chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 88.0
Sex: M
Vaccine: COVID19-2, FLU4, COVID19-2, FLU4, VARZOS
Symptoms: Agitation, Arthralgia, Back pain, COVID-19, COVID-19 pneumonia
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: Admission Date: 1/6/2023 Discharge Date: 01/07/2023 COVID positive date: 01/06/2023 Chief Complaint Patient presents with ? WEAKNESS         HOSPITAL COURSE     Patient is an 88-year-old man in admitted to hospital with generalized weakness in the setting of COVID infection. Patient was admitted January 6, 2023 for evaluation with physical therapy and occupational therapy. Upon presentation the patient was found to have stable vital signs and overall unremarkable labs. He was a bit confused and disoriented on his presentation. As he was COVID positive it is likely that this viral infection as source of the patient?s symptoms. He is not hypoxic and has had symptoms for couple of days without a candidate for Decadron or remdesivir patient did work physical therapy and occupational therapy on January 7th is recommended patient return home with home health care. This time he is clinically stable. Patient is oriented x4 and would like to return home.
Age: 88.0
Sex: M
Vaccine: COVID19-2, FLU4, COVID19-2, FLU4, VARZOS
Symptoms: Computerised tomogram head normal, Computerised tomogram neck, Computerised tomogram spine, Confusional state, Death
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: Admission Date: 1/6/2023 Discharge Date: 01/07/2023 COVID positive date: 01/06/2023 Chief Complaint Patient presents with ? WEAKNESS         HOSPITAL COURSE     Patient is an 88-year-old man in admitted to hospital with generalized weakness in the setting of COVID infection. Patient was admitted January 6, 2023 for evaluation with physical therapy and occupational therapy. Upon presentation the patient was found to have stable vital signs and overall unremarkable labs. He was a bit confused and disoriented on his presentation. As he was COVID positive it is likely that this viral infection as source of the patient?s symptoms. He is not hypoxic and has had symptoms for couple of days without a candidate for Decadron or remdesivir patient did work physical therapy and occupational therapy on January 7th is recommended patient return home with home health care. This time he is clinically stable. Patient is oriented x4 and would like to return home.
Age: 88.0
Sex: M
Vaccine: COVID19-2, FLU4, COVID19-2, FLU4, VARZOS
Symptoms: Delirium, Dysphagia, Epiglottitis, Fall, Fracture
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: Admission Date: 1/6/2023 Discharge Date: 01/07/2023 COVID positive date: 01/06/2023 Chief Complaint Patient presents with ? WEAKNESS         HOSPITAL COURSE     Patient is an 88-year-old man in admitted to hospital with generalized weakness in the setting of COVID infection. Patient was admitted January 6, 2023 for evaluation with physical therapy and occupational therapy. Upon presentation the patient was found to have stable vital signs and overall unremarkable labs. He was a bit confused and disoriented on his presentation. As he was COVID positive it is likely that this viral infection as source of the patient?s symptoms. He is not hypoxic and has had symptoms for couple of days without a candidate for Decadron or remdesivir patient did work physical therapy and occupational therapy on January 7th is recommended patient return home with home health care. This time he is clinically stable. Patient is oriented x4 and would like to return home.
Age: 88.0
Sex: M
Vaccine: COVID19-2, FLU4, COVID19-2, FLU4, VARZOS
Symptoms: Hypophagia, Lumbar vertebral fracture, Oropharyngeal pain, Scan with contrast abnormal, Spinal compression fracture
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: Admission Date: 1/6/2023 Discharge Date: 01/07/2023 COVID positive date: 01/06/2023 Chief Complaint Patient presents with ? WEAKNESS         HOSPITAL COURSE     Patient is an 88-year-old man in admitted to hospital with generalized weakness in the setting of COVID infection. Patient was admitted January 6, 2023 for evaluation with physical therapy and occupational therapy. Upon presentation the patient was found to have stable vital signs and overall unremarkable labs. He was a bit confused and disoriented on his presentation. As he was COVID positive it is likely that this viral infection as source of the patient?s symptoms. He is not hypoxic and has had symptoms for couple of days without a candidate for Decadron or remdesivir patient did work physical therapy and occupational therapy on January 7th is recommended patient return home with home health care. This time he is clinically stable. Patient is oriented x4 and would like to return home.
Age: 88.0
Sex: M
Vaccine: COVID19-2, FLU4, COVID19-2, FLU4, VARZOS
Symptoms: Streptococcus test negative, X-ray limb normal
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: Admission Date: 1/6/2023 Discharge Date: 01/07/2023 COVID positive date: 01/06/2023 Chief Complaint Patient presents with ? WEAKNESS         HOSPITAL COURSE     Patient is an 88-year-old man in admitted to hospital with generalized weakness in the setting of COVID infection. Patient was admitted January 6, 2023 for evaluation with physical therapy and occupational therapy. Upon presentation the patient was found to have stable vital signs and overall unremarkable labs. He was a bit confused and disoriented on his presentation. As he was COVID positive it is likely that this viral infection as source of the patient?s symptoms. He is not hypoxic and has had symptoms for couple of days without a candidate for Decadron or remdesivir patient did work physical therapy and occupational therapy on January 7th is recommended patient return home with home health care. This time he is clinically stable. Patient is oriented x4 and would like to return home.
