chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sinus tachycardia, Sputum culture positive, Staphylococcus test positive, Streptococcus test positive
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/7/2023 Discharge Date: Jun 13, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cavitary pneumonia [J18.9, J98.4] Multifocal pneumonia [J18.9]   HOSPITAL COURSE: 63 y.o. male with past medical history of COPD, HTN, Crohn's disease, and right lung mass s/p EBUS with biopsy negative for malignancy who presented to the ED with chief complaint of SOB, productive cough, and weakness.    Patient was recently evaluated last month for hemoptysis and found to have right sided lung lesion highly suspicious for malignancy. He has been following with the clinic and has a chest port placed on 5/17 for anticipation of starting chemotherapy. Patient underwent bronchoscopy on 5/25 for lung biopsy with fine needle aspiration negative for malignancy. Tissue pathology showed pulmonary parenchyma with reactive pneumocyte hyperplasia.  Tissue culture grew Streptococcus agalactiae and streptococcus intermedius. Patient was scheduled to follow up with office this month and have repeat chest imaging. In the interim patient reports he had worsening cough and dyspnea with malaise and loss of appetite. He presented to ED for further care.    In the emergency department, patient was afebrile, tachycardic with heart rate 108bpm, otherwise hemodynamically stable on room air.  Labs significant for leukocytosis with WBC 24.76, anemia with hemoglobin 10.1, and thrombocytosis with platelets 449.  EKG revealed sinus tachycardia without signs of ischemia.  CTA thorax was negative for PE but did show rapidly progressive RUL, RML, and RLL dense consolidative changes concerning for multifocal PNA. In addition COVID-19 PCR was positive. Patient was started on broad spectrum abx and admitted to hospitalist.    The patient slowly improved. COVID-19 was thought to be incidental and not contributing to PNA. ID was consulted. Sputum cx grew MSSA. ID recommended 4-6 weeks total of abx with IV unasyn while inpatient and discharge on cefadroxil 1000 mg bid x 4-6 weeks to treat GBS and strep intermedius seen on cultures from 5/25 bronch as well as MSSA in sputum cx.    Pulmonology was also consulted and recommended outpatient follow up in clinic with repeat imaging to document improvement.    SLP was consulted and evaluation negative for dysphagia.    PT/OT evaluated patient and recommended SAR, the patient declined and the was discharged home with assistance from his brother, with whom he will be staying.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Thrombocytosis, White blood cell count increased
Clinical narrative: BRIEF OVERVIEW: Admission Date: 6/7/2023 Discharge Date: Jun 13, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Cavitary pneumonia [J18.9, J98.4] Multifocal pneumonia [J18.9]   HOSPITAL COURSE: 63 y.o. male with past medical history of COPD, HTN, Crohn's disease, and right lung mass s/p EBUS with biopsy negative for malignancy who presented to the ED with chief complaint of SOB, productive cough, and weakness.    Patient was recently evaluated last month for hemoptysis and found to have right sided lung lesion highly suspicious for malignancy. He has been following with the clinic and has a chest port placed on 5/17 for anticipation of starting chemotherapy. Patient underwent bronchoscopy on 5/25 for lung biopsy with fine needle aspiration negative for malignancy. Tissue pathology showed pulmonary parenchyma with reactive pneumocyte hyperplasia.  Tissue culture grew Streptococcus agalactiae and streptococcus intermedius. Patient was scheduled to follow up with office this month and have repeat chest imaging. In the interim patient reports he had worsening cough and dyspnea with malaise and loss of appetite. He presented to ED for further care.    In the emergency department, patient was afebrile, tachycardic with heart rate 108bpm, otherwise hemodynamically stable on room air.  Labs significant for leukocytosis with WBC 24.76, anemia with hemoglobin 10.1, and thrombocytosis with platelets 449.  EKG revealed sinus tachycardia without signs of ischemia.  CTA thorax was negative for PE but did show rapidly progressive RUL, RML, and RLL dense consolidative changes concerning for multifocal PNA. In addition COVID-19 PCR was positive. Patient was started on broad spectrum abx and admitted to hospitalist.    The patient slowly improved. COVID-19 was thought to be incidental and not contributing to PNA. ID was consulted. Sputum cx grew MSSA. ID recommended 4-6 weeks total of abx with IV unasyn while inpatient and discharge on cefadroxil 1000 mg bid x 4-6 weeks to treat GBS and strep intermedius seen on cultures from 5/25 bronch as well as MSSA in sputum cx.    Pulmonology was also consulted and recommended outpatient follow up in clinic with repeat imaging to document improvement.    SLP was consulted and evaluation negative for dysphagia.    PT/OT evaluated patient and recommended SAR, the patient declined and the was discharged home with assistance from his brother, with whom he will be staying.
