chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 86.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood lactic acid increased, COVID-19, Chest X-ray normal, Electrocardiogram abnormal, Electrolyte depletion
Clinical narrative: Discharge Physician:  MD Primary Care Physician: MD   Date of Admission: 8/23/2023 Discharge Date: 8/29/2023 Room Number: 2022/2022-1  PRESENTING PROBLEM: Acute respiratory failure with hypoxia [J96.01] Acute renal failure, unspecified acute renal failure type [N17.9] Acute hypoxemic respiratory failure due to COVID-19 [U07.1, J96.01] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 86 y.o. male past medical history diabetes, HLD, HTN, CAD, RA, BPH who presents with weakness and a fall.    In the Emergency Department, he had labs showing AKI with Cr of 1.49. His procal was negative, lactic acid elevated at 3.8. He had no leukocytosis. He was found to be febrile on presentation and tested positive for COVID. He was given IVF and tylenol with improvement of his symptoms. He became hypoxic requiring supplemental oxygen and was treated with decadron. CXR was negative. The hospitalist team was contacted for admission and further management. Hypoxia rapidly resolved and covid 19 therapy was not continued. PT/OT evaluated recommended SAR. MSW/CM consulted for discharge planning. Local wound care for bilateral knee scrapes was performed. Discussed Afib on EKG and therapeutic anticoagulation. After consideration family and patient agreed to start eliquis. Initially recommended by PT for pt to discharge to SAR. Pt improved during admit, so was eventually discharged home with HHC under the care of his daughters.    Electrolytes were monitored and repleted PRN throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge
Age: 86.0
Sex: M
Vaccine: COVID19-2
Symptoms: Electrolyte substitution therapy, Fall, Hypoxia, Procalcitonin normal, Pyrexia
Clinical narrative: Discharge Physician:  MD Primary Care Physician: MD   Date of Admission: 8/23/2023 Discharge Date: 8/29/2023 Room Number: 2022/2022-1  PRESENTING PROBLEM: Acute respiratory failure with hypoxia [J96.01] Acute renal failure, unspecified acute renal failure type [N17.9] Acute hypoxemic respiratory failure due to COVID-19 [U07.1, J96.01] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 86 y.o. male past medical history diabetes, HLD, HTN, CAD, RA, BPH who presents with weakness and a fall.    In the Emergency Department, he had labs showing AKI with Cr of 1.49. His procal was negative, lactic acid elevated at 3.8. He had no leukocytosis. He was found to be febrile on presentation and tested positive for COVID. He was given IVF and tylenol with improvement of his symptoms. He became hypoxic requiring supplemental oxygen and was treated with decadron. CXR was negative. The hospitalist team was contacted for admission and further management. Hypoxia rapidly resolved and covid 19 therapy was not continued. PT/OT evaluated recommended SAR. MSW/CM consulted for discharge planning. Local wound care for bilateral knee scrapes was performed. Discussed Afib on EKG and therapeutic anticoagulation. After consideration family and patient agreed to start eliquis. Initially recommended by PT for pt to discharge to SAR. Pt improved during admit, so was eventually discharged home with HHC under the care of his daughters.    Electrolytes were monitored and repleted PRN throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge
Age: 86.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Skin laceration, Wound treatment
Clinical narrative: Discharge Physician:  MD Primary Care Physician: MD   Date of Admission: 8/23/2023 Discharge Date: 8/29/2023 Room Number: 2022/2022-1  PRESENTING PROBLEM: Acute respiratory failure with hypoxia [J96.01] Acute renal failure, unspecified acute renal failure type [N17.9] Acute hypoxemic respiratory failure due to COVID-19 [U07.1, J96.01] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 86 y.o. male past medical history diabetes, HLD, HTN, CAD, RA, BPH who presents with weakness and a fall.    In the Emergency Department, he had labs showing AKI with Cr of 1.49. His procal was negative, lactic acid elevated at 3.8. He had no leukocytosis. He was found to be febrile on presentation and tested positive for COVID. He was given IVF and tylenol with improvement of his symptoms. He became hypoxic requiring supplemental oxygen and was treated with decadron. CXR was negative. The hospitalist team was contacted for admission and further management. Hypoxia rapidly resolved and covid 19 therapy was not continued. PT/OT evaluated recommended SAR. MSW/CM consulted for discharge planning. Local wound care for bilateral knee scrapes was performed. Discussed Afib on EKG and therapeutic anticoagulation. After consideration family and patient agreed to start eliquis. Initially recommended by PT for pt to discharge to SAR. Pt improved during admit, so was eventually discharged home with HHC under the care of his daughters.    Electrolytes were monitored and repleted PRN throughout the admission. Patient clinically improved and hemodynamically stable for discharge.  Discussed plan of care discharge with patient including outpatient follow-up PCP within 7 days. Patient voiced understanding was agreeable with plan of care discharge
Age: 59.0
Sex: F
Vaccine: COVID19, FLU4, HEPAB, VARZOS
Symptoms: Influenza like illness, Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
Clinical narrative: Pt reported feeling sick like she has the flu, redness and blotchy arm at site of injection on, soreness, hard to the touch, felt warm and was itchy all over and felt sick for 5 days. Patient reported taking some tylenol for her fever and some benadryl for the itching.
