chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal distension, Alpha-1 anti-trypsin, Analgesic drug level, Antimitochondrial antibody, Antinuclear antibody
Clinical narrative: Diagnosed with autoimmune hepatitis in October 2021; c/o dark urine, abdominal distension, general malaise, elevated LFTs
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Autoimmune hepatitis, Biopsy liver, Blood creatine phosphokinase, Blood iron, Blood lactate dehydrogenase
Clinical narrative: Diagnosed with autoimmune hepatitis in October 2021; c/o dark urine, abdominal distension, general malaise, elevated LFTs
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Blood thyroid stimulating hormone, Chromaturia, Culture urine, Full blood count, Hepatitis viral test
Clinical narrative: Diagnosed with autoimmune hepatitis in October 2021; c/o dark urine, abdominal distension, general malaise, elevated LFTs
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: International normalised ratio, Iron binding capacity total, Laboratory test, Lipase, Liver function test increased
Clinical narrative: Diagnosed with autoimmune hepatitis in October 2021; c/o dark urine, abdominal distension, general malaise, elevated LFTs
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Metabolic function test, Prothrombin time, Smooth muscle antibody, Thyroxine free
Clinical narrative: Diagnosed with autoimmune hepatitis in October 2021; c/o dark urine, abdominal distension, general malaise, elevated LFTs
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Urine albumin/creatinine ratio, Urine analysis
Clinical narrative: Diagnosed with autoimmune hepatitis in October 2021; c/o dark urine, abdominal distension, general malaise, elevated LFTs
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT WAS GIVEN SHOT AFTER EXPIRATION DATE
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Atrial flutter, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of Parkinson's disease with an memory impairment, asthma, COPD not oxygen dependent, presented with shortness of breath   Acute hypoxemic respiratory failure due to COVID-19 Sepsis due to COVID-19 Virus Infection Multifocal pneumonia due to COVID-19   Procalcitonin elevated Oxygen requirements on admission: 3 L NC (not oxygen dependent at baseline) Current oxygen requirements: On RA with sats >95% Medical therapy: Decadron (started 12/4/2022): Continue for 7 more days Prior outpatient treatment: Paxlovid Leukocytosis improving Complete 4 more days of Augmentin +  Azithromycin   Elevated BNP Suspect acute HFpEF BNP 2718; prior BNP noted to be 121 on 1/21/2020 Started on Lopressor 25 mg BID   Hypotension Losartan is discontinued due to borderline hypotension and patient being started on lopressor   Hyponatremia, mild Improved. Encourage PO intake   Parkinson's disease with memory impairment At baseline   Abnormal EKG Atrial flutter on presentation Changed to NSR Needs discussion with PCP to determine if he is good anticoagulation candidate
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Cardiac failure, Dyspnoea, Electrocardiogram abnormal, Hyponatraemia, Hypotension
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of Parkinson's disease with an memory impairment, asthma, COPD not oxygen dependent, presented with shortness of breath   Acute hypoxemic respiratory failure due to COVID-19 Sepsis due to COVID-19 Virus Infection Multifocal pneumonia due to COVID-19   Procalcitonin elevated Oxygen requirements on admission: 3 L NC (not oxygen dependent at baseline) Current oxygen requirements: On RA with sats >95% Medical therapy: Decadron (started 12/4/2022): Continue for 7 more days Prior outpatient treatment: Paxlovid Leukocytosis improving Complete 4 more days of Augmentin +  Azithromycin   Elevated BNP Suspect acute HFpEF BNP 2718; prior BNP noted to be 121 on 1/21/2020 Started on Lopressor 25 mg BID   Hypotension Losartan is discontinued due to borderline hypotension and patient being started on lopressor   Hyponatremia, mild Improved. Encourage PO intake   Parkinson's disease with memory impairment At baseline   Abnormal EKG Atrial flutter on presentation Changed to NSR Needs discussion with PCP to determine if he is good anticoagulation candidate
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Leukocytosis, Procalcitonin increased, Sepsis
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of Parkinson's disease with an memory impairment, asthma, COPD not oxygen dependent, presented with shortness of breath   Acute hypoxemic respiratory failure due to COVID-19 Sepsis due to COVID-19 Virus Infection Multifocal pneumonia due to COVID-19   Procalcitonin elevated Oxygen requirements on admission: 3 L NC (not oxygen dependent at baseline) Current oxygen requirements: On RA with sats >95% Medical therapy: Decadron (started 12/4/2022): Continue for 7 more days Prior outpatient treatment: Paxlovid Leukocytosis improving Complete 4 more days of Augmentin +  Azithromycin   Elevated BNP Suspect acute HFpEF BNP 2718; prior BNP noted to be 121 on 1/21/2020 Started on Lopressor 25 mg BID   Hypotension Losartan is discontinued due to borderline hypotension and patient being started on lopressor   Hyponatremia, mild Improved. Encourage PO intake   Parkinson's disease with memory impairment At baseline   Abnormal EKG Atrial flutter on presentation Changed to NSR Needs discussion with PCP to determine if he is good anticoagulation candidate
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Headache, Laryngitis, Nausea, Oropharyngeal pain
Clinical narrative: All symptoms started around the 11/27/2022 Coughing Runny nose Fever Headache Nausea Sore Throat Laryngitis  Doctor prescribed via email messages Azithromycin 250 MG tablets (quantity of 6) on 12/12/2022. From onset of symptoms, it has taken at least 5 weeks to get over most of the symptoms.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative
Clinical narrative: All symptoms started around the 11/27/2022 Coughing Runny nose Fever Headache Nausea Sore Throat Laryngitis  Doctor prescribed via email messages Azithromycin 250 MG tablets (quantity of 6) on 12/12/2022. From onset of symptoms, it has taken at least 5 weeks to get over most of the symptoms.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: No adverse reaction. Vaccine was given beyond use date of 5 days.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Abdominal pain upper, Asthenia, Dehydration, Diverticulitis, Ear injury
Clinical narrative: 12/5 Patient was vomiting all day (no eating) and experiencing paralysis. Wife found husband on the floor several times. Tried to pick up bag from nightstand but couldn't move his arm and arm was hanging. Couldn't move body or legs and was slipping out of bed. Felt very weak and couldn't move to use the bathroom. Hit his head on the nightstand and injured his ear. Wife called ambulance to come take him to emergency. Was admitted on 12/5. Found diverticulitis, dehydration, pain, viral infection, and stomach pain. Hospital ruling out sepsis.
