chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 59.0
Sex: M
Vaccine: COVID19-2
Symptoms: Gout, Impaired work ability, Joint injury, Joint swelling, Peripheral swelling
Clinical narrative: The most adverse symptom was that my right leg swelled up and did not go away. I went to my doctor's office and they diagnosed blood clot by doing an ultrasound On Wednesday October 12, 2022. I was prescribed the blood thinner Eloquis, advised to modify my diet and get plenty of rest. I have since got worse and developed a new symptom where I could not put any weight on my leg and my knee swelled. I went to the doctor who sent me to the emergency room. The did several blood test and x-rays and drained the fluid out of my knee. I was diagnosed with Gout. I was prescribed Allopurinol and Colchicine and released after 10 hours. I went to work yesterday but woke up today swollen again and was not able to go to work. I have 2 follow ups at the end of the month. One is for an orthopedic doctor for my ankle as it is also swollen. It was an old injury that flared up pretty bad with everything else.
Age: 59.0
Sex: M
Vaccine: COVID19-2
Symptoms: Thrombosis, Ultrasound Doppler abnormal, Weight bearing difficulty, X-ray normal
Clinical narrative: The most adverse symptom was that my right leg swelled up and did not go away. I went to my doctor's office and they diagnosed blood clot by doing an ultrasound On Wednesday October 12, 2022. I was prescribed the blood thinner Eloquis, advised to modify my diet and get plenty of rest. I have since got worse and developed a new symptom where I could not put any weight on my leg and my knee swelled. I went to the doctor who sent me to the emergency room. The did several blood test and x-rays and drained the fluid out of my knee. I was diagnosed with Gout. I was prescribed Allopurinol and Colchicine and released after 10 hours. I went to work yesterday but woke up today swollen again and was not able to go to work. I have 2 follow ups at the end of the month. One is for an orthopedic doctor for my ankle as it is also swollen. It was an old injury that flared up pretty bad with everything else.
Age: 66.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: COVID-19, Dyspnoea, Pyrexia, Quarantine, Respiratory tract congestion
Clinical narrative: LAB-TESTED POSITIVE, 09/26/2022, FOLLOWING A NASAL SWAB 09/24/2022.  SYMPTOMS INCLUDED UPPER CHEST CONGESTION AND MODERATE DIFFICULTY BREATHING.  TREATED WITH MOLNUPIRAVIR DUE TO POTENTIAL INTERACTION WITH XARELTO. FEVER VARIED FROM 99.0º TO 103º FOR 3 DAYS. PER CDC GUIDELINES, HOME-ISOLATED 5 DAYS AND MASKED UP IN CROWDS FOR 2 WEEKS FOLLOWING DIAGNOSIS.
Age: 66.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: SARS-CoV-2 test positive
Clinical narrative: LAB-TESTED POSITIVE, 09/26/2022, FOLLOWING A NASAL SWAB 09/24/2022.  SYMPTOMS INCLUDED UPPER CHEST CONGESTION AND MODERATE DIFFICULTY BREATHING.  TREATED WITH MOLNUPIRAVIR DUE TO POTENTIAL INTERACTION WITH XARELTO. FEVER VARIED FROM 99.0º TO 103º FOR 3 DAYS. PER CDC GUIDELINES, HOME-ISOLATED 5 DAYS AND MASKED UP IN CROWDS FOR 2 WEEKS FOLLOWING DIAGNOSIS.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Disorientation, Fatigue, Hypoxia, Lethargy
Clinical narrative: Patient was admitted on 2/14/2022 for chief complaint of fatigue. Patient tested positive for Covid-19 as outpatient on 2/10/22 and has had symptoms for greater than 10 days prior to presentation. He had PCP appointment on day of presentation and was found to be hypoxic as well as lethargic and somewhat disoriented. Patient has been vaccinated for Covid-19 but has not had a booster dose. Patient was hypoxic in the EC and placed on supplemental O2. Patient was started on Decadron. He did received 1 dose of remdesivir but this was discontinued due to the duration of his symptoms and elevated LFTs. Patient remained stable on 3L nasal cannula during his hospitalization. He was evaluated for home O2 and qualified. He will continue Decadron at discharge to complete a 10 day course and will follow up with his PCP for continued weaning of his oxygen.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Liver function test increased, Malaise, SARS-CoV-2 test positive
