chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Skin odour abnormal, Thyroid function test normal
Clinical narrative: 102 temperature for 36 hours, large swollen lymphnode under left arm. 1 week later, joint aches, body odor change to metallic sour smell, and excessive hair loss.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Aspartate aminotransferase, Atrial fibrillation, Blood magnesium, Blood potassium, Blood thyroid stimulating hormone
Clinical narrative: My symptoms came on suddenly and strong. I could feel my heart rate accelerate; it felt  like a 50% increase, in beats. It was different to get a breath, and I had no stamina. I could not walk up or down a standard set of stairs without needing to pause to catch my breath.  I experienced overwhelming fatigue and exhaustion. I could not do anything easily. I could only lay down and sleep. These symptoms did not alleviate or change. The heart beat stayed accelerated. I continued to feel this way with these symptoms and same intensity without relief. It felt like my heart was going to give out, and I was dying. I went to the ER on 04/19/2021 and was diagnosed with atrial fibrillation. On 05/12/2021 I underwent an electrical cardioversion. I immediately felt relief. My heart rate felt normal. I felt short of breath. I felt like I had most of my life back. On 05/27/2021,I felt my heart rhythm change. It accelerated and felt just like before the cardioversion. I felt tired, and I had no stamina. My heart rate was accelerated. My blood pressure cuff read my pulse rate jumping from 50bpm to 80 to 120 within a span of five minutes. My heart was pounding and beating really fast. I underwent an electrical cardioversion on 06/07/2021. I could feel my heart rate return to a slower more normal rhythm, but it didn't feel completely the same. I don't have the stamina I had before. I easily get short of breath. I feel so tired once-a-day that I need to take a nap or lay down as it feels dangerous to stay awake. At my most recent appointment, the EKG revealed pre-ventricular contractions. I continue to have no stamina, am easily short of breath, and feel overwhelmingly tired once-a-day. I can feel my heart flutter and accelerate. This feeling is sporadic and typically does not exceed 24 hours. With this fluttering feeling, my blood pressure cuff reads my pulse rate jumping from 50-80 bpm.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide, Cardiac flutter, Cardiac stress test, Cardioversion, Chest X-ray
Clinical narrative: My symptoms came on suddenly and strong. I could feel my heart rate accelerate; it felt  like a 50% increase, in beats. It was different to get a breath, and I had no stamina. I could not walk up or down a standard set of stairs without needing to pause to catch my breath.  I experienced overwhelming fatigue and exhaustion. I could not do anything easily. I could only lay down and sleep. These symptoms did not alleviate or change. The heart beat stayed accelerated. I continued to feel this way with these symptoms and same intensity without relief. It felt like my heart was going to give out, and I was dying. I went to the ER on 04/19/2021 and was diagnosed with atrial fibrillation. On 05/12/2021 I underwent an electrical cardioversion. I immediately felt relief. My heart rate felt normal. I felt short of breath. I felt like I had most of my life back. On 05/27/2021,I felt my heart rhythm change. It accelerated and felt just like before the cardioversion. I felt tired, and I had no stamina. My heart rate was accelerated. My blood pressure cuff read my pulse rate jumping from 50bpm to 80 to 120 within a span of five minutes. My heart was pounding and beating really fast. I underwent an electrical cardioversion on 06/07/2021. I could feel my heart rate return to a slower more normal rhythm, but it didn't feel completely the same. I don't have the stamina I had before. I easily get short of breath. I feel so tired once-a-day that I need to take a nap or lay down as it feels dangerous to stay awake. At my most recent appointment, the EKG revealed pre-ventricular contractions. I continue to have no stamina, am easily short of breath, and feel overwhelmingly tired once-a-day. I can feel my heart flutter and accelerate. This feeling is sporadic and typically does not exceed 24 hours. With this fluttering feeling, my blood pressure cuff reads my pulse rate jumping from 50-80 bpm.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram, Differential white blood cell count, Dyspnoea, Echocardiogram, Electrocardiogram
Clinical narrative: My symptoms came on suddenly and strong. I could feel my heart rate accelerate; it felt  like a 50% increase, in beats. It was different to get a breath, and I had no stamina. I could not walk up or down a standard set of stairs without needing to pause to catch my breath.  I experienced overwhelming fatigue and exhaustion. I could not do anything easily. I could only lay down and sleep. These symptoms did not alleviate or change. The heart beat stayed accelerated. I continued to feel this way with these symptoms and same intensity without relief. It felt like my heart was going to give out, and I was dying. I went to the ER on 04/19/2021 and was diagnosed with atrial fibrillation. On 05/12/2021 I underwent an electrical cardioversion. I immediately felt relief. My heart rate felt normal. I felt short of breath. I felt like I had most of my life back. On 05/27/2021,I felt my heart rhythm change. It accelerated and felt just like before the cardioversion. I felt tired, and I had no stamina. My heart rate was accelerated. My blood pressure cuff read my pulse rate jumping from 50bpm to 80 to 120 within a span of five minutes. My heart was pounding and beating really fast. I underwent an electrical cardioversion on 06/07/2021. I could feel my heart rate return to a slower more normal rhythm, but it didn't feel completely the same. I don't have the stamina I had before. I easily get short of breath. I feel so tired once-a-day that I need to take a nap or lay down as it feels dangerous to stay awake. At my most recent appointment, the EKG revealed pre-ventricular contractions. I continue to have no stamina, am easily short of breath, and feel overwhelmingly tired once-a-day. I can feel my heart flutter and accelerate. This feeling is sporadic and typically does not exceed 24 hours. With this fluttering feeling, my blood pressure cuff reads my pulse rate jumping from 50-80 bpm.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Fibrin D dimer, Full blood count, Heart rate increased, International normalised ratio