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hypophagia, Movement disorder, Pain, Paralysis, Viral infection
Clinical narrative: 12/5 Patient was vomiting all day (no eating) and experiencing paralysis. Wife found husband on the floor several times. Tried to pick up bag from nightstand but couldn't move his arm and arm was hanging. Couldn't move body or legs and was slipping out of bed. Felt very weak and couldn't move to use the bathroom. Hit his head on the nightstand and injured his ear. Wife called ambulance to come take him to emergency. Was admitted on 12/5. Found diverticulitis, dehydration, pain, viral infection, and stomach pain. Hospital ruling out sepsis.
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Vomiting
Clinical narrative: 12/5 Patient was vomiting all day (no eating) and experiencing paralysis. Wife found husband on the floor several times. Tried to pick up bag from nightstand but couldn't move his arm and arm was hanging. Couldn't move body or legs and was slipping out of bed. Felt very weak and couldn't move to use the bathroom. Hit his head on the nightstand and injured his ear. Wife called ambulance to come take him to emergency. Was admitted on 12/5. Found diverticulitis, dehydration, pain, viral infection, and stomach pain. Hospital ruling out sepsis.
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea
Clinical narrative: Hospital Course:    COVID-19 PNEUMONITIS Patient was sent from his extended care facility with shortness of breath on the 28th and was found to be COVID-positive on that day.  His symptoms started on the 26th.  He had been at facility from the fourth of 15 November for resection of tongue cancer.  His COPD was found to be mildly exacerbated.  He was seen by pulmonology.  He was started on frequent inhaled bronchodilators via his trach mask and his oxygen was able to be weaned down nicely.  He was cleared by pulmonology to return to his extended care facility.  His exam on the day of discharge was unremarkable and he was asymptomatic.
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Tongue neoplasm, Tumour excision
Clinical narrative: Hospital Course:    COVID-19 PNEUMONITIS Patient was sent from his extended care facility with shortness of breath on the 28th and was found to be COVID-positive on that day.  His symptoms started on the 26th.  He had been at facility from the fourth of 15 November for resection of tongue cancer.  His COPD was found to be mildly exacerbated.  He was seen by pulmonology.  He was started on frequent inhaled bronchodilators via his trach mask and his oxygen was able to be weaned down nicely.  He was cleared by pulmonology to return to his extended care facility.  His exam on the day of discharge was unremarkable and he was asymptomatic.
Age: 58.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood test abnormal, Condition aggravated, Platelet count decreased
Clinical narrative: I had a routine health screening and I had my blood drawn and also the platelets, and that is when they noticed the levels were low, I tested at 50,000 per UL. After that I went to a specialist, and they wanted to stabilize my platelets so they gave me prednisolone. Still doing more testing at this time. The steroids are helping but it is better than it was.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 53.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: COVID-19, Cough, Fatigue, Malaise, Rash
Clinical narrative: I started to feel very tired, felt sick, and head congestion. I took a COVID-19 test at home and it was positive. Later, I developed a cough, running nose, and chest rash. I took ibuprofen, SUDAFED, antihistamine, and TYLENOL. I still have a cough, nasal drip, and fatigue.
Age: 53.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I started to feel very tired, felt sick, and head congestion. I took a COVID-19 test at home and it was positive. Later, I developed a cough, running nose, and chest rash. I took ibuprofen, SUDAFED, antihistamine, and TYLENOL. I still have a cough, nasal drip, and fatigue.
