chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 47.0
Sex: F
Vaccine: HEPA, TYP, YF
Symptoms: Erythema, Paraesthesia, Swelling face
Clinical narrative: Pt stopped back in the office several hours after vaccination. The right side of her face was red, a bit swollen and tingling. Pt does not have SOB, hives or any other symptoms. Pt states she did not take any medication or eat anything unusual this morning. Pt told to go to Urgent Care/ ER to be assessed for potential allergic reaction to vaccines. Patient went to ER and was evaluated.  Prescriptions were given for Predisone 5-day pack, Benadryl PRN, and also given a script for an Epi Pen.  On 01-04-2023 patient states the swelling is resolved and most of the redness and tingling is resolved / improving. Patient requested that only minimal PHI be used for this report.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: covid vaccine breakthrough case  dose 1 Moderna 3/9/21  040A21A dose 2 Moderna 4/6/21  045A21A
Age: 56.0
Sex: M
Vaccine: HEPAB
Symptoms: Expired product administered
Clinical narrative: Administered expired vaccine by accident. Vaccine administered on 01/03/2023 and vaccine expired on 01/01/2023. No symptoms reported by the patient. Patient made aware of the mistake and does not have any additional questions or concerns. Patient will not be billed for this vaccine. Medical Director, Dr.  has been notified.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Anaemia of chronic disease, Anosmia, Blood culture negative, COVID-19
Clinical narrative: The patient is a 83 y.o. female with history of presented to Hospital with severe abdominal pain.   SBO Admit to hospitalist service Surgical consult N.p.o. Continue NGT to suction Gentle IV hydration Pain control CT showed high-grade partial distal small bowel obstruction, with suggested point of transition in the lateral right lower quadrant.   Surgery ordered SBFT and did not show obstruction 12/16, clamp trial and clears as tolerated 12/18, patient tolerates liquids. Advanced to regular diet. 12/19: tolerating regular diet On Discharge tolerating regular diet and stooling regularly on bowel regimen   Bibasilar pneumonia CT scan suggest airspace both lung bases Patient asymptomatic Cannot rule out aspiration given multiple episodes of vomiting lately Received 5 Days zosyn Blood culture with no growth to date 1 Dose po levofloxacin on day of discharge and 1 dose to complete the day after discharge for a total of 7 days antibiotics   Leucopenia Anemia combination of anemia of chronic disease secondary to rheumatoid and iron deficiency She is on iron supplementation held while n.p.o. inpatient, to be resumed in the outpatient 12/15, Hemoglobin dropped 9.7 -> 7.5. Possible effect of IVF.  Continue to monitor hemoglobin and WBC Leucopenia possible due to Zosyn.  WBC 2.71 and hemoglobin 7.5 on discharge     History of rheumatoid arthritis Methotrexate and prednisone held while inpatient Continue to hold methotrexate at discharge until 1 week after acute infection resolves Prednisone 5 mg 3 times daily resumed at discharge Patient will need to follow-up with her rheumatologist patient had no recent fill history of Lasix and it was held while inpatient, continue to hold on discharge   Chronic congestive heart failure with preserved systolic function Ejection fraction 60 to 65% with diastolic dysfunction compensated Hold home Lasix until able to maintain hydration  Covid 19 Covid-19 Virus Infection Date of onset of symptoms: 12/18/2022 (loss of smell) Symptoms present on admission: none, developed loss of smell on  Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: none, no change in O2 requirements from baseline Oxygen requirements on admission: 2L, same as home Current oxygen requirements: 2L, same as home Medical therapy: not indicated Consultants following: none Anticipated special isolation end date: 12/27/2022   Chronic hypoxic respiratory failure The patient uses 2L nasal canula at home. She uses the same here.      Physical deconditioning Secondary to advanced age combined with acute illness Patient lives alone Working with PT and OT Discharged to rehab
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Diastolic dysfunction, Ejection fraction normal, Gastrointestinal tube insertion