Age: 59.0
Sex: F
Vaccine: COVID19, FLU4, HEPAB, VARZOS
Symptoms: Malaise, Pruritus, Pyrexia, Rash macular
Clinical narrative: Pt reported feeling sick like she has the flu, redness and blotchy arm at site of injection on, soreness, hard to the touch, felt warm and was itchy all over and felt sick for 5 days. Patient reported taking some tylenol for her fever and some benadryl for the itching.
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Dyspnoea, Electrolyte imbalance, Fluid intake restriction
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: DO Admission Date: 8/22/2023 Discharge Date: 08/28/2023  Discharge Disposition: Home DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Shortness of breath   HOSPITAL COURSE: Patient is a 83-year-old female who was admitted on 08/22/2023 for worsening shortness of breath and cough.  She had been treated outpatient for these symptoms the past 11 days prior to admission with doxycycline, cefdinir, and prednisone.  Initially patient was meeting sepsis criteria and was requiring up to 10 L of oxygen on high-flow.  COVID-19 was positive.  Patient also had electrolyte abnormalities and was given IV magnesium and potassium four repletion.   During admission patient has been treated with Decadron (8/222 present) will continue for 3 more days to complete a 10 day course treatment.  Oxygen has been reduced to 2 L at rest 24/7 this is an increase from her baseline which is 2 L nocturnal and with activity.  Home health care will assist in weaning this.  PT and OT to see at home.  We will also send p.r.n. Tessalon Perles and Mucinex. She does have slight crackles to bilateral bases today on exam and she did not want to work with therapy due to shortness of breath.  Patient states though she feels significantly improved and wants to discharge.  She is on Lasix and I advised that she stick to a 2 L fluid restriction.  Will also have her finish 3 days of doxycyline, that was prescribed before admission.
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rales, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge: DO Admission Date: 8/22/2023 Discharge Date: 08/28/2023  Discharge Disposition: Home DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Shortness of breath   HOSPITAL COURSE: Patient is a 83-year-old female who was admitted on 08/22/2023 for worsening shortness of breath and cough.  She had been treated outpatient for these symptoms the past 11 days prior to admission with doxycycline, cefdinir, and prednisone.  Initially patient was meeting sepsis criteria and was requiring up to 10 L of oxygen on high-flow.  COVID-19 was positive.  Patient also had electrolyte abnormalities and was given IV magnesium and potassium four repletion.   During admission patient has been treated with Decadron (8/222 present) will continue for 3 more days to complete a 10 day course treatment.  Oxygen has been reduced to 2 L at rest 24/7 this is an increase from her baseline which is 2 L nocturnal and with activity.  Home health care will assist in weaning this.  PT and OT to see at home.  We will also send p.r.n. Tessalon Perles and Mucinex. She does have slight crackles to bilateral bases today on exam and she did not want to work with therapy due to shortness of breath.  Patient states though she feels significantly improved and wants to discharge.  She is on Lasix and I advised that she stick to a 2 L fluid restriction.  Will also have her finish 3 days of doxycyline, that was prescribed before admission.
Age: 1.33
Sex: F
Vaccine: FLU4
Symptoms: Circumstance or information capable of leading to medication error, Injection site injury
Clinical narrative: WHILE GIVING VACCINE MOTHER LET GO OF PATIENTS ARM AND NEEDLE SCRATCHED PATIENTS LEG
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Arthralgia, Asthenia, Avulsion fracture, COVID-19, Computerised tomogram head normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/23/2023 Discharge Date: Sep 2, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 77 year old male with history of CKD stage 3, hypertension, BPH, Parkinson's disease, and hyperlipidemia who presented to the emergency department with complaint of weakness and a fall.  He had been in the emergency department the day prior and was found to have COVID-19.  He was started on Paxlovid for cough.  Upon discharge home he had a fall in the bathroom and returned to the emergency department.  In the emergency department he was febrile.  He remained on room air. CT head was without an acute process.  He was admitted to the hospitalist service for further evaluation. He remained stable from a COVID standpoint.  He completed a 5 day course of Paxlovid.  PT/OT evaluated the patient and recommended subacute rehab at discharge.  The patient completed his isolation 9/2.   The patient was having significant right foot and ankle pain over the course of the hospitalization.  Right ankle x-ray was negative for an acute process.  Follow-up right lower extremity CT was negative for an acute fracture deformity.  There were remote avulsion fracture seen on imaging.  Because of the patient's persistent symptoms ortho was consulted and recommended repeat bilateral foot x-rays.  These were negative for fracture.  They recommended walking boot as needed, weight bearing as tolerated and outpatient follow-up with Dr. after discharge from SAR.   The patient was discharged to SAR in stable condition on 9/2
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram normal, Cough, Fall, Imaging procedure abnormal, Pain in extremity