Age: 38.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Dermatitis allergic, Mechanical urticaria, Pruritus, Rash
Clinical narrative: 14 days after vaccine I started getting itchy in my groin and inner thighs after a walk. I itched all night and thought I had poison oak rash or something. Next day it was worse but on other parts of my body. Within 24 hours I was desperately itchy from head to toe, anything I touched or rubbed was incredibly itchy within a few minutes. I could draw lines and welts on my skin just by rubbing with my fingers. I took BENADRYL and it helped with the itching but the rash remained. Next day I went to my doctor and he prescribed me some antihistamines and prednisone if the itching got really bad or I developed hives. I continued to take antihistamines each day, sometimes twice a day. My condition aligns exactly with "dermatographia" or skin writing. Two weeks later I am still itching and get the rash at my waistline and anywhere that I rub or scratch, but it is completely manageable as long as I take ZYRTEC each day. The reactivity of my skin seems to be decreasing as time passes and I hope to be done with this in the coming weeks. My brother (same genetics) got hives and dermatographia, as well as anaphylaxis within 11 days of his booster shot in 2021. My brother and myself have never had an allergic skin reaction prior to this.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Back pain, Blood test abnormal, Chest X-ray abnormal, Chest pain, Electrocardiogram abnormal
Clinical narrative: I had chest pains off and on for three days. It was an aching pain that had went through painfully from my chest, ribs and back. The pain was so bad I went to the ER. They performed testing I had to wait until my cardiologist came, and said things weren't any different from his last visit with me. He did not feel it was heart related. I feel better now it did take a couple of days. They do not know what caused this.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Eosinophil count, Lung disorder, Lymphocyte percentage decreased, Musculoskeletal chest pain
Clinical narrative: I had chest pains off and on for three days. It was an aching pain that had went through painfully from my chest, ribs and back. The pain was so bad I went to the ER. They performed testing I had to wait until my cardiologist came, and said things weren't any different from his last visit with me. He did not feel it was heart related. I feel better now it did take a couple of days. They do not know what caused this.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Blood culture positive, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient is a 83 y.o. male patient of CNP with history of moderate aortic valve stenosis with preserved systolic function, bipolar disorder,  benign prostatic hypertrophy, COPD, hypertension, hyperlipidemia, diabetes mellitus, iron deficiency, and essential tremor.  He was admitted on 12/7/2022 with shortness of breath and dizziness.   Acute hypoxemic respiratory failure Covid-19 pneumonia Presenting with dyspnea, cough, and fever.  Chest x-ray showing patchy bilateral opacities on admission, COVID-19 testing positive Date of onset of symptoms: 2 to 3 days Symptoms present on admission: Cough, dyspnea Date of covid positive test: 12/7/2022 Vaccination status: vaccinated, received 3 mRNA vaccines Imaging: Chest x-ray showing scattered bilateral opacities Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: Weaned to room air 12/10/2022 Medical therapy: remdesivir and steroids Consultants following: Infectious disease Anticipated special isolation end date: 12/16/2022   Acute kidney injury: Resolved Suspect most likely prerenal in the setting of decreased p.o. intake from COVID-19.  Home NSAID contributory as well.  Now resolved with IV fluid resuscitation Trend chemistry Avoid nephrotoxins   COPD Community-acquired pneumonia with haemophilus influenza Continue as needed albuterol IV antibiotics with ceftriaxone Discharged home on oral cefdinir   Positive blood culture Rule out sepsis 1 out of 4 blood cultures positive on admission, strep on molecular testing, final speciation pending Repeat blood culture with no growth, suspect most likely contaminant Infectious disease following, antibiotics discontinued with low concern for bacterial infection.   Sinus tachycardia: (Resolved) Likely physiologic in the setting of COVID-19 infection and dehydration Discontinue beta-blocker started on admission Status post fluid resuscitation as above   Hyperglycemia/history of diabetes mellitus A1c 7.6 on admission Hyperglycemia likely stress-induced this admission due to steroids Increase NPH with steroid dose to 15 units Sliding scale insulin  Benign prostatic hypertrophy Continue home finasteride   Depression: Continue home Effexor
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dehydration