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Parosmia, SARS-CoV-2 test negative
Clinical narrative: Parosmia (persistent burning smell) starting a few weeks after Comirnaty injection
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Atrial fibrillation, COVID-19, COVID-19 pneumonia, Condition aggravated, Cough
Clinical narrative: Primary Care Physician at Discharge:  MD   Hematologist/Oncologist: Dr.   Admission Date: 6/6/2023 Discharge Date: 06/10/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Neutropenic fever [D70.9, R50.81] Pneumonia due to COVID-19 virus [U07.1, J12.82]   DISCHARGE PROBLEM: COVID 19 Pneumonia  CLL AFIB Warm autoimmune hemolytic anemia Left atrial appendage device closure   PRESENTING COURSE: Patient is a 70 y.o. patient with a past medical history significant for warm hemolytic anemia, afib, chronic BLE swelling, and CLL currently on treatment with Gazyva and Venetoclax who presented to Health ED for symptoms of fever x 1 week and cough x 2 weeks. The patient started to not feel well on 5/20. He took a home Covid test and was positive on 5/23.    HOSPITAL COURSE: Patient was admitted and started on IV Remdesivir in which he completed 5 days. He did require supplemental oxygen and was set up for home oxygen as well. He continued to improve and felt well enough to discharge home today with plans to complete 5 days of Paxlovid and 10 days of dexamethasone. He will hold his Venclexta while taking Paxlovid and will discuss restarting at follow up. He was educated on when to call with questions or concerns. He is stable and ready for discharge
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Febrile neutropenia, Left atrial appendage closure implant, Malaise, SARS-CoV-2 test positive
Clinical narrative: Primary Care Physician at Discharge:  MD   Hematologist/Oncologist: Dr.   Admission Date: 6/6/2023 Discharge Date: 06/10/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Neutropenic fever [D70.9, R50.81] Pneumonia due to COVID-19 virus [U07.1, J12.82]   DISCHARGE PROBLEM: COVID 19 Pneumonia  CLL AFIB Warm autoimmune hemolytic anemia Left atrial appendage device closure   PRESENTING COURSE: Patient is a 70 y.o. patient with a past medical history significant for warm hemolytic anemia, afib, chronic BLE swelling, and CLL currently on treatment with Gazyva and Venetoclax who presented to Health ED for symptoms of fever x 1 week and cough x 2 weeks. The patient started to not feel well on 5/20. He took a home Covid test and was positive on 5/23.    HOSPITAL COURSE: Patient was admitted and started on IV Remdesivir in which he completed 5 days. He did require supplemental oxygen and was set up for home oxygen as well. He continued to improve and felt well enough to discharge home today with plans to complete 5 days of Paxlovid and 10 days of dexamethasone. He will hold his Venclexta while taking Paxlovid and will discuss restarting at follow up. He was educated on when to call with questions or concerns. He is stable and ready for discharge
Age: 70.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site haemorrhage, Injection site swelling
Clinical narrative: Patient received immunization. After injection, patient experienced localized blood loss and swelling due to blood thinner use. Pressure was applied. Blood loss quickly stopped but swelling at the injection site remained. Patient was offered ice pack to reduce swelling but patient declined treatment. (time course 30 minutes)
Age: 4.0
Sex: M
Vaccine: FLUN4
Symptoms: Illness, Malaise, Pyrexia
Clinical narrative: Mother called clinic staff 9 days after clinic to report child developed symptoms of illness the week following the vaccination date. Mother reported malaise and fever. She was treating with Advil and Tylenol. Mother reports other children sick with similar symptoms at the school. Mother verbalizes concern with vaccine causing symptoms of illness. Mother encouraged to seek medical evaluation for child
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Malaise, Myalgia, Pyrexia
Clinical narrative: General unwell feeling,  shivering, likely fever, muscle aches and extreme tiredness.  Went to sleep and after 10 hours sleep, felt much better.  (I took 2 Tylenol before going to sleep.)  I still feel very tired.
Age: 4.0
Sex: M
Vaccine: COVID19, UNK
Symptoms: Injection site pruritus, Pruritus, Urticaria
Clinical narrative: 11/06/2023: Patient a 4 year old male received a Pfizer COVID-19 vaccine (COVID-19, mRNA, LNP-S, PF, tris-sucrose, 10 mcg/0.3 mL), site of administration is the deltoid (side unknown). On the opposite arm at the deltoid patient received an Influenza (Seasonal) (Quadrivalent), brand/manufacturer uknown.  11/07/2023: Around 7 pm, patient complained of itching at the injection sites. No apparent rashes or hives were visible at this time, hydrocortisone 1% was applied sites of itching on the back and rib cage area.  Hives appeared in the evening about 9 pm, hives are seen on chest, sides, back, and bilaterally on the hip area, Cereve and hydrocortisone 1% was applied.  11/08/2023: 2 am patient wakes up complaining of itching from hives, gave patient 5 mL children's diphenydramine, applied 1% hydrocortisone cream.