Age: 31.0
Sex: F
Vaccine: FLUR4
Symptoms: Injection site bruising, Product storage error
Clinical narrative: Site: Bruising at Injection Site-Mild, Additional Details: vaccine refrigerator temperature is outside the recommended range
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: pt was given an expired vaccine due to local vaccine recording having incorrect manufactures expiration date listed on site
Age: 29.0
Sex: F
Vaccine: HEP
Symptoms: Underdose
Clinical narrative: Adult client was given child dose of intended Adult dose Hep B
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Anxiety, Dizziness, Injection site bruising, Injection site haemorrhage, Injection site swelling
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Additional Details: Administered Shingrix vaccine in left deltoid. After admin, injection site started to bleed. I applied a cottonball to which stopped bleeding. When I removed cottonball, injection site appeared slightly swollen and bruised. Pt. stated she had no pain. I asked my supervising pharmacist to look at it. We then applied an ice pack and gave pt. water as she stated she felt a bit lightheaded, but she said was likely due to her feeling a bit anxious/nervous. Observed & she felt better when she left.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Nervousness
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Additional Details: Administered Shingrix vaccine in left deltoid. After admin, injection site started to bleed. I applied a cottonball to which stopped bleeding. When I removed cottonball, injection site appeared slightly swollen and bruised. Pt. stated she had no pain. I asked my supervising pharmacist to look at it. We then applied an ice pack and gave pt. water as she stated she felt a bit lightheaded, but she said was likely due to her feeling a bit anxious/nervous. Observed & she felt better when she left.
Age: 85.0
Sex: F
Vaccine: FLUA4
Symptoms: Injection site pain
Clinical narrative: Site: Pain at Injection Site-Mild
Age: 29.0
Sex: M
Vaccine: COVID19-2
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Error: Dose in Series Given Too Early-
Age: 7.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Error - Discovered after vaccine administration that the Pfizer Bivalent Covid vaccine for ages 5 to 11 years was not diluted as instructed so patient received a higher than intended dose.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient should have received Pfizer Bivalent, however, the Pfizer monovalent was administered.  Pharmacist was working on 1/8/23 when she noticed that monovalent and bivalent Pfizer vaccines were mixed in the same basket.  She compared lot numbers for vaccines administered from 12/28/22 (when the monovalent box was opened) through 1/8/23 and discovered this error.
Age: 49.0
Sex: M
Vaccine: COVID19-2
Symptoms: Bradycardia, Dizziness, Flushing, Hyperhidrosis, Hypotension
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Systemic: Bradycardia-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Additional Details: After receiving vaccine, pt was sitting in waiting room; then family member alerted nurse that pt was feeling dizzy. Nurse & NP assessed pt; pt was alert, awake, conversant, diaphoretic, pulse in 40-50s, with low BP. Pt had vasovagal response, without syncope. Pt recovered after a few minutes & reported that he always has anxiety with needles/vaccines.
Age: 49.0
Sex: M
Vaccine: COVID19-2
Symptoms: Presyncope
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Systemic: Bradycardia-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Additional Details: After receiving vaccine, pt was sitting in waiting room; then family member alerted nurse that pt was feeling dizzy. Nurse & NP assessed pt; pt was alert, awake, conversant, diaphoretic, pulse in 40-50s, with low BP. Pt had vasovagal response, without syncope. Pt recovered after a few minutes & reported that he always has anxiety with needles/vaccines.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cardiac monitoring normal, Cerebrovascular accident, Coagulation test normal, Echocardiogram normal, Hemiparesis
Clinical narrative: Right temporal lobe stroke on 10/7/22, symptoms included left hand numbness, and weakness in left arm and left leg through 10/10/22.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypoaesthesia, Implantable cardiac monitor insertion, Laboratory test normal, Ultrasound Doppler normal
Clinical narrative: Right temporal lobe stroke on 10/7/22, symptoms included left hand numbness, and weakness in left arm and left leg through 10/10/22.
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: COVID diagnosis on 11/28/2022
Age: 11.0
Sex: M
Vaccine: MNQ
Symptoms: Disorientation, Dizziness, Flushing, Head injury, Hyperhidrosis
Clinical narrative: Site: Pain at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: All occured right after administration of both vaccines on 01/07/2023. Pt was sitting on the chair and was feeling light headed and tipped over on the chair and hit is head on the wall. Was disoriented for a few minutes and came to. Was able to breath and was sweating profusely. Mother wanted to contact her PCP before calling EMS. She decided to take her son to the ER herself without me contacting EMS. Epipen was not used due to the patient was not having anaphylaxsis and was able to breathe.
