chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 81.0
Sex: M
Vaccine: COVID19-2
Symptoms: Urinary tract infection
Clinical narrative: Patient is an 81 y.o. male who presented to the Hospital ED from home on 11/29/2022 with weakness and inability to ambulate following 3 days of a sore throat, malaise and limited dietary/fluid intake.    Discharge Diagnosis and Associated Hospital Course   COVID-19 related pneumonia with dehydration Presented with viral-symptoms inclusive of  myalgias, sore throat, cough and weakness from which he has clinically improved - Symptom onset: 11/27/2022 - Positive COVID-19: 11/29/2022 at Hospital  - Vaccination status: Moderna series with boosters x 3  - CTPE: negative for emboli; ground glass opacities right upper and lower lobes - Oxygen status: stable on room air  - Hypoxemia: isolated value recorded at 85% in ED with a range of 95-99% with low for oxygen by nasal cannula at 2 L/min - Dexamethasone: 6 mg x 1 on 11/29; discontinued 11/30/2022 given no history of COPD and clinical timeline (presented on day 4 of illness) - Remdesivir: Yes. Started 11/29/2022. Received 3 doses while hospitalized   Acute cystitis Urine culture returned with Escherichia coli sensitive to cephalexin -Plan for 7 days of therapy   Benign prostatic hyperplasia with LUTS Historical symptoms include frequency, nocturia, and incomplete emptying established with urology this has been controlled with alfuzosin   History of left ureteral stone status post ESWL Bladder stone Known to Dr. with tentative plans for cystoscopy evaluation and extraction; as above treat for suspected UTI  CAD Hyperlipidemia No active ACS; continue with aspirin and statin therapy   GERD Continue home deslansoprazole   History of lumbar stenosis with residual peripheral neuropathy  History of chronic daily headache Status post surgery; continue gabapentin
Age: 39.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram thorax abnormal, Dyspnoea, Post-acute COVID-19 syndrome, Pulmonary embolism, Pulmonary fibrosis
Clinical narrative: I had COVID-19 back in July of 2022. I had pulmonary embolisms in my lungs that gave me issues with my breathing. I went to the ER and the saw scarring in my lungs and send it was signs and causes from long COVID-19 giving people pneumonia shortly after. I am still having issues with breathing; my PCP says it's most likely caused by the scarring.
Age: 39.0
Sex: M
Vaccine: COVID19-2
Symptoms: Scan with contrast abnormal
Clinical narrative: I had COVID-19 back in July of 2022. I had pulmonary embolisms in my lungs that gave me issues with my breathing. I went to the ER and the saw scarring in my lungs and send it was signs and causes from long COVID-19 giving people pneumonia shortly after. I am still having issues with breathing; my PCP says it's most likely caused by the scarring.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized for covid; fully vaccinated with 1 booster
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Eye haemorrhage, Retinal tear, Vision blurred, Visual impairment, Vitreous floaters
Clinical narrative: The problems started in October. It started with blurred vision, but mild. Then a week later, my vision was wavy and had spots. I saw the eye doctor, who diagnosed a rental tear in the right eye. I went to a local eye department and did a laser treatment in the office for what they called a horseshoe tear. In November the problems began, more light floaters and more blurry. Doctor did another laser treatment and also saw some blood. Then in late November saw a different doctor specialist, and then another one in the beginning in December. The eye continues to be blurry and have floaters.
Age: 11.0
Sex: F
Vaccine: HPV9, MNQ, TDAP
Symptoms: Dizziness, Head injury, Loss of consciousness, Syncope
Clinical narrative: Post vaccination for about 10 minutes patient started feeling dizzy and fainted. As she fainted she hit her head on the wall. Patient was unconscious for about 1 minute before provider was able to render aid. Blood Pressure was 101/65 and pulse was 73. Patient left ambulating and parent was instructed to take patient to ER if patient was vomiting, sleepy or had a headache.
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anaemia, Back pain, Blood iron decreased, Blood loss anaemia
Clinical narrative: Patient is a 61 y.o. female with a history of Asthma, COPD, Chronic respiratory failure on 2 L oxygen, HFpEF, Hypertension, DM2,  Hyperlipidemia,  Anemia,  Arthritis,  Spinal stenosis, Chronic back pain, Tobacco abuse who presented with acute on chronic neck/back pain and cough/dyspnea, found to have cervical and lumbar spinal stenosis, worsening hypoxia, acute bronchitis and COVID-19 infection. Course complicated by acute blood loss anemia and GI determined she can f/u with EGD as an outpatient. She improved with supportive care, finished a 7 day course of antibiotics and was discharged to complete 10 total days of steroids for COVID.    Acute on chronic respiratory failure with hypoxia Acute bronchitis COPD without exacerbation Baseline 2L NC O2 -- > requiring up to 3-4L currently CXR clear lungs COVID+ Completed 7 days of antibiotics for possible bacterial process Decadron as below Has nebs at home and continue home symbicort Tolerating home O2 but pt prefers higher doses   Covid-19 Virus Infection Date of onset of symptoms: 10-14 days Symptoms present on admission: cough, SOB Date of covid positive test: 11/23/22 Imaging: CXR unremarkable Oxygen requirements on admission: 2 L Current oxygen requirements: 3L  Medical therapy: PO decadron x10 days (ends 12/5) Special isolation ended 12/01/22   Acute exacerbation of chronic back pain with right-sided sciatica Acute on chronic neck pain Spinal stenosis MRI C/L spine -- C4-5 disc bulge with moderate canal stenosis, L3-4 dis bulge and severe canal stenosis, plus other findings Neurosurgery consulted -- can be considered for surgery once back cellulitis resolved Neurosurgery signed off -- f/u ~1/2022 with ESR/CRP and flex/ext XR of C + L spine   Acute on chronic anemia Hemoglobin 8.1 (10/25/2021) -- > 6.2 on admission, MCV 62.1 Iron studies with severe iron deficiency  Pt declining PO and IV iron GI signed off -- EGD once improved and out of COVID isolation (12/1), can be done as outpatient S/p 2u PRBCs total during admission (last 11/27) Hgb stable ~8 after last transfusion  R>L leg edema RLE Duplex negative for DVT   Cellulitis neck and back More likely related to heating pad overuse but either way completed 5 days of doxycycline while inpatient    Chronic diastolic heart failure  Essential hypertension EF 55-60% with abnormal LV diastolic function on echocardiogram 7/25/2018 Continue Toprol and Lasix   Diabetes type 2 controlled Held metformin and Actos during hospitalization Stop Actos on discharge due to dCHF F/u with PCP to consider SGLT-2 instead   Hyperlipidemia Cigarette nicotine dependence
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Bronchitis, COVID-19, Cardiac failure congestive, Cellulitis, Cervical spinal stenosis
Clinical narrative: Patient is a 61 y.o. female with a history of Asthma, COPD, Chronic respiratory failure on 2 L oxygen, HFpEF, Hypertension, DM2,  Hyperlipidemia,  Anemia,  Arthritis,  Spinal stenosis, Chronic back pain, Tobacco abuse who presented with acute on chronic neck/back pain and cough/dyspnea, found to have cervical and lumbar spinal stenosis, worsening hypoxia, acute bronchitis and COVID-19 infection. Course complicated by acute blood loss anemia and GI determined she can f/u with EGD as an outpatient. She improved with supportive care, finished a 7 day course of antibiotics and was discharged to complete 10 total days of steroids for COVID.    Acute on chronic respiratory failure with hypoxia Acute bronchitis COPD without exacerbation Baseline 2L NC O2 -- > requiring up to 3-4L currently CXR clear lungs COVID+ Completed 7 days of antibiotics for possible bacterial process Decadron as below Has nebs at home and continue home symbicort Tolerating home O2 but pt prefers higher doses   Covid-19 Virus Infection Date of onset of symptoms: 10-14 days Symptoms present on admission: cough, SOB Date of covid positive test: 11/23/22 Imaging: CXR unremarkable Oxygen requirements on admission: 2 L Current oxygen requirements: 3L  Medical therapy: PO decadron x10 days (ends 12/5) Special isolation ended 12/01/22   Acute exacerbation of chronic back pain with right-sided sciatica Acute on chronic neck pain Spinal stenosis MRI C/L spine -- C4-5 disc bulge with moderate canal stenosis, L3-4 dis bulge and severe canal stenosis, plus other findings Neurosurgery consulted -- can be considered for surgery once back cellulitis resolved Neurosurgery signed off -- f/u ~1/2022 with ESR/CRP and flex/ext XR of C + L spine   Acute on chronic anemia Hemoglobin 8.1 (10/25/2021) -- > 6.2 on admission, MCV 62.1 Iron studies with severe iron deficiency  Pt declining PO and IV iron GI signed off -- EGD once improved and out of COVID isolation (12/1), can be done as outpatient S/p 2u PRBCs total during admission (last 11/27) Hgb stable ~8 after last transfusion  R>L leg edema RLE Duplex negative for DVT   Cellulitis neck and back More likely related to heating pad overuse but either way completed 5 days of doxycycline while inpatient    Chronic diastolic heart failure  Essential hypertension EF 55-60% with abnormal LV diastolic function on echocardiogram 7/25/2018 Continue Toprol and Lasix   Diabetes type 2 controlled Held metformin and Actos during hospitalization Stop Actos on discharge due to dCHF F/u with PCP to consider SGLT-2 instead   Hyperlipidemia Cigarette nicotine dependence
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Condition aggravated, Cough, Dyspnoea, Haemoglobin decreased
Clinical narrative: Patient is a 61 y.o. female with a history of Asthma, COPD, Chronic respiratory failure on 2 L oxygen, HFpEF, Hypertension, DM2,  Hyperlipidemia,  Anemia,  Arthritis,  Spinal stenosis, Chronic back pain, Tobacco abuse who presented with acute on chronic neck/back pain and cough/dyspnea, found to have cervical and lumbar spinal stenosis, worsening hypoxia, acute bronchitis and COVID-19 infection. Course complicated by acute blood loss anemia and GI determined she can f/u with EGD as an outpatient. She improved with supportive care, finished a 7 day course of antibiotics and was discharged to complete 10 total days of steroids for COVID.    Acute on chronic respiratory failure with hypoxia Acute bronchitis COPD without exacerbation Baseline 2L NC O2 -- > requiring up to 3-4L currently CXR clear lungs COVID+ Completed 7 days of antibiotics for possible bacterial process Decadron as below Has nebs at home and continue home symbicort Tolerating home O2 but pt prefers higher doses   Covid-19 Virus Infection Date of onset of symptoms: 10-14 days Symptoms present on admission: cough, SOB Date of covid positive test: 11/23/22 Imaging: CXR unremarkable Oxygen requirements on admission: 2 L Current oxygen requirements: 3L  Medical therapy: PO decadron x10 days (ends 12/5) Special isolation ended 12/01/22   Acute exacerbation of chronic back pain with right-sided sciatica Acute on chronic neck pain Spinal stenosis MRI C/L spine -- C4-5 disc bulge with moderate canal stenosis, L3-4 dis bulge and severe canal stenosis, plus other findings Neurosurgery consulted -- can be considered for surgery once back cellulitis resolved Neurosurgery signed off -- f/u ~1/2022 with ESR/CRP and flex/ext XR of C + L spine   Acute on chronic anemia Hemoglobin 8.1 (10/25/2021) -- > 6.2 on admission, MCV 62.1 Iron studies with severe iron deficiency  Pt declining PO and IV iron GI signed off -- EGD once improved and out of COVID isolation (12/1), can be done as outpatient S/p 2u PRBCs total during admission (last 11/27) Hgb stable ~8 after last transfusion  R>L leg edema RLE Duplex negative for DVT   Cellulitis neck and back More likely related to heating pad overuse but either way completed 5 days of doxycycline while inpatient    Chronic diastolic heart failure  Essential hypertension EF 55-60% with abnormal LV diastolic function on echocardiogram 7/25/2018 Continue Toprol and Lasix   Diabetes type 2 controlled Held metformin and Actos during hospitalization Stop Actos on discharge due to dCHF F/u with PCP to consider SGLT-2 instead   Hyperlipidemia Cigarette nicotine dependence