Clinical narrative: Patient was admitted on 2/14/2022 for chief complaint of fatigue. Patient tested positive for Covid-19 as outpatient on 2/10/22 and has had symptoms for greater than 10 days prior to presentation. He had PCP appointment on day of presentation and was found to be hypoxic as well as lethargic and somewhat disoriented. Patient has been vaccinated for Covid-19 but has not had a booster dose. Patient was hypoxic in the EC and placed on supplemental O2. Patient was started on Decadron. He did received 1 dose of remdesivir but this was discontinued due to the duration of his symptoms and elevated LFTs. Patient remained stable on 3L nasal cannula during his hospitalization. He was evaluated for home O2 and qualified. He will continue Decadron at discharge to complete a 10 day course and will follow up with his PCP for continued weaning of his oxygen.
Age: 65.0
Sex: F
Vaccine: FLU4
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: Continued pain of the left deltoid and some limited left arm movement.  Occasionally pain will radiate to left shoulder.  Able to freely move left arm forward and back.  Painful left arm abduction.  Pain started within minutes of injection and continues today (16 days later).  Limited medical evaluation by primary NP on 10/20/22.   No treatment provided.  NP suggested that time will heal and instructed to complete VAERS.
Age: 29.0
Sex: M
Vaccine: FLU4
Symptoms: Body temperature increased
Clinical narrative: Pt received influenza vaccine at 1200, began experiencing elevated temperature starting at 16:18. Vitals as follows: Time                        Temp 10/25 1618         99.1 10/26 0547         99.0 10/26 0907         99.7 10/26 1050         100.0
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Neuropathy peripheral, Paraesthesia
Clinical narrative: My symptoms started on September 11, 2022 and I experienced below both knees I felt tingling surrounding  the legs and feet.  The Dr. called it Peripherl neuropathy. I was told to take vitamin B-12.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Ear discomfort, Ear pain
Clinical narrative: My ears hurt as though I had an ear infection and burned inside and out. Seemed to resolve itself about 24 hours later.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site pain
Clinical narrative: Reported that the patient felt the injection site may have been too high. Reported soreness at the injection site and in the arm/shoulder the next day. This was educated as a potential side effect. Was also educated on the proper location of the deltoid muscle and the proper injection site.
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient incorrectly received a full dose Monovalent Moderna instead of the indicated Bivalent Moderna Booster.  The vaccinator was confused as to which vaccine to administer since patient had not previously received a booster.
Age: 23.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient incorrectly received a full dose Monovalent Moderna instead of the indicated Bivalent Moderna Booster.  The vaccinator was confused as to which vaccine to administer since patient had not previously received a booster.
Age: 26.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Aphasia, Asthenia, Crying, Dizziness, Dysstasia
Clinical narrative: Patient, (staff member at this facility) complained of severe arm pain (Rt. Arm - Booster dose given)shortly after receiving both vaccinations. Within a short amount of time she got the point where she couldn?t move it without crying. She then began feeling faint. She sat in the employee breakroom for a while. She spiked a fever of 102, got very weak to the point that she could not stand, and at one point couldn?t talk. A relative took her to the ER.
Age: 26.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Mobility decreased, Pain in extremity, Pyrexia
Clinical narrative: Patient, (staff member at this facility) complained of severe arm pain (Rt. Arm - Booster dose given)shortly after receiving both vaccinations. Within a short amount of time she got the point where she couldn?t move it without crying. She then began feeling faint. She sat in the employee breakroom for a while. She spiked a fever of 102, got very weak to the point that she could not stand, and at one point couldn?t talk. A relative took her to the ER.