Clinical narrative: My symptoms came on suddenly and strong. I could feel my heart rate accelerate; it felt  like a 50% increase, in beats. It was different to get a breath, and I had no stamina. I could not walk up or down a standard set of stairs without needing to pause to catch my breath.  I experienced overwhelming fatigue and exhaustion. I could not do anything easily. I could only lay down and sleep. These symptoms did not alleviate or change. The heart beat stayed accelerated. I continued to feel this way with these symptoms and same intensity without relief. It felt like my heart was going to give out, and I was dying. I went to the ER on 04/19/2021 and was diagnosed with atrial fibrillation. On 05/12/2021 I underwent an electrical cardioversion. I immediately felt relief. My heart rate felt normal. I felt short of breath. I felt like I had most of my life back. On 05/27/2021,I felt my heart rhythm change. It accelerated and felt just like before the cardioversion. I felt tired, and I had no stamina. My heart rate was accelerated. My blood pressure cuff read my pulse rate jumping from 50bpm to 80 to 120 within a span of five minutes. My heart was pounding and beating really fast. I underwent an electrical cardioversion on 06/07/2021. I could feel my heart rate return to a slower more normal rhythm, but it didn't feel completely the same. I don't have the stamina I had before. I easily get short of breath. I feel so tired once-a-day that I need to take a nap or lay down as it feels dangerous to stay awake. At my most recent appointment, the EKG revealed pre-ventricular contractions. I continue to have no stamina, am easily short of breath, and feel overwhelmingly tired once-a-day. I can feel my heart flutter and accelerate. This feeling is sporadic and typically does not exceed 24 hours. With this fluttering feeling, my blood pressure cuff reads my pulse rate jumping from 50-80 bpm.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Malaise, Metabolic function test, Palpitations, Prothrombin time, Red blood cell sedimentation rate
Clinical narrative: My symptoms came on suddenly and strong. I could feel my heart rate accelerate; it felt  like a 50% increase, in beats. It was different to get a breath, and I had no stamina. I could not walk up or down a standard set of stairs without needing to pause to catch my breath.  I experienced overwhelming fatigue and exhaustion. I could not do anything easily. I could only lay down and sleep. These symptoms did not alleviate or change. The heart beat stayed accelerated. I continued to feel this way with these symptoms and same intensity without relief. It felt like my heart was going to give out, and I was dying. I went to the ER on 04/19/2021 and was diagnosed with atrial fibrillation. On 05/12/2021 I underwent an electrical cardioversion. I immediately felt relief. My heart rate felt normal. I felt short of breath. I felt like I had most of my life back. On 05/27/2021,I felt my heart rhythm change. It accelerated and felt just like before the cardioversion. I felt tired, and I had no stamina. My heart rate was accelerated. My blood pressure cuff read my pulse rate jumping from 50bpm to 80 to 120 within a span of five minutes. My heart was pounding and beating really fast. I underwent an electrical cardioversion on 06/07/2021. I could feel my heart rate return to a slower more normal rhythm, but it didn't feel completely the same. I don't have the stamina I had before. I easily get short of breath. I feel so tired once-a-day that I need to take a nap or lay down as it feels dangerous to stay awake. At my most recent appointment, the EKG revealed pre-ventricular contractions. I continue to have no stamina, am easily short of breath, and feel overwhelmingly tired once-a-day. I can feel my heart flutter and accelerate. This feeling is sporadic and typically does not exceed 24 hours. With this fluttering feeling, my blood pressure cuff reads my pulse rate jumping from 50-80 bpm.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test, Somnolence, Troponin I, Urine analysis, Ventricular extrasystoles
Clinical narrative: My symptoms came on suddenly and strong. I could feel my heart rate accelerate; it felt  like a 50% increase, in beats. It was different to get a breath, and I had no stamina. I could not walk up or down a standard set of stairs without needing to pause to catch my breath.  I experienced overwhelming fatigue and exhaustion. I could not do anything easily. I could only lay down and sleep. These symptoms did not alleviate or change. The heart beat stayed accelerated. I continued to feel this way with these symptoms and same intensity without relief. It felt like my heart was going to give out, and I was dying. I went to the ER on 04/19/2021 and was diagnosed with atrial fibrillation. On 05/12/2021 I underwent an electrical cardioversion. I immediately felt relief. My heart rate felt normal. I felt short of breath. I felt like I had most of my life back. On 05/27/2021,I felt my heart rhythm change. It accelerated and felt just like before the cardioversion. I felt tired, and I had no stamina. My heart rate was accelerated. My blood pressure cuff read my pulse rate jumping from 50bpm to 80 to 120 within a span of five minutes. My heart was pounding and beating really fast. I underwent an electrical cardioversion on 06/07/2021. I could feel my heart rate return to a slower more normal rhythm, but it didn't feel completely the same. I don't have the stamina I had before. I easily get short of breath. I feel so tired once-a-day that I need to take a nap or lay down as it feels dangerous to stay awake. At my most recent appointment, the EKG revealed pre-ventricular contractions. I continue to have no stamina, am easily short of breath, and feel overwhelmingly tired once-a-day. I can feel my heart flutter and accelerate. This feeling is sporadic and typically does not exceed 24 hours. With this fluttering feeling, my blood pressure cuff reads my pulse rate jumping from 50-80 bpm.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram abnormal, Anticoagulant therapy, Arthralgia, Condition aggravated, Inappropriate schedule of product administration
