there was a painful, itchy rash on my calf. I took pictures of it and emailed them to my doctor, who messaged me back and told me that it looked like shingles. They prescribed me valaciclovir. About a day after the onset, I also had a rash on my left calf. My doctor thought it was a strange presentation of shingles, since only my calves were affected, but since I had pre-existing lupus and had recently received my booster for COVID-19, it wasn't entirely surprising. It took about 2 weeks for my shingles to subside, and during that time, my sores blistered and oozed. On 5/26/2022, I developed an itch on my right calf while I was in bed, and I immediately knew what it was. I went to the doctor later that day, and he told me it was a shingles recurrence and prescribed me valaciclovir. The presentation was exactly the same as it had been before. Both calves were affected, and the sores blistered and oozed. And again, it took about 2 weeks for the shingles to subside. On 12/28/2022, I developed a sore throat and runny nose. They continued on 12/29/2022. On 12/30/2022 at around 12:30PM, I developed a fever. At 1:25PM, my fever was 102, and I started to develop a cough. By 8:40PM, the fever 103.3, and my oxygen level was 92%. On 12/31/2022, my fever was 105.4 at 12:13AM. I took TYLENOL, which brought it down to 103.8. I slept with an ice pack for the rest of the night. When I took a home antigen test at 8:15AM on 12/31/2022, the result was positive. I then went to a pharmacy at 11:45AM to take a PCR test, which ultimately also yielded a positive result. For most of the day, the fever stayed at around 102, even though I took TYLENOL or ADVIL every 4 hours. At 10:00PM, it shot up to 103.7. I woke up at 5:30AM on 1/1/2023, and my temperature was 102.4. I then developed new symptoms that included a migraine on the left side of my head behind my eye, and my left foot and toes became numb and tingly. Both the migraine and leg numbness lasted for the entire day of 1/1/2023. At about 8:00PM that night, my fever dropped to 101. I slept most of the night that night. On 1/2/2023, I had a fever of 101 for almost the entire day. I would take a TYLENOL, which drop the temperature to only 100. When I woke up that morning, I had a migraine affecting both sides of my head that was concentrated behind my eyes, and it lasted all day that day until I went to sleep at about 8:00PM. At the time of this writing, I have no fever, but I still have a cough.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Migraine, Oropharyngeal pain, Pain in extremity, Paraesthesia, Pruritus
Clinical narrative: I received my Pfizer COVID-19 booster on 1/2/2022. On 1/12/2022 or 1/14/2022, I woke up early in the morning with an itch on my right calf. When I turned on the light, I saw there was a painful, itchy rash on my calf. I took pictures of it and emailed them to my doctor, who messaged me back and told me that it looked like shingles. They prescribed me valaciclovir. About a day after the onset, I also had a rash on my left calf. My doctor thought it was a strange presentation of shingles, since only my calves were affected, but since I had pre-existing lupus and had recently received my booster for COVID-19, it wasn't entirely surprising. It took about 2 weeks for my shingles to subside, and during that time, my sores blistered and oozed. On 5/26/2022, I developed an itch on my right calf while I was in bed, and I immediately knew what it was. I went to the doctor later that day, and he told me it was a shingles recurrence and prescribed me valaciclovir. The presentation was exactly the same as it had been before. Both calves were affected, and the sores blistered and oozed. And again, it took about 2 weeks for the shingles to subside. On 12/28/2022, I developed a sore throat and runny nose. They continued on 12/29/2022. On 12/30/2022 at around 12:30PM, I developed a fever. At 1:25PM, my fever was 102, and I started to develop a cough. By 8:40PM, the fever 103.3, and my oxygen level was 92%. On 12/31/2022, my fever was 105.4 at 12:13AM. I took TYLENOL, which brought it down to 103.8. I slept with an ice pack for the rest of the night. When I took a home antigen test at 8:15AM on 12/31/2022, the result was positive. I then went to a pharmacy at 11:45AM to take a PCR test, which ultimately also yielded a positive result. For most of the day, the fever stayed at around 102, even though I took TYLENOL or ADVIL every 4 hours. At 10:00PM, it shot up to 103.7. I woke up at 5:30AM on 1/1/2023, and my temperature was 