Clinical narrative: Patient is a 83 y.o. male patient of CNP with history of moderate aortic valve stenosis with preserved systolic function, bipolar disorder,  benign prostatic hypertrophy, COPD, hypertension, hyperlipidemia, diabetes mellitus, iron deficiency, and essential tremor.  He was admitted on 12/7/2022 with shortness of breath and dizziness.   Acute hypoxemic respiratory failure Covid-19 pneumonia Presenting with dyspnea, cough, and fever.  Chest x-ray showing patchy bilateral opacities on admission, COVID-19 testing positive Date of onset of symptoms: 2 to 3 days Symptoms present on admission: Cough, dyspnea Date of covid positive test: 12/7/2022 Vaccination status: vaccinated, received 3 mRNA vaccines Imaging: Chest x-ray showing scattered bilateral opacities Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: Weaned to room air 12/10/2022 Medical therapy: remdesivir and steroids Consultants following: Infectious disease Anticipated special isolation end date: 12/16/2022   Acute kidney injury: Resolved Suspect most likely prerenal in the setting of decreased p.o. intake from COVID-19.  Home NSAID contributory as well.  Now resolved with IV fluid resuscitation Trend chemistry Avoid nephrotoxins   COPD Community-acquired pneumonia with haemophilus influenza Continue as needed albuterol IV antibiotics with ceftriaxone Discharged home on oral cefdinir   Positive blood culture Rule out sepsis 1 out of 4 blood cultures positive on admission, strep on molecular testing, final speciation pending Repeat blood culture with no growth, suspect most likely contaminant Infectious disease following, antibiotics discontinued with low concern for bacterial infection.   Sinus tachycardia: (Resolved) Likely physiologic in the setting of COVID-19 infection and dehydration Discontinue beta-blocker started on admission Status post fluid resuscitation as above   Hyperglycemia/history of diabetes mellitus A1c 7.6 on admission Hyperglycemia likely stress-induced this admission due to steroids Increase NPH with steroid dose to 15 units Sliding scale insulin  Benign prostatic hypertrophy Continue home finasteride   Depression: Continue home Effexor
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Glycosylated haemoglobin increased, Haemophilus infection, Hyperglycaemia
Clinical narrative: Patient is a 83 y.o. male patient of CNP with history of moderate aortic valve stenosis with preserved systolic function, bipolar disorder,  benign prostatic hypertrophy, COPD, hypertension, hyperlipidemia, diabetes mellitus, iron deficiency, and essential tremor.  He was admitted on 12/7/2022 with shortness of breath and dizziness.   Acute hypoxemic respiratory failure Covid-19 pneumonia Presenting with dyspnea, cough, and fever.  Chest x-ray showing patchy bilateral opacities on admission, COVID-19 testing positive Date of onset of symptoms: 2 to 3 days Symptoms present on admission: Cough, dyspnea Date of covid positive test: 12/7/2022 Vaccination status: vaccinated, received 3 mRNA vaccines Imaging: Chest x-ray showing scattered bilateral opacities Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: Weaned to room air 12/10/2022 Medical therapy: remdesivir and steroids Consultants following: Infectious disease Anticipated special isolation end date: 12/16/2022   Acute kidney injury: Resolved Suspect most likely prerenal in the setting of decreased p.o. intake from COVID-19.  Home NSAID contributory as well.  Now resolved with IV fluid resuscitation Trend chemistry Avoid nephrotoxins   COPD Community-acquired pneumonia with haemophilus influenza Continue as needed albuterol IV antibiotics with ceftriaxone Discharged home on oral cefdinir   Positive blood culture Rule out sepsis 1 out of 4 blood cultures positive on admission, strep on molecular testing, final speciation pending Repeat blood culture with no growth, suspect most likely contaminant Infectious disease following, antibiotics discontinued with low concern for bacterial infection.   Sinus tachycardia: (Resolved) Likely physiologic in the setting of COVID-19 infection and dehydration Discontinue beta-blocker started on admission Status post fluid resuscitation as above   Hyperglycemia/history of diabetes mellitus A1c 7.6 on admission Hyperglycemia likely stress-induced this admission due to steroids Increase NPH with steroid dose to 15 units Sliding scale insulin  Benign prostatic hypertrophy Continue home finasteride   Depression: Continue home Effexor
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Hypophagia, Lung opacity, Pneumonia, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Patient is a 83 y.o. male patient of CNP with history of moderate aortic valve stenosis with preserved systolic function, bipolar disorder,  benign prostatic hypertrophy, COPD, hypertension, hyperlipidemia, diabetes mellitus, iron deficiency, and essential tremor.  He was admitted on 12/7/2022 with shortness of breath and dizziness.   Acute hypoxemic respiratory failure Covid-19 pneumonia Presenting with dyspnea, cough, and fever.  Chest x-ray showing patchy bilateral opacities on admission, COVID-19 testing positive Date of onset of symptoms: 2 to 3 days Symptoms present on admission: Cough, dyspnea Date of covid positive test: 12/7/2022 Vaccination status: vaccinated, received 3 mRNA vaccines Imaging: Chest x-ray showing scattered bilateral opacities Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: Weaned to room air 12/10/2022 Medical therapy: remdesivir and steroids Consultants following: Infectious disease Anticipated special isolation end date: 12/16/2022   Acute kidney injury: Resolved Suspect most likely prerenal in the setting of decreased p.o. intake from COVID-19.  Home NSAID contributory as well.  Now resolved with IV fluid resuscitation Trend chemistry Avoid nephrotoxins   COPD Community-acquired pneumonia with haemophilus influenza Continue as needed albuterol IV antibiotics with ceftriaxone Discharged home on oral cefdinir   Positive blood culture Rule out sepsis 1 out of 4 blood cultures positive on admission, strep on molecular testing, final speciation pending Repeat blood culture with no growth, suspect most likely contaminant Infectious disease following, antibiotics discontinued with low concern for bacterial infection.   Sinus tachycardia: (Resolved) Likely physiologic in the setting of COVID-19 infection and dehydration Discontinue beta-blocker started on admission Status post fluid resuscitation as above   Hyperglycemia/history of diabetes mellitus A1c 7.6 on admission Hyperglycemia likely stress-induced this admission due to steroids Increase NPH with steroid dose to 15 units Sliding scale insulin  Benign prostatic hypertrophy Continue home finasteride   Depression: Continue home Effexor