Clinical narrative: History of right stage Ia breast cancer 2 mm hormone positive treated with breast conservation therapy completed October 2019 and was placed on tamoxifen (due to history of osteonecrosis of the jaw aromatase inhibitor was avoided)  15 March 2021 due to some left shoulder pain a CT angiogram showed acute bilateral lower lobe segmental PE occlusive at anterior left lower lobe with small left lower lobe infarct, no RV strain, tamoxifen was discontinued 15 March 2021 bilateral lower extremity ultrasounds were negative She was treated with heparin and transition to warfarin due to cost, and then after financial assistance she was switched to Eliquis  Of note she had Pfizer Covid vaccines 24 February and 19 March 2021, in addition she had the tamoxifen and age as likely risk factors, no family history of blood clots, and no current active cancer at this time
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary artery occlusion, Pulmonary embolism, Pulmonary infarction, Ultrasound Doppler abnormal
Clinical narrative: History of right stage Ia breast cancer 2 mm hormone positive treated with breast conservation therapy completed October 2019 and was placed on tamoxifen (due to history of osteonecrosis of the jaw aromatase inhibitor was avoided)  15 March 2021 due to some left shoulder pain a CT angiogram showed acute bilateral lower lobe segmental PE occlusive at anterior left lower lobe with small left lower lobe infarct, no RV strain, tamoxifen was discontinued 15 March 2021 bilateral lower extremity ultrasounds were negative She was treated with heparin and transition to warfarin due to cost, and then after financial assistance she was switched to Eliquis  Of note she had Pfizer Covid vaccines 24 February and 19 March 2021, in addition she had the tamoxifen and age as likely risk factors, no family history of blood clots, and no current active cancer at this time
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Breast mass, Breast swelling, Fibroadenoma of breast, Headache, Oedema peripheral
Clinical narrative: The day of the vaccine, I had no symptoms, no fatigue, nothing. Next day I woke up and the opposite side right arm was swollen, and armpit was swollen. I had a headache, but I was still able to go to work. The swelling lasted for maybe 2-3 days and otherwise, it was fine. I just noticed the swelling moved into my right breast. I did have an ultrasound done in August 2021. They wanted to wait 6 months just to make sure the swelling would go down. No treatment, currently unknown, going for 2nd ultrasound in a couple weeks. The lump is still in my breast, but the armpit swelling is back to normal. Was referred to the Women's Center for further examination.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, Ultrasound breast abnormal
Clinical narrative: The day of the vaccine, I had no symptoms, no fatigue, nothing. Next day I woke up and the opposite side right arm was swollen, and armpit was swollen. I had a headache, but I was still able to go to work. The swelling lasted for maybe 2-3 days and otherwise, it was fine. I just noticed the swelling moved into my right breast. I did have an ultrasound done in August 2021. They wanted to wait 6 months just to make sure the swelling would go down. No treatment, currently unknown, going for 2nd ultrasound in a couple weeks. The lump is still in my breast, but the armpit swelling is back to normal. Was referred to the Women's Center for further examination.
Age: 61.0
Sex: M
Vaccine: FLU4
Symptoms: Blood test, Chest pain, Heart rate increased, Hypertension, Paraesthesia
Clinical narrative: High Blood Pressure, Fast Heartbeat, Tingling in arms and legs, pain in chest
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Chills, Feeling abnormal, Feeling cold, Headache, Injection site erythema
Clinical narrative: 12:30pm day after shot starting getting major headache ,achy, chills, fever.  Hard to sleep over night but fever broke around 12:30am. Today, 2 days after, woke up ok, but as the day goes on: headahe, chills, fever  100.6, and feeling like crap. Have taken tylenol, pushed fluids, rested-but too frozen to sleep, ibuprofin. Injection site is red, hard, hot & itchy
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Injection site induration, Injection site pruritus, Injection site warmth, Insomnia, Pain
Clinical narrative: 12:30pm day after shot starting getting major headache ,achy, chills, fever.  Hard to sleep over night but fever broke around 12:30am. Today, 2 days after, woke up ok, but as the day goes on: headahe, chills, fever  100.6, and feeling like crap. Have taken tylenol, pushed fluids, rested-but too frozen to sleep, ibuprofin. Injection site is red, hard, hot & itchy
Age: 58.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pyrexia
Clinical narrative: 12:30pm day after shot starting getting major headache ,achy, chills, fever.  Hard to sleep over night but fever broke around 12:30am. Today, 2 days after, woke up ok, but as the day goes on: headahe, chills, fever  100.6, and feeling like crap. Have taken tylenol, pushed fluids, rested-but too frozen to sleep, ibuprofin. Injection site is red, hard, hot & itchy
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Asymptomatic COVID-19, SARS-CoV-2 test positive
Clinical narrative: I test positive for COVID 19 on 07/26/2021, but didn't have any symptoms. I spoke with my health provider over the phone on 07/27/2021 he prescribed an antibody, Vitamin C, Zinc and D3.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Atrial fibrillation