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/23/2023 Discharge Date: Sep 2, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 77 year old male with history of CKD stage 3, hypertension, BPH, Parkinson's disease, and hyperlipidemia who presented to the emergency department with complaint of weakness and a fall.  He had been in the emergency department the day prior and was found to have COVID-19.  He was started on Paxlovid for cough.  Upon discharge home he had a fall in the bathroom and returned to the emergency department.  In the emergency department he was febrile.  He remained on room air. CT head was without an acute process.  He was admitted to the hospitalist service for further evaluation. He remained stable from a COVID standpoint.  He completed a 5 day course of Paxlovid.  PT/OT evaluated the patient and recommended subacute rehab at discharge.  The patient completed his isolation 9/2.   The patient was having significant right foot and ankle pain over the course of the hospitalization.  Right ankle x-ray was negative for an acute process.  Follow-up right lower extremity CT was negative for an acute fracture deformity.  There were remote avulsion fracture seen on imaging.  Because of the patient's persistent symptoms ortho was consulted and recommended repeat bilateral foot x-rays.  These were negative for fracture.  They recommended walking boot as needed, weight bearing as tolerated and outpatient follow-up with Dr. after discharge from SAR.   The patient was discharged to SAR in stable condition on 9/2
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pyrexia, X-ray limb normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 8/23/2023 Discharge Date: Sep 2, 2023 Discharge Disposition:  skilled nursing facility   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 77 year old male with history of CKD stage 3, hypertension, BPH, Parkinson's disease, and hyperlipidemia who presented to the emergency department with complaint of weakness and a fall.  He had been in the emergency department the day prior and was found to have COVID-19.  He was started on Paxlovid for cough.  Upon discharge home he had a fall in the bathroom and returned to the emergency department.  In the emergency department he was febrile.  He remained on room air. CT head was without an acute process.  He was admitted to the hospitalist service for further evaluation. He remained stable from a COVID standpoint.  He completed a 5 day course of Paxlovid.  PT/OT evaluated the patient and recommended subacute rehab at discharge.  The patient completed his isolation 9/2.   The patient was having significant right foot and ankle pain over the course of the hospitalization.  Right ankle x-ray was negative for an acute process.  Follow-up right lower extremity CT was negative for an acute fracture deformity.  There were remote avulsion fracture seen on imaging.  Because of the patient's persistent symptoms ortho was consulted and recommended repeat bilateral foot x-rays.  These were negative for fracture.  They recommended walking boot as needed, weight bearing as tolerated and outpatient follow-up with Dr. after discharge from SAR.   The patient was discharged to SAR in stable condition on 9/2
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Chills, Lethargy, Pain
Clinical narrative: Severe chills, chest tightness, achiness, lethargy, low grade fever (99)
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Contusion, Deep vein thrombosis, Erythema, Pain in extremity, Peripheral swelling
Clinical narrative: On 11/8/2023 resident developed bruising and the anterior right shin.  This progressed to increased pain and swelling of the area.  11/9/2023 pain and swelling continued. Call placed to Hospice to notify of ongoing pain and swelling.  Pain medications increased and monitoring continued.  Hospice nurse visited resident in the afternoon of 11/9, picture taken by hospice nurse and sent to provider.  Order received to obtain x-ray of RLE to r/o trauma.  11/10/2023: Morning - continues to have swelling and pain in RLE - also now noted with increasing warmth and erythema.  Order for X-ray cancelled d/t progressing course of illness. No ultrasound ordered d/t goals of care. Diagnosis of DVT based on clinical presentation. All scheduled (non-comfort) medications discontinued.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Skin warm
Clinical narrative: On 11/8/2023 resident developed bruising and the anterior right shin.  This progressed to increased pain and swelling of the area.  11/9/2023 pain and swelling continued. Call placed to Hospice to notify of ongoing pain and swelling.  Pain medications increased and monitoring continued.  Hospice nurse visited resident in the afternoon of 11/9, picture taken by hospice nurse and sent to provider.  Order received to obtain x-ray of RLE to r/o trauma.  11/10/2023: Morning - continues to have swelling and pain in RLE - also now noted with increasing warmth and erythema.  Order for X-ray cancelled d/t progressing course of illness. No ultrasound ordered d/t goals of care. Diagnosis of DVT based on clinical presentation. All scheduled (non-comfort) medications discontinued.
Age: 1.5
Sex: M
Vaccine: PNC15
Symptoms: Wrong product administered
Clinical narrative: Vaxnuevance was administered in error at 18 month well exam.  Child was to Hep a and DTaP, but received Hep A and PVC 15
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Dysphagia, Hypotension, Lethargy
Clinical narrative: Hypotension, severe lethargy, dysphagia.   supportive treatment, BP has improved as of day of reporting, still lethargic, continued dysphagia
Age: 82.0
Sex: F
Vaccine: RSV
Symptoms: Chills, Headache, Pain
Clinical narrative: Chills, body aches, headache
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Swelling face, Urticaria
Clinical narrative: Welps/raised itchy patches on my face, hairline and neck when I overheat due to workout.