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Sinus tachycardia, Streptococcus test positive
Clinical narrative: Patient is a 83 y.o. male patient of CNP with history of moderate aortic valve stenosis with preserved systolic function, bipolar disorder,  benign prostatic hypertrophy, COPD, hypertension, hyperlipidemia, diabetes mellitus, iron deficiency, and essential tremor.  He was admitted on 12/7/2022 with shortness of breath and dizziness.   Acute hypoxemic respiratory failure Covid-19 pneumonia Presenting with dyspnea, cough, and fever.  Chest x-ray showing patchy bilateral opacities on admission, COVID-19 testing positive Date of onset of symptoms: 2 to 3 days Symptoms present on admission: Cough, dyspnea Date of covid positive test: 12/7/2022 Vaccination status: vaccinated, received 3 mRNA vaccines Imaging: Chest x-ray showing scattered bilateral opacities Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: Weaned to room air 12/10/2022 Medical therapy: remdesivir and steroids Consultants following: Infectious disease Anticipated special isolation end date: 12/16/2022   Acute kidney injury: Resolved Suspect most likely prerenal in the setting of decreased p.o. intake from COVID-19.  Home NSAID contributory as well.  Now resolved with IV fluid resuscitation Trend chemistry Avoid nephrotoxins   COPD Community-acquired pneumonia with haemophilus influenza Continue as needed albuterol IV antibiotics with ceftriaxone Discharged home on oral cefdinir   Positive blood culture Rule out sepsis 1 out of 4 blood cultures positive on admission, strep on molecular testing, final speciation pending Repeat blood culture with no growth, suspect most likely contaminant Infectious disease following, antibiotics discontinued with low concern for bacterial infection.   Sinus tachycardia: (Resolved) Likely physiologic in the setting of COVID-19 infection and dehydration Discontinue beta-blocker started on admission Status post fluid resuscitation as above   Hyperglycemia/history of diabetes mellitus A1c 7.6 on admission Hyperglycemia likely stress-induced this admission due to steroids Increase NPH with steroid dose to 15 units Sliding scale insulin  Benign prostatic hypertrophy Continue home finasteride   Depression: Continue home Effexor
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood sodium decreased, COVID-19, Chest X-ray normal, Culture negative
Clinical narrative: FINAL DIAGNOSIS:   1. Covid-19 Virus Infection 2. Acute hypoxemic respiratory failure 2/2 COVID 3. Mild Hyponatremia - 130 on admission - repeating CMP today  4. HTN 5. Hx frontotemporal dementia 6. Hx of CVA and TIA with aphasia 7. Obesity with BMI 31.44 Elevated LFTs         REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Illness Hypoxia Fever, unspecified fever cause COVID-19 virus infection   HOSPITAL COURSE:  Date of onset of symptoms:  Unknown Symptoms present on admission: Hypoxemia Date of covid positive test:  12/7/2022 Unknown when SNF test was positive Vaccination status:  Vaccinated Imaging:   12/7/2022 CXR no acute process Oxygen requirements on admission:   no home oxygen - 3-4LPM/NC Current oxygen requirements:  4LPM/NC  Medical therapy: Decadron started 12/7/2022   Consultants following:  NA Anticipated special isolation end date 12/17/2022   Obtained from EMR as patient is aphasic Patient is a 65 y.o. year-old male, who presented with illness. From ECF with known positive COVID, hypoxemia, increased AMS, and fever.  Patient is there for rehab after having a fall.  Per records patient was discharged from hospital on 12/1 where he had subdural hematoma and subarachnoid hemorrhage.  Per records patient also has frontotemporal dementia and Parkinson's likely.  Per report patient has been getting IV fluids/hydration at nursing facility and has diagnosis of COVID.  Per report patient is full code.  Per report patient running fever and more altered therefore sent to the ER.  Patient is awake but has difficulty speaking/giving history.  He is able to give yes and no answers.  No family present at this time.  Upon arrival to the ER patient was found to have fever of 101.6, tachycardia of 114 respiratory rate of 20.   Patient now on room air.  Improving with current therapy being provided.  We will discharge to skilled nursing facility for continued PT/OT.  Patient in agreement with plan.  All cultures have remained negative.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Hypertension, Hyponatraemia, Hypoxia, Illness
Clinical narrative: FINAL DIAGNOSIS:   1. Covid-19 Virus Infection 2. Acute hypoxemic respiratory failure 2/2 COVID 3. Mild Hyponatremia - 130 on admission - repeating CMP today  4. HTN 5. Hx frontotemporal dementia 6. Hx of CVA and TIA with aphasia 7. Obesity with BMI 31.44 Elevated LFTs         REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Illness Hypoxia Fever, unspecified fever cause COVID-19 virus infection   HOSPITAL COURSE:  Date of onset of symptoms:  Unknown Symptoms present on admission: Hypoxemia Date of covid positive test:  12/7/2022 Unknown when SNF test was positive Vaccination status:  Vaccinated Imaging:   12/7/2022 CXR no acute process Oxygen requirements on admission:   no home oxygen - 3-4LPM/NC Current oxygen requirements:  4LPM/NC  Medical therapy: Decadron started 12/7/2022   Consultants following:  NA Anticipated special isolation end date 12/17/2022   Obtained from EMR as patient is aphasic Patient is a 65 y.o. year-old male, who presented with illness. From ECF with known positive COVID, hypoxemia, increased AMS, and fever.  