Clinical narrative: The patient is a 83 y.o. female with history of presented to Hospital with severe abdominal pain.   SBO Admit to hospitalist service Surgical consult N.p.o. Continue NGT to suction Gentle IV hydration Pain control CT showed high-grade partial distal small bowel obstruction, with suggested point of transition in the lateral right lower quadrant.   Surgery ordered SBFT and did not show obstruction 12/16, clamp trial and clears as tolerated 12/18, patient tolerates liquids. Advanced to regular diet. 12/19: tolerating regular diet On Discharge tolerating regular diet and stooling regularly on bowel regimen   Bibasilar pneumonia CT scan suggest airspace both lung bases Patient asymptomatic Cannot rule out aspiration given multiple episodes of vomiting lately Received 5 Days zosyn Blood culture with no growth to date 1 Dose po levofloxacin on day of discharge and 1 dose to complete the day after discharge for a total of 7 days antibiotics   Leucopenia Anemia combination of anemia of chronic disease secondary to rheumatoid and iron deficiency She is on iron supplementation held while n.p.o. inpatient, to be resumed in the outpatient 12/15, Hemoglobin dropped 9.7 -> 7.5. Possible effect of IVF.  Continue to monitor hemoglobin and WBC Leucopenia possible due to Zosyn.  WBC 2.71 and hemoglobin 7.5 on discharge     History of rheumatoid arthritis Methotrexate and prednisone held while inpatient Continue to hold methotrexate at discharge until 1 week after acute infection resolves Prednisone 5 mg 3 times daily resumed at discharge Patient will need to follow-up with her rheumatologist patient had no recent fill history of Lasix and it was held while inpatient, continue to hold on discharge   Chronic congestive heart failure with preserved systolic function Ejection fraction 60 to 65% with diastolic dysfunction compensated Hold home Lasix until able to maintain hydration  Covid 19 Covid-19 Virus Infection Date of onset of symptoms: 12/18/2022 (loss of smell) Symptoms present on admission: none, developed loss of smell on  Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: none, no change in O2 requirements from baseline Oxygen requirements on admission: 2L, same as home Current oxygen requirements: 2L, same as home Medical therapy: not indicated Consultants following: none Anticipated special isolation end date: 12/27/2022   Chronic hypoxic respiratory failure The patient uses 2L nasal canula at home. She uses the same here.      Physical deconditioning Secondary to advanced age combined with acute illness Patient lives alone Working with PT and OT Discharged to rehab
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Infection, Iron deficiency anaemia, Leukopenia, Malaise
Clinical narrative: The patient is a 83 y.o. female with history of presented to Hospital with severe abdominal pain.   SBO Admit to hospitalist service Surgical consult N.p.o. Continue NGT to suction Gentle IV hydration Pain control CT showed high-grade partial distal small bowel obstruction, with suggested point of transition in the lateral right lower quadrant.   Surgery ordered SBFT and did not show obstruction 12/16, clamp trial and clears as tolerated 12/18, patient tolerates liquids. Advanced to regular diet. 12/19: tolerating regular diet On Discharge tolerating regular diet and stooling regularly on bowel regimen   Bibasilar pneumonia CT scan suggest airspace both lung bases Patient asymptomatic Cannot rule out aspiration given multiple episodes of vomiting lately Received 5 Days zosyn Blood culture with no growth to date 1 Dose po levofloxacin on day of discharge and 1 dose to complete the day after discharge for a total of 7 days antibiotics   Leucopenia Anemia combination of anemia of chronic disease secondary to rheumatoid and iron deficiency She is on iron supplementation held while n.p.o. inpatient, to be resumed in the outpatient 12/15, Hemoglobin dropped 9.7 -> 7.5. Possible effect of IVF.  Continue to monitor hemoglobin and WBC Leucopenia possible due to Zosyn.  WBC 2.71 and hemoglobin 7.5 on discharge     History of rheumatoid arthritis Methotrexate and prednisone held while inpatient Continue to hold methotrexate at discharge until 1 week after acute infection resolves Prednisone 5 mg 3 times daily resumed at discharge Patient will need to follow-up with her rheumatologist patient had no recent fill history of Lasix and it was held while inpatient, continue to hold on discharge   Chronic congestive heart failure with preserved systolic function Ejection fraction 60 to 65% with diastolic dysfunction compensated Hold home Lasix until able to maintain hydration  Covid 19 Covid-19 Virus Infection Date of onset of symptoms: 12/18/2022 (loss of smell) Symptoms present on admission: none, developed loss of smell on  Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: none, no change in O2 requirements from baseline Oxygen requirements on admission: 2L, same as home Current oxygen requirements: 2L, same as home Medical therapy: not indicated Consultants following: none Anticipated special isolation end date: 12/27/2022   Chronic hypoxic respiratory failure The patient uses 2L nasal canula at home. She uses the same here.      Physical deconditioning Secondary to advanced age combined with acute illness Patient lives alone Working with PT and OT Discharged to rehab