Age: 88.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Acute respiratory failure, COVID-19, Condition aggravated, Malaise, Platelet count decreased
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: DO  Admission Date: 6/16/2023 Discharge Date: 7/11/2023  DETAILS OF HOSPITAL STAY:   HOSPITAL COURSE: Patient is an 89 y/o man with history of CAD, SSS s/p AICD, AS s/p AVR, paroxysmal AFib on Eliquis and daily alcohol use who presented with acute hypoxic respiratory failure secondary to COVID 19. Had been having symptoms for about 2 weeks prior to admission. He was treated with steroids, remdesivir, and tocilizumab. He completed a course of empiric antibiotics for suspected bacterial pneumonia. His oxygen requirements worsened on 6/18 and he required HFNC at max settings. He had slow improvement in his respiratory status and was able to be weaned back to nasal cannula oxygen (3 L at rest, 6 L with activity). He was kept on prednisone at 40 mg daily, with slow taper. Due to prolonged use of higher dose of prednisone, he was also placed on Bactrim 1 SS PO daily.  He will remain on this for 14 days.   He was noted to have worsening thrombocytopenia, so Hematology was consulted. They recommended increasing dose of prednisone back to 40 mg. His Eliquis was held and not resumed, due to persistent platelet counts less than 50,000.   Due to slow improvement and stated goals of care, he and his son met with hospice on 7/11.  He elected to proceed with hospice services, and will be discharged on 7/11 with hospice care
Age: 88.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Pneumonia bacterial, Respiratory distress, Thrombocytopenia
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: DO  Admission Date: 6/16/2023 Discharge Date: 7/11/2023  DETAILS OF HOSPITAL STAY:   HOSPITAL COURSE: Patient is an 89 y/o man with history of CAD, SSS s/p AICD, AS s/p AVR, paroxysmal AFib on Eliquis and daily alcohol use who presented with acute hypoxic respiratory failure secondary to COVID 19. Had been having symptoms for about 2 weeks prior to admission. He was treated with steroids, remdesivir, and tocilizumab. He completed a course of empiric antibiotics for suspected bacterial pneumonia. His oxygen requirements worsened on 6/18 and he required HFNC at max settings. He had slow improvement in his respiratory status and was able to be weaned back to nasal cannula oxygen (3 L at rest, 6 L with activity). He was kept on prednisone at 40 mg daily, with slow taper. Due to prolonged use of higher dose of prednisone, he was also placed on Bactrim 1 SS PO daily.  He will remain on this for 14 days.   He was noted to have worsening thrombocytopenia, so Hematology was consulted. They recommended increasing dose of prednisone back to 40 mg. His Eliquis was held and not resumed, due to persistent platelet counts less than 50,000.   Due to slow improvement and stated goals of care, he and his son met with hospice on 7/11.  He elected to proceed with hospice services, and will be discharged on 7/11 with hospice care
Age: 75.0
Sex: M
Vaccine: VARZOS
Symptoms: Blister, Herpes zoster, Laboratory test, Rash vesicular
Clinical narrative: Patient has a rash that started within 24hrs that appears to be Shingles. Fluid filled blisters in clusters.
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Tachycardia
Clinical narrative: tachycardia causing atrial fibrillation treated with dilatiazem 60 mg duration 7 hours
Age: 33.0
Sex: F
Vaccine: UNK
Symptoms: Dry throat, Sensation of foreign body, Throat clearing
Clinical narrative: Just over 30 minutes after receiving the injection this year 10/12/2023, I experienced dry throat, Globus sensation and throat clearing sensation that ended up lasting 36 hours. I treated with 50 mg of Benadryl, 10 mg of Claritin, 10 mg of Zyrtec for 2 days in a row. There was no trismus, drooling or hives. However, last year when I received the seasonal influenza shot (manufacturer ID Biomedical, Lot # Y72ZZ, received on 10/13/22 to right deltoid), about 4 hours after receiving the injection, I experienced whole body itching and hives to chest. This resolved about 24 hours later after taking 10 mg of Zyrtec and 50 mg of Benadryl.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Eye irritation, Herpes zoster, Visual impairment
Clinical narrative: After the Covid Booster I developed irritation in my left eye. Then I got shingles on my left jaw. I saw an eye Dr. after my regular PCP had no solution. I saw an eye surgeon right  about the same time in consideration of cataract surgery. He told me the irritation, which got increasingly worse. was the result of the Covid vaccination/booster shot. He' d written a paper on the subject. Some 1.6% got a herpes virus in their eye and that's what I had, and still have. It has affected my every day life. The medication, Acyclovir, causes gastrointestinal issues and insomnia. The other newer drug did the same thing. I take what I can, but it's not enough, and my vision is impaired.
Age: 58.0
Sex: F
Vaccine: FLUC4
Symptoms: Throat irritation
Clinical narrative: Patient had a potential allergic reaction to the vaccine. She felt a scratchiness in her throat after vaccination that would not go away. After waiting a few minutes, we administered an epi-pen to the patient. Symptoms went away. Patient refused 911 and left the pharmacy after administration.
Age: 16.0
Sex: F
Vaccine: FLU4, MNQ
Symptoms: Presyncope, Unresponsive to stimuli
Clinical narrative: NO difficulties for 15 minutes after injections. In car she experienced what appears to be a short vasovagal episode in which she was unresponsive for less than 1-2 minutes per mother. No memory of event by patient. Not postictal and BP and exam WNL when returned to clinic immediately after.