Age: 11.0
Sex: M
Vaccine: MNQ
Symptoms: Injection site pain, Injection site swelling, Posture abnormal
Clinical narrative: Site: Pain at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Additional Details: All occured right after administration of both vaccines on 01/07/2023. Pt was sitting on the chair and was feeling light headed and tipped over on the chair and hit is head on the wall. Was disoriented for a few minutes and came to. Was able to breath and was sweating profusely. Mother wanted to contact her PCP before calling EMS. She decided to take her son to the ER herself without me contacting EMS. Epipen was not used due to the patient was not having anaphylaxsis and was able to breathe.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood culture, COVID-19, COVID-19 pneumonia, Cellulitis
Clinical narrative: Hospital Course:  This is a 73 year man with hx of cerebral palsy and chronic bilateral lower extremity weakness presented with cough and generalized weakness for 1 day prior to admission. Patient also develop fever, and fell using  toilet prior to admission. He felt too weak to get up, and called EMS.     He was evaluated in the ER, found to have COVID 19 infection and sepsis.  He was given 1L of normal saline.  They discussed returning home vs observation stay for generalized weakness and COVID 19 infection and he preferred to stay overnight as he lives alone.   Of note, he had a stroke 12/7 and discharged on ASA and Plavix but was only taking the Plavix once every other day due to upset stomach.  He also has asymmetric leg swelling, right leg larger and slightly red/warm compared to the left.  Blood cultures were obtained.  Venous duplex was negative for DVT.    Patient was treated for Enterococcus UTI with Macrobid for 3 days. For RLE cellulitis, patient was transitioned from ceftriaxone to Keflex for 5 more days to complete 7 days of treatment. For COVID pneumonia, patient briefly required supplemental oxygen and was placed on dexamethasone. As patient's oxygen needs improved to room air, dexamethasone was not prescribed at discharge.    Patient was discharged to Home with services - Nursing in stable condition.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Erythema, Fall, Mobility decreased
Clinical narrative: Hospital Course:  This is a 73 year man with hx of cerebral palsy and chronic bilateral lower extremity weakness presented with cough and generalized weakness for 1 day prior to admission. Patient also develop fever, and fell using  toilet prior to admission. He felt too weak to get up, and called EMS.     He was evaluated in the ER, found to have COVID 19 infection and sepsis.  He was given 1L of normal saline.  They discussed returning home vs observation stay for generalized weakness and COVID 19 infection and he preferred to stay overnight as he lives alone.   Of note, he had a stroke 12/7 and discharged on ASA and Plavix but was only taking the Plavix once every other day due to upset stomach.  He also has asymmetric leg swelling, right leg larger and slightly red/warm compared to the left.  Blood cultures were obtained.  Venous duplex was negative for DVT.    Patient was treated for Enterococcus UTI with Macrobid for 3 days. For RLE cellulitis, patient was transitioned from ceftriaxone to Keflex for 5 more days to complete 7 days of treatment. For COVID pneumonia, patient briefly required supplemental oxygen and was placed on dexamethasone. As patient's oxygen needs improved to room air, dexamethasone was not prescribed at discharge.    Patient was discharged to Home with services - Nursing in stable condition.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Peripheral swelling, Pyrexia, Sepsis, Skin warm, Ultrasound Doppler normal
Clinical narrative: Hospital Course:  This is a 73 year man with hx of cerebral palsy and chronic bilateral lower extremity weakness presented with cough and generalized weakness for 1 day prior to admission. Patient also develop fever, and fell using  toilet prior to admission. He felt too weak to get up, and called EMS.     He was evaluated in the ER, found to have COVID 19 infection and sepsis.  He was given 1L of normal saline.  They discussed returning home vs observation stay for generalized weakness and COVID 19 infection and he preferred to stay overnight as he lives alone.   Of note, he had a stroke 12/7 and discharged on ASA and Plavix but was only taking the Plavix once every other day due to upset stomach.  He also has asymmetric leg swelling, right leg larger and slightly red/warm compared to the left.  Blood cultures were obtained.  Venous duplex was negative for DVT.    Patient was treated for Enterococcus UTI with Macrobid for 3 days. For RLE cellulitis, patient was transitioned from ceftriaxone to Keflex for 5 more days to complete 7 days of treatment. For COVID pneumonia, patient briefly required supplemental oxygen and was placed on dexamethasone. As patient's oxygen needs improved to room air, dexamethasone was not prescribed at discharge.    Patient was discharged to Home with services - Nursing in stable condition.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary tract infection enterococcal
Clinical narrative: Hospital Course:  This is a 73 year man with hx of cerebral palsy and chronic bilateral lower extremity weakness presented with cough and generalized weakness for 1 day prior to admission. Patient also develop fever, and fell using  toilet prior to admission. He felt too weak to get up, and called EMS.     He was evaluated in the ER, found to have COVID 19 infection and sepsis.  He was given 1L of normal saline.  They discussed returning home vs observation stay for generalized weakness and COVID 19 infection and he preferred to stay overnight as he lives alone.   Of note, he had a stroke 12/7 and discharged on ASA and Plavix but was only taking the Plavix once every other day due to upset stomach.  He also has asymmetric leg swelling, right leg larger and slightly red/warm compared to the left.  Blood cultures were obtained.  Venous duplex was negative for DVT.    Patient was treated for Enterococcus UTI with Macrobid for 3 days. For RLE cellulitis, patient was transitioned from ceftriaxone to Keflex for 5 more days to complete 7 days of treatment. For COVID pneumonia, patient briefly required supplemental oxygen and was placed on dexamethasone. As patient's oxygen needs improved to room air, dexamethasone was not prescribed at discharge.    Patient was discharged to Home with services - Nursing in stable condition.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Asthenia, COVID-19, COVID-19 pneumonia