Clinical narrative: atrial fibrillation less than 24 hours after receiving a moderna booster
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Rash, Rash pruritic
Clinical narrative: intensely pruritic  numular rash on neck, forearms, and lower legs
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient was given 0.5ml of Moderna as a booster dose.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Inappropriate schedule of product administration, No adverse event
Clinical narrative: No adverse reaction occurred; Patient was vaccinated for booster dose too soon (12/9/21). Six month waiting period occurs 12/29/21
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Pruritus, Urticaria
Clinical narrative: PT FELT BURING THROUGH, THEN STOPPED AND DEVELOPED HIVES AND VAS VERY ITCHY
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Blood creatinine normal, Blood folate normal, Blood thyroid stimulating hormone normal, Deep vein thrombosis
Clinical narrative: They had driven to another state on vacation, stayed there for 7 to 10 days, and then drove back 1 long car ride, during the car ride home he noticed a charley horse in his right lower extremity calf, and the next day he tried to hydrate well but pain continued to worsen over the next few days and on 14 July 2021 right lower extremity ultrasound showed near completely occlusive right gastrocnemius vein thrombus within the calf (deep vein), he was started on Xarelto, and the pain resolved within a couple days, and within 1 to 2 weeks the phantom paresthesia sensations resolved, he did not have significant swelling  Family history includes a father with blood clots, his first was 12 days after knee arthroscopy, pulmonary embolism at the age of 60, and a second 1 was unprovoked at about the age of 68 and he continues on Coumadin since  Risk factors include family history, long car drive, and Covid vaccinations with Pfizer on 23 March and 13 April 2021  Labs have included in September 2021 B12 347, folate of 17.8, ferritin of 305, CBC normal, creatinine 0.9, TSH 2.68
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Full blood count normal, Muscle spasms, Pain, Paraesthesia, Serum ferritin normal
Clinical narrative: They had driven to another state on vacation, stayed there for 7 to 10 days, and then drove back 1 long car ride, during the car ride home he noticed a charley horse in his right lower extremity calf, and the next day he tried to hydrate well but pain continued to worsen over the next few days and on 14 July 2021 right lower extremity ultrasound showed near completely occlusive right gastrocnemius vein thrombus within the calf (deep vein), he was started on Xarelto, and the pain resolved within a couple days, and within 1 to 2 weeks the phantom paresthesia sensations resolved, he did not have significant swelling  Family history includes a father with blood clots, his first was 12 days after knee arthroscopy, pulmonary embolism at the age of 60, and a second 1 was unprovoked at about the age of 68 and he continues on Coumadin since  Risk factors include family history, long car drive, and Covid vaccinations with Pfizer on 23 March and 13 April 2021  Labs have included in September 2021 B12 347, folate of 17.8, ferritin of 305, CBC normal, creatinine 0.9, TSH 2.68
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Ultrasound Doppler abnormal, Venous occlusion, Vitamin B12 normal
Clinical narrative: They had driven to another state on vacation, stayed there for 7 to 10 days, and then drove back 1 long car ride, during the car ride home he noticed a charley horse in his right lower extremity calf, and the next day he tried to hydrate well but pain continued to worsen over the next few days and on 14 July 2021 right lower extremity ultrasound showed near completely occlusive right gastrocnemius vein thrombus within the calf (deep vein), he was started on Xarelto, and the pain resolved within a couple days, and within 1 to 2 weeks the phantom paresthesia sensations resolved, he did not have significant swelling  Family history includes a father with blood clots, his first was 12 days after knee arthroscopy, pulmonary embolism at the age of 60, and a second 1 was unprovoked at about the age of 68 and he continues on Coumadin since  Risk factors include family history, long car drive, and Covid vaccinations with Pfizer on 23 March and 13 April 2021  Labs have included in September 2021 B12 347, folate of 17.8, ferritin of 305, CBC normal, creatinine 0.9, TSH 2.68
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Paraesthesia, Pyrexia, Tremor
Clinical narrative: Mild fever, severe chills and shaking, tingling skin. Treatment: Tylenol and rest. Symptoms eased and ended next day.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Anion gap increased, Azotaemia, Blood glucose decreased, Blood glucose increased, Blood ketone body
Clinical narrative: 57 Y male  with multiple medical issues significant for HTN, CAD s/p on pump CABG x 4v (LIMA to LAD, SVG to OM, ramus, PDA) in 7/2018, DM, ESRD on PD, HLD, HFpEF EF 50%, anemia, COVID+ on 11/2, who initially presented with hypoglycemia and poor PO intake.    Date of initial sx: 11/2. Had 2 doses of Pfizer vaccine, no booster. Presented with elevated T: 102.3 and elevated RR. He also had an elevated troponin which peaked, likely from demand ischemia. His glucose was 45 on admission, likely from poor PO intake and improved after he received dextrose 50% in the ED and received  dexamethasone 10 mg IV x1.  He was started on decadron 6 mg PO and remdesivir.  Nephrology was consulted for ongoing PD requirements and the patient has been receiving daily PD. On 11/11 the patient had BGs in the 500s and an elevated AG to 18. He was given IVFs and started on lantus, and high ISS. There was thought that the patient could be in DKA, however after discussing with endocrine and nephrology, more likely that anion gap was related to his uremia. Urine ketones and beta hydroxybutyrate negative.   His sugars continued to remain elevated during his hospital course, and the patient was switched from lantus 16 units to NPH 5 units BID) on 11/12. The patient takes PTA glipizide 7.5 mg BID, has never used insulin.  