Age: 5.0
Sex: M
Vaccine: FLUC4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: flu vaccine received 10/27/2023 ad md office per mother flu vaccine received 11/1/2023 at flu school clinic with signed consent submitted to the school by mother No adverse effects or symptoms reported by parent
Age: 78.0
Sex: F
Vaccine: COVID19-2, FLUR4
Symptoms: Dizziness
Clinical narrative: dizziness
Age: 73.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Aortic stenosis, Blood lactic acid normal, Blood potassium decreased, C-reactive protein normal, COVID-19
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 6/15/2023 Discharge Date: 06/16/2023   DETAILS OF HOSPITAL STAY: HOSPITAL COURSE: Patient is a 74 y.o. female who presented for nausea and vomiting.  At time of presentation, patient appeared confused. Vitals notable for bp 199/68, otherwise unremarkable.  Lab workup was notable for mild leukocytosis with WBC 11.8, platelet 426, potassium 3.1, and patient found to be COVID positive.  Lactic acid, CRP, and troponins were normal.  CT head obtained which showed no acute abnormality.  Chest x-ray with no acute abnormality.  Patient was admitted for further management and workup.   Initially, patient was reporting significant dizziness and nausea, this resolved over time with administration of a scopolamine patch. No focal neurologic symptoms so suspected that dizziness and nausea were likely vestibular in origin. She denied COVID symptoms and it was unclear if finding incidental given exposure 3 weeks prior, no antiviral or steroid initiated.  During admission, she also endorsed recent dyspnea on exertion and chest pain in exam revealed a significant murmur.  Echo obtained which did show mild-to-moderate aortic stenosis, normal ejection fraction.  Stress test obtained which showed no evidence of myocardial ischemia.  At time of discharge, patient's symptoms were much improved.  She was able to work with physical therapy and ambulate independently.  She reported resolution of dizziness and nausea.  She denied any acute recurrence of chest pain or shortness of breath.  Her blood pressures were noted to be fairly soft, 90s/50s, home amlodipine was reduced to 5 mg daily.  She is sent home with scopolamine patch and is instructed to follow up with PCP upon discharge
Age: 73.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Cardiac murmur, Cardiac stress test normal, Chest X-ray normal, Chest pain, Computerised tomogram head normal
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 6/15/2023 Discharge Date: 06/16/2023   DETAILS OF HOSPITAL STAY: HOSPITAL COURSE: Patient is a 74 y.o. female who presented for nausea and vomiting.  At time of presentation, patient appeared confused. Vitals notable for bp 199/68, otherwise unremarkable.  Lab workup was notable for mild leukocytosis with WBC 11.8, platelet 426, potassium 3.1, and patient found to be COVID positive.  Lactic acid, CRP, and troponins were normal.  CT head obtained which showed no acute abnormality.  Chest x-ray with no acute abnormality.  Patient was admitted for further management and workup.   Initially, patient was reporting significant dizziness and nausea, this resolved over time with administration of a scopolamine patch. No focal neurologic symptoms so suspected that dizziness and nausea were likely vestibular in origin. She denied COVID symptoms and it was unclear if finding incidental given exposure 3 weeks prior, no antiviral or steroid initiated.  During admission, she also endorsed recent dyspnea on exertion and chest pain in exam revealed a significant murmur.  Echo obtained which did show mild-to-moderate aortic stenosis, normal ejection fraction.  Stress test obtained which showed no evidence of myocardial ischemia.  At time of discharge, patient's symptoms were much improved.  She was able to work with physical therapy and ambulate independently.  She reported resolution of dizziness and nausea.  She denied any acute recurrence of chest pain or shortness of breath.  Her blood pressures were noted to be fairly soft, 90s/50s, home amlodipine was reduced to 5 mg daily.  She is sent home with scopolamine patch and is instructed to follow up with PCP upon discharge
Age: 73.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Confusional state, Dizziness, Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction normal
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 6/15/2023 Discharge Date: 06/16/2023   DETAILS OF HOSPITAL STAY: HOSPITAL COURSE: Patient is a 74 y.o. female who presented for nausea and vomiting.  At time of presentation, patient appeared confused. Vitals notable for bp 199/68, otherwise unremarkable.  Lab workup was notable for mild leukocytosis with WBC 11.8, platelet 426, potassium 3.1, and patient found to be COVID positive.  Lactic acid, CRP, and troponins were normal.  CT head obtained which showed no acute abnormality.  Chest x-ray with no acute abnormality.  Patient was admitted for further management and workup.   Initially, patient was reporting significant dizziness and nausea, this resolved over time with administration of a scopolamine patch. No focal neurologic symptoms so suspected that dizziness and nausea were likely vestibular in origin. She denied COVID symptoms and it was unclear if finding incidental given exposure 3 weeks prior, no antiviral or steroid initiated.  During admission, she also endorsed recent dyspnea on exertion and chest pain in exam revealed a significant murmur.  Echo obtained which did show mild-to-moderate aortic stenosis, normal ejection fraction.  Stress test obtained which showed no evidence of myocardial ischemia.  At time of discharge, patient's symptoms were much improved.  She was able to work with physical therapy and ambulate independently.  She reported resolution of dizziness and nausea.  She denied any acute recurrence of chest pain or shortness of breath.  Her blood pressures were noted to be fairly soft, 90s/50s, home amlodipine was reduced to 5 mg daily.  She is sent home with scopolamine patch and is instructed to follow up with PCP upon discharge
Age: 73.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Exposure to SARS-CoV-2, Leukocytosis, Nausea, Platelet count increased, SARS-CoV-2 test positive