102.4. I then developed new symptoms that included a migraine on the left side of my head behind my eye, and my left foot and toes became numb and tingly. Both the migraine and leg numbness lasted for the entire day of 1/1/2023. At about 8:00PM that night, my fever dropped to 101. I slept most of the night that night. On 1/2/2023, I had a fever of 101 for almost the entire day. I would take a TYLENOL, which drop the temperature to only 100. When I woke up that morning, I had a migraine affecting both sides of my head that was concentrated behind my eyes, and it lasted all day that day until I went to sleep at about 8:00PM. At the time of this writing, I have no fever, but I still have a cough.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Rash, Rash pruritic, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I received my Pfizer COVID-19 booster on 1/2/2022. On 1/12/2022 or 1/14/2022, I woke up early in the morning with an itch on my right calf. When I turned on the light, I saw there was a painful, itchy rash on my calf. I took pictures of it and emailed them to my doctor, who messaged me back and told me that it looked like shingles. They prescribed me valaciclovir. About a day after the onset, I also had a rash on my left calf. My doctor thought it was a strange presentation of shingles, since only my calves were affected, but since I had pre-existing lupus and had recently received my booster for COVID-19, it wasn't entirely surprising. It took about 2 weeks for my shingles to subside, and during that time, my sores blistered and oozed. On 5/26/2022, I developed an itch on my right calf while I was in bed, and I immediately knew what it was. I went to the doctor later that day, and he told me it was a shingles recurrence and prescribed me valaciclovir. The presentation was exactly the same as it had been before. Both calves were affected, and the sores blistered and oozed. And again, it took about 2 weeks for the shingles to subside. On 12/28/2022, I developed a sore throat and runny nose. They continued on 12/29/2022. On 12/30/2022 at around 12:30PM, I developed a fever. At 1:25PM, my fever was 102, and I started to develop a cough. By 8:40PM, the fever 103.3, and my oxygen level was 92%. On 12/31/2022, my fever was 105.4 at 12:13AM. I took TYLENOL, which brought it down to 103.8. I slept with an ice pack for the rest of the night. When I took a home antigen test at 8:15AM on 12/31/2022, the result was positive. I then went to a pharmacy at 11:45AM to take a PCR test, which ultimately also yielded a positive result. For most of the day, the fever stayed at around 102, even though I took TYLENOL or ADVIL every 4 hours. At 10:00PM, it shot up to 103.7. I woke up at 5:30AM on 1/1/2023, and my temperature was 102.4. I then developed new symptoms that included a migraine on the left side of my head behind my eye, and my left foot and toes became numb and tingly. Both the migraine and leg numbness lasted for the entire day of 1/1/2023. At about 8:00PM that night, my fever dropped to 101. I slept most of the night that night. On 1/2/2023, I had a fever of 101 for almost the entire day. I would take a TYLENOL, which drop the temperature to only 100. When I woke up that morning, I had a migraine affecting both sides of my head that was concentrated behind my eyes, and it lasted all day that day until I went to sleep at about 8:00PM. At the time of this writing, I have no fever, but I still have a cough.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Skin lesion, Skin weeping
Clinical narrative: I received my Pfizer COVID-19 booster on 1/2/2022. On 1/12/2022 or 1/14/2022, I woke up early in the morning with an itch on my right calf. When I turned on the light, I saw there was a painful, itchy rash on my calf. I took pictures of it and emailed them to my doctor, who messaged me back and told me that it looked like shingles. They prescribed me valaciclovir. About a day after the onset, I also had a rash on my left calf. My doctor thought it was a strange presentation of shingles, since only my calves were affected, but since I had pre-existing lupus and had recently received my booster for COVID-19, it wasn't entirely surprising. It took about 2 weeks for my shingles to subside, and during that time, my sores blistered and oozed. On 5/26/2022, I developed an itch on my right calf while I was in bed, and I immediately knew what it was. I went to the doctor later that day, and he told me it was a shingles recurrence and prescribed me valaciclovir. The presentation was