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Intervertebral disc protrusion, Iron deficiency, Left ventricular failure, Lumbar spinal stenosis
Clinical narrative: Patient is a 61 y.o. female with a history of Asthma, COPD, Chronic respiratory failure on 2 L oxygen, HFpEF, Hypertension, DM2,  Hyperlipidemia,  Anemia,  Arthritis,  Spinal stenosis, Chronic back pain, Tobacco abuse who presented with acute on chronic neck/back pain and cough/dyspnea, found to have cervical and lumbar spinal stenosis, worsening hypoxia, acute bronchitis and COVID-19 infection. Course complicated by acute blood loss anemia and GI determined she can f/u with EGD as an outpatient. She improved with supportive care, finished a 7 day course of antibiotics and was discharged to complete 10 total days of steroids for COVID.    Acute on chronic respiratory failure with hypoxia Acute bronchitis COPD without exacerbation Baseline 2L NC O2 -- > requiring up to 3-4L currently CXR clear lungs COVID+ Completed 7 days of antibiotics for possible bacterial process Decadron as below Has nebs at home and continue home symbicort Tolerating home O2 but pt prefers higher doses   Covid-19 Virus Infection Date of onset of symptoms: 10-14 days Symptoms present on admission: cough, SOB Date of covid positive test: 11/23/22 Imaging: CXR unremarkable Oxygen requirements on admission: 2 L Current oxygen requirements: 3L  Medical therapy: PO decadron x10 days (ends 12/5) Special isolation ended 12/01/22   Acute exacerbation of chronic back pain with right-sided sciatica Acute on chronic neck pain Spinal stenosis MRI C/L spine -- C4-5 disc bulge with moderate canal stenosis, L3-4 dis bulge and severe canal stenosis, plus other findings Neurosurgery consulted -- can be considered for surgery once back cellulitis resolved Neurosurgery signed off -- f/u ~1/2022 with ESR/CRP and flex/ext XR of C + L spine   Acute on chronic anemia Hemoglobin 8.1 (10/25/2021) -- > 6.2 on admission, MCV 62.1 Iron studies with severe iron deficiency  Pt declining PO and IV iron GI signed off -- EGD once improved and out of COVID isolation (12/1), can be done as outpatient S/p 2u PRBCs total during admission (last 11/27) Hgb stable ~8 after last transfusion  R>L leg edema RLE Duplex negative for DVT   Cellulitis neck and back More likely related to heating pad overuse but either way completed 5 days of doxycycline while inpatient    Chronic diastolic heart failure  Essential hypertension EF 55-60% with abnormal LV diastolic function on echocardiogram 7/25/2018 Continue Toprol and Lasix   Diabetes type 2 controlled Held metformin and Actos during hospitalization Stop Actos on discharge due to dCHF F/u with PCP to consider SGLT-2 instead   Hyperlipidemia Cigarette nicotine dependence
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging spinal abnormal, Malaise, Mean cell volume decreased, Neck pain, Oedema peripheral
Clinical narrative: Patient is a 61 y.o. female with a history of Asthma, COPD, Chronic respiratory failure on 2 L oxygen, HFpEF, Hypertension, DM2,  Hyperlipidemia,  Anemia,  Arthritis,  Spinal stenosis, Chronic back pain, Tobacco abuse who presented with acute on chronic neck/back pain and cough/dyspnea, found to have cervical and lumbar spinal stenosis, worsening hypoxia, acute bronchitis and COVID-19 infection. Course complicated by acute blood loss anemia and GI determined she can f/u with EGD as an outpatient. She improved with supportive care, finished a 7 day course of antibiotics and was discharged to complete 10 total days of steroids for COVID.    Acute on chronic respiratory failure with hypoxia Acute bronchitis COPD without exacerbation Baseline 2L NC O2 -- > requiring up to 3-4L currently CXR clear lungs COVID+ Completed 7 days of antibiotics for possible bacterial process Decadron as below Has nebs at home and continue home symbicort Tolerating home O2 but pt prefers higher doses   Covid-19 Virus Infection Date of onset of symptoms: 10-14 days Symptoms present on admission: cough, SOB Date of covid positive test: 11/23/22 Imaging: CXR unremarkable Oxygen requirements on admission: 2 L Current oxygen requirements: 3L  Medical therapy: PO decadron x10 days (ends 12/5) Special isolation ended 12/01/22   Acute exacerbation of chronic back pain with right-sided sciatica Acute on chronic neck pain Spinal stenosis MRI C/L spine -- C4-5 disc bulge with moderate canal stenosis, L3-4 dis bulge and severe canal stenosis, plus other findings Neurosurgery consulted -- can be considered for surgery once back cellulitis resolved Neurosurgery signed off -- f/u ~1/2022 with ESR/CRP and flex/ext XR of C + L spine   Acute on chronic anemia Hemoglobin 8.1 (10/25/2021) -- > 6.2 on admission, MCV 62.1 Iron studies with severe iron deficiency  Pt declining PO and IV iron GI signed off -- EGD once improved and out of COVID isolation (12/1), can be done as outpatient S/p 2u PRBCs total during admission (last 11/27) Hgb stable ~8 after last transfusion  R>L leg edema RLE Duplex negative for DVT   Cellulitis neck and back More likely related to heating pad overuse but either way completed 5 days of doxycycline while inpatient    Chronic diastolic heart failure  Essential hypertension EF 55-60% with abnormal LV diastolic function on echocardiogram 7/25/2018 Continue Toprol and Lasix   Diabetes type 2 controlled Held metformin and Actos during hospitalization Stop Actos on discharge due to dCHF F/u with PCP to consider SGLT-2 instead   Hyperlipidemia Cigarette nicotine dependence