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Mineral supplementation, Nothing by mouth order, Physical deconditioning, Pneumonia, SARS-CoV-2 test positive
Clinical narrative: The patient is a 83 y.o. female with history of presented to Hospital with severe abdominal pain.   SBO Admit to hospitalist service Surgical consult N.p.o. Continue NGT to suction Gentle IV hydration Pain control CT showed high-grade partial distal small bowel obstruction, with suggested point of transition in the lateral right lower quadrant.   Surgery ordered SBFT and did not show obstruction 12/16, clamp trial and clears as tolerated 12/18, patient tolerates liquids. Advanced to regular diet. 12/19: tolerating regular diet On Discharge tolerating regular diet and stooling regularly on bowel regimen   Bibasilar pneumonia CT scan suggest airspace both lung bases Patient asymptomatic Cannot rule out aspiration given multiple episodes of vomiting lately Received 5 Days zosyn Blood culture with no growth to date 1 Dose po levofloxacin on day of discharge and 1 dose to complete the day after discharge for a total of 7 days antibiotics   Leucopenia Anemia combination of anemia of chronic disease secondary to rheumatoid and iron deficiency She is on iron supplementation held while n.p.o. inpatient, to be resumed in the outpatient 12/15, Hemoglobin dropped 9.7 -> 7.5. Possible effect of IVF.  Continue to monitor hemoglobin and WBC Leucopenia possible due to Zosyn.  WBC 2.71 and hemoglobin 7.5 on discharge     History of rheumatoid arthritis Methotrexate and prednisone held while inpatient Continue to hold methotrexate at discharge until 1 week after acute infection resolves Prednisone 5 mg 3 times daily resumed at discharge Patient will need to follow-up with her rheumatologist patient had no recent fill history of Lasix and it was held while inpatient, continue to hold on discharge   Chronic congestive heart failure with preserved systolic function Ejection fraction 60 to 65% with diastolic dysfunction compensated Hold home Lasix until able to maintain hydration  Covid 19 Covid-19 Virus Infection Date of onset of symptoms: 12/18/2022 (loss of smell) Symptoms present on admission: none, developed loss of smell on  Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: none, no change in O2 requirements from baseline Oxygen requirements on admission: 2L, same as home Current oxygen requirements: 2L, same as home Medical therapy: not indicated Consultants following: none Anticipated special isolation end date: 12/27/2022   Chronic hypoxic respiratory failure The patient uses 2L nasal canula at home. She uses the same here.      Physical deconditioning Secondary to advanced age combined with acute illness Patient lives alone Working with PT and OT Discharged to rehab
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Small intestinal obstruction, Vomiting, White blood cell count decreased, X-ray with contrast upper gastrointestinal tract
Clinical narrative: The patient is a 83 y.o. female with history of presented to Hospital with severe abdominal pain.   SBO Admit to hospitalist service Surgical consult N.p.o. Continue NGT to suction Gentle IV hydration Pain control CT showed high-grade partial distal small bowel obstruction, with suggested point of transition in the lateral right lower quadrant.   Surgery ordered SBFT and did not show obstruction 12/16, clamp trial and clears as tolerated 12/18, patient tolerates liquids. Advanced to regular diet. 12/19: tolerating regular diet On Discharge tolerating regular diet and stooling regularly on bowel regimen   Bibasilar pneumonia CT scan suggest airspace both lung bases Patient asymptomatic Cannot rule out aspiration given multiple episodes of vomiting lately Received 5 Days zosyn Blood culture with no growth to date 1 Dose po levofloxacin on day of discharge and 1 dose to complete the day after discharge for a total of 7 days antibiotics   Leucopenia Anemia combination of anemia of chronic disease secondary to rheumatoid and iron deficiency She is on iron supplementation held while n.p.o. inpatient, to be resumed in the outpatient 12/15, Hemoglobin dropped 9.7 -> 7.5. Possible effect of IVF.  