Remdesivir stopped on 11/12 and decadron stopped on 11/13.  Adjustments in his NPH were made based on his blood glucose levels: his NPH was increased to 8 units BID on 11/13 and again increased to 14 units BID on 11/14. His anion gap closed on 11/14. The patient received a insulin kit and has received diabetes/insulin teaching via nursing staff.    Throughout the course the patient's vent settings have been stable. He has been on minimal oxygen settings 3 L NC-> 2 L NC, and social work has already set up home O2. The rest of his PTA medications have been continued with the exception of his PTA torsemide which has been held since his admission. He does not appear volume overloaded on exam, but can consider restarting torsemide on discharge if blood pressures can tolerate it.      Primary Procedures:  None   Secondary Procedures: None   Reason for Hospital Admission (Admitting Diagnosis):  Covid Pneumonia
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Body temperature increased, COVID-19 pneumonia, Hypoglycaemia, Hypophagia, Mechanical ventilation
Clinical narrative: 57 Y male  with multiple medical issues significant for HTN, CAD s/p on pump CABG x 4v (LIMA to LAD, SVG to OM, ramus, PDA) in 7/2018, DM, ESRD on PD, HLD, HFpEF EF 50%, anemia, COVID+ on 11/2, who initially presented with hypoglycemia and poor PO intake.    Date of initial sx: 11/2. Had 2 doses of Pfizer vaccine, no booster. Presented with elevated T: 102.3 and elevated RR. He also had an elevated troponin which peaked, likely from demand ischemia. His glucose was 45 on admission, likely from poor PO intake and improved after he received dextrose 50% in the ED and received  dexamethasone 10 mg IV x1.  He was started on decadron 6 mg PO and remdesivir.  Nephrology was consulted for ongoing PD requirements and the patient has been receiving daily PD. On 11/11 the patient had BGs in the 500s and an elevated AG to 18. He was given IVFs and started on lantus, and high ISS. There was thought that the patient could be in DKA, however after discussing with endocrine and nephrology, more likely that anion gap was related to his uremia. Urine ketones and beta hydroxybutyrate negative.   His sugars continued to remain elevated during his hospital course, and the patient was switched from lantus 16 units to NPH 5 units BID) on 11/12. The patient takes PTA glipizide 7.5 mg BID, has never used insulin.  Remdesivir stopped on 11/12 and decadron stopped on 11/13.  Adjustments in his NPH were made based on his blood glucose levels: his NPH was increased to 8 units BID on 11/13 and again increased to 14 units BID on 11/14. His anion gap closed on 11/14. The patient received a insulin kit and has received diabetes/insulin teaching via nursing staff.    Throughout the course the patient's vent settings have been stable. He has been on minimal oxygen settings 3 L NC-> 2 L NC, and social work has already set up home O2. The rest of his PTA medications have been continued with the exception of his PTA torsemide which has been held since his admission. He does not appear volume overloaded on exam, but can consider restarting torsemide on discharge if blood pressures can tolerate it.      Primary Procedures:  None   Secondary Procedures: None   Reason for Hospital Admission (Admitting Diagnosis):  Covid Pneumonia
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Myocardial ischaemia, Respiratory rate increased, SARS-CoV-2 test positive, Troponin increased, Urine ketone body absent
Clinical narrative: 57 Y male  with multiple medical issues significant for HTN, CAD s/p on pump CABG x 4v (LIMA to LAD, SVG to OM, ramus, PDA) in 7/2018, DM, ESRD on PD, HLD, HFpEF EF 50%, anemia, COVID+ on 11/2, who initially presented with hypoglycemia and poor PO intake.    Date of initial sx: 11/2. Had 2 doses of Pfizer vaccine, no booster. Presented with elevated T: 102.3 and elevated RR. He also had an elevated troponin which peaked, likely from demand ischemia. His glucose was 45 on admission, likely from poor PO intake and improved after he received dextrose 50% in the ED and received  dexamethasone 10 mg IV x1.  He was started on decadron 6 mg PO and remdesivir.  Nephrology was consulted for ongoing PD requirements and the patient has been receiving daily PD. On 11/11 the patient had BGs in the 500s and an elevated AG to 18. He was given IVFs and started on lantus, and high ISS. There was thought that the patient could be in DKA, however after discussing with endocrine and nephrology, more likely that anion gap was related to his uremia. Urine ketones and beta hydroxybutyrate negative.   His sugars continued to remain elevated during his hospital course, and the patient was switched from lantus 16 units to NPH 5 units BID) on 11/12. The patient takes PTA glipizide 7.5 mg BID, has never used insulin.  Remdesivir stopped on 11/12 and decadron stopped on 11/13.  Adjustments in his NPH were made based on his blood glucose levels: his NPH was increased to 8 units BID on 11/13 and again increased to 14 units BID on 11/14. His anion gap closed on 11/14. The patient received a insulin kit and has received diabetes/insulin teaching via nursing staff.    Throughout the course the patient's vent settings have been stable. He has been on minimal oxygen settings 3 L NC-> 2 L NC, and social work has already set up home O2. The rest of his PTA medications have been continued with the exception of his PTA torsemide which has been held since his admission. He does not appear volume overloaded on exam, but can consider restarting torsemide on discharge if blood pressures can tolerate it.      Primary Procedures:  None   Secondary Procedures: None   Reason for Hospital Admission (Admitting Diagnosis):  Covid Pneumonia
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Patient was inadvertently given 0.3mls of Pfizer and 0.2 mls of Janssen from the same syringe at the same time.  There were no adverse events that I am aware of.  Patient waited 15 minutes after dose with no side effects.  Attempts to contact her have been unsuccessful via phone and MyChart.