exactly the same as it had been before. Both calves were affected, and the sores blistered and oozed. And again, it took about 2 weeks for the shingles to subside. On 12/28/2022, I developed a sore throat and runny nose. They continued on 12/29/2022. On 12/30/2022 at around 12:30PM, I developed a fever. At 1:25PM, my fever was 102, and I started to develop a cough. By 8:40PM, the fever 103.3, and my oxygen level was 92%. On 12/31/2022, my fever was 105.4 at 12:13AM. I took TYLENOL, which brought it down to 103.8. I slept with an ice pack for the rest of the night. When I took a home antigen test at 8:15AM on 12/31/2022, the result was positive. I then went to a pharmacy at 11:45AM to take a PCR test, which ultimately also yielded a positive result. For most of the day, the fever stayed at around 102, even though I took TYLENOL or ADVIL every 4 hours. At 10:00PM, it shot up to 103.7. I woke up at 5:30AM on 1/1/2023, and my temperature was 102.4. I then developed new symptoms that included a migraine on the left side of my head behind my eye, and my left foot and toes became numb and tingly. Both the migraine and leg numbness lasted for the entire day of 1/1/2023. At about 8:00PM that night, my fever dropped to 101. I slept most of the night that night. On 1/2/2023, I had a fever of 101 for almost the entire day. I would take a TYLENOL, which drop the temperature to only 100. When I woke up that morning, I had a migraine affecting both sides of my head that was concentrated behind my eyes, and it lasted all day that day until I went to sleep at about 8:00PM. At the time of this writing, I have no fever, but I still have a cough.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, COVID-19, Cardiac function test normal, Chest X-ray normal
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 12/15/2022 COVID positive date: 12/14/2022 PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 74 y.o. male with complicated hx of AML s/p allogenic BMT w/ complication of GVHD, hx of EBV, lymphocytic ILD, NIDDM2, chronic diastolic heart failure, HTN, CKD stage 3a who is presenting with COVID-19.    Pt has had multiple recent admissions. He was admitted to Hospital from 10/24-11/03 with acute severe diarrhea. He had been off immunospuression since 7/2022. His infectious w/o was negative. He had EGD and colonoscopy which did confirm Grade II Acute GVHD of gut. He was started back on budesonide and prednisone and started on taper. He was discharged to acute rehab. He was then again admitted to hospital for AKI and weakness. It was felt pt had steroid myopathy. It was felt his GVHD of GI tract had resolved, his prednisone was weaned to 5 mg daily and maintained on tacro and budesonide 3 mg BID with plans to start weaning on12/2. He was noted to have persistent pancytopenia which BMT was following for. PT was then transferred to inpt rehab on 11/29.    On 12/10 pt wife tested positive for COVID, pt was tested on 12/11 but found to be negative. Pt had been stable however then on 12/14 pt started complaining of congestion, sore throat and rhinorrhea. His COVID was repeated and he was found to be positive. CXR was obtained and showed no infiltrate. However then in AM of 12/15 pt was found to be hypoxic in 80s requiring up to 4 L NC. With this ultimately it was decided to admit pt for further treatment. ID was consulted and pt was started on remdesivir. He was able to be weaned to 1-2 L NC. BMT and ID followed throughout the admission.  Despite resolution of his hypoxemia he was exceedingly weak malnourished and lethargic.  He was seen by palliative care/bone marrow transplant and unfortunately had exhausted all therapeutic options.  Multiple goals of care discussions were held and was ultimately decided that the patient would benefit from hospice evaluation. He was transitioned to comfort care on 12/29 and hospice team worked to arrange discharge home. Patient passed away in the hospital on 1/1/23 at 6:35 AM. His wife was notified via phone shortly after his passing and condolences offered.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Cytopenia, Death, Dehydration, Diarrhoea