Age: 0.58
Sex: F
Vaccine: DTPPVHBHPB
Symptoms: Abnormal behaviour, Decreased activity, Pyrexia
Clinical narrative: Fever started after WCC visit, Tmax 103.0 On 11/8, fever did not resolve and mother noted change in behavior and less active so they went to UC Treatments tried: Gave a fever reducer (80 mg Acetaminophen chew tablets) Warm-cool bath, cool wash cloths with temp decrease from 103-102
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Blindness unilateral, Blood test, Computerised tomogram, Endocrine ophthalmopathy, Vision blurred
Clinical narrative: Dose 1 given on 01/20/21 lot#042L20A, Dose 2 given on 02/17/2021 lot#022M20A, , Dose 3 was given on 10/30/2021 lot#0491221A,  DOSE 4 was on June 5th, 2022  . He developed Thyroid disease in his right eye. He can't see out of that eye, he gets blurred vision. He went to the doctor when his eye started going which way 4/7/23, and medical facility misdiagnosed him. So we had to go and get a second opinion. So on May 25, 2023, we went to Dr., and she is a neuro ophthalmologist. She diagnosed him with Thyroid disease. She recommended he go back to medical facility, since we had insurance with medical facility. I had to ask to be seen by a neuro Opthamologist. He had an er visit on April 2023, unsure about the date.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Blood pressure systolic increased, Chest pain, Tachycardia
Clinical narrative: Chest pain, elevated Systolic pressure, tachycardia  Hospitalized, hospital reports dx of NSTEMI
Age: 12.0
Sex: F
Vaccine: COVID19, HPV9, MNQ, TDAP
Symptoms: Syncope
Clinical narrative: Vasovagal syncope (Fainting) after 4th vaccine administration.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure systolic increased, COVID-19, Cardiomyopathy, Chest X-ray normal, Computerised tomogram abdomen normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 9/4/2023 Discharge Date: Sep 7, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypertensive emergency [I16.1]   HOSPITAL COURSE: Patient is a 73 y.o. female with past medical history significant for MI, takotsubo cardiomyopathy, HTN, Afib, Aortic stenosis, CAD who presents  to the ED for N/V, cough. In the emergency department she was hypertensive with systolic blood pressure of 220, also found to be COVID-positive.  CT abdomen and pelvis showed no acute process, chest x-ray did not show evidence of an acute infiltrate. Patient was started on remdesivir x 3 days for treatment of her COVID. Hypertensive urgency likely secondary to nausea/vomiting of home anti-hypertensive and COVID. Cardiology consulted given elevated troponin on admission, thought to be likely secondary in setting of marked hypertension and resultant global myocardial strain, along with her noted COVID infection. Echocardiogram obtained and revealed EF 66%, no regional wall motion abnormalities. Patient resumed on home anti-hypertensives and started on losartan with significant improvement of her blood pressure. Patient medically stable for discharge home on 9/7.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Echocardiogram normal, Ejection fraction normal, Hypertensive emergency, Hypertensive urgency
Clinical narrative: BRIEF OVERVIEW: Admission Date: 9/4/2023 Discharge Date: Sep 7, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypertensive emergency [I16.1]   HOSPITAL COURSE: Patient is a 73 y.o. female with past medical history significant for MI, takotsubo cardiomyopathy, HTN, Afib, Aortic stenosis, CAD who presents  to the ED for N/V, cough. In the emergency department she was hypertensive with systolic blood pressure of 220, also found to be COVID-positive.  CT abdomen and pelvis showed no acute process, chest x-ray did not show evidence of an acute infiltrate. Patient was started on remdesivir x 3 days for treatment of her COVID. Hypertensive urgency likely secondary to nausea/vomiting of home anti-hypertensive and COVID. Cardiology consulted given elevated troponin on admission, thought to be likely secondary in setting of marked hypertension and resultant global myocardial strain, along with her noted COVID infection. Echocardiogram obtained and revealed EF 66%, no regional wall motion abnormalities. Patient resumed on home anti-hypertensives and started on losartan with significant improvement of her blood pressure. Patient medically stable for discharge home on 9/7.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, SARS-CoV-2 test positive, Troponin increased, Vomiting, Wall motion score index normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 9/4/2023 Discharge Date: Sep 7, 2023 Discharge Disposition:  home or self care   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Hypertensive emergency [I16.1]   HOSPITAL COURSE: Patient is a 73 y.o. female with past medical history significant for MI, takotsubo cardiomyopathy, HTN, Afib, Aortic stenosis, CAD who presents  to the ED for N/V, cough. In the emergency department she was hypertensive with systolic blood pressure of 220, also found to be COVID-positive.  CT abdomen and pelvis showed no acute process, chest x-ray did not show evidence of an acute infiltrate. Patient was started on remdesivir x 3 days for treatment of her COVID. Hypertensive urgency likely secondary to nausea/vomiting of home anti-hypertensive and COVID. Cardiology consulted given elevated troponin on admission, thought to be likely secondary in setting of marked hypertension and resultant global myocardial strain, along with her noted COVID infection. Echocardiogram obtained and revealed EF 66%, no regional wall motion abnormalities. Patient resumed on home anti-hypertensives and started on losartan with significant improvement of her blood pressure. Patient medically stable for discharge home on 9/7.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Joint swelling, Tenderness
Clinical narrative: Patient states after receiving vaccine on 11/4 that night he began to experience pain in his wrist and they began swelling up . He continued this way for the week and took aspirin to help with swelling and pain. He eventually came in on 11/9 and spoke to the pharmacist on duty who observed it  was swollen compared to his other wrist. He was referred to take Aleeve  and that has helped with the swelling and pain. he states his wrist is now just tender.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute myocardial infarction, Anxiety, Atrial fibrillation, COVID-19