Clinical narrative: Discharge Provider: MD  Primary Care Provider : MD    Admitting Service: Internal Medicine Service Admission Date: 1/5/2023 Discharge Date: 01/08/2023 COVID positive 01/05/2023 PRESENTING PROBLEM:  Hypoxia [R09.02] Chronic obstructive pulmonary disease with (acute) exacerbation (HCC) [J44.1] Acute hypoxemic respiratory failure (HCC) [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE:    79 y.o. female who presented with SOB and generalized weakness/fatigue. Pt. has a PMH of HTN, lymph edema, COPD. Pt. reports for the past two to three days she has had a nonproductive cough, SOB, generalized fatigue/weakness. She had an appointment with her PCP scheduled for today and she was found to be hypoxic in the 80s for which she was then sent to the ED. Pt. has since been sating well on 2L supplemental O2. Labs with elevated D dimer and positive COVID. CT angio thorax consistent with COVID pneumonia, no evidence of PE. Pt. was given solumedrol in the ED.  during the hospitalization received couple of doses of remdesivir and dexamethasone, did not have any more shortness of breath, did not require any more oxygen, doing well discharge home today in stable condition.  Instructions discussed in detail with patient verbalized understanding.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dyspnoea, Fatigue
Clinical narrative: Discharge Provider: MD  Primary Care Provider : MD    Admitting Service: Internal Medicine Service Admission Date: 1/5/2023 Discharge Date: 01/08/2023 COVID positive 01/05/2023 PRESENTING PROBLEM:  Hypoxia [R09.02] Chronic obstructive pulmonary disease with (acute) exacerbation (HCC) [J44.1] Acute hypoxemic respiratory failure (HCC) [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE:    79 y.o. female who presented with SOB and generalized weakness/fatigue. Pt. has a PMH of HTN, lymph edema, COPD. Pt. reports for the past two to three days she has had a nonproductive cough, SOB, generalized fatigue/weakness. She had an appointment with her PCP scheduled for today and she was found to be hypoxic in the 80s for which she was then sent to the ED. Pt. has since been sating well on 2L supplemental O2. Labs with elevated D dimer and positive COVID. CT angio thorax consistent with COVID pneumonia, no evidence of PE. Pt. was given solumedrol in the ED.  during the hospitalization received couple of doses of remdesivir and dexamethasone, did not have any more shortness of breath, did not require any more oxygen, doing well discharge home today in stable condition.  Instructions discussed in detail with patient verbalized understanding.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Fibrin D dimer increased, Hypoxia, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD  Primary Care Provider : MD    Admitting Service: Internal Medicine Service Admission Date: 1/5/2023 Discharge Date: 01/08/2023 COVID positive 01/05/2023 PRESENTING PROBLEM:  Hypoxia [R09.02] Chronic obstructive pulmonary disease with (acute) exacerbation (HCC) [J44.1] Acute hypoxemic respiratory failure (HCC) [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE:    79 y.o. female who presented with SOB and generalized weakness/fatigue. Pt. has a PMH of HTN, lymph edema, COPD. Pt. reports for the past two to three days she has had a nonproductive cough, SOB, generalized fatigue/weakness. She had an appointment with her PCP scheduled for today and she was found to be hypoxic in the 80s for which she was then sent to the ED. Pt. has since been sating well on 2L supplemental O2. Labs with elevated D dimer and positive COVID. CT angio thorax consistent with COVID pneumonia, no evidence of PE. Pt. was given solumedrol in the ED.  during the hospitalization received couple of doses of remdesivir and dexamethasone, did not have any more shortness of breath, did not require any more oxygen, doing well discharge home today in stable condition.  Instructions discussed in detail with patient verbalized understanding.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Wrong product administered
Clinical narrative: Error: Wrong Vaccine/Product Administered-
Age: 15.0
Sex: F
Vaccine: COVID19, HPV9
Symptoms: Trismus
Clinical narrative: Lockjaw was diagnosed November 18. However, prior symptoms had started several weeks before.
Age: 13.0
Sex: M
Vaccine: MMRV, TDAP
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Client recieved MMRV Proquad on 01/09/2023 approx 4:20pm. Client was 13 years and 22 days at time of adminstration so this is considered a vaccine administration error as Proquad is only licensed through 12 years of age. Client tolerated well, no adverse reactions noted during 15 minute wait period in clinic.  Vaccine program was notified on 01/10/2023 . EMail stated "dose does not need to be repeated, series is complete,  no safety concerns, Proquad has not been studied in patients over the age of 12 years, but no reason to think it is ineffective. ". RN relayed this information to the mother of client via telephone call on 01/11/2023 at 9:50am. At that time client has experienced no side effects from vaccinations. Mother will notify clinic over the next 10 days if client experiencing significant side effects.
Age: 70.0
Sex: M
Vaccine: FLU4
Symptoms: Injection site bruising, Product storage error
Clinical narrative: Site: Bruising at Injection Site-Mild, Additional Details: vaccine refrigerator temperature outside the recommended range
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient should have received Pfizer Bivalent, however, the Pfizer monovalent was administered.  Pharmacist was working on 1/8/23 when she noticed that monovalent and bivalent Pfizer vaccines were mixed in the same basket.  She compared lot numbers for vaccines administered from 12/28/22 (when the monovalent box was opened) through 1/8/23 and discovered this error.