Continue to monitor hemoglobin and WBC Leucopenia possible due to Zosyn.  WBC 2.71 and hemoglobin 7.5 on discharge     History of rheumatoid arthritis Methotrexate and prednisone held while inpatient Continue to hold methotrexate at discharge until 1 week after acute infection resolves Prednisone 5 mg 3 times daily resumed at discharge Patient will need to follow-up with her rheumatologist patient had no recent fill history of Lasix and it was held while inpatient, continue to hold on discharge   Chronic congestive heart failure with preserved systolic function Ejection fraction 60 to 65% with diastolic dysfunction compensated Hold home Lasix until able to maintain hydration  Covid 19 Covid-19 Virus Infection Date of onset of symptoms: 12/18/2022 (loss of smell) Symptoms present on admission: none, developed loss of smell on  Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: none, no change in O2 requirements from baseline Oxygen requirements on admission: 2L, same as home Current oxygen requirements: 2L, same as home Medical therapy: not indicated Consultants following: none Anticipated special isolation end date: 12/27/2022   Chronic hypoxic respiratory failure The patient uses 2L nasal canula at home. She uses the same here.      Physical deconditioning Secondary to advanced age combined with acute illness Patient lives alone Working with PT and OT Discharged to rehab
Age: 29.0
Sex: F
Vaccine: COVID19-2
Symptoms: Mobility decreased, Muscle tightness, Pain in extremity
Clinical narrative: I did not have an adverse reaction to the vaccine. Two weeks later on the morning of 10/17, the muscles in my left arm tightened up to the point I couldn't move. I saw my doctor and I was given a prescription for high dose oral steroids for 2 weeks. After the steroids, I can move it a little, but it is very sensitive. I continue to have problems, but I am able to move it.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest pain, Pain, Pain in jaw, Pyrexia, Tremor
Clinical narrative: Initially reported severe severe shaking/trembling and very painful gripping in my jaw. Later developed fever aching and some chest pain on turning from side to side
Age: 1.58
Sex: M
Vaccine: COVID19
Symptoms: Injection site reaction, Injection site warmth, Rash, Urticaria
Clinical narrative: A couple days after the vaccine he developed a small, raised half dollar sized whelp on his right thigh that was hot to the touch. It did not seem to bother him; it did take a week to go away. On December 26, 2022, he awoke with a rash all over his body, certain areas were worse than others. We went to the doctor, they took his temperature, looked at the rash. Said it did not look like hand, foot and mouth and it did not look like any of the rashes that were going around. They did prescribe BACTRIM cream to apply the areas to help clear up the areas. It did not seem to bother him at all and as of today the areas appear to be clearing up.
Age: 49.0
Sex: F
Vaccine: COVID19-2
Symptoms: Electrocardiogram normal, Hypoaesthesia, Nervousness, Pain, Paraesthesia
Clinical narrative: had a low grade, achy and was dry heaving the morning of the 9th.  Low Grade and feeling fluish is typical for me after the covid shot but dry heaving was new.  the night of the 12th I noticed a tingliness in the back of my right leg and buttock (i was standing and chopping vegetables). did not hurt but felt like it was asleep and just starting to wake up. leg was fully functional. Morning of the 13th it was still there. i had been stressed with work so was concerned it could be a cardio event. I called my doctors office. they were concerned it was cardio related as well so they squeezed me in for an 11am appt that morning. by the time I got to my appt, the tingliness had moved up to the right side of my torso and right arm. BP, pulse and EKG was taken.  had a full body check, walked, had reflexes assessed. everything was normal and was ruled out it was cardio. I was told if anything begins to affect my motor skills go immediately to the ER. 2 hours later, the numb and tingliness moved up the right side of my neck and then my entire face where I felt the tingliness move into my earlobes, nostrils, eyelids and face. i had full command of facial movement. then the tingliness in my face left after 2 hours. the tingliness in my face happened the week before Christmas as well. right now my right arm, torso and leg have tingliness.
