chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram thorax abnormal, Dyspnoea, Echocardiogram abnormal, Ejection fraction, Electrocardiogram abnormal
Clinical narrative: Clinical Summary Patient is a 79 y.o. male with a history of HTN, HLD, OSA, chronic pain syndrome, hypothyroidism, CKD 2, TIA who presented to hospital 11/26/2022 with shortness of breath. Labs in ED showed lactic acid 2.1, troponin 36, WBC 15.2, Cr 1.5. CXR showed bilateral basilar atelectasis. Patient was found to be in hypoxic respiratory failure and sepsis as well Afib w/ RVR. COVID-19 was positive.   1. Acute respiratory failure: w/ hypoxia. Secondary to COVID-19, superimposed bacterial pneumonia. Imaging as below. Required BiPAP initially in ED than transitioned to NRB. Improved to 11L oxymizer. Continued supplemental O2 as needed, weaned as tolerated. Incentive spirometry ordered, IV lasix for dry strategy (redosed 11/30). Was able to wean to 2L NC on 11/30. Qualified for home O2, cont to wean as outpatient.  2. Sepsis: met criteria on admission with tachycardia, leukocytosis, tachypnea, lactic acidosis. Suspected pulmonary source. S/p 30 cc/kg IVF. Abx as below. Blood cultures so far NGTD. Completed course for CAP.  3. COVID-19 pneumonia: symptom onset 5 days prior to admission. Vaccinated with booster. Positive test 11/26/22. Continued dexamethasone, remdesevir. Supportive care. Trended inflammatory markers- improved. Complete decadron course.  4. Superimposed bacterial pneumonia: On admission, WBC 15.2, procal 1.28. CT chest suggesting multifocal pneumonia. Atypical antigens negative. Continued rocephin. Stopped azithromycin. Completed course for Cap.  5. Atrial fibrillation w/ RVR: new diagnosis. In ED, HR noted 166. EKG showed Afib w/ RVR. Weaned off diltiazem GTT. Continued heparin GTT, transition to DOAC once more clinically stable. Continued PO metoprolol. Cardiology followed. Transition to eliquis on 11/30.  Follow up afib clinic.  6. Elevated troponins: Trops 9, 22, 36. EKG with no acute ischemic changes. No chest pain noted. ECHO 11/27/22 showed LVEF 62%, no WMA, pulmonary HTN. Suspected demand ischemia related to above, low suspicion for ACS. Continued metoprolol. Cardiology followed. 7. Lactic acidosis: secondary to sepsis. Lactic acid 2.1, 2.4, 2.6. S/p IVF. Resolved. 8. CKD 2: baseline Cr 1.1-1.3. Cr on admission 1.5. Monitored. 9. HTN: continued home amlodipine. Held home losartan with higher than baseline Cr. Restart as able. Monitored. 10. HLD: continued home statin. 11. Hypothyroidism: continued home levothyroxine 12. Chronic pain syndrome: Continued home suboxone. NARx reviewed 13. H/o TIA: per hx. Continued home statin
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Inflammatory marker test, Laboratory test normal, Lactic acidosis, Leukocytosis, Myocardial ischaemia
Clinical narrative: Clinical Summary Patient is a 79 y.o. male with a history of HTN, HLD, OSA, chronic pain syndrome, hypothyroidism, CKD 2, TIA who presented to hospital 11/26/2022 with shortness of breath. Labs in ED showed lactic acid 2.1, troponin 36, WBC 15.2, Cr 1.5. CXR showed bilateral basilar atelectasis. Patient was found to be in hypoxic respiratory failure and sepsis as well Afib w/ RVR. COVID-19 was positive.   1. Acute respiratory failure: w/ hypoxia. Secondary to COVID-19, superimposed bacterial pneumonia. Imaging as below. Required BiPAP initially in ED than transitioned to NRB. Improved to 11L oxymizer. Continued supplemental O2 as needed, weaned as tolerated. Incentive spirometry ordered, IV lasix for dry strategy (redosed 11/30). Was able to wean to 2L NC on 11/30. Qualified for home O2, cont to wean as outpatient.  2. Sepsis: met criteria on admission with tachycardia, leukocytosis, tachypnea, lactic acidosis. Suspected pulmonary source. S/p 30 cc/kg IVF. Abx as below. Blood cultures so far NGTD. Completed course for CAP.  3. COVID-19 pneumonia: symptom onset 5 days prior to admission. Vaccinated with booster. Positive test 11/26/22. Continued dexamethasone, remdesevir. Supportive care. Trended inflammatory markers- improved. Complete decadron course.  4. Superimposed bacterial pneumonia: On admission, WBC 15.2, procal 1.28. CT chest suggesting multifocal pneumonia. Atypical antigens negative. Continued rocephin. Stopped azithromycin. Completed course for Cap.  5. Atrial fibrillation w/ RVR: new diagnosis. In ED, HR noted 166. EKG showed Afib w/ RVR. Weaned off diltiazem GTT. Continued heparin GTT, transition to DOAC once more clinically stable. Continued PO metoprolol. Cardiology followed. Transition to eliquis on 11/30.  Follow up afib clinic.  6. Elevated troponins: Trops 9, 22, 36. EKG with no acute ischemic changes. No chest pain noted. ECHO 11/27/22 showed LVEF 62%, no WMA, pulmonary HTN. Suspected demand ischemia related to above, low suspicion for ACS. Continued metoprolol. Cardiology followed. 7. Lactic acidosis: secondary to sepsis. Lactic acid 2.1, 2.4, 2.6. S/p IVF. Resolved. 8. CKD 2: baseline Cr 1.1-1.3. Cr on admission 1.5. Monitored. 9. HTN: continued home amlodipine. Held home losartan with higher than baseline Cr. Restart as able. Monitored. 10. HLD: continued home statin. 11. Hypothyroidism: continued home levothyroxine 12. Chronic pain syndrome: Continued home suboxone. NARx reviewed 13. H/o TIA: per hx. Continued home statin
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pneumonia, Pneumonia bacterial, Positive airway pressure therapy, Procalcitonin, Pulmonary hypertension