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Red blood cell transfusion, SARS-CoV-2 test positive, Sciatica, Spinal stenosis, Ultrasound Doppler normal
Clinical narrative: Patient is a 61 y.o. female with a history of Asthma, COPD, Chronic respiratory failure on 2 L oxygen, HFpEF, Hypertension, DM2,  Hyperlipidemia,  Anemia,  Arthritis,  Spinal stenosis, Chronic back pain, Tobacco abuse who presented with acute on chronic neck/back pain and cough/dyspnea, found to have cervical and lumbar spinal stenosis, worsening hypoxia, acute bronchitis and COVID-19 infection. Course complicated by acute blood loss anemia and GI determined she can f/u with EGD as an outpatient. She improved with supportive care, finished a 7 day course of antibiotics and was discharged to complete 10 total days of steroids for COVID.    Acute on chronic respiratory failure with hypoxia Acute bronchitis COPD without exacerbation Baseline 2L NC O2 -- > requiring up to 3-4L currently CXR clear lungs COVID+ Completed 7 days of antibiotics for possible bacterial process Decadron as below Has nebs at home and continue home symbicort Tolerating home O2 but pt prefers higher doses   Covid-19 Virus Infection Date of onset of symptoms: 10-14 days Symptoms present on admission: cough, SOB Date of covid positive test: 11/23/22 Imaging: CXR unremarkable Oxygen requirements on admission: 2 L Current oxygen requirements: 3L  Medical therapy: PO decadron x10 days (ends 12/5) Special isolation ended 12/01/22   Acute exacerbation of chronic back pain with right-sided sciatica Acute on chronic neck pain Spinal stenosis MRI C/L spine -- C4-5 disc bulge with moderate canal stenosis, L3-4 dis bulge and severe canal stenosis, plus other findings Neurosurgery consulted -- can be considered for surgery once back cellulitis resolved Neurosurgery signed off -- f/u ~1/2022 with ESR/CRP and flex/ext XR of C + L spine   Acute on chronic anemia Hemoglobin 8.1 (10/25/2021) -- > 6.2 on admission, MCV 62.1 Iron studies with severe iron deficiency  Pt declining PO and IV iron GI signed off -- EGD once improved and out of COVID isolation (12/1), can be done as outpatient S/p 2u PRBCs total during admission (last 11/27) Hgb stable ~8 after last transfusion  R>L leg edema RLE Duplex negative for DVT   Cellulitis neck and back More likely related to heating pad overuse but either way completed 5 days of doxycycline while inpatient    Chronic diastolic heart failure  Essential hypertension EF 55-60% with abnormal LV diastolic function on echocardiogram 7/25/2018 Continue Toprol and Lasix   Diabetes type 2 controlled Held metformin and Actos during hospitalization Stop Actos on discharge due to dCHF F/u with PCP to consider SGLT-2 instead   Hyperlipidemia Cigarette nicotine dependence
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Malaise, Oropharyngeal pain, Pain, Pyrexia
Clinical narrative: I started having a sore throat, with a slight fever, achy. I did a home COVID-19 test, the first one was negative the second came back positive. I called my doctor's office, had a telehealth visit, they had me come in for an antigen COVID-19 test that came back positive. I was prescribed PAXLOVID for three days. I felt a little rough for a couple days but day five I was testing negative. I am still experiencing the stuffy of a head in the morning but by afternoon it is gone.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, SARS-CoV-2 test negative, SARS-CoV-2 test positive
Clinical narrative: I started having a sore throat, with a slight fever, achy. I did a home COVID-19 test, the first one was negative the second came back positive. I called my doctor's office, had a telehealth visit, they had me come in for an antigen COVID-19 test that came back positive. I was prescribed PAXLOVID for three days. I felt a little rough for a couple days but day five I was testing negative. I am still experiencing the stuffy of a head in the morning but by afternoon it is gone.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Atelectasis, Blood glucose increased, Blood lactic acid, COVID-19, COVID-19 pneumonia
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 12/20/2022 Discharge Date: Dec 27, 2022 COVID positive 12/20/2022 PRESENTING PROBLEM: COPD exacerbation Respiratory tract infection due to COVID-19 virus   HOSPITAL COURSE: Patient is a 59 y.o. female with PMHx of RA on humira and prednisone, chronic respiratory failure on 2L with ILD and pulmonary fibrosis, COPD, emphysema, HLD, migraine, NASH, DM who presented with COVID-19 pneumonia.   Patient's symptoms started on 12/17/22 with dyspnea, non-productive cough, aches, and fatigue. She took a home COVID test which returned positive. She was referred to COVID clinic and they met with her remotely. They had concerns about her respiratory status and referred her to the ER for further evaluation.    In the ER, her COVID test was positive. CXR showed left basilar discoid atelectasis. She did not get a CTA due to contrast allergy, though she is open to it. CBC and CMP largely unremarkable. LA was 0.9. Procal was 0.14. She attempted to ambulate and her symptoms were significantly worse. Her HR elevated to 130's-140's. Given her progressive symptoms, and unstable vitals with minimal ambulation, she was admitted to medicine for further management of COVID.   Patient was initially is based on dexamethasone and remdesivir for COVID infection.  Due to presence of interstitial lung disease and immunosuppression pulmonology was consulted.  Patient was transitioned to aggressive IV steroid regimen.  With improvement in respiratory status patient was transitioned to steroid taper.  Patient on baseline steroid use of 10 mg daily.  CellCept was held during this admission and can be resumed after holding it for total 2 weeks.  Patient's oxygen saturations improved to baseline 2 L per nasal cannula.   Patient had elevated blood sugars in the presence of aggressive steroid regimen.  As steroids are being weaned on blood sugar should improve.   Patient was cleared for discharge..
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 12/20/2022 Discharge Date: Dec 27, 2022 COVID positive 12/20/2022 PRESENTING PROBLEM: COPD exacerbation Respiratory tract infection due to COVID-19 virus   HOSPITAL COURSE: Patient is a 59 y.o. female with PMHx of RA on humira and prednisone, chronic respiratory failure on 2L with ILD and pulmonary fibrosis, COPD, emphysema, HLD, migraine, NASH, DM who presented with COVID-19 pneumonia.   Patient's symptoms started on 12/17/22 with dyspnea, non-productive cough, aches, and fatigue. She took a home COVID test which returned positive. She was referred to COVID clinic and they met with her remotely. They had concerns about her respiratory status and referred her to the ER for further evaluation.    In the ER, her COVID test was positive. CXR showed left basilar discoid atelectasis. She did not get a CTA due to contrast allergy, though she is open to it. CBC and CMP largely unremarkable. LA was 0.9. Procal was 0.14. She attempted to ambulate and her symptoms were significantly worse. Her HR elevated to 130's-140's. Given her progressive symptoms, and unstable vitals with minimal ambulation, she was admitted to medicine for further management of COVID.   Patient was initially is based on dexamethasone and remdesivir for COVID infection.  Due to presence of interstitial lung disease and immunosuppression pulmonology was consulted.  Patient was transitioned to aggressive IV steroid regimen.  With improvement in respiratory status patient was transitioned to steroid taper.  Patient on baseline steroid use of 10 mg daily.  CellCept was held during this admission and can be resumed after holding it for total 2 weeks.  Patient's oxygen saturations improved to baseline 2 L per nasal cannula.   Patient had elevated blood sugars in the presence of aggressive steroid regimen.  As steroids are being weaned on blood sugar should improve.   Patient was cleared for discharge..
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Full blood count normal, Heart rate increased, Metabolic function test normal, Pain
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 12/20/2022 Discharge Date: Dec 27, 2022 COVID positive 12/20/2022 PRESENTING PROBLEM: COPD exacerbation Respiratory tract infection due to COVID-19 virus   HOSPITAL COURSE: Patient is a 59 y.o. female with PMHx of RA on humira and prednisone, chronic respiratory failure on 2L with ILD and pulmonary fibrosis, COPD, emphysema, HLD, migraine, NASH, DM who presented with COVID-19 pneumonia.   Patient's symptoms started on 12/17/22 with dyspnea, non-productive cough, aches, and fatigue. She took a home COVID test which returned positive. She was referred to COVID clinic and they met with her remotely. They had concerns about her respiratory status and referred her to the ER for further evaluation.    In the ER, her COVID test was positive. CXR showed left basilar discoid atelectasis. She did not get a CTA due to contrast allergy, though she is open to it. CBC and CMP largely unremarkable. LA was 0.9. Procal was 0.14. She attempted to ambulate and her symptoms were significantly worse. Her HR elevated to 130's-140's. Given her progressive symptoms, and unstable vitals with minimal ambulation, she was admitted to medicine for further management of COVID.   Patient was initially is based on dexamethasone and remdesivir for COVID infection.  Due to presence of interstitial lung disease and immunosuppression pulmonology was consulted.  Patient was transitioned to aggressive IV steroid regimen.  With improvement in respiratory status patient was transitioned to steroid taper.  Patient on baseline steroid use of 10 mg daily.  CellCept was held during this admission and can be resumed after holding it for total 2 weeks.  Patient's oxygen saturations improved to baseline 2 L per nasal cannula.   Patient had elevated blood sugars in the presence of aggressive steroid regimen.  As steroids are being weaned on blood sugar should improve.   Patient was cleared for discharge..
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Procalcitonin, Respiratory tract infection, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider:  Primary Care Provider:  DO Admission Date: 12/20/2022 Discharge Date: Dec 27, 2022 COVID positive 12/20/2022 PRESENTING PROBLEM: COPD exacerbation Respiratory tract infection due to COVID-19 virus   HOSPITAL COURSE: Patient is a 59 y.o. female with PMHx of RA on humira and prednisone, chronic respiratory failure on 2L with ILD and pulmonary fibrosis, COPD, emphysema, HLD, migraine, NASH, DM who presented with COVID-19 pneumonia.   Patient's symptoms started on 12/17/22 with dyspnea, non-productive cough, aches, and fatigue. She took a home COVID test which returned positive. She was referred to COVID clinic and they met with her remotely. They had concerns about her respiratory status and referred her to the ER for further evaluation.    In the ER, her COVID test was positive. CXR showed left basilar discoid atelectasis. She did not get a CTA due to contrast allergy, though she is open to it. CBC and CMP largely unremarkable. LA was 0.9. Procal was 0.14. She attempted to ambulate and her symptoms were significantly worse. Her HR elevated to 130's-140's. Given her progressive symptoms, and unstable vitals with minimal ambulation, she was admitted to medicine for further management of COVID.   Patient was initially is based on dexamethasone and remdesivir for COVID infection.  Due to presence of interstitial lung disease and immunosuppression pulmonology was consulted.  Patient was transitioned to aggressive IV steroid regimen.  With improvement in respiratory status patient was transitioned to steroid taper.  Patient on baseline steroid use of 10 mg daily.  CellCept was held during this admission and can be resumed after holding it for total 2 weeks.  Patient's oxygen saturations improved to baseline 2 L per nasal cannula.   Patient had elevated blood sugars in the presence of aggressive steroid regimen.  As steroids are being weaned on blood sugar should improve.   Patient was cleared for discharge..
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Rhinorrhoea, SARS-CoV-2 test negative
Clinical narrative: I had a runny nose and a cough but this is not unusual for me this time of year, my wife however, did test positive for COVID-19, this prompted me to test as well. I began testing on 12/06/2022 and tested daily until 12/10/2022 at 2AM I tested positive for the COVID-19 virus. I took PAXLOVID and I have recovered from the COVID-19 virus and back to my normal self.
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I had a runny nose and a cough but this is not unusual for me this time of year, my wife however, did test positive for COVID-19, this prompted me to test as well. I began testing on 12/06/2022 and tested daily until 12/10/2022 at 2AM I tested positive for the COVID-19 virus. I took PAXLOVID and I have recovered from the COVID-19 virus and back to my normal self.
Age: 67.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated
Age: 39.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 54.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Malaise, Oropharyngeal pain
Clinical narrative: I started to have symptoms 12/13 and they were just sore throat and cough. My husband was at home and positive, so I knew it probably came home from him. I tested for COVID-19 home test and I was negative which prompted me to get a PCR test. The results came back on 12/15 and were positive for COVID-19. I called the doctor and did a telehealth, and I was prescribed PAXLOVID. I never felt really bad and never got anything worse than a sore throat. On 12/22 I started getting really sick and I took another home test and it was positive. I took another test this morning and it was positive as well and I feel really sick. I have also noticed my blood oxygen via smart watch is very low. I don't think this is related to the vaccine.
Age: 54.0
Sex: F
Vaccine: COVID19-2
Symptoms: Oxygen saturation decreased, SARS-CoV-2 test positive
Clinical narrative: I started to have symptoms 12/13 and they were just sore throat and cough. My husband was at home and positive, so I knew it probably came home from him. I tested for COVID-19 home test and I was negative which prompted me to get a PCR test. The results came back on 12/15 and were positive for COVID-19. I called the doctor and did a telehealth, and I was prescribed PAXLOVID. I never felt really bad and never got anything worse than a sore throat. On 12/22 I started getting really sick and I took another home test and it was positive. I took another test this morning and it was positive as well and I feel really sick. I have also noticed my blood oxygen via smart watch is very low. I don't think this is related to the vaccine.
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chills, Lymph node pain, Lymphadenopathy, Pain
Clinical narrative: received shot at 10:45 am - symptoms began at 10pm same day chills, body aches, very painful, tender swollen lymph nodes under arm pit of injection site
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Malaise, Oropharyngeal pain, Pain in extremity
Clinical narrative: I had a sore arm for a day after receiving the vaccine. On 06/12/2022, I wasn't feeling well and tested positive for COVID-19. I contacted my doctor via the patient portal and received the prescription for PAXLOVID. I had a runny nose, slight fever for a few hours, minor sore throat for a day and a deep cough for two days. I finally tested negative for COVID-19 on 06/20/2022.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, SARS-CoV-2 test positive
Clinical narrative: I had a sore arm for a day after receiving the vaccine. On 06/12/2022, I wasn't feeling well and tested positive for COVID-19. I contacted my doctor via the patient portal and received the prescription for PAXLOVID. I had a runny nose, slight fever for a few hours, minor sore throat for a day and a deep cough for two days. I finally tested negative for COVID-19 on 06/20/2022.