Age: 49.0
Sex: F
Vaccine: COVID19-2
Symptoms: Reflex test normal, Retching, Stress at work
Clinical narrative: had a low grade, achy and was dry heaving the morning of the 9th.  Low Grade and feeling fluish is typical for me after the covid shot but dry heaving was new.  the night of the 12th I noticed a tingliness in the back of my right leg and buttock (i was standing and chopping vegetables). did not hurt but felt like it was asleep and just starting to wake up. leg was fully functional. Morning of the 13th it was still there. i had been stressed with work so was concerned it could be a cardio event. I called my doctors office. they were concerned it was cardio related as well so they squeezed me in for an 11am appt that morning. by the time I got to my appt, the tingliness had moved up to the right side of my torso and right arm. BP, pulse and EKG was taken.  had a full body check, walked, had reflexes assessed. everything was normal and was ruled out it was cardio. I was told if anything begins to affect my motor skills go immediately to the ER. 2 hours later, the numb and tingliness moved up the right side of my neck and then my entire face where I felt the tingliness move into my earlobes, nostrils, eyelids and face. i had full command of facial movement. then the tingliness in my face left after 2 hours. the tingliness in my face happened the week before Christmas as well. right now my right arm, torso and leg have tingliness.
Age: 51.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: COVID-19, Chills, Conjunctivitis, Deafness unilateral, Ear infection
Clinical narrative: 12/18/2022 approximately 04:00PM, I started getting very tired. I went to lie down and when I woke up I was sick with flu symptoms. I had fever, chills, body aches and sweating. I lost hearing in my right ear. I had pink eye in my right eye. I went to the doctor on 12/29/2022 and I tested positive for COVID-19 and an ear infection and Acute Pharyngitis. I am still testing positive and still cannot hear.
Age: 51.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Fatigue, Hyperhidrosis, Influenza, Pain, Pharyngitis
Clinical narrative: 12/18/2022 approximately 04:00PM, I started getting very tired. I went to lie down and when I woke up I was sick with flu symptoms. I had fever, chills, body aches and sweating. I lost hearing in my right ear. I had pink eye in my right eye. I went to the doctor on 12/29/2022 and I tested positive for COVID-19 and an ear infection and Acute Pharyngitis. I am still testing positive and still cannot hear.
Age: 51.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Pyrexia, SARS-CoV-2 test positive, Streptococcus test negative
Clinical narrative: 12/18/2022 approximately 04:00PM, I started getting very tired. I went to lie down and when I woke up I was sick with flu symptoms. I had fever, chills, body aches and sweating. I lost hearing in my right ear. I had pink eye in my right eye. I went to the doctor on 12/29/2022 and I tested positive for COVID-19 and an ear infection and Acute Pharyngitis. I am still testing positive and still cannot hear.
Age: 47.0
Sex: F
Vaccine: COVID19-2
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Fatigue
Clinical narrative: On 12/27 started having congestion and irritated sore throat. Then fatigue set in. On 12/28 tested positive on at home test. Took NYQUIL and DAYQUIL provided minor relief. Developed persistent cough. Ran fever of 100.9 with TYLENOL. Took SUDAFED for congestion. 12/29 had telehealth visit with PCP. Was prescribed PAXLOVID but didn't take it. Was prescribed TESSALON PEARLS for cough and they really helped. Symptoms began resolving the 12/30 no fever. 12/31 worst of the symptoms resolved but lost entire sense of smell and most of taste. 01/02/2023 smell began to return. 01/03/2023 smell and taste mostly returned 01/04/2023 still having congestion and occasional cough.
Age: 47.0
Sex: F
Vaccine: COVID19-2
Symptoms: Oropharyngeal pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: On 12/27 started having congestion and irritated sore throat. Then fatigue set in. On 12/28 tested positive on at home test. Took NYQUIL and DAYQUIL provided minor relief. Developed persistent cough. Ran fever of 100.9 with TYLENOL. Took SUDAFED for congestion. 12/29 had telehealth visit with PCP. Was prescribed PAXLOVID but didn't take it. Was prescribed TESSALON PEARLS for cough and they really helped. Symptoms began resolving the 12/30 no fever. 12/31 worst of the symptoms resolved but lost entire sense of smell and most of taste. 01/02/2023 smell began to return. 01/03/2023 smell and taste mostly returned 01/04/2023 still having congestion and occasional cough.