Patient is there for rehab after having a fall.  Per records patient was discharged from hospital on 12/1 where he had subdural hematoma and subarachnoid hemorrhage.  Per records patient also has frontotemporal dementia and Parkinson's likely.  Per report patient has been getting IV fluids/hydration at nursing facility and has diagnosis of COVID.  Per report patient is full code.  Per report patient running fever and more altered therefore sent to the ER.  Patient is awake but has difficulty speaking/giving history.  He is able to give yes and no answers.  No family present at this time.  Upon arrival to the ER patient was found to have fever of 101.6, tachycardia of 114 respiratory rate of 20.   Patient now on room air.  Improving with current therapy being provided.  We will discharge to skilled nursing facility for continued PT/OT.  Patient in agreement with plan.  All cultures have remained negative.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Liver function test increased, Mental status changes, Obesity, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: FINAL DIAGNOSIS:   1. Covid-19 Virus Infection 2. Acute hypoxemic respiratory failure 2/2 COVID 3. Mild Hyponatremia - 130 on admission - repeating CMP today  4. HTN 5. Hx frontotemporal dementia 6. Hx of CVA and TIA with aphasia 7. Obesity with BMI 31.44 Elevated LFTs         REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Illness Hypoxia Fever, unspecified fever cause COVID-19 virus infection   HOSPITAL COURSE:  Date of onset of symptoms:  Unknown Symptoms present on admission: Hypoxemia Date of covid positive test:  12/7/2022 Unknown when SNF test was positive Vaccination status:  Vaccinated Imaging:   12/7/2022 CXR no acute process Oxygen requirements on admission:   no home oxygen - 3-4LPM/NC Current oxygen requirements:  4LPM/NC  Medical therapy: Decadron started 12/7/2022   Consultants following:  NA Anticipated special isolation end date 12/17/2022   Obtained from EMR as patient is aphasic Patient is a 65 y.o. year-old male, who presented with illness. From ECF with known positive COVID, hypoxemia, increased AMS, and fever.  Patient is there for rehab after having a fall.  Per records patient was discharged from hospital on 12/1 where he had subdural hematoma and subarachnoid hemorrhage.  Per records patient also has frontotemporal dementia and Parkinson's likely.  Per report patient has been getting IV fluids/hydration at nursing facility and has diagnosis of COVID.  Per report patient is full code.  Per report patient running fever and more altered therefore sent to the ER.  Patient is awake but has difficulty speaking/giving history.  He is able to give yes and no answers.  No family present at this time.  Upon arrival to the ER patient was found to have fever of 101.6, tachycardia of 114 respiratory rate of 20.   Patient now on room air.  Improving with current therapy being provided.  We will discharge to skilled nursing facility for continued PT/OT.  Patient in agreement with plan.  All cultures have remained negative.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Speech disorder, Subarachnoid haemorrhage, Subdural haematoma, Tachycardia
Clinical narrative: FINAL DIAGNOSIS:   1. Covid-19 Virus Infection 2. Acute hypoxemic respiratory failure 2/2 COVID 3. Mild Hyponatremia - 130 on admission - repeating CMP today  4. HTN 5. Hx frontotemporal dementia 6. Hx of CVA and TIA with aphasia 7. Obesity with BMI 31.44 Elevated LFTs         REASON FOR HOSPITALIZATION AND ADMITTING DIAGNOSIS:   Illness Hypoxia Fever, unspecified fever cause COVID-19 virus infection   HOSPITAL COURSE:  Date of onset of symptoms:  Unknown Symptoms present on admission: Hypoxemia Date of covid positive test:  12/7/2022 Unknown when SNF test was positive Vaccination status:  Vaccinated Imaging:   12/7/2022 CXR no acute process Oxygen requirements on admission:   no home oxygen - 3-4LPM/NC Current oxygen requirements:  4LPM/NC  Medical therapy: Decadron started 12/7/2022   Consultants following:  NA Anticipated special isolation end date 12/17/2022   Obtained from EMR as patient is aphasic Patient is a 65 y.o. year-old male, who presented with illness. From ECF with known positive COVID, hypoxemia, increased AMS, and fever.  Patient is there for rehab after having a fall.  Per records patient was discharged from hospital on 12/1 where he had subdural hematoma and subarachnoid hemorrhage.  Per records patient also has frontotemporal dementia and Parkinson's likely.  Per report patient has been getting IV fluids/hydration at nursing facility and has diagnosis of COVID.  Per report patient is full code.  Per report patient running fever and more altered therefore sent to the ER.  Patient is awake but has difficulty speaking/giving history.  He is able to give yes and no answers.  No family present at this time.  Upon arrival to the ER patient was found to have fever of 101.6, tachycardia of 114 respiratory rate of 20.   Patient now on room air.  Improving with current therapy being provided.  We will discharge to skilled nursing facility for continued PT/OT.  Patient in agreement with plan.  All cultures have remained negative.
Age: 57.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cardiac stress test, Computerised tomogram, Electrocardiogram, Hypoaesthesia, Paraesthesia
Clinical narrative: Initially both hands would "fall asleep" (go numb and tingle) no matter what I was doing and blood flow was not constricted (e,g walking, driving, working).  A week later my feet because numb and I have lost feeling in the toes of my right foot.  My right arm and hand because swollen and remained swollen.