Clinical narrative: Discharge Provider:  DO Primary Care Provider at Discharge:  MD   Admission Date: 9/4/2023 Discharge Date: 9/6/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Orthostatic hypotension [I95.1] COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 84 year old male with a history of HLD, DM 2, CKD stage 3. He was admitted for chest pain, NSTEMI, on 8/31, had a dobutamine stress test and post infusion developed atrial fib with RVR, alternated with NSR, SVT. Rhythm management took several days and he was discharged with the addition of metoprolol succinate and apixaban on 9/3. History of hypotension with metoprolol in past. He returned to the ED on 9/4 with increased cough overnight, feeling of low blood pressure with dizziness and feeling "out of it". He reports a decreased appetite, shortness of breath, palpitations, and rhinorrhea as well. He denies chest pain, sore throat, nausea, vomiting, diarrhea. Vital signs significant for orthostatic hypotension in ED, heart rate controlled and NSR, afebrile, oxygen sat stable on room air. Lab work significant for AKI, hyperglycemia, elevated LFTs, trop 38, 31 indeterminate. He was Covid positive. He was given a 1 liter bolus in ED. He was admitted with Covid-19 and orthostatic hypotension for further monitoring and treatment as needed.  Patient was admitted remained stable throughout his stay he never had significant physical symptoms from the COVID-19.  His inflammatory markers did not require acute intervention.  He remained stable and was seen on the day of discharge anxious to go home.  He was evaluated by Physical and Occupational therapy who recommended home with no skilled services.  He could return to his regular medications as previously ordered.  He could return to diet and activity as tolerated.  He was cautioned that given his COVID-19 infection he was to make sure he was getting plenty of rest for the next 2-4 weeks.  He understood all these instructions and was discharged home in stable condition.   32 minutes were spent discharging this patient over 50% of this was spent in face-to-face counseling and coordination of care
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac stress test, Chest pain, Cough, Decreased appetite, Dizziness
Clinical narrative: Discharge Provider:  DO Primary Care Provider at Discharge:  MD   Admission Date: 9/4/2023 Discharge Date: 9/6/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Orthostatic hypotension [I95.1] COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 84 year old male with a history of HLD, DM 2, CKD stage 3. He was admitted for chest pain, NSTEMI, on 8/31, had a dobutamine stress test and post infusion developed atrial fib with RVR, alternated with NSR, SVT. Rhythm management took several days and he was discharged with the addition of metoprolol succinate and apixaban on 9/3. History of hypotension with metoprolol in past. He returned to the ED on 9/4 with increased cough overnight, feeling of low blood pressure with dizziness and feeling "out of it". He reports a decreased appetite, shortness of breath, palpitations, and rhinorrhea as well. He denies chest pain, sore throat, nausea, vomiting, diarrhea. Vital signs significant for orthostatic hypotension in ED, heart rate controlled and NSR, afebrile, oxygen sat stable on room air. Lab work significant for AKI, hyperglycemia, elevated LFTs, trop 38, 31 indeterminate. He was Covid positive. He was given a 1 liter bolus in ED. He was admitted with Covid-19 and orthostatic hypotension for further monitoring and treatment as needed.  Patient was admitted remained stable throughout his stay he never had significant physical symptoms from the COVID-19.  His inflammatory markers did not require acute intervention.  He remained stable and was seen on the day of discharge anxious to go home.  He was evaluated by Physical and Occupational therapy who recommended home with no skilled services.  He could return to his regular medications as previously ordered.  He could return to diet and activity as tolerated.  He was cautioned that given his COVID-19 infection he was to make sure he was getting plenty of rest for the next 2-4 weeks.  He understood all these instructions and was discharged home in stable condition.   32 minutes were spent discharging this patient over 50% of this was spent in face-to-face counseling and coordination of care
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Feeling abnormal, Hyperglycaemia, Hypotension, Inflammatory marker test
Clinical narrative: Discharge Provider:  DO Primary Care Provider at Discharge:  MD   Admission Date: 9/4/2023 Discharge Date: 9/6/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Orthostatic hypotension [I95.1] COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 84 year old male with a history of HLD, DM 2, CKD stage 3. He was admitted for chest pain, NSTEMI, on 8/31, had a dobutamine stress test and post infusion developed atrial fib with RVR, alternated with NSR, SVT. Rhythm management took several days and he was discharged with the addition of metoprolol succinate and apixaban on 9/3. History of hypotension with metoprolol in past. He returned to the ED on 9/4 with increased cough overnight, feeling of low blood pressure with dizziness and feeling "out of it". He reports a decreased appetite, shortness of breath, palpitations, and rhinorrhea as well. He denies chest pain, sore throat, nausea, vomiting, diarrhea. Vital signs significant for orthostatic hypotension in ED, heart rate controlled and NSR, afebrile, oxygen sat stable on room air. Lab work significant for AKI, hyperglycemia, elevated LFTs, trop 38, 31 indeterminate. He was Covid positive. He was given a 1 liter bolus in ED. He was admitted with Covid-19 and orthostatic hypotension for further monitoring and treatment as needed.  Patient was admitted remained stable throughout his stay he never had significant physical symptoms from the COVID-19.  His inflammatory markers did not require acute intervention.  He remained stable and was seen on the day of discharge anxious to go home.  He was evaluated by Physical and Occupational therapy who recommended home with no skilled services.  He could return to his regular medications as previously ordered.  He could return to diet and activity as tolerated.  He was cautioned that given his COVID-19 infection he was to make sure he was getting plenty of rest for the next 2-4 weeks.  He understood all these instructions and was discharged home in stable condition.   32 minutes were spent discharging this patient over 50% of this was spent in face-to-face counseling and coordination of care
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Infusion, Liver function test increased, Orthostatic hypotension, Palpitations, Rhinorrhoea
Clinical narrative: Discharge Provider:  DO Primary Care Provider at Discharge:  MD   Admission Date: 9/4/2023 Discharge Date: 9/6/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Orthostatic hypotension [I95.1] COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 84 year old male with a history of HLD, DM 2, CKD stage 3. He was admitted for chest pain, NSTEMI, on 8/31, had a dobutamine stress test and post infusion developed atrial fib with RVR, alternated with NSR, SVT. Rhythm management took several days and he was discharged with the addition of metoprolol succinate and apixaban on 9/3. History of hypotension with metoprolol in past. He returned to the ED on 9/4 with increased cough overnight, feeling of low blood pressure with dizziness and feeling "out of it". He reports a decreased appetite, shortness of breath, palpitations, and rhinorrhea as well. He denies chest pain, sore throat, nausea, vomiting, diarrhea. Vital signs significant for orthostatic hypotension in ED, heart rate controlled and NSR, afebrile, oxygen sat stable on room air. Lab work significant for AKI, hyperglycemia, elevated LFTs, trop 38, 31 indeterminate. He was Covid positive. He was given a 1 liter bolus in ED. He was admitted with Covid-19 and orthostatic hypotension for further monitoring and treatment as needed.  Patient was admitted remained stable throughout his stay he never had significant physical symptoms from the COVID-19.  His inflammatory markers did not require acute intervention.  He remained stable and was seen on the day of discharge anxious to go home.  He was evaluated by Physical and Occupational therapy who recommended home with no skilled services.  He could return to his regular medications as previously ordered.  He could return to diet and activity as tolerated.  He was cautioned that given his COVID-19 infection he was to make sure he was getting plenty of rest for the next 2-4 weeks.  He understood all these instructions and was discharged home in stable condition.   32 minutes were spent discharging this patient over 50% of this was spent in face-to-face counseling and coordination of care
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sinus rhythm, Supraventricular tachycardia, Troponin
Clinical narrative: Discharge Provider:  DO Primary Care Provider at Discharge:  MD   Admission Date: 9/4/2023 Discharge Date: 9/6/2023  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Orthostatic hypotension [I95.1] COVID [U07.1] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 84 year old male with a history of HLD, DM 2, CKD stage 3. He was admitted for chest pain, NSTEMI, on 8/31, had a dobutamine stress test and post infusion developed atrial fib with RVR, alternated with NSR, SVT. Rhythm management took several days and he was discharged with the addition of metoprolol succinate and apixaban on 9/3. History of hypotension with metoprolol in past. He returned to the ED on 9/4 with increased cough overnight, feeling of low blood pressure with dizziness and feeling "out of it". He reports a decreased appetite, shortness of breath, palpitations, and rhinorrhea as well. He denies chest pain, sore throat, nausea, vomiting, diarrhea. Vital signs significant for orthostatic hypotension in ED, heart rate controlled and NSR, afebrile, oxygen sat stable on room air. Lab work significant for AKI, hyperglycemia, elevated LFTs, trop 38, 31 indeterminate. He was Covid positive. He was given a 1 liter bolus in ED. He was admitted with Covid-19 and orthostatic hypotension for further monitoring and treatment as needed.  Patient was admitted remained stable throughout his stay he never had significant physical symptoms from the COVID-19.  His inflammatory markers did not require acute intervention.  He remained stable and was seen on the day of discharge anxious to go home.  He was evaluated by Physical and Occupational therapy who recommended home with no skilled services.  He could return to his regular medications as previously ordered.  He could return to diet and activity as tolerated.  He was cautioned that given his COVID-19 infection he was to make sure he was getting plenty of rest for the next 2-4 weeks.  He understood all these instructions and was discharged home in stable condition.   32 minutes were spent discharging this patient over 50% of this was spent in face-to-face counseling and coordination of care
Age: 67.0
Sex: M
Vaccine: COVID19, FLU4, RSV
Symptoms: Angiogram, Blood glucose increased, Fall, Gait disturbance, Hyperhidrosis
Clinical narrative: I got out of bed at 5:10 am, and tried to make it to the bathroom to void, falling to the right 3 times en route. I was stable while sitting and voiding but again experienced instability trying to walk back to bed in the dark.   I did take 3 aspirin.   I developed severe diaphoresis, dry heaves on 3 separate occasions usually after trying to walk. I had no problems with finger to nose, arm drift, leg instability and according to my wife, no nystagmus.  I was able to balance on each foot individually, but still had a perception of a tendency to veer to the right while walking. My wife drove me to the ER and I was stable if still.  Nausea improved with Zofran. Instability resolved with Meclizine. Labs and CT angiography was essentially normal. Glu was 204 with known diabetes, although slightly higher than expected, perhaps related to vomiting etc.