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Chest discomfort, Chest pain, Dizziness, Dyspnoea, Eye swelling
Clinical narrative: Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Nausea-Mild
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Injection site swelling, Lethargy, Mouth swelling, Nausea
Clinical narrative: Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Nausea-Mild
Age: 67.0
Sex: F
Vaccine: VARZOS
Symptoms: Swelling face, Swollen tongue
Clinical narrative: Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Exhaustion / Lethargy-Mild, Systemic: Nausea-Mild
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Brain natriuretic peptide normal, COVID-19, Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal
Clinical narrative: DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia  [J96.21] Chronic obstructive pulmonary disease, unspecified COPD type  [J44.9] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 70 y/o male with history of COPD, ILD and amiodarone toxicity, chronic oxygen use, DM, HTN and PAF. He presented to the ER on 1/2/2023 with increased dyspnea on exertion and hypoxia with exertion. He is on 3L NC at baseline and on arrival to the ER was requiring up to 6L NC. He tested positive for COVID at home on 12/24 and completed a course of Paxlovid outpatient on 1/1.    In the ER he had CT that showed no PE, mild diffuse ground glass opacities superimposed upon pulmonary fibrosis which could be related to atypical pneumonia. He had slightly elevated WBC and normal BNP. His other labs were fairly unremarkable. He was admitted to the hospitalist team due to his increased oxygen needs. He was started on decadron in the ER. After admission his pulmonologist was contacted who recommended treatment with solumedrol 1mg/kg while hospitalized and transition to prednisone 60 mg daily at discharge. The patient's oxygen needs returned to baseline quickly. He has close follow up with pulmonology next week. He will be discharged home on daily prednisone 60 mg with a slow taper until he can follow up with his pulmonologist. He was also encouraged to follow up with his PCP after discharge. The patient verbalized understanding of these instructions and discharged home in stable condition.     CONSULTANTS: Care management Pulmonology    INPATIENT PROCEDURES: None     BP 117/63  | Pulse 78  | Temp 36.5 °C (Oral)  | Resp 18  | Ht 1.702 m  | Wt 125.1 kg  | SpO2 90%  | BMI 43.20 kg/m²    Physical Exam Constitutional:      General: He is not in acute distress.    Appearance: He is obese. He is not diaphoretic.  HENT:     Head: Normocephalic and atraumatic.  Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.     Pulses: Normal pulses.     Heart sounds: Normal heart sounds.  Pulmonary:     Breath sounds: Normal breath sounds.     Comments: Mild tachypnea after walking around Abdominal:     Tenderness: There is no abdominal tenderness.  Musculoskeletal:     Right lower leg: No edema.     Left lower leg: No edema.  Skin:    General: Skin is warm and dry.  Neurological:     Mental Status: He is alert and oriented to person, place, and time.  Psychiatric:        Mood and Affect: Mood normal.        Behavior: Behavior normal.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Condition aggravated, Dyspnoea exertional, Hypoxia, Laboratory test normal, Lung opacity
Clinical narrative: DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia  [J96.21] Chronic obstructive pulmonary disease, unspecified COPD type  [J44.9] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 70 y/o male with history of COPD, ILD and amiodarone toxicity, chronic oxygen use, DM, HTN and PAF. He presented to the ER on 1/2/2023 with increased dyspnea on exertion and hypoxia with exertion. He is on 3L NC at baseline and on arrival to the ER was requiring up to 6L NC. He tested positive for COVID at home on 12/24 and completed a course of Paxlovid outpatient on 1/1.    In the ER he had CT that showed no PE, mild diffuse ground glass opacities superimposed upon pulmonary fibrosis which could be related to atypical pneumonia. He had slightly elevated WBC and normal BNP. His other labs were fairly unremarkable. He was admitted to the hospitalist team due to his increased oxygen needs. He was started on decadron in the ER. After admission his pulmonologist was contacted who recommended treatment with solumedrol 1mg/kg while hospitalized and transition to prednisone 60 mg daily at discharge. The patient's oxygen needs returned to baseline quickly. He has close follow up with pulmonology next week. He will be discharged home on daily prednisone 60 mg with a slow taper until he can follow up with his pulmonologist. He was also encouraged to follow up with his PCP after discharge. The patient verbalized understanding of these instructions and discharged home in stable condition.     CONSULTANTS: Care management Pulmonology    INPATIENT PROCEDURES: None     BP 117/63  | Pulse 78  | Temp 36.5 °C (Oral)  | Resp 18  | Ht 1.702 m  | Wt 125.1 kg  | SpO2 90%  | BMI 43.20 kg/m²    Physical Exam Constitutional:      General: He is not in acute distress.    Appearance: He is obese. He is not diaphoretic.  HENT:     Head: Normocephalic and atraumatic.  Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.     Pulses: Normal pulses.     Heart sounds: Normal heart sounds.  Pulmonary:     Breath sounds: Normal breath sounds.     Comments: Mild tachypnea after walking around Abdominal:     Tenderness: There is no abdominal tenderness.  Musculoskeletal:     Right lower leg: No edema.     Left lower leg: No edema.  Skin:    General: Skin is warm and dry.  Neurological:     Mental Status: He is alert and oriented to person, place, and time.  Psychiatric:        Mood and Affect: Mood normal.        Behavior: Behavior normal.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pulmonary fibrosis, Tachypnoea, White blood cell count increased
Clinical narrative: DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute on chronic respiratory failure with hypoxia  [J96.21] Chronic obstructive pulmonary disease, unspecified COPD type  [J44.9] COVID [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: HOSPITAL COURSE: Patient is a 70 y/o male with history of COPD, ILD and amiodarone toxicity, chronic oxygen use, DM, HTN and PAF. He presented to the ER on 1/2/2023 with increased dyspnea on exertion and hypoxia with exertion. He is on 3L NC at baseline and on arrival to the ER was requiring up to 6L NC. He tested positive for COVID at home on 12/24 and completed a course of Paxlovid outpatient on 1/1.    In the ER he had CT that showed no PE, mild diffuse ground glass opacities superimposed upon pulmonary fibrosis which could be related to atypical pneumonia. He had slightly elevated WBC and normal BNP. His other labs were fairly unremarkable. He was admitted to the hospitalist team due to his increased oxygen needs. He was started on decadron in the ER. After admission his pulmonologist was contacted who recommended treatment with solumedrol 1mg/kg while hospitalized and transition to prednisone 60 mg daily at discharge. The patient's oxygen needs returned to baseline quickly. He has close follow up with pulmonology next week. He will be discharged home on daily prednisone 60 mg with a slow taper until he can follow up with his pulmonologist. He was also encouraged to follow up with his PCP after discharge. The patient verbalized understanding of these instructions and discharged home in stable condition.     CONSULTANTS: Care management Pulmonology    INPATIENT PROCEDURES: None     BP 117/63  | Pulse 78  | Temp 36.5 °C (Oral)  | Resp 18  | Ht 1.702 m  | Wt 125.1 kg  | SpO2 90%  | BMI 43.20 kg/m²    Physical Exam Constitutional:      General: He is not in acute distress.    Appearance: He is obese. He is not diaphoretic.  HENT:     Head: Normocephalic and atraumatic.  Cardiovascular:     Rate and Rhythm: Normal rate and regular rhythm.     Pulses: Normal pulses.     Heart sounds: Normal heart sounds.  Pulmonary:     Breath sounds: Normal breath sounds.     Comments: Mild tachypnea after walking around Abdominal:     Tenderness: There is no abdominal tenderness.  Musculoskeletal:     Right lower leg: No edema.     Left lower leg: No edema.  Skin:    General: Skin is warm and dry.  Neurological:     Mental Status: He is alert and oriented to person, place, and time.  Psychiatric:        Mood and Affect: Mood normal.        Behavior: Behavior normal.
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Unevaluable event
Clinical narrative: hospitalization
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Biopsy, Computerised tomogram, Diplopia, Eyelid ptosis, Gait disturbance
Clinical narrative: It was about 11PM and my nephew needed gas and my wife was driving and I noticed that my left eye was odd, and I could not see correctly. I was having double vision and it was affecting me so much that to walk I had to close my left eye and not use my left eye. It was also looking down and to the right and the eye lid was swollen and drooping. We came home from the holidays, and I ended up going to my optometrist the day or two after I got home. He sent me to the hospital and said I may end up being there for a few days as he was concerned this was potentially very serious. I was in the hospital for a few days, and they did end up doing a biopsy. At this point they have ruled out cancer, a blood clot, a stroke. I do have a follow up to go over what the biopsy shows.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Laboratory test, Magnetic resonance imaging, Swelling of eyelid
Clinical narrative: It was about 11PM and my nephew needed gas and my wife was driving and I noticed that my left eye was odd, and I could not see correctly. I was having double vision and it was affecting me so much that to walk I had to close my left eye and not use my left eye. It was also looking down and to the right and the eye lid was swollen and drooping. We came home from the holidays, and I ended up going to my optometrist the day or two after I got home. He sent me to the hospital and said I may end up being there for a few days as he was concerned this was potentially very serious. I was in the hospital for a few days, and they did end up doing a biopsy. At this point they have ruled out cancer, a blood clot, a stroke. I do have a follow up to go over what the biopsy shows.