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 12/15/2022 COVID positive date: 12/14/2022 PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 74 y.o. male with complicated hx of AML s/p allogenic BMT w/ complication of GVHD, hx of EBV, lymphocytic ILD, NIDDM2, chronic diastolic heart failure, HTN, CKD stage 3a who is presenting with COVID-19.    Pt has had multiple recent admissions. He was admitted to Hospital from 10/24-11/03 with acute severe diarrhea. He had been off immunospuression since 7/2022. His infectious w/o was negative. He had EGD and colonoscopy which did confirm Grade II Acute GVHD of gut. He was started back on budesonide and prednisone and started on taper. He was discharged to acute rehab. He was then again admitted to hospital for AKI and weakness. It was felt pt had steroid myopathy. It was felt his GVHD of GI tract had resolved, his prednisone was weaned to 5 mg daily and maintained on tacro and budesonide 3 mg BID with plans to start weaning on12/2. He was noted to have persistent pancytopenia which BMT was following for. PT was then transferred to inpt rehab on 11/29.    On 12/10 pt wife tested positive for COVID, pt was tested on 12/11 but found to be negative. Pt had been stable however then on 12/14 pt started complaining of congestion, sore throat and rhinorrhea. His COVID was repeated and he was found to be positive. CXR was obtained and showed no infiltrate. However then in AM of 12/15 pt was found to be hypoxic in 80s requiring up to 4 L NC. With this ultimately it was decided to admit pt for further treatment. ID was consulted and pt was started on remdesivir. He was able to be weaned to 1-2 L NC. BMT and ID followed throughout the admission.  Despite resolution of his hypoxemia he was exceedingly weak malnourished and lethargic.  He was seen by palliative care/bone marrow transplant and unfortunately had exhausted all therapeutic options.  Multiple goals of care discussions were held and was ultimately decided that the patient would benefit from hospice evaluation. He was transitioned to comfort care on 12/29 and hospice team worked to arrange discharge home. Patient passed away in the hospital on 1/1/23 at 6:35 AM. His wife was notified via phone shortly after his passing and condolences offered.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Echocardiogram normal, Ejection fraction normal, Endoscopy normal, Fatigue
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 12/15/2022 COVID positive date: 12/14/2022 PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 74 y.o. male with complicated hx of AML s/p allogenic BMT w/ complication of GVHD, hx of EBV, lymphocytic ILD, NIDDM2, chronic diastolic heart failure, HTN, CKD stage 3a who is presenting with COVID-19.    Pt has had multiple recent admissions. He was admitted to Hospital from 10/24-11/03 with acute severe diarrhea. He had been off immunospuression since 7/2022. His infectious w/o was negative. He had EGD and colonoscopy which did confirm Grade II Acute GVHD of gut. He was started back on budesonide and prednisone and started on taper. He was discharged to acute rehab. He was then again admitted to hospital for AKI and weakness. It was felt pt had steroid myopathy. It was felt his GVHD of GI tract had resolved, his prednisone was weaned to 5 mg daily and maintained on tacro and budesonide 3 mg BID with plans to start weaning on12/2. He was noted to have persistent pancytopenia which BMT was following for. PT was then transferred to inpt rehab on 11/29.    On 12/10 pt wife tested positive for COVID, pt was tested on 12/11 but found to be negative. Pt had been stable however then on 12/14 pt started complaining of congestion, sore throat and rhinorrhea. His COVID was repeated and he was found to be positive. CXR was obtained and showed no infiltrate. However then in AM of 12/15 pt was found to be hypoxic in 80s requiring up to 4 L NC. With this ultimately it was decided to admit pt for further treatment. ID was consulted and pt was started on remdesivir. He was able to be weaned to 1-2 L NC. BMT and ID followed throughout the admission.  Despite resolution of his hypoxemia he was exceedingly weak malnourished and lethargic.  He was seen by palliative care/bone marrow transplant and unfortunately had exhausted all therapeutic options.  Multiple goals of care discussions were held and was ultimately decided that the patient would benefit from hospice evaluation. He was transitioned to comfort care on 12/29 and hospice team worked to arrange discharge home. Patient passed away in the hospital on 1/1/23 at 6:35 AM. His wife was notified via phone shortly after his passing and condolences offered.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Graft versus host disease, Hypoxia, Laboratory test normal, Lethargy, Malnutrition
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 12/15/2022 COVID positive date: 12/14/2022 PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 74 y.o. male with complicated hx of AML s/p allogenic BMT w/ complication of GVHD, hx of EBV, lymphocytic ILD, NIDDM2, chronic diastolic heart failure, HTN, CKD stage 3a who is presenting with COVID-19.    Pt has had multiple recent admissions. He was admitted to Hospital from 10/24-11/03 with acute severe diarrhea. He had been off immunospuression since 7/2022. His infectious w/o was negative. He had EGD and colonoscopy which did confirm Grade II Acute GVHD of gut. He was started back on budesonide and prednisone and started on taper. He was discharged to acute rehab. He was then again admitted to hospital for AKI and weakness. It was felt pt had steroid myopathy. It was felt his GVHD of GI tract had resolved, his prednisone was weaned to 5 mg daily and maintained on tacro and budesonide 3 mg BID with plans to start weaning on12/2. He was noted to have persistent pancytopenia which BMT was following for. PT was then transferred to inpt rehab on 11/29.    On 12/10 pt wife tested positive for COVID, pt was tested on 12/11 but found to be negative. Pt had been stable however then on 12/14 pt started complaining of congestion, sore throat and rhinorrhea. His COVID was repeated and he was found to be positive. CXR was obtained and showed no infiltrate. However then in AM of 12/15 pt was found to be hypoxic in 80s requiring up to 4 L NC. With this ultimately it was decided to admit pt for further treatment. ID was consulted and pt was started on remdesivir. He was able to be weaned to 1-2 L NC. BMT and ID followed throughout the admission.  Despite resolution of his hypoxemia he was exceedingly weak malnourished and lethargic.  He was seen by palliative care/bone marrow transplant and unfortunately had exhausted all therapeutic options.  Multiple goals of care discussions were held and was ultimately decided that the patient would benefit from hospice evaluation. He was transitioned to comfort care on 12/29 and hospice team worked to arrange discharge home. Patient passed away in the hospital on 1/1/23 at 6:35 AM. His wife was notified via phone shortly after his passing and condolences offered.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Muscular weakness, Myopathy, Oropharyngeal pain, Pancytopenia, Pathology test
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: DO  Admission Date: 12/15/2022 COVID positive date: 12/14/2022 PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 74 y.o. male with complicated hx of AML s/p allogenic BMT w/ complication of GVHD, hx of EBV, lymphocytic ILD, NIDDM2, chronic diastolic heart failure, HTN, CKD stage 3a who is presenting with COVID-19.    Pt has had multiple recent admissions. He was admitted to Hospital from 10/24-11/03 with acute severe diarrhea. He had been off immunospuression since 7/2022. His infectious w/o was negative. He had EGD and colonoscopy which did confirm Grade II Acute GVHD of gut. He was started back on budesonide and prednisone and started on taper. He was discharged to acute rehab. He was then again admitted to hospital for AKI and weakness. It was felt pt had steroid myopathy. It was felt his GVHD of GI tract had resolved, his prednisone was weaned to 5 mg daily and maintained on tacro and budesonide 3 mg BID with plans to start weaning on12/2. He was noted to have persistent pancytopenia which BMT was following for. PT was then transferred to inpt rehab on 11/29.    On 12/10 pt wife tested positive for COVID, pt was tested on 12/11 but found to be negative. Pt had been stable however then on 12/14 pt started complaining of congestion, sore throat and rhinorrhea. His COVID was repeated and he was found to be positive. CXR was obtained and showed no infiltrate. However then in AM of 12/15 pt was found to be hypoxic in 80s requiring up to 4 L NC. With this ultimately it was decided to admit pt for further treatment. ID was consulted and pt was started on remdesivir. He was able to be weaned to 1-2 L NC. BMT and ID followed throughout the admission.  Despite resolution of his hypoxemia he was exceedingly weak malnourished and lethargic.  He was seen by palliative care/bone marrow transplant and unfortunately had exhausted all therapeutic options.  Multiple goals of care discussions were held and was ultimately decided that the patient would benefit from hospice evaluation. He was transitioned to comfort care on 12/29 and hospice team worked to arrange discharge home. Patient passed away in the hospital on 1/1/23 at 6:35 AM. His wife was notified via phone shortly after his passing and condolences offered.