Age: 9.0
Sex: M
Vaccine: COVID19
Symptoms: Loss of consciousness, Vision blurred
Clinical narrative: Patient walked out of the wellness room and passed out.  Patient's father was able to caught him.  Patient was awake when I stepped out of the pharmacy.  Patient stated he felt blurry.  Patient was able to walk normal when he left.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Malaise, Vomiting
Clinical narrative: Patient said that she started to feel sick and somewhat dizzy approximately 5 minutes after receiving the vaccination.  She vomited; after about 5-10 minutes later the vomiting/dizziness subsided.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Joint dislocation, Joint dislocation reduction, Magnetic resonance imaging, Nerve injury, Pain in extremity
Clinical narrative: On 10/09/2021 I experienced sharp R arm pain while sedentary and sitting on my sofa which became increasingly excruciating requiring me to go the ED and found to have an unprovoked R shoulder dislocation.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: X-ray limb abnormal
Clinical narrative: On 10/09/2021 I experienced sharp R arm pain while sedentary and sitting on my sofa which became increasingly excruciating requiring me to go the ED and found to have an unprovoked R shoulder dislocation.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Rash erythematous, Rash pruritic, Urticaria
Clinical narrative: Hives/rash red deep itch sacrum, upper hips, lower front abdomen
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Dizziness, Sleep disorder, Vertigo, Vomiting
Clinical narrative: I had sudden onset vertigo 4 hours after the injection that put me to bed. The following night I woke up from a sound sleep and vomited. Had stomach cramps. I have been dizzy since. The worst lasted about a week. Am still not completely right, but dizziness is something that happens to me some times. I have had Muniere's in the past.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Interchange of vaccine products
Clinical narrative: I had a J&J vaccine back in April (there was nowhere to list that on this form), and then the Modern booster on November 28. Since getting the booster I have had a horrible headache every day for almost two weeks now. I feel the pain the most right in my forehead. It's the same level of pain every day and no OTC medicine makes it better. My PCP prescribed me Indomethacin yesterday and I started taking it but it's not helping at all. My doctor's recommendation is that I go to a neurologist, but I called multiple neurologists today and they can't see me for until March.  I'm very concerned that this isn't going away. I do not have any history of headaches and did not have a headache before getting the booster.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Anti-cyclic citrullinated peptide antibody negative, Antimitochondrial antibody normal, Antineutrophil cytoplasmic antibody negative, Antinuclear antibody, Antinuclear antibody negative
Clinical narrative: received pfizer covid vaccines 3/29/2021 and 4/19/2021  as of 10 Dec 2021 Admission summary in 10/ 2021- This previously healthy young man with a history of sensorineural hearing loss approximately 10 years ago first developed some arthralgia following coronavirus 19 vaccination in April 2021 however he and his father report that the symptoms resolved and he returned to normal health before starting to feel poor again in the summer 2021.  He has developed intermittent myalgia and arthralgia and has been experiencing fevers.  He did develop fatigue and has been coughing for weeks.  He was admitted on 10/15 with left hemiparesis and found to have a subacute right lacunar infarct of unstated location and narrowing of bilateral external carotid arteries on CT. On 10/17, he developed right hemiparesis and acute dysphagia and found to have a right lateral medullar infarct. He was transferred another medical facility on 10/17. Rheumatology was consulted for evaluation of a rheumatologic process contributing to presentation in setting of reported ANA positive serology.    He does have unexplained fevers, inflammatory "arthritis", dry eyes (positive Schirmer's test on R eye, negative on L eye), dry mouth, neurologic symptoms (stroke), cytopenias, hypergammaglobulinemia, elevated Immunoglobulin level, positive ANA, weakly positive anti-SSA which could be explained by Sjogren's symptoms. People with seronegative (weakly positive in his case) Sjogren's tend to have neurological manifestations.    Received IV cyclophosphamide 500 mg/m2 (900 mg) (first dose on 11/6/2021), IV methylprednislone 500 mg bid x 6 doses. Tapered to equivalent of prednisone 1 mg/kg, Plaquenil 300 mg daily (started on 11/5/21)    Laboratory studies Abnormal - anti-SSA (2.5), ANA 1:640 homogeneous, SPEP consistent with chronic inflammation (hypoalbuminemia, hypergammaglobinemia), anti-smooth muscle, MOG antibody, elevated interleukin 2 receptor, elevated ESR, elevated CRP.   Normal/Negative - antiMPO/PR3, RF, anti-Smith, anti-SSB, anti-Scl70, anti-centromere, C3/C4, anti-CCP, anti-beta 2 glycoprotein 1 Ab, anti-cardiolipin Ab, urine studies, anti-ds-DNA, serum immunofixation, anti-mitochondrial aby, DRVVT, cryoglobulin, Hex lupus anticoagulant Negative NMO in CSF, TB   Pathology: Lip biopsy showed mild focal periductal chronic inflammation with focus score<1 (focus score 0.44).    INTERVAL HISTORY:  He he has noticed improvement after he was discharged.  He is able to walk at home without problem but he still uses walker whenever he goes out.  He denies any new neurologic symptoms. He is currently on prednisone 30 mg daily. He monitors his blood pressure every day and taking beta-blocker for it.  Beta-blocker is managed by primary doctor. His dry eyes and dry mouth do not really bother him.  He has been drinking a lot of fluid for the dry mouth.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Antinuclear antibody positive, Antiphospholipid antibodies negative, Arthralgia, Arthritis, Autoantibody positive
