Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection
Clinical narrative: Patient Covid + on 10/18/2021. Patient received Pfizer vaccine with 1st dose on 01/16/2021, 2nd dose on 02/05/2021 and booster dose on 10/01/2021. Per ED Note:  Patient is an 82-year-old female with PMH significant for HTN who presents complaining of weakness, cough, shortness of breath.  Patient states she tested positive for Covid 1 week ago. Per H & P: The patient states that she is little bit cold when I first walked in the room but after getting her blood get she actually feels quite warm.  She states that she just feels very exhausted from her bout with COVID-19.  She is having some mild diarrhea.  She is stating that she is short of breath and having a cough as well.  The cough is dry in nature.  She denies any chest pain or pressure.  Denies any overt dizziness or palpitations but apparently had an episode of passing out at home that lasted about 2 seconds.  She has been having some dysuria as well.   Lungs?coarse breath sounds bilaterally with diminished breath sounds diffusely  Extremities?no edema bilateral lower extremities   Plan Inflammatory markers are pending  Rocephin for urinary tract infection  Urine culture is pending  Initiate IV Decadron  Trend inflammatory markers  COVID-19 isolation  ID consult is pending  Hold immunosuppressive agents  Monitor electrolytes closely  Monitor oxygen closely  Supportive care  DVT prophylaxis??Lovenox  GI prophylaxis due to steroids?pepcid 82-year-old female past medical history of hypertension, hyperlipidemia, rheumatoid arthritis on MTX and leucovorin and possibly leflunomide, recurrent UTIs, unexplained syncope s/p loop recorder in 2015 without significant results, came in with fatigue, cough and shortness of breath. Patient states that the symptoms started about 2 weeks ago and it been gradually getting worse. Patient got a COVID-19 test at a local pharmacy about a week ago which was positive. She states that she did not see a doctor nor take any medications after testing positive. She has been fully vaccinated with the Pfizer vaccine and received her Pfizer booster dose on 10/1, she denies having COVID infection in the past. Patient was also treated for a acute UTI at that time with a 5-day course of Keflex. Patient states that she has been having dysuria, and noticed a darkened color to her urine for about 3 to 4 days. Patient recalls having small amount of loose watery and dark stools with increasing urgency for about 1 week. Patient states that she started wearing adult pull-ups because of the urgency to have a bowel movement and states that she has become incontinent, she cannot recall the amount of bowel movements she has been having in the past 24 hours but states that she had to change her pull ups multiple times. This morning patient experienced a 2-second episode of loss of consciousness, while being seated, witnessed by her grandson. According to him she seemed very anxious and her eyes rolled back to the back of her head and she was unresponsive. When she regained consciousness she was not confused but seemed very anxious. Patient admits to increasing anxiety about her diagnosis of COVID and her prognosis.