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acquired diaphragmatic eventration, Antiplatelet therapy, Aortic valve incompetence, Asthenia, Asthma
Clinical narrative: Is a 74 y.o. female who presented to the Hospital ED from home on 11/30/2022 with complaint of progressive weakness, increasing shortness of breath, and worsening cough.  Symptoms started on 11/27/2022 and she was diagnosed with SARS-CoV-2 infection on 11/29/2022.   Discharge Diagnosis and Associated Hospital Course     SARS-CoV-2 infection with COVID-19 pneumonia with sepsis Acute exacerbation of asthma Presented with cough, fever, myalgias, shortness of breath, n/v/d, and generalized weakness -Symptom onset: 11/27/2022 -Positive COVID-19: positive at home; prescribed nirmatrelvir-ritonavir on 11/29 -Confirmed COVID-19 testing on admission 11/30/2022  -Vaccination status: Moderna x 4, bivalent x 1 -CXR on admission showed bibasilar opacities secondary to atelectasis versus early infiltrates -Oxygen status: Briefly required low-flow supplemental oxygen at 2 L/min -Dexamethasone: Yes.  Will complete 5 days of dexamethasone -Remdesivir: Yes.  Therapy completed -Inhaled bronchodilator therapy/asthma: Resume tiotropium, montelukast, dupixent and dulera   Abnormal chest x-ray Right phrenic nerve palsy Elevated right diaphram Known history of phrenic nerve injury/palsy with elevated right diaphragm present on current chest imaging likely contributing to abnormal findings -No acute issues   Paroxysmal atrial fibrillation Status post left atrial appendage closure (watchman procedure) Chronically managed with sotalol with less than 1% burden present on holter monitor following left and right atrial ablations in May 2022 status post placement of Watchman device 8/3/2022 on dual anti-platelet therapy as of 11/10/2022 office visit with CHA2DS2-VASc score of 3 -Assessed September 2022 -Continue sotalol and dual anti-platelet therapy; no indication for anticoagulation   Mitral and aortic valve regurgitation  Atrial septal defect  Valvular disease was described in September 2022 as mild while the ASD was reported as large, residual, with left-to-right shunting -No acute issues apparent  Hyponatremia  Hypokalemia Hypomagnesia Mild at 129 on admission improved to 134 presumed secondary to nausea and decreased dietary intake as well as GI losse -Volume replete with IV isotonic crystalloid fluids   Hypertension, essential Lisinopril and spironolactone for held due to low normal blood pressure -Continue to his medications until follow-up with PCP   Hypothyroidism Continue levothyroxine
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Atelectasis, Atrial septal defect, CHA2DS2-VASc-score, COVID-19, COVID-19 pneumonia
Clinical narrative: Is a 74 y.o. female who presented to the Hospital ED from home on 11/30/2022 with complaint of progressive weakness, increasing shortness of breath, and worsening cough.  Symptoms started on 11/27/2022 and she was diagnosed with SARS-CoV-2 infection on 11/29/2022.   Discharge Diagnosis and Associated Hospital Course     SARS-CoV-2 infection with COVID-19 pneumonia with sepsis Acute exacerbation of asthma Presented with cough, fever, myalgias, shortness of breath, n/v/d, and generalized weakness -Symptom onset: 11/27/2022 -Positive COVID-19: positive at home; prescribed nirmatrelvir-ritonavir on 11/29 -Confirmed COVID-19 testing on admission 11/30/2022  -Vaccination status: Moderna x 4, bivalent x 1 -CXR on admission showed bibasilar opacities secondary to atelectasis versus early infiltrates -Oxygen status: Briefly required low-flow supplemental oxygen at 2 L/min -Dexamethasone: Yes.  Will complete 5 days of dexamethasone -Remdesivir: Yes.  Therapy completed -Inhaled bronchodilator therapy/asthma: Resume tiotropium, montelukast, dupixent and dulera   Abnormal chest x-ray Right phrenic nerve palsy Elevated right diaphram Known history of phrenic nerve injury/palsy with elevated right diaphragm present on current chest imaging likely contributing to abnormal findings -No acute issues   Paroxysmal atrial fibrillation Status post left atrial appendage closure (watchman procedure) Chronically managed with sotalol with less than 1% burden present on holter monitor following left and right atrial ablations in May 2022 status post placement of Watchman device 8/3/2022 on dual anti-platelet therapy as of 11/10/2022 office visit with CHA2DS2-VASc score of 3 -Assessed September 2022 -Continue sotalol and dual anti-platelet therapy; no indication for anticoagulation   Mitral and aortic valve regurgitation  Atrial septal defect  Valvular disease was described in September 2022 as mild while the ASD was reported as large, residual, with left-to-right shunting -No acute issues apparent  Hyponatremia  Hypokalemia Hypomagnesia Mild at 129 on admission improved to 134 presumed secondary to nausea and decreased dietary intake as well as GI losse -Volume replete with IV isotonic crystalloid fluids   Hypertension, essential Lisinopril and spironolactone for held due to low normal blood pressure -Continue to his medications until follow-up with PCP   Hypothyroidism Continue levothyroxine
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cardiac septal defect residual shunt, Cardiac valve disease, Chest X-ray abnormal, Condition aggravated, Cough
Clinical narrative: Is a 74 y.o. female who presented to the Hospital ED from home on 11/30/2022 with complaint of progressive weakness, increasing shortness of breath, and worsening cough.  Symptoms started on 11/27/2022 and she was diagnosed with SARS-CoV-2 infection on 11/29/2022.   Discharge Diagnosis and Associated Hospital Course     SARS-CoV-2 infection with COVID-19 pneumonia with sepsis Acute exacerbation of asthma Presented with cough, fever, myalgias, shortness of breath, n/v/d, and generalized weakness -Symptom onset: 11/27/2022 -Positive COVID-19: positive at home; prescribed nirmatrelvir-ritonavir on 11/29 -Confirmed COVID-19 testing on admission 11/30/2022  -Vaccination status: Moderna x 4, bivalent x 1 -CXR on admission showed bibasilar opacities secondary to atelectasis versus early infiltrates -Oxygen status: Briefly required low-flow supplemental oxygen at 2 L/min -Dexamethasone: Yes.  Will complete 5 days of dexamethasone -Remdesivir: Yes.  