Age: 57.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Peripheral swelling, Vascular test
Clinical narrative: Initially both hands would "fall asleep" (go numb and tingle) no matter what I was doing and blood flow was not constricted (e,g walking, driving, working).  A week later my feet because numb and I have lost feeling in the toes of my right foot.  My right arm and hand because swollen and remained swollen.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Asthenia, Atelectasis, Bacterial infection
Clinical narrative: Clinical Summary Patient is a 76 y.o. male with a history of HFrEF, Atrial fibrillation, chronic left heel osteomyelitis  who presented to ER 11/27/22 with shortness of breath, transferred to alternate hospital 11/27/22 for ICU care. Course complicated by septic shock, (+)COVID, HAP with MDR-organism, and intubation. Medical Care assumed care 12/2/22 on transfer. Hospital course further complicated by progressive debility. Medical Care consulted 12/2/22 to assume care upon transfer.   1. Acute hypoxemic and hypercapnic respiratory failure: In the setting of COVID-19, HAP and left lung atelectasis. Chest x-ray 11/28/2022 with left hemothorax opacification. S/P bronchoscopy 11/28/2022. S/p inhaled thromboxane. Extubated 12/1/2022, weaned to 2-3L NC by 12/5/22.  2. COVID-19 Infection: Fully vaccinated, symptom onset 11/26/22, (+)test 11/27/22. Completed 10 days of Decadron end date 12/7/22 and out of isolation since 12/8/22. 3. HAP: BAL cultures 11/28/22 with MDR actinobacter. Completed Unasyn 12/6/22.  4. Septic shock: Likely related to above. Transiently required pressors in ER, resolved by 12/1/22. 5. Acute metabolic encephalopathy: Suspect metabolic from above. CT head 11/27/22 non-acute. Resolved. 6. Chronic left heel osteomyelitis: With diabetic neuropathy and PVD. Follows with Dr. (podiatry). Hospitalized at local facility on 10/2022 and placed on IV daptomycin and Invanz. Antibiotic course completed 11/28/22.  7. AKI on CKD3: Follows with Dr. (Nephrology) Baseline Cr 1.9, Cr 2.2  on admit due to septic shock. CR improved by 12/2/22 8. Persistent Hyperkalemia: due to AKI on CKD, added Lokelma 12/5/22.  9. CAD: S/p DES mid-LAD 5/2022. Continued asa, plavix and lipitor. 10. Chronic HFrEF: Ischemic CM, EF Nadir 35% (5/2022). Euvolemic on admit, last TTE 8/4/22 (at local facility) EF 50%. Initially held home Toprol XL due to hypotension, restarted 12/6/22. 11. Paroxysmal atrial fibrillation: AC stopped due to hx of recurrent GI bleeding in 11/2022 admit. Follows with Dr. who is considering LAA closure device in the future. Home BB and Propafenone restarted 12/6/22 12. Melena/recurrent GI bleed admitted 11/18 to 11/20/2022.  S/p blood transfusion.  EGD 11/19/2022 negative for bleeding. 13. Diet Controlled T2DM: Hgb A1c 5.9% on 5/13/22. Not on home medications. Stopped insulin 12/2/22. 14. Abnormal chest imaging: 3 cm right lower lobe calcified nodule on CT/5/16/2022.  Outpatient follow-up with repeat CT in 3 to 6 months. 15. Code status: DNR-CCA/DNI-Spouse. Palliative medicine following and has had multiple goals of care meetings.  16. DVT Prophylaxis: lovenox
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Bacterial test positive, Blood creatinine increased, Bronchoalveolar lavage abnormal, Bronchoscopy, COVID-19
Clinical narrative: Clinical Summary Patient is a 76 y.o. male with a history of HFrEF, Atrial fibrillation, chronic left heel osteomyelitis  who presented to ER 11/27/22 with shortness of breath, transferred to alternate hospital 11/27/22 for ICU care. Course complicated by septic shock, (+)COVID, HAP with MDR-organism, and intubation. Medical Care assumed care 12/2/22 on transfer. Hospital course further complicated by progressive debility. Medical Care consulted 12/2/22 to assume care upon transfer.   1. Acute hypoxemic and hypercapnic respiratory failure: In the setting of COVID-19, HAP and left lung atelectasis. Chest x-ray 11/28/2022 with left hemothorax opacification. S/P bronchoscopy 11/28/2022. S/p inhaled thromboxane. Extubated 12/1/2022, weaned to 2-3L NC by 12/5/22.  2. COVID-19 Infection: Fully vaccinated, symptom onset 11/26/22, (+)test 11/27/22. Completed 10 days of Decadron end date 12/7/22 and out of isolation since 12/8/22. 3. HAP: BAL cultures 11/28/22 with MDR actinobacter. Completed Unasyn 12/6/22.  4. Septic shock: Likely related to above. Transiently required pressors in ER, resolved by 12/1/22. 5. Acute metabolic encephalopathy: Suspect metabolic from above. CT head 11/27/22 non-acute. Resolved. 6. Chronic left heel osteomyelitis: With diabetic neuropathy and PVD. Follows with Dr. (podiatry). Hospitalized at local facility on 10/2022 and placed on IV daptomycin and Invanz. Antibiotic course completed 11/28/22.  7. AKI on CKD3: Follows with Dr. (Nephrology) Baseline Cr 1.9, Cr 2.2  on admit due to septic shock. CR improved by 12/2/22 8. Persistent Hyperkalemia: due to AKI on CKD, added Lokelma 12/5/22.  9. CAD: S/p DES mid-LAD 5/2022. Continued asa, plavix and lipitor. 10. Chronic HFrEF: Ischemic CM, EF Nadir 35% (5/2022). Euvolemic on admit, last TTE 8/4/22 (at local facility) EF 50%. Initially held home Toprol XL due to hypotension, restarted 12/6/22. 11. Paroxysmal atrial fibrillation: AC stopped due to hx of recurrent GI bleeding in 11/2022 admit. Follows with Dr. who is considering LAA closure device in the future. Home BB and Propafenone restarted 12/6/22 12. Melena/recurrent GI bleed admitted 11/18 to 11/20/2022.  S/p blood transfusion.  EGD 11/19/2022 negative for bleeding. 13. Diet Controlled T2DM: Hgb A1c 5.9% on 5/13/22. Not on home medications. Stopped insulin 12/2/22. 14. Abnormal chest imaging: 3 cm right lower lobe calcified nodule on CT/5/16/2022.  Outpatient follow-up with repeat CT in 3 to 6 months. 15. Code status: DNR-CCA/DNI-Spouse. Palliative medicine following and has had multiple goals of care meetings.  16. DVT Prophylaxis: lovenox