Clinical narrative: Clinical Summary Patient is a 79 y.o. male with a history of HTN, HLD, OSA, chronic pain syndrome, hypothyroidism, CKD 2, TIA who presented to hospital 11/26/2022 with shortness of breath. Labs in ED showed lactic acid 2.1, troponin 36, WBC 15.2, Cr 1.5. CXR showed bilateral basilar atelectasis. Patient was found to be in hypoxic respiratory failure and sepsis as well Afib w/ RVR. COVID-19 was positive.   1. Acute respiratory failure: w/ hypoxia. Secondary to COVID-19, superimposed bacterial pneumonia. Imaging as below. Required BiPAP initially in ED than transitioned to NRB. Improved to 11L oxymizer. Continued supplemental O2 as needed, weaned as tolerated. Incentive spirometry ordered, IV lasix for dry strategy (redosed 11/30). Was able to wean to 2L NC on 11/30. Qualified for home O2, cont to wean as outpatient.  2. Sepsis: met criteria on admission with tachycardia, leukocytosis, tachypnea, lactic acidosis. Suspected pulmonary source. S/p 30 cc/kg IVF. Abx as below. Blood cultures so far NGTD. Completed course for CAP.  3. COVID-19 pneumonia: symptom onset 5 days prior to admission. Vaccinated with booster. Positive test 11/26/22. Continued dexamethasone, remdesevir. Supportive care. Trended inflammatory markers- improved. Complete decadron course.  4. Superimposed bacterial pneumonia: On admission, WBC 15.2, procal 1.28. CT chest suggesting multifocal pneumonia. Atypical antigens negative. Continued rocephin. Stopped azithromycin. Completed course for Cap.  5. Atrial fibrillation w/ RVR: new diagnosis. In ED, HR noted 166. EKG showed Afib w/ RVR. Weaned off diltiazem GTT. Continued heparin GTT, transition to DOAC once more clinically stable. Continued PO metoprolol. Cardiology followed. Transition to eliquis on 11/30.  Follow up afib clinic.  6. Elevated troponins: Trops 9, 22, 36. EKG with no acute ischemic changes. No chest pain noted. ECHO 11/27/22 showed LVEF 62%, no WMA, pulmonary HTN. Suspected demand ischemia related to above, low suspicion for ACS. Continued metoprolol. Cardiology followed. 7. Lactic acidosis: secondary to sepsis. Lactic acid 2.1, 2.4, 2.6. S/p IVF. Resolved. 8. CKD 2: baseline Cr 1.1-1.3. Cr on admission 1.5. Monitored. 9. HTN: continued home amlodipine. Held home losartan with higher than baseline Cr. Restart as able. Monitored. 10. HLD: continued home statin. 11. Hypothyroidism: continued home levothyroxine 12. Chronic pain syndrome: Continued home suboxone. NARx reviewed 13. H/o TIA: per hx. Continued home statin
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sepsis, Superinfection, Tachycardia, Tachypnoea
Clinical narrative: Clinical Summary Patient is a 79 y.o. male with a history of HTN, HLD, OSA, chronic pain syndrome, hypothyroidism, CKD 2, TIA who presented to hospital 11/26/2022 with shortness of breath. Labs in ED showed lactic acid 2.1, troponin 36, WBC 15.2, Cr 1.5. CXR showed bilateral basilar atelectasis. Patient was found to be in hypoxic respiratory failure and sepsis as well Afib w/ RVR. COVID-19 was positive.   1. Acute respiratory failure: w/ hypoxia. Secondary to COVID-19, superimposed bacterial pneumonia. Imaging as below. Required BiPAP initially in ED than transitioned to NRB. Improved to 11L oxymizer. Continued supplemental O2 as needed, weaned as tolerated. Incentive spirometry ordered, IV lasix for dry strategy (redosed 11/30). Was able to wean to 2L NC on 11/30. Qualified for home O2, cont to wean as outpatient.  2. Sepsis: met criteria on admission with tachycardia, leukocytosis, tachypnea, lactic acidosis. Suspected pulmonary source. S/p 30 cc/kg IVF. Abx as below. Blood cultures so far NGTD. Completed course for CAP.  3. COVID-19 pneumonia: symptom onset 5 days prior to admission. Vaccinated with booster. Positive test 11/26/22. Continued dexamethasone, remdesevir. Supportive care. Trended inflammatory markers- improved. Complete decadron course.  4. Superimposed bacterial pneumonia: On admission, WBC 15.2, procal 1.28. CT chest suggesting multifocal pneumonia. Atypical antigens negative. Continued rocephin. Stopped azithromycin. Completed course for Cap.  5. Atrial fibrillation w/ RVR: new diagnosis. In ED, HR noted 166. EKG showed Afib w/ RVR. Weaned off diltiazem GTT. Continued heparin GTT, transition to DOAC once more clinically stable. Continued PO metoprolol. Cardiology followed. Transition to eliquis on 11/30.  Follow up afib clinic.  6. Elevated troponins: Trops 9, 22, 36. EKG with no acute ischemic changes. No chest pain noted. ECHO 11/27/22 showed LVEF 62%, no WMA, pulmonary HTN. Suspected demand ischemia related to above, low suspicion for ACS. Continued metoprolol. Cardiology followed. 7. Lactic acidosis: secondary to sepsis. Lactic acid 2.1, 2.4, 2.6. S/p IVF. Resolved. 8. CKD 2: baseline Cr 1.1-1.3. Cr on admission 1.5. Monitored. 9. HTN: continued home amlodipine. Held home losartan with higher than baseline Cr. Restart as able. Monitored. 10. HLD: continued home statin. 11. Hypothyroidism: continued home levothyroxine 12. Chronic pain syndrome: Continued home suboxone. NARx reviewed 13. H/o TIA: per hx. Continued home statin
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Troponin increased, White blood cell count increased
Clinical narrative: Clinical Summary Patient is a 79 y.o. male with a history of HTN, HLD, OSA, chronic pain syndrome, hypothyroidism, CKD 2, TIA who presented to hospital 11/26/2022 with shortness of breath. Labs in ED showed lactic acid 2.1, troponin 36, WBC 15.2, Cr 1.5. CXR showed bilateral basilar atelectasis. Patient was found to be in hypoxic respiratory failure and sepsis as well Afib w/ RVR. COVID-19 was positive.   1. Acute respiratory failure: w/ hypoxia. Secondary to COVID-19, superimposed bacterial pneumonia. Imaging as below. Required BiPAP initially in ED than transitioned to NRB. Improved to 11L oxymizer. Continued supplemental O2 as needed, weaned as tolerated. Incentive spirometry ordered, IV lasix for dry strategy (redosed 11/30). Was able to wean to 2L NC on 11/30. Qualified for home O2, cont to wean as outpatient.  2. Sepsis: met criteria on admission with tachycardia, leukocytosis, tachypnea, lactic acidosis. Suspected pulmonary source. S/p 30 cc/kg IVF. Abx as below. Blood cultures so far NGTD. Completed course for CAP.  3. COVID-19 pneumonia: symptom onset 5 days prior to admission. Vaccinated with booster. Positive test 11/26/22. Continued dexamethasone, remdesevir. Supportive care. Trended inflammatory markers- improved. Complete decadron course.  4. Superimposed bacterial pneumonia: On admission, WBC 15.2, procal 1.28. CT chest suggesting multifocal pneumonia. Atypical antigens negative. Continued rocephin. Stopped azithromycin. Completed course for Cap.  5. Atrial fibrillation w/ RVR: new diagnosis. In ED, HR noted 166. EKG showed Afib w/ RVR. Weaned off diltiazem GTT. Continued heparin GTT, transition to DOAC once more clinically stable. Continued PO metoprolol. Cardiology followed. Transition to eliquis on 11/30.  Follow up afib clinic.  6. Elevated troponins: Trops 9, 22, 36. EKG with no acute ischemic changes. No chest pain noted. ECHO 11/27/22 showed LVEF 62%, no WMA, pulmonary HTN. Suspected demand ischemia related to above, low suspicion for ACS. Continued metoprolol. Cardiology followed. 7. Lactic acidosis: secondary to sepsis. Lactic acid 2.1, 2.4, 2.6. S/p IVF. Resolved. 8. CKD 2: baseline Cr 1.1-1.3. Cr on admission 1.5. Monitored. 9. HTN: continued home amlodipine. Held home losartan with higher than baseline Cr. Restart as able. Monitored. 10. HLD: continued home statin. 11. Hypothyroidism: continued home levothyroxine 12. Chronic pain syndrome: Continued home suboxone. NARx reviewed 13. H/o TIA: per hx. Continued home statin
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 3/10/21, 4/5/21, 12/16/21, 5/25/22, 11/29/22. Positive on 12/20/22 (OF)
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Moderna 4/21/21, 5/19/21, 1/19/22, 4/12/22. Positive on 12/27/22
Age: 82.0
Sex: F
Vaccine: COVID19, PPV
Symptoms: Acute kidney injury, Acute respiratory failure, Aspiration pleural cavity, Asthenia, Atrial fibrillation
Clinical narrative: COVID+ 12/22/22.  Vaccination Status - Moderna x3 BRIEF OVERVIEW: Discharge Provider:  Primary Care Provider at Discharge:  Admission Date: 12/22/2022 Discharge Date: 12/27/2022   Active Hospital Problems   Diagnosis Date Noted POA ? AKI (acute kidney injury)  12/24/2022 Unknown ? COVID-19 12/22/2022 Unknown ? Atrial fibrillation with RVR 12/22/2022 Unknown ? Pleural effusion, bilateral 12/22/2022 Unknown ? Chronic combined systolic and diastolic heart failure 09/28/2022 Yes ? Valvular heart disease 09/28/2022 Yes ? Paroxysmal atrial fibrillation 09/14/2022 Yes ? Primary hypertension   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pleural effusion [J90] Atrial fibrillation with RVR [I48.91] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Pt. is a 83 y.o. female who presented with shortness of breath, fatigue and weakness that started roughly 5 days ago.  She denies dizziness, headache, palpitations, chest pain/pressure, fever, chills, body aches, cough, congestion, lower extremity edema.  No nausea, vomiting, diarrhea, dysuria.   Upon arrival to the emergency department she was found to be hypoxic with SpO2 79%, and tachypnea with RR 29. EKG was performed and demonstrated atrial fibrillation with RVR.  CXR demonstrated large left pleural effusion and small right pleural effusion with vascular congestion bilaterally.  BNP 10478.  Troponin 21.  Positive COVID nasal swab.  Current vital signs 95% on 2 L nasal cannula, RR 28, blood pressure 160/122, HR 154. Patient reports that her symptoms have improved since arrival however she does state that her shortness of breath continues to be moderate in intensity.  She denies pain at this time.  The above vital signs, and radiographs, labs reviewed and interpreted by me on 12/22/2022.  Patient was referred to admission to hospitalist service, inpatient progressive care unit.   Patient was diuresed with intravenous Lasix and placed on a Cardizem drip for rate control.  She underwent thoracentesis with removal of 500 mL of fluid.  With these measures she was able to be weaned off oxygen but she became mildly hypotensive.  Cardizem had to be discontinued.  She was started on digoxin for control of her heart rate with good results; however she did have some pauses with an elevated digoxin level.  Case was discussed with Cardiology to was recommended maintaining her on a beta-blocker, adding a low-dose of oral Cardizem with the patient could tolerate.  Patient continue improved but she did have some nighttime hypoxemia.  She was kept an additional day for a nighttime oxygen saturation study to possibly qualify her for oxygen. She did not qualify for oxygen. Labs and vitals are stable.Patient is eager to discharge, she has been discharged in a stable medical condition with her family.
Age: 82.0
Sex: F
Vaccine: COVID19, PPV
Symptoms: Brain natriuretic peptide increased, COVID-19, Cardiac valve disease, Cardioactive drug level increased, Chest X-ray abnormal
Clinical narrative: COVID+ 12/22/22.  Vaccination Status - Moderna x3 BRIEF OVERVIEW: Discharge Provider:  Primary Care Provider at Discharge:  Admission Date: 12/22/2022 Discharge Date: 12/27/2022   Active Hospital Problems   Diagnosis Date Noted POA ? AKI (acute kidney injury)  12/24/2022 Unknown ? COVID-19 12/22/2022 Unknown ? Atrial fibrillation with RVR 12/22/2022 Unknown ? Pleural effusion, bilateral 12/22/2022 Unknown ? Chronic combined systolic and diastolic heart failure 09/28/2022 Yes ? Valvular heart disease 09/28/2022 Yes ? Paroxysmal atrial fibrillation 09/14/2022 Yes ? Primary hypertension   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pleural effusion [J90] Atrial fibrillation with RVR [I48.91] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Pt. is a 83 y.o. female who presented with shortness of breath, fatigue and weakness that started roughly 5 days ago.  She denies dizziness, headache, palpitations, chest pain/pressure, fever, chills, body aches, cough, congestion, lower extremity edema.  No nausea, vomiting, diarrhea, dysuria.   Upon arrival to the emergency department she was found to be hypoxic with SpO2 79%, and tachypnea with RR 29. EKG was performed and demonstrated atrial fibrillation with RVR.  CXR demonstrated large left pleural effusion and small right pleural effusion with vascular congestion bilaterally.  BNP 10478.  Troponin 21.  Positive COVID nasal swab.  Current vital signs 95% on 2 L nasal cannula, RR 28, blood pressure 160/122, HR 154. Patient reports that her symptoms have improved since arrival however she does state that her shortness of breath continues to be moderate in intensity.  She denies pain at this time.  The above vital signs, and radiographs, labs reviewed and interpreted by me on 12/22/2022.  Patient was referred to admission to hospitalist service, inpatient progressive care unit.   Patient was diuresed with intravenous Lasix and placed on a Cardizem drip for rate control.  She underwent thoracentesis with removal of 500 mL of fluid.  With these measures she was able to be weaned off oxygen but she became mildly hypotensive.  Cardizem had to be discontinued.  She was started on digoxin for control of her heart rate with good results; however she did have some pauses with an elevated digoxin level.  Case was discussed with Cardiology to was recommended maintaining her on a beta-blocker, adding a low-dose of oral Cardizem with the patient could tolerate.  Patient continue improved but she did have some nighttime hypoxemia.  She was kept an additional day for a nighttime oxygen saturation study to possibly qualify her for oxygen. She did not qualify for oxygen. Labs and vitals are stable.Patient is eager to discharge, she has been discharged in a stable medical condition with her family.
Age: 82.0
Sex: F
Vaccine: COVID19, PPV
Symptoms: Chronic left ventricular failure, Condition aggravated, Diuretic therapy, Dyspnoea, Electrocardiogram abnormal
Clinical narrative: COVID+ 12/22/22.  Vaccination Status - Moderna x3 BRIEF OVERVIEW: Discharge Provider:  Primary Care Provider at Discharge:  Admission Date: 12/22/2022 Discharge Date: 12/27/2022   Active Hospital Problems   Diagnosis Date Noted POA ? AKI (acute kidney injury)  12/24/2022 Unknown ? COVID-19 12/22/2022 Unknown ? Atrial fibrillation with RVR 12/22/2022 Unknown ? Pleural effusion, bilateral 12/22/2022 Unknown ? Chronic combined systolic and diastolic heart failure 09/28/2022 Yes ? Valvular heart disease 09/28/2022 Yes ? Paroxysmal atrial fibrillation 09/14/2022 Yes ? Primary hypertension   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pleural effusion [J90] Atrial fibrillation with RVR [I48.91] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Pt. is a 83 y.o. female who presented with shortness of breath, fatigue and weakness that started roughly 5 days ago.  She denies dizziness, headache, palpitations, chest pain/pressure, fever, chills, body aches, cough, congestion, lower extremity edema.  No nausea, vomiting, diarrhea, dysuria.   Upon arrival to the emergency department she was found to be hypoxic with SpO2 79%, and tachypnea with RR 29. EKG was performed and demonstrated atrial fibrillation with RVR.  CXR demonstrated large left pleural effusion and small right pleural effusion with vascular congestion bilaterally.  BNP 10478.  Troponin 21.  Positive COVID nasal swab.  Current vital signs 95% on 2 L nasal cannula, RR 28, blood pressure 160/122, HR 154. Patient reports that her symptoms have improved since arrival however she does state that her shortness of breath continues to be moderate in intensity.  She denies pain at this time.  The above vital signs, and radiographs, labs reviewed and interpreted by me on 12/22/2022.  Patient was referred to admission to hospitalist service, inpatient progressive care unit.   Patient was diuresed with intravenous Lasix and placed on a Cardizem drip for rate control.  She underwent thoracentesis with removal of 500 mL of fluid.  With these measures she was able to be weaned off oxygen but she became mildly hypotensive.  Cardizem had to be discontinued.  She was started on digoxin for control of her heart rate with good results; however she did have some pauses with an elevated digoxin level.  Case was discussed with Cardiology to was recommended maintaining her on a beta-blocker, adding a low-dose of oral Cardizem with the patient could tolerate.  Patient continue improved but she did have some nighttime hypoxemia.  She was kept an additional day for a nighttime oxygen saturation study to possibly qualify her for oxygen. She did not qualify for oxygen. Labs and vitals are stable.Patient is eager to discharge, she has been discharged in a stable medical condition with her family.
Age: 82.0
Sex: F
Vaccine: COVID19, PPV
Symptoms: Essential hypertension, Fatigue, Hypotension, Hypoxia, Pleural effusion
Clinical narrative: COVID+ 12/22/22.  Vaccination Status - Moderna x3 BRIEF OVERVIEW: Discharge Provider:  Primary Care Provider at Discharge:  Admission Date: 12/22/2022 Discharge Date: 12/27/2022   Active Hospital Problems   Diagnosis Date Noted POA ? AKI (acute kidney injury)  12/24/2022 Unknown ? COVID-19 12/22/2022 Unknown ? Atrial fibrillation with RVR 12/22/2022 Unknown ? Pleural effusion, bilateral 12/22/2022 Unknown ? Chronic combined systolic and diastolic heart failure 09/28/2022 Yes ? Valvular heart disease 09/28/2022 Yes ? Paroxysmal atrial fibrillation 09/14/2022 Yes ? Primary hypertension   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pleural effusion [J90] Atrial fibrillation with RVR [I48.91] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Pt. is a 83 y.o. female who presented with shortness of breath, fatigue and weakness that started roughly 5 days ago.  She denies dizziness, headache, palpitations, chest pain/pressure, fever, chills, body aches, cough, congestion, lower extremity edema.  No nausea, vomiting, diarrhea, dysuria.   Upon arrival to the emergency department she was found to be hypoxic with SpO2 79%, and tachypnea with RR 29. EKG was performed and demonstrated atrial fibrillation with RVR.  CXR demonstrated large left pleural effusion and small right pleural effusion with vascular congestion bilaterally.  BNP 10478.  Troponin 21.  Positive COVID nasal swab.  Current vital signs 95% on 2 L nasal cannula, RR 28, blood pressure 160/122, HR 154. Patient reports that her symptoms have improved since arrival however she does state that her shortness of breath continues to be moderate in intensity.  She denies pain at this time.  The above vital signs, and radiographs, labs reviewed and interpreted by me on 12/22/2022.  Patient was referred to admission to hospitalist service, inpatient progressive care unit.   Patient was diuresed with intravenous Lasix and placed on a Cardizem drip for rate control.  She underwent thoracentesis with removal of 500 mL of fluid.  With these measures she was able to be weaned off oxygen but she became mildly hypotensive.  Cardizem had to be discontinued.  She was started on digoxin for control of her heart rate with good results; however she did have some pauses with an elevated digoxin level.  Case was discussed with Cardiology to was recommended maintaining her on a beta-blocker, adding a low-dose of oral Cardizem with the patient could tolerate.  Patient continue improved but she did have some nighttime hypoxemia.  She was kept an additional day for a nighttime oxygen saturation study to possibly qualify her for oxygen. She did not qualify for oxygen. Labs and vitals are stable.Patient is eager to discharge, she has been discharged in a stable medical condition with her family.
Age: 82.0
Sex: F
Vaccine: COVID19, PPV
Symptoms: Pulmonary congestion, SARS-CoV-2 test positive, Tachypnoea, Troponin increased
Clinical narrative: COVID+ 12/22/22.  Vaccination Status - Moderna x3 BRIEF OVERVIEW: Discharge Provider:  Primary Care Provider at Discharge:  Admission Date: 12/22/2022 Discharge Date: 12/27/2022   Active Hospital Problems   Diagnosis Date Noted POA ? AKI (acute kidney injury)  12/24/2022 Unknown ? COVID-19 12/22/2022 Unknown ? Atrial fibrillation with RVR 12/22/2022 Unknown ? Pleural effusion, bilateral 12/22/2022 Unknown ? Chronic combined systolic and diastolic heart failure 09/28/2022 Yes ? Valvular heart disease 09/28/2022 Yes ? Paroxysmal atrial fibrillation 09/14/2022 Yes ? Primary hypertension   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pleural effusion [J90] Atrial fibrillation with RVR [I48.91] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Pt. is a 83 y.o. female who presented with shortness of breath, fatigue and weakness that started roughly 5 days ago.  She denies dizziness, headache, palpitations, chest pain/pressure, fever, chills, body aches, cough, congestion, lower extremity edema.  No nausea, vomiting, diarrhea, dysuria.   Upon arrival to the emergency department she was found to be hypoxic with SpO2 79%, and tachypnea with RR 29. EKG was performed and demonstrated atrial fibrillation with RVR.  CXR demonstrated large left pleural effusion and small right pleural effusion with vascular congestion bilaterally.  BNP 10478.  Troponin 21.  Positive COVID nasal swab.  Current vital signs 95% on 2 L nasal cannula, RR 28, blood pressure 160/122, HR 154. Patient reports that her symptoms have improved since arrival however she does state that her shortness of breath continues to be moderate in intensity.  She denies pain at this time.  The above vital signs, and radiographs, labs reviewed and interpreted by me on 12/22/2022.  Patient was referred to admission to hospitalist service, inpatient progressive care unit.   Patient was diuresed with intravenous Lasix and placed on a Cardizem drip for rate control.  She underwent thoracentesis with removal of 500 mL of fluid.  With these measures she was able to be weaned off oxygen but she became mildly hypotensive.  Cardizem had to be discontinued.  She was started on digoxin for control of her heart rate with good results; however she did have some pauses with an elevated digoxin level.  Case was discussed with Cardiology to was recommended maintaining her on a beta-blocker, adding a low-dose of oral Cardizem with the patient could tolerate.  Patient continue improved but she did have some nighttime hypoxemia.  She was kept an additional day for a nighttime oxygen saturation study to possibly qualify her for oxygen. She did not qualify for oxygen. Labs and vitals are stable.Patient is eager to discharge, she has been discharged in a stable medical condition with her family.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Exposure to SARS-CoV-2, Headache, Malaise, Nausea
Clinical narrative: 06/25/2022 I woke up and I was sick as a dog. I had a headache, nausea, coughing and congested. The headache lasted most of the week. The other symptoms were not so bad. I did not take a COVID test, but my partner tested positive with same symptoms.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion
Clinical narrative: 06/25/2022 I woke up and I was sick as a dog. I had a headache, nausea, coughing and congested. The headache lasted most of the week. The other symptoms were not so bad. I did not take a COVID test, but my partner tested positive with same symptoms.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Antibody test positive, Fatigue, Feeling abnormal, Migraine, Nausea
Clinical narrative: I received my Covid-19 vaccine on 06/11/2022. On 08/29/2022 started having migraines and feeling nauseous. withing the next week I started having horrible fatigue, brain fog, ringing in ear and hyper smell. Around September 30 I was still having post Covid-19 symptoms, so I went to the doctor and tested positive for Antibodies.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Parosmia, Post-acute COVID-19 syndrome, Tinnitus
Clinical narrative: I received my Covid-19 vaccine on 06/11/2022. On 08/29/2022 started having migraines and feeling nauseous. withing the next week I started having horrible fatigue, brain fog, ringing in ear and hyper smell. Around September 30 I was still having post Covid-19 symptoms, so I went to the doctor and tested positive for Antibodies.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 51.0
Sex: F
Vaccine: UNK
Symptoms: Bursitis
Clinical narrative: Shoulder Bursitis from flu vaccine
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, Cellulitis, Chest X-ray normal, Cough
Clinical narrative: COVID+ 12/17/22.  Vaccination Status - J&J x1, Pfizer x1 Discharge Information: Discharge Provider: MD  Primary Care Provider: DO Procedures to be scheduled by PCP: None  Results/Procedures requiring PCP followup: Follow up left finger celluliits  Admission Date: 12/21/2022 Discharge Date: 12/26/2022  Admitting Diagnoses: COVID-19 Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure with hypoxia (HCC) [J96.01] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 51 y.o. female  who presents to hospital with difficulty breathing. The patient is known to have history of multiple comorbidities including anxiety, diabetes mellitus type 2, DVT, hypertension, GERD, peptic ulcer disease, peripheral arterial disease, OCD, morbid obesity with body mass index 51, chronic obstructive pulmonary disease, tobacco use, and chronic kidney disease stage 3. in the last 4 days before her presentation, the patient has been complaining of coughing, difficulty breathing, and had fever.  The patient has been using her significant other?s oxygen at her home in the last 2 days before her presentation.  Because of the deterioration of her breathing, EMS was called and the patient was presented to the emergency department for evaluation.  On arrival the patient was hypoxic with oxygen saturation 84% on room air.  She required 2 liters/minute nasal cannula oxygen supplement.  Also the patient was initially tachypneic with respiratory 37 and hypertensive with blood pressure 171/95.  Her initial workup showed   Positive PCR rapid test for COVID 19 but her chest x-ray did not show any acute cardiopulmonary process.  On the physical exam, the patient had diffuse bilateral moderate expiratory wheezing.  The patient has morbid obesity and likely sleep apnea.  When I did my telehealth visit, the patient was initially sleeping and she requires 4 liters/minute nasal cannula oxygen supplement while sleeping.  The patient denies chest pain.  Dexamethasone has already started in the emergency department.     Patient was treated with dexamethasone and remdesivir.  Her oxygen was gradually weaned.  She was found to have a small cut on the inner surface of her left index finger.  This became swollen and tender with some erythema.  X-ray did not show any acute findings.  She was started on cefazolin and it was felt she could safely be discharged on a course of Keflex to complete 7 days of treatment.  She completed a course of remdesivir and was able to be weaned to room air.  It was felt that she could be safely discharged home for outpatient follow-up care.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Hypertension, Hypoxia, Peripheral swelling, Pyrexia
Clinical narrative: COVID+ 12/17/22.  Vaccination Status - J&J x1, Pfizer x1 Discharge Information: Discharge Provider: MD  Primary Care Provider: DO Procedures to be scheduled by PCP: None  Results/Procedures requiring PCP followup: Follow up left finger celluliits  Admission Date: 12/21/2022 Discharge Date: 12/26/2022  Admitting Diagnoses: COVID-19 Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure with hypoxia (HCC) [J96.01] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 51 y.o. female  who presents to hospital with difficulty breathing. The patient is known to have history of multiple comorbidities including anxiety, diabetes mellitus type 2, DVT, hypertension, GERD, peptic ulcer disease, peripheral arterial disease, OCD, morbid obesity with body mass index 51, chronic obstructive pulmonary disease, tobacco use, and chronic kidney disease stage 3. in the last 4 days before her presentation, the patient has been complaining of coughing, difficulty breathing, and had fever.  The patient has been using her significant other?s oxygen at her home in the last 2 days before her presentation.  Because of the deterioration of her breathing, EMS was called and the patient was presented to the emergency department for evaluation.  On arrival the patient was hypoxic with oxygen saturation 84% on room air.  She required 2 liters/minute nasal cannula oxygen supplement.  Also the patient was initially tachypneic with respiratory 37 and hypertensive with blood pressure 171/95.  Her initial workup showed   Positive PCR rapid test for COVID 19 but her chest x-ray did not show any acute cardiopulmonary process.  On the physical exam, the patient had diffuse bilateral moderate expiratory wheezing.  The patient has morbid obesity and likely sleep apnea.  When I did my telehealth visit, the patient was initially sleeping and she requires 4 liters/minute nasal cannula oxygen supplement while sleeping.  The patient denies chest pain.  Dexamethasone has already started in the emergency department.     Patient was treated with dexamethasone and remdesivir.  Her oxygen was gradually weaned.  She was found to have a small cut on the inner surface of her left index finger.  This became swollen and tender with some erythema.  X-ray did not show any acute findings.  She was started on cefazolin and it was felt she could safely be discharged on a course of Keflex to complete 7 days of treatment.  She completed a course of remdesivir and was able to be weaned to room air.  It was felt that she could be safely discharged home for outpatient follow-up care.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Skin laceration, Tachypnoea, Tenderness, Wheezing
Clinical narrative: COVID+ 12/17/22.  Vaccination Status - J&J x1, Pfizer x1 Discharge Information: Discharge Provider: MD  Primary Care Provider: DO Procedures to be scheduled by PCP: None  Results/Procedures requiring PCP followup: Follow up left finger celluliits  Admission Date: 12/21/2022 Discharge Date: 12/26/2022  Admitting Diagnoses: COVID-19 Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure with hypoxia (HCC) [J96.01] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 51 y.o. female  who presents to hospital with difficulty breathing. The patient is known to have history of multiple comorbidities including anxiety, diabetes mellitus type 2, DVT, hypertension, GERD, peptic ulcer disease, peripheral arterial disease, OCD, morbid obesity with body mass index 51, chronic obstructive pulmonary disease, tobacco use, and chronic kidney disease stage 3. in the last 4 days before her presentation, the patient has been complaining of coughing, difficulty breathing, and had fever.  The patient has been using her significant other?s oxygen at her home in the last 2 days before her presentation.  Because of the deterioration of her breathing, EMS was called and the patient was presented to the emergency department for evaluation.  On arrival the patient was hypoxic with oxygen saturation 84% on room air.  She required 2 liters/minute nasal cannula oxygen supplement.  Also the patient was initially tachypneic with respiratory 37 and hypertensive with blood pressure 171/95.  Her initial workup showed   Positive PCR rapid test for COVID 19 but her chest x-ray did not show any acute cardiopulmonary process.  On the physical exam, the patient had diffuse bilateral moderate expiratory wheezing.  The patient has morbid obesity and likely sleep apnea.  When I did my telehealth visit, the patient was initially sleeping and she requires 4 liters/minute nasal cannula oxygen supplement while sleeping.  The patient denies chest pain.  Dexamethasone has already started in the emergency department.     Patient was treated with dexamethasone and remdesivir.  Her oxygen was gradually weaned.  She was found to have a small cut on the inner surface of her left index finger.  This became swollen and tender with some erythema.  X-ray did not show any acute findings.  She was started on cefazolin and it was felt she could safely be discharged on a course of Keflex to complete 7 days of treatment.  She completed a course of remdesivir and was able to be weaned to room air.  It was felt that she could be safely discharged home for outpatient follow-up care.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Wound complication, X-ray limb normal
Clinical narrative: COVID+ 12/17/22.  Vaccination Status - J&J x1, Pfizer x1 Discharge Information: Discharge Provider: MD  Primary Care Provider: DO Procedures to be scheduled by PCP: None  Results/Procedures requiring PCP followup: Follow up left finger celluliits  Admission Date: 12/21/2022 Discharge Date: 12/26/2022  Admitting Diagnoses: COVID-19 Details of Hospital Stay PRESENTING PROBLEM:  Acute respiratory failure with hypoxia (HCC) [J96.01] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 51 y.o. female  who presents to hospital with difficulty breathing. The patient is known to have history of multiple comorbidities including anxiety, diabetes mellitus type 2, DVT, hypertension, GERD, peptic ulcer disease, peripheral arterial disease, OCD, morbid obesity with body mass index 51, chronic obstructive pulmonary disease, tobacco use, and chronic kidney disease stage 3. in the last 4 days before her presentation, the patient has been complaining of coughing, difficulty breathing, and had fever.  The patient has been using her significant other?s oxygen at her home in the last 2 days before her presentation.  Because of the deterioration of her breathing, EMS was called and the patient was presented to the emergency department for evaluation.  On arrival the patient was hypoxic with oxygen saturation 84% on room air.  She required 2 liters/minute nasal cannula oxygen supplement.  Also the patient was initially tachypneic with respiratory 37 and hypertensive with blood pressure 171/95.  Her initial workup showed   Positive PCR rapid test for COVID 19 but her chest x-ray did not show any acute cardiopulmonary process.  On the physical exam, the patient had diffuse bilateral moderate expiratory wheezing.  The patient has morbid obesity and likely sleep apnea.  When I did my telehealth visit, the patient was initially sleeping and she requires 4 liters/minute nasal cannula oxygen supplement while sleeping.  The patient denies chest pain.  Dexamethasone has already started in the emergency department.     Patient was treated with dexamethasone and remdesivir.  Her oxygen was gradually weaned.  She was found to have a small cut on the inner surface of her left index finger.  This became swollen and tender with some erythema.  X-ray did not show any acute findings.  She was started on cefazolin and it was felt she could safely be discharged on a course of Keflex to complete 7 days of treatment.  She completed a course of remdesivir and was able to be weaned to room air.  It was felt that she could be safely discharged home for outpatient follow-up care.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Headache, Idiopathic intracranial hypertension, Lumbar puncture, Maternal exposure before pregnancy
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/4/2022   Admission Diagnosis: Pregnant state, incidental [Z33.1] Labor and delivery indication for care or intervention [O75.9] Intractable headache   Hospital Principal Problem (Discharge Diagnoses): Idiopathic intracranial hypertension Spinal Headache following LP
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Post lumbar puncture syndrome, Pregnancy, SARS-CoV-2 test positive
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/4/2022   Admission Diagnosis: Pregnant state, incidental [Z33.1] Labor and delivery indication for care or intervention [O75.9] Intractable headache   Hospital Principal Problem (Discharge Diagnoses): Idiopathic intracranial hypertension Spinal Headache following LP
Age: 43.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dizziness, Syncope
Clinical narrative: Dizziness, fainting overnight
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, COVID-19, Essential hypertension, SARS-CoV-2 test positive, Systemic inflammatory response syndrome
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/1/2022   Admission Diagnosis: COVID-19 [U07.1]     Hospital Principal Problem (Discharge Diagnoses): COVID-19   All Hospital Problems (Other Diagnoses): Active Hospital Problems   Diagnosis o Principal Problem: COVID-19 o AKI (acute kidney injury)  o SIRS (systemic inflammatory response syndrome)  o Type 2 diabetes mellitus  o Essential hypertension
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Type 2 diabetes mellitus
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/1/2022   Admission Diagnosis: COVID-19 [U07.1]     Hospital Principal Problem (Discharge Diagnoses): COVID-19   All Hospital Problems (Other Diagnoses): Active Hospital Problems   Diagnosis o Principal Problem: COVID-19 o AKI (acute kidney injury)  o SIRS (systemic inflammatory response syndrome)  o Type 2 diabetes mellitus  o Essential hypertension
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, COVID-19, Cardiac assistance device user, Cardiac failure, Essential hypertension
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/1/2022   Admission Diagnosis: Atrial fibrillation with RVR (CMS/HCC) [I48.91]   Hospital Principal Problem (Discharge Diagnoses): Atrial fibrillation with RVR (CMS/HCC)   All Hospital Problems (Other Diagnoses): Active Hospital Problems   Diagnosis o Principal Problem: Atrial fibrillation with RVR (CMS/HCC) o Lung mass o Primary hypertension o COVID-19 o Acute on chronic heart failure with preserved ejection fraction (CMS/HCC) o Sinus node dysfunction (CMS/HCC) o Cardiac pacemaker in situ o Mixed hyperlipidemia
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pulmonary mass, SARS-CoV-2 test positive, Sinus node dysfunction, Type V hyperlipidaemia
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/1/2022   Admission Diagnosis: Atrial fibrillation with RVR (CMS/HCC) [I48.91]   Hospital Principal Problem (Discharge Diagnoses): Atrial fibrillation with RVR (CMS/HCC)   All Hospital Problems (Other Diagnoses): Active Hospital Problems   Diagnosis o Principal Problem: Atrial fibrillation with RVR (CMS/HCC) o Lung mass o Primary hypertension o COVID-19 o Acute on chronic heart failure with preserved ejection fraction (CMS/HCC) o Sinus node dysfunction (CMS/HCC) o Cardiac pacemaker in situ o Mixed hyperlipidemia
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Dementia Alzheimer's type, SARS-CoV-2 test positive
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/3/2022   Diagnoses on Admission Order: No associated diagnoses for current labs covid19 Discharge Summary     Hospital Principal Problem (Discharge Diagnoses): Dementia due to Alzheimer's disease
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, Endotracheal intubation, Intensive care, Respiratory failure
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 11/29/2022   Admission Diagnosis: COVID [U07.1]   Hospital Principal Problem (Discharge Diagnoses): COVID   All Hospital Problems (Other Diagnoses): Active Hospital Problems   Diagnosis o Principal Problem: COVID o COVID-19 o Acute respiratory failure with hypoxia and hypercapnia (CMS/HCC)     Overview Note:     Patient is intubated and sedated on high-flow oxygen Will monitor the patient's blood gases closely Will continue breathing treatments as needed Will monitor the patient closely.   Will continue current ICU management Serial chest x-rays   Monitor lactic acid level closely
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 11/29/2022   Admission Diagnosis: COVID [U07.1]   Hospital Principal Problem (Discharge Diagnoses): COVID   All Hospital Problems (Other Diagnoses): Active Hospital Problems   Diagnosis o Principal Problem: COVID o COVID-19 o Acute respiratory failure with hypoxia and hypercapnia (CMS/HCC)     Overview Note:     Patient is intubated and sedated on high-flow oxygen Will monitor the patient's blood gases closely Will continue breathing treatments as needed Will monitor the patient closely.   Will continue current ICU management Serial chest x-rays   Monitor lactic acid level closely
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Bundle branch block left, COVID-19, Decubitus ulcer, Dermatitis
Clinical narrative: Date of Admission: 11/28/2022   Date of Discharge: 12/6/2022   Admission Diagnosis: Shock [R57.9] Pain [R52] Septicemia [A41.9]   Hospital Principal Problem (Discharge Diagnoses): Septic shock    All Hospital Problems (Other Diagnoses): Active Hospital Problems   Diagnosis o Principal Problem: Septic shock  o COVID-19 o Unstageable pressure ulcer of left buttock  o Unstageable pressure ulcer of right buttock  o Dermatitis associated with moisture (coccyx, left upper buttock) o Septicemia  o Pain o Encephalopathy o Elevated troponin o LBBB (left bundle branch block) o Lactic acidosis o AKI (acute kidney injury)