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 6/15/2023 Discharge Date: 06/16/2023   DETAILS OF HOSPITAL STAY: HOSPITAL COURSE: Patient is a 74 y.o. female who presented for nausea and vomiting.  At time of presentation, patient appeared confused. Vitals notable for bp 199/68, otherwise unremarkable.  Lab workup was notable for mild leukocytosis with WBC 11.8, platelet 426, potassium 3.1, and patient found to be COVID positive.  Lactic acid, CRP, and troponins were normal.  CT head obtained which showed no acute abnormality.  Chest x-ray with no acute abnormality.  Patient was admitted for further management and workup.   Initially, patient was reporting significant dizziness and nausea, this resolved over time with administration of a scopolamine patch. No focal neurologic symptoms so suspected that dizziness and nausea were likely vestibular in origin. She denied COVID symptoms and it was unclear if finding incidental given exposure 3 weeks prior, no antiviral or steroid initiated.  During admission, she also endorsed recent dyspnea on exertion and chest pain in exam revealed a significant murmur.  Echo obtained which did show mild-to-moderate aortic stenosis, normal ejection fraction.  Stress test obtained which showed no evidence of myocardial ischemia.  At time of discharge, patient's symptoms were much improved.  She was able to work with physical therapy and ambulate independently.  She reported resolution of dizziness and nausea.  She denied any acute recurrence of chest pain or shortness of breath.  Her blood pressures were noted to be fairly soft, 90s/50s, home amlodipine was reduced to 5 mg daily.  She is sent home with scopolamine patch and is instructed to follow up with PCP upon discharge
Age: 73.0
Sex: F
Vaccine: COVID19-2, FLUA4
Symptoms: Troponin normal, Vomiting, White blood cell count increased
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider at Discharge: MD Admission Date: 6/15/2023 Discharge Date: 06/16/2023   DETAILS OF HOSPITAL STAY: HOSPITAL COURSE: Patient is a 74 y.o. female who presented for nausea and vomiting.  At time of presentation, patient appeared confused. Vitals notable for bp 199/68, otherwise unremarkable.  Lab workup was notable for mild leukocytosis with WBC 11.8, platelet 426, potassium 3.1, and patient found to be COVID positive.  Lactic acid, CRP, and troponins were normal.  CT head obtained which showed no acute abnormality.  Chest x-ray with no acute abnormality.  Patient was admitted for further management and workup.   Initially, patient was reporting significant dizziness and nausea, this resolved over time with administration of a scopolamine patch. No focal neurologic symptoms so suspected that dizziness and nausea were likely vestibular in origin. She denied COVID symptoms and it was unclear if finding incidental given exposure 3 weeks prior, no antiviral or steroid initiated.  During admission, she also endorsed recent dyspnea on exertion and chest pain in exam revealed a significant murmur.  Echo obtained which did show mild-to-moderate aortic stenosis, normal ejection fraction.  Stress test obtained which showed no evidence of myocardial ischemia.  At time of discharge, patient's symptoms were much improved.  She was able to work with physical therapy and ambulate independently.  She reported resolution of dizziness and nausea.  She denied any acute recurrence of chest pain or shortness of breath.  Her blood pressures were noted to be fairly soft, 90s/50s, home amlodipine was reduced to 5 mg daily.  She is sent home with scopolamine patch and is instructed to follow up with PCP upon discharge
Age: 60.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19
Clinical narrative: ADMITTED WITH COVID ON 11/7/23
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Eyelid disorder, Facial paralysis, Hypoaesthesia, Hypoaesthesia oral
Clinical narrative: Facial numbness / paralysis, mostly in the left side of my face. I?m not able to independently close my right eye but most of the numbness is in the left side of my face and mouth.
Age: 2.0
Sex: F
Vaccine: HEPA
Symptoms: Injection site urticaria, Pruritus, Urticaria
Clinical narrative: Urticaria the evening that the vaccine was given, cluster of urticaria around the injection site with other scattered urticaria on body. Benadryl 12.5mg given due to itching. Hives nearly resolved by 11/7/23 except one spot on arm and one spot on leg.
Age: 68.0
Sex: M
Vaccine: COVID19-2, FLU4, VARZOS
Symptoms: Acute respiratory failure, Chest X-ray abnormal, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Cough
Clinical narrative: Admission Date: 6/13/2023 Discharge Date: 6/17/2023   DETAILS OF HOSPITAL STAY:   Clinical Narrative: Patient is a 69 y.o. male patient who presented on 6/14/2023 with shortness of breath and exertional dyspnea that started on 6/13. He has hx of severe COPD/lives on 5L/uses Trilogy, GERD, hypertension, OSA, lung cancer s/p chemo/resection in close surveillance, diabetes mellitus. His wife has had a cold for a few weeks, and a few days ago, he started having cough, nasal drainage. He began having dyspnea that responded to his inhalers on the day prior to admission, but on 6/14, met with no improvement so came in. In the ED, he was quite distressed, given steroids multiple breathing treatments with little relief but finally improved when placed on Bipap. CXR without acute findings, however with mass in RUL similar to prior.    CT C/A/P obtained as his pulmonologist wanted one this month for surveillance of his NSCC, and to better elucidate cause of his acute on chronic respiratory failure. This showed stable changes in RUL, no evidence for metastatic disease in chest, abd or pelvis. There was some note of mild pancreatic fat stranding, though had no abdominal pain or nausea. He requires admission for further evaluation and management of Acute on chronic respiratory failure with hypoxia and hypercapnea.
Age: 68.0
Sex: M
Vaccine: COVID19-2, FLU4, VARZOS
Symptoms: Dyspnoea, Dyspnoea exertional, Hypercapnia, Hypoxia, Pancreatic disorder
Clinical narrative: Admission Date: 6/13/2023 Discharge Date: 6/17/2023   DETAILS OF HOSPITAL STAY:   Clinical Narrative: Patient is a 69 y.o. male patient who presented on 6/14/2023 with shortness of breath and exertional dyspnea that started on 6/13. He has hx of severe COPD/lives on 5L/uses Trilogy, GERD, hypertension, OSA, lung cancer s/p chemo/resection in close surveillance, diabetes mellitus. His wife has had a cold for a few weeks, and a few days ago, he started having cough, nasal drainage. He began having dyspnea that responded to his inhalers on the day prior to admission, but on 6/14, met with no improvement so came in. In the ED, he was quite distressed, given steroids multiple breathing treatments with little relief but finally improved when placed on Bipap. CXR without acute findings, however with mass in RUL similar to prior.    CT C/A/P obtained as his pulmonologist wanted one this month for surveillance of his NSCC, and to better elucidate cause of his acute on chronic respiratory failure. This showed stable changes in RUL, no evidence for metastatic disease in chest, abd or pelvis. There was some note of mild pancreatic fat stranding, though had no abdominal pain or nausea. He requires admission for further evaluation and management of Acute on chronic respiratory failure with hypoxia and hypercapnea.