Therapy completed -Inhaled bronchodilator therapy/asthma: Resume tiotropium, montelukast, dupixent and dulera   Abnormal chest x-ray Right phrenic nerve palsy Elevated right diaphram Known history of phrenic nerve injury/palsy with elevated right diaphragm present on current chest imaging likely contributing to abnormal findings -No acute issues   Paroxysmal atrial fibrillation Status post left atrial appendage closure (watchman procedure) Chronically managed with sotalol with less than 1% burden present on holter monitor following left and right atrial ablations in May 2022 status post placement of Watchman device 8/3/2022 on dual anti-platelet therapy as of 11/10/2022 office visit with CHA2DS2-VASc score of 3 -Assessed September 2022 -Continue sotalol and dual anti-platelet therapy; no indication for anticoagulation   Mitral and aortic valve regurgitation  Atrial septal defect  Valvular disease was described in September 2022 as mild while the ASD was reported as large, residual, with left-to-right shunting -No acute issues apparent  Hyponatremia  Hypokalemia Hypomagnesia Mild at 129 on admission improved to 134 presumed secondary to nausea and decreased dietary intake as well as GI losse -Volume replete with IV isotonic crystalloid fluids   Hypertension, essential Lisinopril and spironolactone for held due to low normal blood pressure -Continue to his medications until follow-up with PCP   Hypothyroidism Continue levothyroxine
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diarrhoea, Dyspnoea, Echocardiogram abnormal, Hypokalaemia, Hypomagnesaemia
Clinical narrative: Is a 74 y.o. female who presented to the Hospital ED from home on 11/30/2022 with complaint of progressive weakness, increasing shortness of breath, and worsening cough.  Symptoms started on 11/27/2022 and she was diagnosed with SARS-CoV-2 infection on 11/29/2022.   Discharge Diagnosis and Associated Hospital Course     SARS-CoV-2 infection with COVID-19 pneumonia with sepsis Acute exacerbation of asthma Presented with cough, fever, myalgias, shortness of breath, n/v/d, and generalized weakness -Symptom onset: 11/27/2022 -Positive COVID-19: positive at home; prescribed nirmatrelvir-ritonavir on 11/29 -Confirmed COVID-19 testing on admission 11/30/2022  -Vaccination status: Moderna x 4, bivalent x 1 -CXR on admission showed bibasilar opacities secondary to atelectasis versus early infiltrates -Oxygen status: Briefly required low-flow supplemental oxygen at 2 L/min -Dexamethasone: Yes.  Will complete 5 days of dexamethasone -Remdesivir: Yes.  Therapy completed -Inhaled bronchodilator therapy/asthma: Resume tiotropium, montelukast, dupixent and dulera   Abnormal chest x-ray Right phrenic nerve palsy Elevated right diaphram Known history of phrenic nerve injury/palsy with elevated right diaphragm present on current chest imaging likely contributing to abnormal findings -No acute issues   Paroxysmal atrial fibrillation Status post left atrial appendage closure (watchman procedure) Chronically managed with sotalol with less than 1% burden present on holter monitor following left and right atrial ablations in May 2022 status post placement of Watchman device 8/3/2022 on dual anti-platelet therapy as of 11/10/2022 office visit with CHA2DS2-VASc score of 3 -Assessed September 2022 -Continue sotalol and dual anti-platelet therapy; no indication for anticoagulation   Mitral and aortic valve regurgitation  Atrial septal defect  Valvular disease was described in September 2022 as mild while the ASD was reported as large, residual, with left-to-right shunting -No acute issues apparent  Hyponatremia  Hypokalemia Hypomagnesia Mild at 129 on admission improved to 134 presumed secondary to nausea and decreased dietary intake as well as GI losse -Volume replete with IV isotonic crystalloid fluids   Hypertension, essential Lisinopril and spironolactone for held due to low normal blood pressure -Continue to his medications until follow-up with PCP   Hypothyroidism Continue levothyroxine
Age: 74.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hyponatraemia, Hypophagia, Hypovolaemia, Lung infiltration, Lung opacity
Clinical narrative: Is a 74 y.o. female who presented to the Hospital ED from home on 11/30/2022 with complaint of progressive weakness, increasing shortness of breath, and worsening cough.  Symptoms started on 11/27/2022 and she was diagnosed with SARS-CoV-2 infection on 11/29/2022.   Discharge Diagnosis and Associated Hospital Course     SARS-CoV-2 infection with COVID-19 pneumonia with sepsis Acute exacerbation of asthma Presented with cough, fever, myalgias, shortness of breath, n/v/d, and generalized weakness -Symptom onset: 11/27/2022 -Positive COVID-19: positive at home; prescribed nirmatrelvir-ritonavir on 11/29 -Confirmed COVID-19 testing on admission 11/30/2022  -Vaccination status: Moderna x 4, bivalent x 1 -CXR on admission showed bibasilar opacities secondary to atelectasis versus early infiltrates -Oxygen status: Briefly required low-flow supplemental oxygen at 2 L/min -Dexamethasone: Yes.  Will complete 5 days of dexamethasone -Remdesivir: Yes.  Therapy completed -Inhaled bronchodilator therapy/asthma: Resume tiotropium, montelukast, dupixent and dulera   Abnormal chest x-ray Right phrenic nerve palsy Elevated right diaphram Known history of phrenic nerve injury/palsy with elevated right diaphragm present on current chest imaging likely contributing to abnormal findings -No acute issues   Paroxysmal atrial fibrillation Status post left atrial appendage closure (watchman procedure) Chronically managed with sotalol with less than 1% burden present on holter monitor following left and right atrial ablations in May 2022 status post placement of Watchman device 8/3/2022 on dual anti-platelet therapy as of 11/10/2022 office visit with CHA2DS2-VASc score of 3 -Assessed September 2022 -Continue sotalol and dual anti-platelet therapy; no indication for anticoagulation   Mitral and aortic valve regurgitation  Atrial septal defect  Valvular disease was described in September 2022 as mild while the ASD was reported as large, residual, with left-to-right shunting -No acute issues apparent  Hyponatremia  Hypokalemia Hypomagnesia Mild at 129 on admission improved to 134 presumed secondary to nausea and decreased dietary intake as well as GI losse -Volume replete with IV isotonic crystalloid fluids   Hypertension, essential Lisinopril and spironolactone for held due to low normal blood pressure -Continue to his medications until follow-up with PCP   Hypothyroidism Continue levothyroxine