Age: 44.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Injection site pain, Injection site swelling, Limb injury, Paraesthesia
Clinical narrative: Site: Pain at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Joint Pain-Severe, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fall, Gait disturbance, Limb injury
Clinical narrative: Systemic: patient fell upon standing after vaccine administration-Mild, Additional Details: patient fell upon standing after recieving the vaccine and hurt shoulder. The vaccine was administered to the patient in the chair in the waiting room because he is extremely unsteady on his feet and could not make it into the vaccine room for vaccine administration.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, Chills
Clinical narrative: Discharge Provider: MD Primary Care Provider:MD Admission Date: 1/4/2023 Discharge Date: 1/7/23 COVID positive date: 01/04/2023  PRESENTING PROBLEM: Lung nodule  Hypoxia  Acute hypoxemic respiratory failure  Nausea and vomiting, unspecified vomiting type Respiratory tract infection due to COVID-19 virus    HOSPITAL COURSE: 65-year-old female with possible history of combined systolic and diastolic CHF with EF 10% status post ICD, AFib on Eliquis, hypertension, CKD 3, dyslipidemia.  Patient admitted with COVID and acute hypoxic respiratory failure after presenting with shortness of breath, cough, congestion, abdominal pain, nausea and chills.  She tested positive for COVID and was given a dose of Decadron.  She was initially hypoxic with ambulation and required 3 L of supplemental oxygen but was weaned back to room air prior to discharge.  CT abdomen and pelvis was without acute abnormality.  CTA chest was without evidence of PE but noted small right pleural effusion, mildly enlarged mediastinal lymph nodes which have been stable and consolidation in the left upper lobe with spiculated nodule in the right upper lobe.  Patient will need repeat CT within 3 months to re-evaluate.  She was felt to have a component of fluid overload at the time of admission and was placed on IV Lasix.  Cardiology was consulted but felt patient euvolemic and patient was transitioned back to home diuretics.  She had some soft blood pressures and hydralazine was held at discharge.  Aldactone was also decreased to 25 mg daily given poor orally intake in the setting of COVID.  She was instructed to monitor her blood pressure both morning and evening and keep a log to follow-up with cardiology.  She was instructed to call Cardiology if blood pressure became elevated or she had any evidence of volume overload, weight gain, worsening edema.  She was set up with the transition to home program.   Of note patient had productive cough so a sputum culture was sent and is pending at time of discharge.  Symptoms improved without antibiotic treatment.  She did culture to be followed up by transition to home program.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram abdomen normal, Diuretic therapy, Dyspnoea, Hypervolaemia, Hypophagia
Clinical narrative: Discharge Provider: MD Primary Care Provider:MD Admission Date: 1/4/2023 Discharge Date: 1/7/23 COVID positive date: 01/04/2023  PRESENTING PROBLEM: Lung nodule  Hypoxia  Acute hypoxemic respiratory failure  Nausea and vomiting, unspecified vomiting type Respiratory tract infection due to COVID-19 virus    HOSPITAL COURSE: 65-year-old female with possible history of combined systolic and diastolic CHF with EF 10% status post ICD, AFib on Eliquis, hypertension, CKD 3, dyslipidemia.  Patient admitted with COVID and acute hypoxic respiratory failure after presenting with shortness of breath, cough, congestion, abdominal pain, nausea and chills.  She tested positive for COVID and was given a dose of Decadron.  She was initially hypoxic with ambulation and required 3 L of supplemental oxygen but was weaned back to room air prior to discharge.  CT abdomen and pelvis was without acute abnormality.  CTA chest was without evidence of PE but noted small right pleural effusion, mildly enlarged mediastinal lymph nodes which have been stable and consolidation in the left upper lobe with spiculated nodule in the right upper lobe.  Patient will need repeat CT within 3 months to re-evaluate.  She was felt to have a component of fluid overload at the time of admission and was placed on IV Lasix.  Cardiology was consulted but felt patient euvolemic and patient was transitioned back to home diuretics.  She had some soft blood pressures and hydralazine was held at discharge.  Aldactone was also decreased to 25 mg daily given poor orally intake in the setting of COVID.  She was instructed to monitor her blood pressure both morning and evening and keep a log to follow-up with cardiology.  She was instructed to call Cardiology if blood pressure became elevated or she had any evidence of volume overload, weight gain, worsening edema.  She was set up with the transition to home program.   Of note patient had productive cough so a sputum culture was sent and is pending at time of discharge.  Symptoms improved without antibiotic treatment.  She did culture to be followed up by transition to home program.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Lung consolidation, Lymphadenopathy, Nausea, Pleural effusion
Clinical narrative: Discharge Provider: MD Primary Care Provider:MD Admission Date: 1/4/2023 Discharge Date: 1/7/23 COVID positive date: 01/04/2023  PRESENTING PROBLEM: Lung nodule  Hypoxia  Acute hypoxemic respiratory failure  Nausea and vomiting, unspecified vomiting type Respiratory tract infection due to COVID-19 virus    HOSPITAL COURSE: 65-year-old female with possible history of combined systolic and diastolic CHF with EF 10% status post ICD, AFib on Eliquis, hypertension, CKD 3, dyslipidemia.  Patient admitted with COVID and acute hypoxic respiratory failure after presenting with shortness of breath, cough, congestion, abdominal pain, nausea and chills.  She tested positive for COVID and was given a dose of Decadron.  She was initially hypoxic with ambulation and required 3 L of supplemental oxygen but was weaned back to room air prior to discharge.  CT abdomen and pelvis was without acute abnormality.  CTA chest was without evidence of PE but noted small right pleural effusion, mildly enlarged mediastinal lymph nodes which have been stable and consolidation in the left upper lobe with spiculated nodule in the right upper lobe.  