Age: 67.0
Sex: M
Vaccine: COVID19, FLU4, RSV
Symptoms: Nausea, Retching, Vomiting
Clinical narrative: I got out of bed at 5:10 am, and tried to make it to the bathroom to void, falling to the right 3 times en route. I was stable while sitting and voiding but again experienced instability trying to walk back to bed in the dark.   I did take 3 aspirin.   I developed severe diaphoresis, dry heaves on 3 separate occasions usually after trying to walk. I had no problems with finger to nose, arm drift, leg instability and according to my wife, no nystagmus.  I was able to balance on each foot individually, but still had a perception of a tendency to veer to the right while walking. My wife drove me to the ER and I was stable if still.  Nausea improved with Zofran. Instability resolved with Meclizine. Labs and CT angiography was essentially normal. Glu was 204 with known diabetes, although slightly higher than expected, perhaps related to vomiting etc.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Angiogram pulmonary normal, Blood creatinine increased, Blood lactic acid normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 9/4/2023 Discharge Date: 9/6/23 Discharge Disposition:  home health care svc   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AKI (acute kidney injury) [N17.9] COVID-19 [U07.1] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 67 y.o. male past medical history former smoker, COPD, currently undergoing treatment for NSCLC post LLL resection in June 2022 who presents with increased cough, fatigue and congestion.   Patient lives at home with decreased outside exposure. At baseline he wears 3 L n/c upon getting up and ambulating in his garage and with increased level of activity around his house. He reports some infrequent monitoring of pulse ox in which he usually ranges from 96- 88% on RA. He reports the lowest he has observed is 85%. Patient reported he has a housemate who had gone on a trip from 8/27-8/31 and upon returning home has congestion in which was contributed to his allergies. The patient noticed later in the night and early am of 9/1, he began coughing with increased congestion. Patient reported continued increase of symptoms with decreased appetite. He denies nausea, vomiting or fever. Due to continued cough he called EMS this am because he "just couldn't take it" any longer. EMS gave patient breathing treatment enroute and continued him on 3L n/c as he was wearing at home.    In the Emergency Department, patient continued to remain tachycardic and tachypneic therefore remaining on 3 L nasal cannula with an oxygen saturation of 96-98%.  Laboratory testing showed mild renal insufficiency with slightly elevated creatinine of 1.42 and positive COVID testing.  Other laboratory testing was unremarkable.  CT angiogram thorax was completed and showed no evidence of PE, coronary artery disease, pulmonary emphysema, and stable postoperative changes of the left lower lobectomy.  EKG was performed and showed sinus tachycardia with a heart rate of 125. Lactic acid was within normal.  Troponin level was negative.  Patient was given Tessalon capsule, dual nebs and IV fluid bolus with Decadron for treatment of hypoxic COVID.  Admission to the hospitalist service was accepted for continued care and treatment.     He had improvement with steroids and declined therapy evaluation. He was discharged on his home oxygen requirements in stable conditions to home.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Decreased appetite, Electrocardiogram abnormal, Fatigue
Clinical narrative: BRIEF OVERVIEW: Admission Date: 9/4/2023 Discharge Date: 9/6/23 Discharge Disposition:  home health care svc   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AKI (acute kidney injury) [N17.9] COVID-19 [U07.1] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 67 y.o. male past medical history former smoker, COPD, currently undergoing treatment for NSCLC post LLL resection in June 2022 who presents with increased cough, fatigue and congestion.   Patient lives at home with decreased outside exposure. At baseline he wears 3 L n/c upon getting up and ambulating in his garage and with increased level of activity around his house. He reports some infrequent monitoring of pulse ox in which he usually ranges from 96- 88% on RA. He reports the lowest he has observed is 85%. Patient reported he has a housemate who had gone on a trip from 8/27-8/31 and upon returning home has congestion in which was contributed to his allergies. The patient noticed later in the night and early am of 9/1, he began coughing with increased congestion. Patient reported continued increase of symptoms with decreased appetite. He denies nausea, vomiting or fever. Due to continued cough he called EMS this am because he "just couldn't take it" any longer. EMS gave patient breathing treatment enroute and continued him on 3L n/c as he was wearing at home.    In the Emergency Department, patient continued to remain tachycardic and tachypneic therefore remaining on 3 L nasal cannula with an oxygen saturation of 96-98%.  Laboratory testing showed mild renal insufficiency with slightly elevated creatinine of 1.42 and positive COVID testing.  Other laboratory testing was unremarkable.  CT angiogram thorax was completed and showed no evidence of PE, coronary artery disease, pulmonary emphysema, and stable postoperative changes of the left lower lobectomy.  EKG was performed and showed sinus tachycardia with a heart rate of 125. Lactic acid was within normal.  Troponin level was negative.  Patient was given Tessalon capsule, dual nebs and IV fluid bolus with Decadron for treatment of hypoxic COVID.  Admission to the hospitalist service was accepted for continued care and treatment.     He had improvement with steroids and declined therapy evaluation. He was discharged on his home oxygen requirements in stable conditions to home.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Renal failure, Respiratory tract congestion, SARS-CoV-2 test positive, Sinus tachycardia
Clinical narrative: BRIEF OVERVIEW: Admission Date: 9/4/2023 Discharge Date: 9/6/23 Discharge Disposition:  home health care svc   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AKI (acute kidney injury) [N17.9] COVID-19 [U07.1] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 67 y.o. male past medical history former smoker, COPD, currently undergoing treatment for NSCLC post LLL resection in June 2022 who presents with increased cough, fatigue and congestion.   Patient lives at home with decreased outside exposure. At baseline he wears 3 L n/c upon getting up and ambulating in his garage and with increased level of activity around his house. He reports some infrequent monitoring of pulse ox in which he usually ranges from 96- 88% on RA. He reports the lowest he has observed is 85%. Patient reported he has a housemate who had gone on a trip from 8/27-8/31 and upon returning home has congestion in which was contributed to his allergies. The patient noticed later in the night and early am of 9/1, he began coughing with increased congestion. Patient reported continued increase of symptoms with decreased appetite. He denies nausea, vomiting or fever. Due to continued cough he called EMS this am because he "just couldn't take it" any longer. EMS gave patient breathing treatment enroute and continued him on 3L n/c as he was wearing at home.    In the Emergency Department, patient continued to remain tachycardic and tachypneic therefore remaining on 3 L nasal cannula with an oxygen saturation of 96-98%.  Laboratory testing showed mild renal insufficiency with slightly elevated creatinine of 1.42 and positive COVID testing.  Other laboratory testing was unremarkable.  CT angiogram thorax was completed and showed no evidence of PE, coronary artery disease, pulmonary emphysema, and stable postoperative changes of the left lower lobectomy.  EKG was performed and showed sinus tachycardia with a heart rate of 125. Lactic acid was within normal.  Troponin level was negative.  Patient was given Tessalon capsule, dual nebs and IV fluid bolus with Decadron for treatment of hypoxic COVID.  Admission to the hospitalist service was accepted for continued care and treatment.     He had improvement with steroids and declined therapy evaluation. He was discharged on his home oxygen requirements in stable conditions to home.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Tachycardia, Tachypnoea, Troponin normal
Clinical narrative: BRIEF OVERVIEW: Admission Date: 9/4/2023 Discharge Date: 9/6/23 Discharge Disposition:  home health care svc   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: AKI (acute kidney injury) [N17.9] COVID-19 [U07.1] Acute respiratory failure due to COVID-19 [U07.1, J96.00]   HOSPITAL COURSE: Patient is a 67 y.o. male past medical history former smoker, COPD, currently undergoing treatment for NSCLC post LLL resection in June 2022 who presents with increased cough, fatigue and congestion.   Patient lives at home with decreased outside exposure. At baseline he wears 3 L n/c upon getting up and ambulating in his garage and with increased level of activity around his house. He reports some infrequent monitoring of pulse ox in which he usually ranges from 96- 88% on RA. He reports the lowest he has observed is 85%. Patient reported he has a housemate who had gone on a trip from 8/27-8/31 and upon returning home has congestion in which was contributed to his allergies. The patient noticed later in the night and early am of 9/1, he began coughing with increased congestion. Patient reported continued increase of symptoms with decreased appetite. He denies nausea, vomiting or fever. Due to continued cough he called EMS this am because he "just couldn't take it" any longer. EMS gave patient breathing treatment enroute and continued him on 3L n/c as he was wearing at home.    In the Emergency Department, patient continued to remain tachycardic and tachypneic therefore remaining on 3 L nasal cannula with an oxygen saturation of 96-98%.  Laboratory testing showed mild renal insufficiency with slightly elevated creatinine of 1.42 and positive COVID testing.  Other laboratory testing was unremarkable.  CT angiogram thorax was completed and showed no evidence of PE, coronary artery disease, pulmonary emphysema, and stable postoperative changes of the left lower lobectomy.  EKG was performed and showed sinus tachycardia with a heart rate of 125. Lactic acid was within normal.  Troponin level was negative.  Patient was given Tessalon capsule, dual nebs and IV fluid bolus with Decadron for treatment of hypoxic COVID.  Admission to the hospitalist service was accepted for continued care and treatment.     He had improvement with steroids and declined therapy evaluation. He was discharged on his home oxygen requirements in stable conditions to home.
Age: 35.0
Sex: F
Vaccine: FLU4
Symptoms: Burning sensation, Feeling hot, Hypersensitivity, Rash, Urticaria
Clinical narrative: 20 min after injection patient developed. a rash/hives mid chest to laterally of right chest wall and mid axilla. This also occurred upon her neck and face. She described a burning, "hot" sensation over her chest, neck, face and down her right arm. She was taken to the ER via her supervisor, admitted to the ER, given IVF's, steroids and Benadryl. She was monitored and was released later. MD stated she had an allergic reaction to this vaccine. She has had many Flu vaccines over the years and never had a reaction before.
Age: 62.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site reaction, Lymph node pain, Lymphadenopathy, Rash erythematous
Clinical narrative: Patient noticed that there was a small red rash around the injection site 2 days after injection and reported that her lymph node near her armpit was swollen and tender.