Age: 68.0
Sex: M
Vaccine: COVID19-2, FLU4, VARZOS
Symptoms: Positive airway pressure therapy, Rhinorrhoea, Sick relative
Clinical narrative: Admission Date: 6/13/2023 Discharge Date: 6/17/2023   DETAILS OF HOSPITAL STAY:   Clinical Narrative: Patient is a 69 y.o. male patient who presented on 6/14/2023 with shortness of breath and exertional dyspnea that started on 6/13. He has hx of severe COPD/lives on 5L/uses Trilogy, GERD, hypertension, OSA, lung cancer s/p chemo/resection in close surveillance, diabetes mellitus. His wife has had a cold for a few weeks, and a few days ago, he started having cough, nasal drainage. He began having dyspnea that responded to his inhalers on the day prior to admission, but on 6/14, met with no improvement so came in. In the ED, he was quite distressed, given steroids multiple breathing treatments with little relief but finally improved when placed on Bipap. CXR without acute findings, however with mass in RUL similar to prior.    CT C/A/P obtained as his pulmonologist wanted one this month for surveillance of his NSCC, and to better elucidate cause of his acute on chronic respiratory failure. This showed stable changes in RUL, no evidence for metastatic disease in chest, abd or pelvis. There was some note of mild pancreatic fat stranding, though had no abdominal pain or nausea. He requires admission for further evaluation and management of Acute on chronic respiratory failure with hypoxia and hypercapnea.
Age: 66.0
Sex: F
Vaccine: FLU4
Symptoms: Erythema, Rash
Clinical narrative: The patient reported a rash on the trunk and up the chest. She was also very red on the neck chin. The patient took 50 mg of Benadryl, and the rash has now gone away.
Age: 77.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Anxiety, Asthenia, Blood test, Malaise, Respiratory disorder
Clinical narrative: Extreme breathing issues. I went to the ER and an xray showed clear and I had a blood test. They gave me medication because I was so anxious.  I was also very sick and weak since the vaccine. I am just now starting to get better (11/8/23).
Age: 77.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: X-ray normal
Clinical narrative: Extreme breathing issues. I went to the ER and an xray showed clear and I had a blood test. They gave me medication because I was so anxious.  I was also very sick and weak since the vaccine. I am just now starting to get better (11/8/23).
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal behaviour, Blood gases normal, Blood potassium decreased, Bundle branch block right, COVID-19
Clinical narrative: Date of Admission: 6/13/2023 Discharge Date: 6/15/2023  PRESENTING PROBLEM: Delirium, acute [R41.0] COVID-19 [U07.1]   Patient is a 76 y.o. female who presented  with medical history of breast carcinoma, HTN, and thyroid disease with a chief concern of increased confusion. Patient is accompanied by her grandson who reports she has been experiencing increase confusion over the past few days. Over the last year she has been showing signs increased altered mentation such as leaving the house and getting lost and odd behaviors around the house. Grandson reports she needs 24/7 monitoring. She lives with her husband who is currently in rehab. Their house was recently damaged from a storm so they have been staying in a cabin. Grandson reported over the previous few days, patient has been excessively sleepy, won't eat, and experiencing increased confusion which has resulted in him bringing her to RCED. Presentation to ED; BP 161/38 rest vitals within normal, chem profile; potassium 2.9, UA and BG unremarkable. EKG normal sinus with RBBB, left anterior fascicular block and prolonged QTC. No significant change from prior EKG. COVID positive. CT head no signs of acute infarct. Patient was administered potassium tablet 40 mEq PO as well as 10 mEq via IV. She was then admitted under hospitalist service for management of hypokalemia and acute delirium.    Patient was placed in isolation and monitored. Clinical course stable. Evaluated by speech and PT/OT. MoCA score of 16/30. Grand son was educated on continued care and management of grandma in her current state of mind.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram head normal, Condition aggravated, Confusional state, Delirium, Diet refusal
Clinical narrative: Date of Admission: 6/13/2023 Discharge Date: 6/15/2023  PRESENTING PROBLEM: Delirium, acute [R41.0] COVID-19 [U07.1]   Patient is a 76 y.o. female who presented  with medical history of breast carcinoma, HTN, and thyroid disease with a chief concern of increased confusion. Patient is accompanied by her grandson who reports she has been experiencing increase confusion over the past few days. Over the last year she has been showing signs increased altered mentation such as leaving the house and getting lost and odd behaviors around the house. Grandson reports she needs 24/7 monitoring. She lives with her husband who is currently in rehab. Their house was recently damaged from a storm so they have been staying in a cabin. Grandson reported over the previous few days, patient has been excessively sleepy, won't eat, and experiencing increased confusion which has resulted in him bringing her to RCED. Presentation to ED; BP 161/38 rest vitals within normal, chem profile; potassium 2.9, UA and BG unremarkable. EKG normal sinus with RBBB, left anterior fascicular block and prolonged QTC. No significant change from prior EKG. COVID positive. CT head no signs of acute infarct. Patient was administered potassium tablet 40 mEq PO as well as 10 mEq via IV. She was then admitted under hospitalist service for management of hypokalemia and acute delirium.    