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest X-ray abnormal, Computerised tomogram head normal, Dyspnoea, Endotracheal intubation, Gastrointestinal haemorrhage
Clinical narrative: Clinical Summary Patient is a 76 y.o. male with a history of HFrEF, Atrial fibrillation, chronic left heel osteomyelitis  who presented to ER 11/27/22 with shortness of breath, transferred to alternate hospital 11/27/22 for ICU care. Course complicated by septic shock, (+)COVID, HAP with MDR-organism, and intubation. Medical Care assumed care 12/2/22 on transfer. Hospital course further complicated by progressive debility. Medical Care consulted 12/2/22 to assume care upon transfer.   1. Acute hypoxemic and hypercapnic respiratory failure: In the setting of COVID-19, HAP and left lung atelectasis. Chest x-ray 11/28/2022 with left hemothorax opacification. S/P bronchoscopy 11/28/2022. S/p inhaled thromboxane. Extubated 12/1/2022, weaned to 2-3L NC by 12/5/22.  2. COVID-19 Infection: Fully vaccinated, symptom onset 11/26/22, (+)test 11/27/22. Completed 10 days of Decadron end date 12/7/22 and out of isolation since 12/8/22. 3. HAP: BAL cultures 11/28/22 with MDR actinobacter. Completed Unasyn 12/6/22.  4. Septic shock: Likely related to above. Transiently required pressors in ER, resolved by 12/1/22. 5. Acute metabolic encephalopathy: Suspect metabolic from above. CT head 11/27/22 non-acute. Resolved. 6. Chronic left heel osteomyelitis: With diabetic neuropathy and PVD. Follows with Dr. (podiatry). Hospitalized at local facility on 10/2022 and placed on IV daptomycin and Invanz. Antibiotic course completed 11/28/22.  7. AKI on CKD3: Follows with Dr. (Nephrology) Baseline Cr 1.9, Cr 2.2  on admit due to septic shock. CR improved by 12/2/22 8. Persistent Hyperkalemia: due to AKI on CKD, added Lokelma 12/5/22.  9. CAD: S/p DES mid-LAD 5/2022. Continued asa, plavix and lipitor. 10. Chronic HFrEF: Ischemic CM, EF Nadir 35% (5/2022). Euvolemic on admit, last TTE 8/4/22 (at local facility) EF 50%. Initially held home Toprol XL due to hypotension, restarted 12/6/22. 11. Paroxysmal atrial fibrillation: AC stopped due to hx of recurrent GI bleeding in 11/2022 admit. Follows with Dr. who is considering LAA closure device in the future. Home BB and Propafenone restarted 12/6/22 12. Melena/recurrent GI bleed admitted 11/18 to 11/20/2022.  S/p blood transfusion.  EGD 11/19/2022 negative for bleeding. 13. Diet Controlled T2DM: Hgb A1c 5.9% on 5/13/22. Not on home medications. Stopped insulin 12/2/22. 14. Abnormal chest imaging: 3 cm right lower lobe calcified nodule on CT/5/16/2022.  Outpatient follow-up with repeat CT in 3 to 6 months. 15. Code status: DNR-CCA/DNI-Spouse. Palliative medicine following and has had multiple goals of care meetings.  16. DVT Prophylaxis: lovenox
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hyperkalaemia, Hypotension, Intensive care, Lung opacity, Malaise
Clinical narrative: Clinical Summary Patient is a 76 y.o. male with a history of HFrEF, Atrial fibrillation, chronic left heel osteomyelitis  who presented to ER 11/27/22 with shortness of breath, transferred to alternate hospital 11/27/22 for ICU care. Course complicated by septic shock, (+)COVID, HAP with MDR-organism, and intubation. Medical Care assumed care 12/2/22 on transfer. Hospital course further complicated by progressive debility. Medical Care consulted 12/2/22 to assume care upon transfer.   1. Acute hypoxemic and hypercapnic respiratory failure: In the setting of COVID-19, HAP and left lung atelectasis. Chest x-ray 11/28/2022 with left hemothorax opacification. S/P bronchoscopy 11/28/2022. S/p inhaled thromboxane. Extubated 12/1/2022, weaned to 2-3L NC by 12/5/22.  2. COVID-19 Infection: Fully vaccinated, symptom onset 11/26/22, (+)test 11/27/22. Completed 10 days of Decadron end date 12/7/22 and out of isolation since 12/8/22. 3. HAP: BAL cultures 11/28/22 with MDR actinobacter. Completed Unasyn 12/6/22.  4. Septic shock: Likely related to above. Transiently required pressors in ER, resolved by 12/1/22. 5. Acute metabolic encephalopathy: Suspect metabolic from above. CT head 11/27/22 non-acute. Resolved. 6. Chronic left heel osteomyelitis: With diabetic neuropathy and PVD. Follows with Dr. (podiatry). Hospitalized at local facility on 10/2022 and placed on IV daptomycin and Invanz. Antibiotic course completed 11/28/22.  7. AKI on CKD3: Follows with Dr. (Nephrology) Baseline Cr 1.9, Cr 2.2  on admit due to septic shock. CR improved by 12/2/22 8. Persistent Hyperkalemia: due to AKI on CKD, added Lokelma 12/5/22.  9. CAD: S/p DES mid-LAD 5/2022. Continued asa, plavix and lipitor. 10. Chronic HFrEF: Ischemic CM, EF Nadir 35% (5/2022). Euvolemic on admit, last TTE 8/4/22 (at local facility) EF 50%. Initially held home Toprol XL due to hypotension, restarted 12/6/22. 11. Paroxysmal atrial fibrillation: AC stopped due to hx of recurrent GI bleeding in 11/2022 admit. Follows with Dr. who is considering LAA closure device in the future. Home BB and Propafenone restarted 12/6/22 12. Melena/recurrent GI bleed admitted 11/18 to 11/20/2022.  S/p blood transfusion.  EGD 11/19/2022 negative for bleeding. 13. Diet Controlled T2DM: Hgb A1c 5.9% on 5/13/22. Not on home medications. Stopped insulin 12/2/22. 14. Abnormal chest imaging: 3 cm right lower lobe calcified nodule on CT/5/16/2022.  Outpatient follow-up with repeat CT in 3 to 6 months. 15. Code status: DNR-CCA/DNI-Spouse. Palliative medicine following and has had multiple goals of care meetings.  16. DVT Prophylaxis: lovenox