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: 11/25/2022 Felt allergy symptoms in the morning.  Tested 11/26 Positive with an At Home COVID-19 Test.  Developed a fever peaking at 100.6 with allergy symptoms continued.  11/27 Visited Doctor who prescribed Lagevrio, Zinc, Vitamin C, Vitamin D3.  Tested positive again on a rapid COVID-19 test.  Advised to treat symptomatically. Fever fell to 99 on 11/28 and gone completely by 11/29.  Allergy symptoms persisted.
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, COVID-19, Cardiac failure acute, Cardiac failure congestive, Catheterisation cardiac abnormal
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray normal, Chronic respiratory failure, Condition aggravated, Coronary artery disease, Dialysis
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Diastolic dysfunction, Dyspnoea, Echocardiogram abnormal, Ejection fraction normal, Fatigue
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Glycosylated haemoglobin increased, Incentive spirometry, Left ventricular failure, Malnutrition, Oropharyngeal pain
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Percutaneous coronary intervention, Positive airway pressure therapy, Productive cough, Pulmonary function test abnormal, Pulmonary hypertension
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Respiratory failure, Rhinorrhoea, SARS-CoV-2 test positive, Sputum discoloured
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Viral infection
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, COVID-19, Cardiac failure acute, Cardiac failure congestive, Catheterisation cardiac
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Catheterisation cardiac abnormal, Chest X-ray, Chest X-ray normal, Chronic respiratory failure, Condition aggravated
Clinical narrative: Patient is a 59 y.o. female with past medical history of hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, chronic diastolic CHF, chronic hypoxemic respiratory failure on 3 L of oxygen through nasal cannula, end-stage renal disease on regular hemodialysis sessions, presented with viral syndrome 4 days duration   Covid-19 Virus Infection Chronic hypoxemic respiratory failure Presumed COPD Presumed obstructive sleep apnea Date of onset of symptoms: 12/14/2022 Symptoms present on admission: Fever chills, rhinorrhea, sore throat, productive cough of yellow sputum, shortness of breath generalized weakness and fatigue Date of covid positive test: 12/18/2022 Vaccination status: vaccinated Imaging: Chest x-ray no infiltrate Oxygen requirements on admission: 3 L NC of oxygen through nasal cannula Current oxygen requirements: 3L Medical therapy: steroids, rocephin, and zithromax, remdesivir.  Antibiotics were discontinued per ID Consultants following: Infectious disease consult Anticipated special isolation end date: 12/28/2022 Continue incentive spirometry and bronchodilators Outpatient pulmonary function test and sleep study   She finished 5 days of remdesivir 10 days of dexamethasone. Now on baseline 3 L nasal cannula during day.  CPAP at nighttime. Lung exam improved. Okay to be discharged home today.   Acute on chronic diastolic congestive heart failure History of coronary artery disease Echocardiogram 10/7/2022 showed normal EF 70%.  Grade 2 diastolic dysfunction.  Pulmonary hypertension RVSP 48 mmHg. Reduced average global longitudinal strain of -12.9%.  Pattern suggestive of cardiac amyloid. Left heart catheterization on November 2022 showed severe two-vessel coronary artery disease with successful percutaneous coronary intervention RCA ISR with POBA. Ultrafiltration with dialysis.  Currently close to euvolemic.  History of hypertension Discharge regimen with Imdur 30 mg daily, Coreg 25 mg twice daily, hydralazine 100 g 3 times daily and Clonidine patch weekly. Initially nifedipine 60 mg twice daily was stopped on admission, resumed at low-dose 30 mg daily. Blood pressure stable over last 24 to 48 hours before discharge.   Insulin-dependent diabetes mellitus Diabetic neuropathy Continue home dose Lantus 10 units nightly and insulin sliding scale. Hemoglobin A1c 6.2 Continue home gabapentin twice daily  End-stage renal disease on regular hemodialysis sessions Anemia of chronic disease Metabolic acidosis Nephrology consulted to resume HD and UF   Hyperlipidemia Atorvastatin 80 mg daily   Moderate protein calorie malnutrition Nutrition consult