Age: 91.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: patient came in office to obtain the COVID19 (Pfizer-BioNTech Bivalent dose. patient was given the Monovalent dose by error. Patient was let known of what was given and patient stated she had no symptoms but would still like to obtain the Bivalent dose after time frame period. This is patient 4 dose of the Monovalent and per Dr. Patient is able to continue with no further directions .
Age: 41.0
Sex: F
Vaccine: UNK
Symptoms: Injected limb mobility decreased, Periarthritis, Swelling
Clinical narrative: frozen shoulder, constricted left arm motion, swelling
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Feeling abnormal, Headache
Clinical narrative: On 7/13/2022 I started feeling like a headache, a little bit of congestion, that got progressively worse. I was feeling feverish. On the 7/14/22 it got worse. On 7/14/2022 I tested positive for COVID-19. On 7/15, I was  very tired, and I had a lot of sinus pressure in my head about 7/18 or 7/19 I started developing a sore throat, the pain was significant. I had a visit with my doctor on 7/20/22 and was prescribed a steroid, Prednisone.  it relieved the sore throat. and the other symptoms started to subside. Once that started to clear up, I had a dry cough that went through the 30th of July.  I was tired the week of the July 25. On 8/3 I started not to feel too much pain. but I felt like I had to clear my throat. I also had a little bit of brain fog on the 1st week of August. kind of like a daze. I started feeling like myself by September 2022.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Oropharyngeal pain, Paranasal sinus discomfort, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: On 7/13/2022 I started feeling like a headache, a little bit of congestion, that got progressively worse. I was feeling feverish. On the 7/14/22 it got worse. On 7/14/2022 I tested positive for COVID-19. On 7/15, I was  very tired, and I had a lot of sinus pressure in my head about 7/18 or 7/19 I started developing a sore throat, the pain was significant. I had a visit with my doctor on 7/20/22 and was prescribed a steroid, Prednisone.  it relieved the sore throat. and the other symptoms started to subside. Once that started to clear up, I had a dry cough that went through the 30th of July.  I was tired the week of the July 25. On 8/3 I started not to feel too much pain. but I felt like I had to clear my throat. I also had a little bit of brain fog on the 1st week of August. kind of like a daze. I started feeling like myself by September 2022.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Throat clearing
Clinical narrative: On 7/13/2022 I started feeling like a headache, a little bit of congestion, that got progressively worse. I was feeling feverish. On the 7/14/22 it got worse. On 7/14/2022 I tested positive for COVID-19. On 7/15, I was  very tired, and I had a lot of sinus pressure in my head about 7/18 or 7/19 I started developing a sore throat, the pain was significant. I had a visit with my doctor on 7/20/22 and was prescribed a steroid, Prednisone.  it relieved the sore throat. and the other symptoms started to subside. Once that started to clear up, I had a dry cough that went through the 30th of July.  I was tired the week of the July 25. On 8/3 I started not to feel too much pain. but I felt like I had to clear my throat. I also had a little bit of brain fog on the 1st week of August. kind of like a daze. I started feeling like myself by September 2022.
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Bundle branch block right, Cardiac ablation, Cardiac disorder, Cardiomyopathy
Clinical narrative: 10/4/2022  1st occurrence atrial fibrillation. Shortness of breath, fainting.  Diagnosed with cardiomyopathy. EKG test indicate possible pericarditis.  Atrial fibrillation re-occurrence, requiring pharmaceutical intervention (metoPROLOL), and surgical intervention (cardiac ablation).
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea, Ejection fraction decreased, Electrocardiogram abnormal, Syncope
Clinical narrative: 10/4/2022  1st occurrence atrial fibrillation. Shortness of breath, fainting.  Diagnosed with cardiomyopathy. EKG test indicate possible pericarditis.  Atrial fibrillation re-occurrence, requiring pharmaceutical intervention (metoPROLOL), and surgical intervention (cardiac ablation).