Patient was placed in isolation and monitored. Clinical course stable. Evaluated by speech and PT/OT. MoCA score of 16/30. Grand son was educated on continued care and management of grandma in her current state of mind.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram QT prolonged, Electrocardiogram abnormal, Mental status changes, SARS-CoV-2 test positive, Somnolence
Clinical narrative: Date of Admission: 6/13/2023 Discharge Date: 6/15/2023  PRESENTING PROBLEM: Delirium, acute [R41.0] COVID-19 [U07.1]   Patient is a 76 y.o. female who presented  with medical history of breast carcinoma, HTN, and thyroid disease with a chief concern of increased confusion. Patient is accompanied by her grandson who reports she has been experiencing increase confusion over the past few days. Over the last year she has been showing signs increased altered mentation such as leaving the house and getting lost and odd behaviors around the house. Grandson reports she needs 24/7 monitoring. She lives with her husband who is currently in rehab. Their house was recently damaged from a storm so they have been staying in a cabin. Grandson reported over the previous few days, patient has been excessively sleepy, won't eat, and experiencing increased confusion which has resulted in him bringing her to RCED. Presentation to ED; BP 161/38 rest vitals within normal, chem profile; potassium 2.9, UA and BG unremarkable. EKG normal sinus with RBBB, left anterior fascicular block and prolonged QTC. No significant change from prior EKG. COVID positive. CT head no signs of acute infarct. Patient was administered potassium tablet 40 mEq PO as well as 10 mEq via IV. She was then admitted under hospitalist service for management of hypokalemia and acute delirium.    Patient was placed in isolation and monitored. Clinical course stable. Evaluated by speech and PT/OT. MoCA score of 16/30. Grand son was educated on continued care and management of grandma in her current state of mind.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Urine analysis normal
Clinical narrative: Date of Admission: 6/13/2023 Discharge Date: 6/15/2023  PRESENTING PROBLEM: Delirium, acute [R41.0] COVID-19 [U07.1]   Patient is a 76 y.o. female who presented  with medical history of breast carcinoma, HTN, and thyroid disease with a chief concern of increased confusion. Patient is accompanied by her grandson who reports she has been experiencing increase confusion over the past few days. Over the last year she has been showing signs increased altered mentation such as leaving the house and getting lost and odd behaviors around the house. Grandson reports she needs 24/7 monitoring. She lives with her husband who is currently in rehab. Their house was recently damaged from a storm so they have been staying in a cabin. Grandson reported over the previous few days, patient has been excessively sleepy, won't eat, and experiencing increased confusion which has resulted in him bringing her to RCED. Presentation to ED; BP 161/38 rest vitals within normal, chem profile; potassium 2.9, UA and BG unremarkable. EKG normal sinus with RBBB, left anterior fascicular block and prolonged QTC. No significant change from prior EKG. COVID positive. CT head no signs of acute infarct. Patient was administered potassium tablet 40 mEq PO as well as 10 mEq via IV. She was then admitted under hospitalist service for management of hypokalemia and acute delirium.    Patient was placed in isolation and monitored. Clinical course stable. Evaluated by speech and PT/OT. MoCA score of 16/30. Grand son was educated on continued care and management of grandma in her current state of mind.
Sex: U
Vaccine: RSV
Symptoms: Exposure during pregnancy, No adverse event, Product use issue, Wrong product administered
Clinical narrative: My sister is pregnant and just found out that 3 weeks ago when she went to get the new maternal RSV vaccine, pharmacy accidentally gave her Arexvy instead. She?s had no negative effects thus far.
Age: 69.0
Sex: M
Vaccine: RSV
Symptoms: Chills, Dizziness, Fatigue, Impaired work ability, Injection site pain
Clinical narrative: After receiving shot on Monday 11/6/23 at 4:00PM, soreness at the injection site became noticeable almost immediately. During the evening the pain got worse so I took some Motrin that got me to sleep. In the morning 11/7/23 I was dizzy and the pain in my arm was worse.  By the afternoon I was very tired and had to quit work. I went to work today 11/8/2023 but came home early as I started having significant chills and a runny nose. I checked my temperature and have a low grade 99.7 fever.