Clinical narrative: received pfizer covid vaccines 3/29/2021 and 4/19/2021  as of 10 Dec 2021 Admission summary in 10/ 2021- This previously healthy young man with a history of sensorineural hearing loss approximately 10 years ago first developed some arthralgia following coronavirus 19 vaccination in April 2021 however he and his father report that the symptoms resolved and he returned to normal health before starting to feel poor again in the summer 2021.  He has developed intermittent myalgia and arthralgia and has been experiencing fevers.  He did develop fatigue and has been coughing for weeks.  He was admitted on 10/15 with left hemiparesis and found to have a subacute right lacunar infarct of unstated location and narrowing of bilateral external carotid arteries on CT. On 10/17, he developed right hemiparesis and acute dysphagia and found to have a right lateral medullar infarct. He was transferred another medical facility on 10/17. Rheumatology was consulted for evaluation of a rheumatologic process contributing to presentation in setting of reported ANA positive serology.    He does have unexplained fevers, inflammatory "arthritis", dry eyes (positive Schirmer's test on R eye, negative on L eye), dry mouth, neurologic symptoms (stroke), cytopenias, hypergammaglobulinemia, elevated Immunoglobulin level, positive ANA, weakly positive anti-SSA which could be explained by Sjogren's symptoms. People with seronegative (weakly positive in his case) Sjogren's tend to have neurological manifestations.    Received IV cyclophosphamide 500 mg/m2 (900 mg) (first dose on 11/6/2021), IV methylprednislone 500 mg bid x 6 doses. Tapered to equivalent of prednisone 1 mg/kg, Plaquenil 300 mg daily (started on 11/5/21)    Laboratory studies Abnormal - anti-SSA (2.5), ANA 1:640 homogeneous, SPEP consistent with chronic inflammation (hypoalbuminemia, hypergammaglobinemia), anti-smooth muscle, MOG antibody, elevated interleukin 2 receptor, elevated ESR, elevated CRP.   Normal/Negative - antiMPO/PR3, RF, anti-Smith, anti-SSB, anti-Scl70, anti-centromere, C3/C4, anti-CCP, anti-beta 2 glycoprotein 1 Ab, anti-cardiolipin Ab, urine studies, anti-ds-DNA, serum immunofixation, anti-mitochondrial aby, DRVVT, cryoglobulin, Hex lupus anticoagulant Negative NMO in CSF, TB   Pathology: Lip biopsy showed mild focal periductal chronic inflammation with focus score<1 (focus score 0.44).    INTERVAL HISTORY:  He he has noticed improvement after he was discharged.  He is able to walk at home without problem but he still uses walker whenever he goes out.  He denies any new neurologic symptoms. He is currently on prednisone 30 mg daily. He monitors his blood pressure every day and taking beta-blocker for it.  Beta-blocker is managed by primary doctor. His dry eyes and dry mouth do not really bother him.  He has been drinking a lot of fluid for the dry mouth.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Beta-2 glycoprotein antibody negative, Biopsy lip abnormal, Bone infarction, C-reactive protein increased, Cardiolipin antibody negative
Clinical narrative: received pfizer covid vaccines 3/29/2021 and 4/19/2021  as of 10 Dec 2021 Admission summary in 10/ 2021- This previously healthy young man with a history of sensorineural hearing loss approximately 10 years ago first developed some arthralgia following coronavirus 19 vaccination in April 2021 however he and his father report that the symptoms resolved and he returned to normal health before starting to feel poor again in the summer 2021.  He has developed intermittent myalgia and arthralgia and has been experiencing fevers.  He did develop fatigue and has been coughing for weeks.  He was admitted on 10/15 with left hemiparesis and found to have a subacute right lacunar infarct of unstated location and narrowing of bilateral external carotid arteries on CT. On 10/17, he developed right hemiparesis and acute dysphagia and found to have a right lateral medullar infarct. He was transferred another medical facility on 10/17. Rheumatology was consulted for evaluation of a rheumatologic process contributing to presentation in setting of reported ANA positive serology.    He does have unexplained fevers, inflammatory "arthritis", dry eyes (positive Schirmer's test on R eye, negative on L eye), dry mouth, neurologic symptoms (stroke), cytopenias, hypergammaglobulinemia, elevated Immunoglobulin level, positive ANA, weakly positive anti-SSA which could be explained by Sjogren's symptoms. People with seronegative (weakly positive in his case) Sjogren's tend to have neurological manifestations.    Received IV cyclophosphamide 500 mg/m2 (900 mg) (first dose on 11/6/2021), IV methylprednislone 500 mg bid x 6 doses. Tapered to equivalent of prednisone 1 mg/kg, Plaquenil 300 mg daily (started on 11/5/21)    Laboratory studies Abnormal - anti-SSA (2.5), ANA 1:640 homogeneous, SPEP consistent with chronic inflammation (hypoalbuminemia, hypergammaglobinemia), anti-smooth muscle, MOG antibody, elevated interleukin 2 receptor, elevated ESR, elevated CRP.   Normal/Negative - antiMPO/PR3, RF, anti-Smith, anti-SSB, anti-Scl70, anti-centromere, C3/C4, anti-CCP, anti-beta 2 glycoprotein 1 Ab, anti-cardiolipin Ab, urine studies, anti-ds-DNA, serum immunofixation, anti-mitochondrial aby, DRVVT, cryoglobulin, Hex lupus anticoagulant Negative NMO in CSF, TB   Pathology: Lip biopsy showed mild focal periductal chronic inflammation with focus score<1 (focus score 0.44).    INTERVAL HISTORY:  He he has noticed improvement after he was discharged.  He is able to walk at home without problem but he still uses walker whenever he goes out.  He denies any new neurologic symptoms. He is currently on prednisone 30 mg daily. He monitors his blood pressure every day and taking beta-blocker for it.  Beta-blocker is managed by primary doctor. His dry eyes and dry mouth do not really bother him.  He has been drinking a lot of fluid for the dry mouth.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Carotid artery stenosis, Cerebrovascular accident, Computerised tomogram abnormal, Cough, Cryoglobulins absent
Clinical narrative: received pfizer covid vaccines 3/29/2021 and 4/19/2021  as of 10 Dec 2021 Admission summary in 10/ 2021- This previously healthy young man with a history of sensorineural hearing loss approximately 10 years ago first developed some arthralgia following coronavirus 19 vaccination in April 2021 however he and his father report that the symptoms resolved and he returned to normal health before starting to feel poor again in the summer 2021.  He has developed intermittent myalgia and arthralgia and has been experiencing fevers.  He did develop fatigue and has been coughing for weeks.  He was admitted on 10/15 with left hemiparesis and found to have a subacute right lacunar infarct of unstated location and narrowing of bilateral external carotid arteries on CT. On 10/17, he developed right hemiparesis and acute dysphagia and found to have a right lateral medullar infarct. He was transferred another medical facility on 10/17. Rheumatology was consulted for evaluation of a rheumatologic process contributing to presentation in setting of reported ANA positive serology.    He does have unexplained fevers, inflammatory "arthritis", dry eyes (positive Schirmer's test on R eye, negative on L eye), dry mouth, neurologic symptoms (stroke), cytopenias, hypergammaglobulinemia, elevated Immunoglobulin level, positive ANA, weakly positive anti-SSA which could be explained by Sjogren's symptoms. People with seronegative (weakly positive in his case) Sjogren's tend to have neurological manifestations.    Received IV cyclophosphamide 500 mg/m2 (900 mg) (first dose on 11/6/2021), IV methylprednislone 500 mg bid x 6 doses. Tapered to equivalent of prednisone 1 mg/kg, Plaquenil 300 mg daily (started on 11/5/21)    Laboratory studies Abnormal - anti-SSA (2.5), ANA 1:640 homogeneous, SPEP consistent with chronic inflammation (hypoalbuminemia, hypergammaglobinemia), anti-smooth muscle, MOG antibody, elevated interleukin 2 receptor, elevated ESR, elevated CRP.   Normal/Negative - antiMPO/PR3, RF, anti-Smith, anti-SSB, anti-Scl70, anti-centromere, C3/C4, anti-CCP, anti-beta 2 glycoprotein 1 Ab, anti-cardiolipin Ab, urine studies, anti-ds-DNA, serum immunofixation, anti-mitochondrial aby, DRVVT, cryoglobulin, Hex lupus anticoagulant Negative NMO in CSF, TB   Pathology: Lip biopsy showed mild focal periductal chronic inflammation with focus score<1 (focus score 0.44).    INTERVAL HISTORY:  He he has noticed improvement after he was discharged.  He is able to walk at home without problem but he still uses walker whenever he goes out.  He denies any new neurologic symptoms. He is currently on prednisone 30 mg daily. He monitors his blood pressure every day and taking beta-blocker for it.  Beta-blocker is managed by primary doctor. His dry eyes and dry mouth do not really bother him.  He has been drinking a lot of fluid for the dry mouth.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Cytopenia, Double stranded DNA antibody, Dry eye, Dry mouth, Dysphagia
Clinical narrative: received pfizer covid vaccines 3/29/2021 and 4/19/2021  as of 10 Dec 2021 Admission summary in 10/ 2021- This previously healthy young man with a history of sensorineural hearing loss approximately 10 years ago first developed some arthralgia following coronavirus 19 vaccination in April 2021 however he and his father report that the symptoms resolved and he returned to normal health before starting to feel poor again in the summer 2021.  He has developed intermittent myalgia and arthralgia and has been experiencing fevers.  He did develop fatigue and has been coughing for weeks.  He was admitted on 10/15 with left hemiparesis and found to have a subacute right lacunar infarct of unstated location and narrowing of bilateral external carotid arteries on CT. On 10/17, he developed right hemiparesis and acute dysphagia and found to have a right lateral medullar infarct. He was transferred another medical facility on 10/17. Rheumatology was consulted for evaluation of a rheumatologic process contributing to presentation in setting of reported ANA positive serology.    He does have unexplained fevers, inflammatory "arthritis", dry eyes (positive Schirmer's test on R eye, negative on L eye), dry mouth, neurologic symptoms (stroke), cytopenias, hypergammaglobulinemia, elevated Immunoglobulin level, positive ANA, weakly positive anti-SSA which could be explained by Sjogren's symptoms. People with seronegative (weakly positive in his case) Sjogren's tend to have neurological manifestations.    Received IV cyclophosphamide 500 mg/m2 (900 mg) (first dose on 11/6/2021), IV methylprednislone 500 mg bid x 6 doses. Tapered to equivalent of prednisone 1 mg/kg, Plaquenil 300 mg daily (started on 11/5/21)    Laboratory studies Abnormal - anti-SSA (2.5), ANA 1:640 homogeneous, SPEP consistent with chronic inflammation (hypoalbuminemia, hypergammaglobinemia), anti-smooth muscle, MOG antibody, elevated interleukin 2 receptor, elevated ESR, elevated CRP.   Normal/Negative - antiMPO/PR3, RF, anti-Smith, anti-SSB, anti-Scl70, anti-centromere, C3/C4, anti-CCP, anti-beta 2 glycoprotein 1 Ab, anti-cardiolipin Ab, urine studies, anti-ds-DNA, serum immunofixation, anti-mitochondrial aby, DRVVT, cryoglobulin, Hex lupus anticoagulant Negative NMO in CSF, TB   Pathology: Lip biopsy showed mild focal periductal chronic inflammation with focus score<1 (focus score 0.44).    INTERVAL HISTORY:  He he has noticed improvement after he was discharged.  He is able to walk at home without problem but he still uses walker whenever he goes out.  He denies any new neurologic symptoms. He is currently on prednisone 30 mg daily. He monitors his blood pressure every day and taking beta-blocker for it.  Beta-blocker is managed by primary doctor. His dry eyes and dry mouth do not really bother him.  He has been drinking a lot of fluid for the dry mouth.