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: On 10/26/2022 the patient above received a .5 ml dose of Moderna Monovalent instead of the intended dose, Moderna Bivalent .5 ml. The Patient waited in the office lobby for 15 minutes after administration and had no reactions or side effects.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test, Lymphoedema, Non-pitting oedema, Peripheral swelling, Therapy non-responder
Clinical narrative: Right foot swelling noted one week post vaccine. Non-pitting edema, no relief with elevation, compression. No pain, no history of injury, no bruising. Saw primary care provider - labs, x-rays, referrals to cardiology, podiatry, vascular, and PT. Diagnosed with idiopathic lymphedema, unresponsive to all treatments, including 15 PT visits.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: X-ray
Clinical narrative: Right foot swelling noted one week post vaccine. Non-pitting edema, no relief with elevation, compression. No pain, no history of injury, no bruising. Saw primary care provider - labs, x-rays, referrals to cardiology, podiatry, vascular, and PT. Diagnosed with idiopathic lymphedema, unresponsive to all treatments, including 15 PT visits.
Age: 47.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pruritus
Clinical narrative: Within 5 minutes of receiving the vaccination, individual experienced itching throughout her body.
Age: 44.0
Sex: M
Vaccine: COVID19-2
Symptoms: Burning sensation, Mechanical urticaria, Pain, Pruritus, Urticaria
Clinical narrative: Two weeks post receiving the Moderna bivalent booster I started developing burny, itchy welts and hives on my body, mainly my torso. Seems that it is dermatographia and I have been taking Allegra or Claritin to help with the symptoms. Both of these antihistamines relive the itching and burning but the hives/welts still appear anywhere on my skin where it is touched with moderate pressure, scratching for example. Without antihistamines it is pretty unbearable and quite painful.
Age: 17.0
Sex: M
Vaccine: FLU4, HEP, HEPA, HPV9, MMR, MNQ, TDAP, VARCEL
Symptoms: Immediate post-injection reaction, Rash
Clinical narrative: Pt broke out In rash immediately after vaccination administered, he was given 25mg Benadryl on site. Pt was transferred out to Hospital to receive care.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Cerebral haemorrhage, Cerebrovascular accident, Computerised tomogram, Diplopia
Clinical narrative: On 05/03/2022, the Tuesday following my fourth dose of Pfizer, I had the worst headache I had ever experienced. Three days later, I began to have double vision. A friend took me to the local emergency room. I was ultimately diagnosed with having a slight stroke. They took me to a larger hospital and did an MRI of my brain. The MRI that was done showed a bleed in the left temporal. I have never had high blood pressure or high cholesterol and have had a good health history, so this was all sort of out of blue.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Magnetic resonance imaging head abnormal
Clinical narrative: On 05/03/2022, the Tuesday following my fourth dose of Pfizer, I had the worst headache I had ever experienced. Three days later, I began to have double vision. A friend took me to the local emergency room. I was ultimately diagnosed with having a slight stroke. They took me to a larger hospital and did an MRI of my brain. The MRI that was done showed a bleed in the left temporal. I have never had high blood pressure or high cholesterol and have had a good health history, so this was all sort of out of blue.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Cough, Fatigue, Gait disturbance
Clinical narrative: I tested positive for COVID-19 on 5/13/22. I had a sore, scratchy throat, body aches, very tired, high fever of 102 that I was controlling with TYLENOL. I was also sweating bad and had chills. I was prescribed PAXLOVID for five days and I felt better, but I still had a deep cough. I tested negative, but still had a bad cough. I am pretty active and since COVID-19 the tops of my feet are always sore. So, it is more difficult for me to take long walks that I used to do.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperhidrosis, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia
Clinical narrative: I tested positive for COVID-19 on 5/13/22. I had a sore, scratchy throat, body aches, very tired, high fever of 102 that I was controlling with TYLENOL. I was also sweating bad and had chills. I was prescribed PAXLOVID for five days and I felt better, but I still had a deep cough. I tested negative, but still had a bad cough. I am pretty active and since COVID-19 the tops of my feet are always sore. So, it is more difficult for me to take long walks that I used to do.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Throat irritation
Clinical narrative: I tested positive for COVID-19 on 5/13/22. I had a sore, scratchy throat, body aches, very tired, high fever of 102 that I was controlling with TYLENOL. I was also sweating bad and had chills. I was prescribed PAXLOVID for five days and I felt better, but I still had a deep cough. I tested negative, but still had a bad cough. I am pretty active and since COVID-19 the tops of my feet are always sore. So, it is more difficult for me to take long walks that I used to do.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect route of product administration, No adverse event
Clinical narrative: Patient received second dose of covid 19-pfizer at our facility. accidentally given SQ instead of IM. No adverse reactions at this time but asked patient to report any reactions to the pharmacy.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Malaise, SARS-CoV-2 test positive
Clinical narrative: I had my vaccination on 10/25/2021. On 10/06/2022 I started not feeling well. I tested COVID-19 Positive on 10/07/2022. I contacted my physician on 10/07/2022 and they prescribed Paxlovid. I am almost better but still residual cough on 10/26/2022.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: On 10/26/2022 the patient above received a .5 ml dose of Moderna Monovalent instead of the intended dose of Moderna Bivalent .5 ml vaccine. After the administration the patient waited in the office lobby for 15 minutes and did not have any side effects or reactions to the vaccine.
Age: 53.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: Covid bivalent vaccine given 18 minutes given 18 minutes past puncture date
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Acidosis, Benign prostatic hyperplasia, Brain natriuretic peptide increased, COVID-19, Cardiac failure congestive
Clinical narrative: Admission Date: 10/12/2022 Discharge Date:10/21/2022   HOSPITAL COURSE Patient is a 72 y.o. male with a history of persistent atrial fibrillation, diastolic heart failure, and oxygen-dependent chronic obstructive pulmonary disease who presented to the hospital 10/12 with dyspnea. Few hours prior to arrival he suddenly became very dyspneic.  He usually uses 3 L of supplemental oxygen at baseline but turned up to 5 at home and then called EMS. Patient received 125 mg of Solu-Medrol and a DuoNeb treatment on the way to the hospital in the ambulance.  On arrival, he had mild leukocytosis.  He tested positive for COVID-19.  He was initially hypercapnic and slightly acidotic.  This resolved after continuous nebulizer. D-dimer was negative. CXR was clear. Patient was admitted for COPD with acute exacerbation 2/2 Covid 19 infection. Remdesivir was started on 10/12 and was completed on 10/16 daily renal and liver function monitoring for kidney and liver toxicity was done. For COPD exacerbation he was started on solumedrol 40 mg IV every 12 hours and then was transitioned to prednisone 40 mg PO. Patient completed a 5 days course of azithromycin IV (10/13-10/17). Patient received duo-nebs every 4 hours while awake. He was continued on his home Budesonide/Fometorol and Spiriva INH. Patient is being discharge on prednisone 10 mg with a taper.    Patients was treated for fasting hyperglycemia. Hyperglycemia was most likely steroid induced and improved from the switch from solumedrol to prednisone. Patient was placed on a moderate sliding scale insulin but d/c at discharge. Hemoglobin A1c obtained was 6.4%.    Patient showed symptoms of a mild acute exacerbation for his chronic diastolic congestive heart failure. CXR showed no acute cardiopulmonary abnormalities but BNP was 2,420. Patient was given 40 mg of IV lasix (10/17-10/18) and then transitioned to lasix 20 mg PO BID which he tolerated well.    Patient had symptoms correlating to BPH he was started on flomax 0.4 mg patient stated this helped with emptying bladder.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Chronic left ventricular failure, Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea
Clinical narrative: Admission Date: 10/12/2022 Discharge Date:10/21/2022   HOSPITAL COURSE Patient is a 72 y.o. male with a history of persistent atrial fibrillation, diastolic heart failure, and oxygen-dependent chronic obstructive pulmonary disease who presented to the hospital 10/12 with dyspnea. Few hours prior to arrival he suddenly became very dyspneic.  He usually uses 3 L of supplemental oxygen at baseline but turned up to 5 at home and then called EMS. Patient received 125 mg of Solu-Medrol and a DuoNeb treatment on the way to the hospital in the ambulance.  On arrival, he had mild leukocytosis.  He tested positive for COVID-19.  He was initially hypercapnic and slightly acidotic.  This resolved after continuous nebulizer. D-dimer was negative. CXR was clear. Patient was admitted for COPD with acute exacerbation 2/2 Covid 19 infection. Remdesivir was started on 10/12 and was completed on 10/16 daily renal and liver function monitoring for kidney and liver toxicity was done. For COPD exacerbation he was started on solumedrol 40 mg IV every 12 hours and then was transitioned to prednisone 40 mg PO. Patient completed a 5 days course of azithromycin IV (10/13-10/17). Patient received duo-nebs every 4 hours while awake. He was continued on his home Budesonide/Fometorol and Spiriva INH. Patient is being discharge on prednisone 10 mg with a taper.    Patients was treated for fasting hyperglycemia. Hyperglycemia was most likely steroid induced and improved from the switch from solumedrol to prednisone. Patient was placed on a moderate sliding scale insulin but d/c at discharge. Hemoglobin A1c obtained was 6.4%.    Patient showed symptoms of a mild acute exacerbation for his chronic diastolic congestive heart failure. CXR showed no acute cardiopulmonary abnormalities but BNP was 2,420. Patient was given 40 mg of IV lasix (10/17-10/18) and then transitioned to lasix 20 mg PO BID which he tolerated well.    Patient had symptoms correlating to BPH he was started on flomax 0.4 mg patient stated this helped with emptying bladder.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Fibrin D dimer normal, Glycosylated haemoglobin increased, Hypercapnia, Hyperglycaemia, Insulin therapy
Clinical narrative: Admission Date: 10/12/2022 Discharge Date:10/21/2022   HOSPITAL COURSE Patient is a 72 y.o. male with a history of persistent atrial fibrillation, diastolic heart failure, and oxygen-dependent chronic obstructive pulmonary disease who presented to the hospital 10/12 with dyspnea. Few hours prior to arrival he suddenly became very dyspneic.  He usually uses 3 L of supplemental oxygen at baseline but turned up to 5 at home and then called EMS. Patient received 125 mg of Solu-Medrol and a DuoNeb treatment on the way to the hospital in the ambulance.  On arrival, he had mild leukocytosis.  He tested positive for COVID-19.  He was initially hypercapnic and slightly acidotic.  This resolved after continuous nebulizer. D-dimer was negative. CXR was clear. Patient was admitted for COPD with acute exacerbation 2/2 Covid 19 infection. Remdesivir was started on 10/12 and was completed on 10/16 daily renal and liver function monitoring for kidney and liver toxicity was done. For COPD exacerbation he was started on solumedrol 40 mg IV every 12 hours and then was transitioned to prednisone 40 mg PO. Patient completed a 5 days course of azithromycin IV (10/13-10/17). Patient received duo-nebs every 4 hours while awake. He was continued on his home Budesonide/Fometorol and Spiriva INH. Patient is being discharge on prednisone 10 mg with a taper.    Patients was treated for fasting hyperglycemia. Hyperglycemia was most likely steroid induced and improved from the switch from solumedrol to prednisone. Patient was placed on a moderate sliding scale insulin but d/c at discharge. Hemoglobin A1c obtained was 6.4%.    Patient showed symptoms of a mild acute exacerbation for his chronic diastolic congestive heart failure. CXR showed no acute cardiopulmonary abnormalities but BNP was 2,420. Patient was given 40 mg of IV lasix (10/17-10/18) and then transitioned to lasix 20 mg PO BID which he tolerated well.    Patient had symptoms correlating to BPH he was started on flomax 0.4 mg patient stated this helped with emptying bladder.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Leukocytosis, Liver function test, Renal function test, SARS-CoV-2 test positive, Urinary retention