Age: 69.0
Sex: M
Vaccine: RSV
Symptoms: Rhinorrhoea
Clinical narrative: After receiving shot on Monday 11/6/23 at 4:00PM, soreness at the injection site became noticeable almost immediately. During the evening the pain got worse so I took some Motrin that got me to sleep. In the morning 11/7/23 I was dizzy and the pain in my arm was worse.  By the afternoon I was very tired and had to quit work. I went to work today 11/8/2023 but came home early as I started having significant chills and a runny nose. I checked my temperature and have a low grade 99.7 fever.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, C-reactive protein increased, COVID-19, Chest X-ray abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD  Admission Date: 6/25/2023 Discharge Date: 6/29/2023  Active Issues Requiring Follow-up * Pneumonia of both lungs due to infectious organism Assessment & Plan Cough, chills, shortness of breath, fatigue and sinus congestion progressing over the last 2 weeks despite antibiotics and steroids.  COVID-19 PCR positive on 06/25/2023.  Although likely onset of COVID 2 weeks ago. Chest x-ray: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.  Pneumonia felt to be viral in nature secondary to COVID Discontinue antibiotics at this time     COVID-19 Assessment & Plan Symptom onset date approximately 2 weeks ago. COVID-19 PCR positive on 06/25/2023. Presentation outside window for remdesivir.   CXR: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.   Current oxygen requirement: SpO2: 92 % O2 Flow Rate (l/min): 2 l/min   CRP: 53.4  D-dimer: 960.   Albuterol INH 2 puffs q 4 hours Dexamethasone - 6 mg oral prescribed at discharge to complete 10 days of therapy.        Acute respiratory failure with hypoxia  Assessment & Plan Secondary to COVID-19 and superimposed bacterial pneumonia. Patient was requiring up to 6 L of oxygen at her worst Overall improving respiratory status and oxygen needs.   Home oxygen at discharge. 2 Liters at rest and 6 Liters with activity.        Pulmonary nodules Assessment & Plan CTA from 06/23/2023: Few small (less than 5 mm) noncalcified/indeterminate apical nodules. Question infectious or inflammatory nodules. Given size, no additional follow-up is indicated if the patient is low risk for lung CA.   Likely inflammatory given current COVID-19 viral illness and superimposed bacterial pneumonia. Follow- up with PCP regarding need for follow- up imaging.    Granulomatosis with polyangiitis  Assessment & Plan Rituximab infusion every 6 months.    Moderate persistent asthma without complication Assessment & Plan Continue home inhalers at discharge.  Follow up with pulmonology outpatient     GERD (gastroesophageal reflux disease) Assessment & Plan Continue PPI
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Condition aggravated, Cough, Dyspnoea, Fatigue
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD  Admission Date: 6/25/2023 Discharge Date: 6/29/2023  Active Issues Requiring Follow-up * Pneumonia of both lungs due to infectious organism Assessment & Plan Cough, chills, shortness of breath, fatigue and sinus congestion progressing over the last 2 weeks despite antibiotics and steroids.  COVID-19 PCR positive on 06/25/2023.  Although likely onset of COVID 2 weeks ago. Chest x-ray: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.  Pneumonia felt to be viral in nature secondary to COVID Discontinue antibiotics at this time     COVID-19 Assessment & Plan Symptom onset date approximately 2 weeks ago. COVID-19 PCR positive on 06/25/2023. Presentation outside window for remdesivir.   CXR: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.   Current oxygen requirement: SpO2: 92 % O2 Flow Rate (l/min): 2 l/min   CRP: 53.4  D-dimer: 960.   Albuterol INH 2 puffs q 4 hours Dexamethasone - 6 mg oral prescribed at discharge to complete 10 days of therapy.        Acute respiratory failure with hypoxia  Assessment & Plan Secondary to COVID-19 and superimposed bacterial pneumonia. Patient was requiring up to 6 L of oxygen at her worst Overall improving respiratory status and oxygen needs.   Home oxygen at discharge. 2 Liters at rest and 6 Liters with activity.        Pulmonary nodules Assessment & Plan CTA from 06/23/2023: Few small (less than 5 mm) noncalcified/indeterminate apical nodules. Question infectious or inflammatory nodules. Given size, no additional follow-up is indicated if the patient is low risk for lung CA.   Likely inflammatory given current COVID-19 viral illness and superimposed bacterial pneumonia. Follow- up with PCP regarding need for follow- up imaging.    Granulomatosis with polyangiitis  Assessment & Plan Rituximab infusion every 6 months.    Moderate persistent asthma without complication Assessment & Plan Continue home inhalers at discharge.  Follow up with pulmonology outpatient     GERD (gastroesophageal reflux disease) Assessment & Plan Continue PPI
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer, Hypoxia, Pneumonia, Pneumonia bacterial, Pneumonia viral
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD  Admission Date: 6/25/2023 Discharge Date: 6/29/2023  Active Issues Requiring Follow-up * Pneumonia of both lungs due to infectious organism Assessment & Plan Cough, chills, shortness of breath, fatigue and sinus congestion progressing over the last 2 weeks despite antibiotics and steroids.  COVID-19 PCR positive on 06/25/2023.  Although likely onset of COVID 2 weeks ago. Chest x-ray: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.  Pneumonia felt to be viral in nature secondary to COVID Discontinue antibiotics at this time     COVID-19 Assessment & Plan Symptom onset date approximately 2 weeks ago. COVID-19 PCR positive on 06/25/2023. Presentation outside window for remdesivir.   CXR: Moderate coarse strandy and hazy/patchy multifocal/bilateral airspace disease.   Current oxygen requirement: SpO2: 92 % O2 Flow Rate (l/min): 2 l/min   CRP: 53.4  D-dimer: 960.   Albuterol INH 2 puffs q 4 hours Dexamethasone - 6 mg oral prescribed at discharge to complete 10 days of therapy.        Acute respiratory failure with hypoxia  Assessment & Plan Secondary to COVID-19 and superimposed bacterial pneumonia. Patient was requiring up to 6 L of oxygen at her worst Overall improving respiratory status and oxygen needs.   Home oxygen at discharge. 2 Liters at rest and 6 Liters with activity.        Pulmonary nodules Assessment & Plan CTA from 06/23/2023: Few small (less than 5 mm) noncalcified/indeterminate apical nodules. Question infectious or inflammatory nodules. Given size, no additional follow-up is indicated if the patient is low risk for lung CA.   Likely inflammatory given current COVID-19 viral illness and superimposed bacterial pneumonia. Follow- up with PCP regarding need for follow- up imaging.    Granulomatosis with polyangiitis  Assessment & Plan Rituximab infusion every 6 months.    Moderate persistent asthma without complication Assessment & Plan Continue home inhalers at discharge.  Follow up with pulmonology outpatient     GERD (gastroesophageal reflux disease) Assessment & Plan Continue PPI