Patient will need repeat CT within 3 months to re-evaluate.  She was felt to have a component of fluid overload at the time of admission and was placed on IV Lasix.  Cardiology was consulted but felt patient euvolemic and patient was transitioned back to home diuretics.  She had some soft blood pressures and hydralazine was held at discharge.  Aldactone was also decreased to 25 mg daily given poor orally intake in the setting of COVID.  She was instructed to monitor her blood pressure both morning and evening and keep a log to follow-up with cardiology.  She was instructed to call Cardiology if blood pressure became elevated or she had any evidence of volume overload, weight gain, worsening edema.  She was set up with the transition to home program.   Of note patient had productive cough so a sputum culture was sent and is pending at time of discharge.  Symptoms improved without antibiotic treatment.  She did culture to be followed up by transition to home program.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Productive cough, Pulmonary mass, Respiratory tract congestion, Respiratory tract infection, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider:MD Admission Date: 1/4/2023 Discharge Date: 1/7/23 COVID positive date: 01/04/2023  PRESENTING PROBLEM: Lung nodule  Hypoxia  Acute hypoxemic respiratory failure  Nausea and vomiting, unspecified vomiting type Respiratory tract infection due to COVID-19 virus    HOSPITAL COURSE: 65-year-old female with possible history of combined systolic and diastolic CHF with EF 10% status post ICD, AFib on Eliquis, hypertension, CKD 3, dyslipidemia.  Patient admitted with COVID and acute hypoxic respiratory failure after presenting with shortness of breath, cough, congestion, abdominal pain, nausea and chills.  She tested positive for COVID and was given a dose of Decadron.  She was initially hypoxic with ambulation and required 3 L of supplemental oxygen but was weaned back to room air prior to discharge.  CT abdomen and pelvis was without acute abnormality.  CTA chest was without evidence of PE but noted small right pleural effusion, mildly enlarged mediastinal lymph nodes which have been stable and consolidation in the left upper lobe with spiculated nodule in the right upper lobe.  Patient will need repeat CT within 3 months to re-evaluate.  She was felt to have a component of fluid overload at the time of admission and was placed on IV Lasix.  Cardiology was consulted but felt patient euvolemic and patient was transitioned back to home diuretics.  She had some soft blood pressures and hydralazine was held at discharge.  Aldactone was also decreased to 25 mg daily given poor orally intake in the setting of COVID.  She was instructed to monitor her blood pressure both morning and evening and keep a log to follow-up with cardiology.  She was instructed to call Cardiology if blood pressure became elevated or she had any evidence of volume overload, weight gain, worsening edema.  She was set up with the transition to home program.   Of note patient had productive cough so a sputum culture was sent and is pending at time of discharge.  Symptoms improved without antibiotic treatment.  She did culture to be followed up by transition to home program.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Sputum culture, Vomiting
Clinical narrative: Discharge Provider: MD Primary Care Provider:MD Admission Date: 1/4/2023 Discharge Date: 1/7/23 COVID positive date: 01/04/2023  PRESENTING PROBLEM: Lung nodule  Hypoxia  Acute hypoxemic respiratory failure  Nausea and vomiting, unspecified vomiting type Respiratory tract infection due to COVID-19 virus    HOSPITAL COURSE: 65-year-old female with possible history of combined systolic and diastolic CHF with EF 10% status post ICD, AFib on Eliquis, hypertension, CKD 3, dyslipidemia.  Patient admitted with COVID and acute hypoxic respiratory failure after presenting with shortness of breath, cough, congestion, abdominal pain, nausea and chills.  She tested positive for COVID and was given a dose of Decadron.  She was initially hypoxic with ambulation and required 3 L of supplemental oxygen but was weaned back to room air prior to discharge.  CT abdomen and pelvis was without acute abnormality.  CTA chest was without evidence of PE but noted small right pleural effusion, mildly enlarged mediastinal lymph nodes which have been stable and consolidation in the left upper lobe with spiculated nodule in the right upper lobe.  Patient will need repeat CT within 3 months to re-evaluate.  She was felt to have a component of fluid overload at the time of admission and was placed on IV Lasix.  Cardiology was consulted but felt patient euvolemic and patient was transitioned back to home diuretics.  She had some soft blood pressures and hydralazine was held at discharge.  Aldactone was also decreased to 25 mg daily given poor orally intake in the setting of COVID.  She was instructed to monitor her blood pressure both morning and evening and keep a log to follow-up with cardiology.  She was instructed to call Cardiology if blood pressure became elevated or she had any evidence of volume overload, weight gain, worsening edema.  She was set up with the transition to home program.   Of note patient had productive cough so a sputum culture was sent and is pending at time of discharge.  Symptoms improved without antibiotic treatment.  She did culture to be followed up by transition to home program.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Angina pectoris, Chest discomfort, Chest pain, Electrocardiogram normal, Fatigue
Clinical narrative: I wasn't feeling good on October 31st, but I was really tired the next day I had some dull chest pain discomfort and my right arm felt the same with some numbness in my left fingers. It continued all week. I called the doctor early the next week and got an appt. She did an EKG and it was normal, and she also ordered a new prescription for me for amlodipine besylate to use for what she said was Angina and High blood pressure and some nitroglycerin pills that I haven't taken yet. After that I felt better. I do still have some left arm discomfort occasionally but my blood pressure has gone done since taking the high blood pressure pills. She referred me to a cardiologist who I saw yesterday, 1/10. He said he thought it was fine but wants me to do a stress test soon.