Clinical narrative: Admission Date: 10/12/2022 Discharge Date:10/21/2022   HOSPITAL COURSE Patient is a 72 y.o. male with a history of persistent atrial fibrillation, diastolic heart failure, and oxygen-dependent chronic obstructive pulmonary disease who presented to the hospital 10/12 with dyspnea. Few hours prior to arrival he suddenly became very dyspneic.  He usually uses 3 L of supplemental oxygen at baseline but turned up to 5 at home and then called EMS. Patient received 125 mg of Solu-Medrol and a DuoNeb treatment on the way to the hospital in the ambulance.  On arrival, he had mild leukocytosis.  He tested positive for COVID-19.  He was initially hypercapnic and slightly acidotic.  This resolved after continuous nebulizer. D-dimer was negative. CXR was clear. Patient was admitted for COPD with acute exacerbation 2/2 Covid 19 infection. Remdesivir was started on 10/12 and was completed on 10/16 daily renal and liver function monitoring for kidney and liver toxicity was done. For COPD exacerbation he was started on solumedrol 40 mg IV every 12 hours and then was transitioned to prednisone 40 mg PO. Patient completed a 5 days course of azithromycin IV (10/13-10/17). Patient received duo-nebs every 4 hours while awake. He was continued on his home Budesonide/Fometorol and Spiriva INH. Patient is being discharge on prednisone 10 mg with a taper.    Patients was treated for fasting hyperglycemia. Hyperglycemia was most likely steroid induced and improved from the switch from solumedrol to prednisone. Patient was placed on a moderate sliding scale insulin but d/c at discharge. Hemoglobin A1c obtained was 6.4%.    Patient showed symptoms of a mild acute exacerbation for his chronic diastolic congestive heart failure. CXR showed no acute cardiopulmonary abnormalities but BNP was 2,420. Patient was given 40 mg of IV lasix (10/17-10/18) and then transitioned to lasix 20 mg PO BID which he tolerated well.    Patient had symptoms correlating to BPH he was started on flomax 0.4 mg patient stated this helped with emptying bladder.
Age: 14.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Dizziness
Clinical narrative: c/o dizziness. Color pink. O2 sat 96%. HR 100. BP 112/76. Alert & oriented x4. Speaking clearly.  Gait steady. Ate crackers & drank juice, then denied further dizziness.
Age: 58.0
Sex: M
Vaccine: COVID19-2
Symptoms: Arthralgia, Body temperature increased, Chills, Malaise, Pain
Clinical narrative: I woke up and had chills and did not feel well, I ran a temperature of 101 degrees including body aches and joint aches. This lasted for two days.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: First Pfizer given on 10/24/22 second Pfizer given on 10/26/22
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Analgesic drug level, Arteriosclerosis, Blood creatine phosphokinase increased, Blood creatinine increased
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Blood ethanol, Blood lactic acid, Blood magnesium, Blood pressure increased, Blood urea increased
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Bundle branch block left, COVID-19, Chest X-ray normal, Computerised tomogram head normal, Condition aggravated
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Coronary artery stenosis, Culture positive, Dizziness, Dyspnoea, Echocardiogram normal
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Exposure to SARS-CoV-2, Fall, Fatigue, Full blood count abnormal
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Globulins increased, Metabolic function test abnormal, Nitrite urine present, Platelet count decreased, Procalcitonin increased
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Productive cough, Proteus test positive, Renal impairment, SARS-CoV-2 test positive, Sinus rhythm
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP