chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Culture urine, Dizziness, Echocardiogram, Electrocardiogram abnormal, Fall
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/21/2023  PRESENTING PROBLEM: Orthostatic hypotension  Hypotension    HOSPITAL COURSE:  Patient is a 75 y.o. male with past medical history of syncope, paroxysmal atrial fibrillation, OSA, idiopathic hypotension, BPH, urinary incontinence, migraine headaches, hypertension, COPD and GERD. Follows with cardiology and urology. He was admitted to hospital 6/2022 after a syncope and collapse- at discharge cardiology consulted with midodrine increased from 2.5 mg BID to 5 mg BID. He has had several syncopal episodes over the last 6 years.   Patient presented on 3/20/2023 with lightheaded and generalized weakness. Reports he took his morning medications around 5 am then checked his blood pressure around 7 am in the bathroom. States SBP 40s-50s with heart rate 60s. He then stood up where he became lightheaded and generally weak that led to a fall. Denies racing heart rate or flutters. Reports he was COVID positive last week and still feeling weak. He was given antiviral medications which he was unable to tolerate due to side effects. Denies chest pain. Denies fever or chills. Denies abdominal pain. Denies nausea or vomiting. Reports using marijuana/CBD monthly.    In the ER, patient arrived hemodynamically stable. Orthostatic vitals- laying 98/73, sitting 88/66, standing 70/41. 500 ml IV fluids given. CMP and CBC unremarkable. EKG:Sinus rhythm with 1st degree AV block. Expressing abdominal discomfort to ER physician- KUB no significant findings. UA small leukocytes, negative urine bacteria. Denied urinary symptoms, Urine culture sent. History of chronic UTI, on Macrobid nightly. The patient was admitted and placed on IV fluids. HIs home dose of midodrine was increased from 5mg BID to 5mg TID. His BP remained stable on this regimen and he was still able to continue taking entresto for underlying heart failure. His symptoms resolved entirely prior to discharge. A limited echocardiogram was obtained but was a very poor study so unable to assess valves or LVEF. Would recommend being outpatient appointment for complete echo in April.  The patient worked with physical therapy and occupational therapy note that he is at his baseline and appropriate to discharge home.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Full blood count normal, Hypotension, Metabolic function test normal, Orthostatic hypotension, SARS-CoV-2 test positive
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/21/2023  PRESENTING PROBLEM: Orthostatic hypotension  Hypotension    HOSPITAL COURSE:  Patient is a 75 y.o. male with past medical history of syncope, paroxysmal atrial fibrillation, OSA, idiopathic hypotension, BPH, urinary incontinence, migraine headaches, hypertension, COPD and GERD. Follows with cardiology and urology. He was admitted to hospital 6/2022 after a syncope and collapse- at discharge cardiology consulted with midodrine increased from 2.5 mg BID to 5 mg BID. He has had several syncopal episodes over the last 6 years.   Patient presented on 3/20/2023 with lightheaded and generalized weakness. Reports he took his morning medications around 5 am then checked his blood pressure around 7 am in the bathroom. States SBP 40s-50s with heart rate 60s. He then stood up where he became lightheaded and generally weak that led to a fall. Denies racing heart rate or flutters. Reports he was COVID positive last week and still feeling weak. He was given antiviral medications which he was unable to tolerate due to side effects. Denies chest pain. Denies fever or chills. Denies abdominal pain. Denies nausea or vomiting. Reports using marijuana/CBD monthly.    In the ER, patient arrived hemodynamically stable. Orthostatic vitals- laying 98/73, sitting 88/66, standing 70/41. 500 ml IV fluids given. CMP and CBC unremarkable. EKG:Sinus rhythm with 1st degree AV block. Expressing abdominal discomfort to ER physician- KUB no significant findings. UA small leukocytes, negative urine bacteria. Denied urinary symptoms, Urine culture sent. History of chronic UTI, on Macrobid nightly. The patient was admitted and placed on IV fluids. HIs home dose of midodrine was increased from 5mg BID to 5mg TID. His BP remained stable on this regimen and he was still able to continue taking entresto for underlying heart failure. His symptoms resolved entirely prior to discharge. A limited echocardiogram was obtained but was a very poor study so unable to assess valves or LVEF. Would recommend being outpatient appointment for complete echo in April.  The patient worked with physical therapy and occupational therapy note that he is at his baseline and appropriate to discharge home.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Sinus rhythm, Substance use, Urinary system X-ray, Urine analysis abnormal, Urine leukocyte esterase positive
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/21/2023  PRESENTING PROBLEM: Orthostatic hypotension  Hypotension    HOSPITAL COURSE:  Patient is a 75 y.o. male with past medical history of syncope, paroxysmal atrial fibrillation, OSA, idiopathic hypotension, BPH, urinary incontinence, migraine headaches, hypertension, COPD and GERD. Follows with cardiology and urology. He was admitted to hospital 6/2022 after a syncope and collapse- at discharge cardiology consulted with midodrine increased from 2.5 mg BID to 5 mg BID. He has had several syncopal episodes over the last 6 years.   Patient presented on 3/20/2023 with lightheaded and generalized weakness. Reports he took his morning medications around 5 am then checked his blood pressure around 7 am in the bathroom. States SBP 40s-50s with heart rate 60s. He then stood up where he became lightheaded and generally weak that led to a fall. Denies racing heart rate or flutters. Reports he was COVID positive last week and still feeling weak. He was given antiviral medications which he was unable to tolerate due to side effects. Denies chest pain. Denies fever or chills. Denies abdominal pain. Denies nausea or vomiting. Reports using marijuana/CBD monthly.    In the ER, patient arrived hemodynamically stable. Orthostatic vitals- laying 98/73, sitting 88/66, standing 70/41. 500 ml IV fluids given. CMP and CBC unremarkable. EKG:Sinus rhythm with 1st degree AV block. Expressing abdominal discomfort to ER physician- KUB no significant findings. UA small leukocytes, negative urine bacteria. Denied urinary symptoms, Urine culture sent. History of chronic UTI, on Macrobid nightly. The patient was admitted and placed on IV fluids. HIs home dose of midodrine was increased from 5mg BID to 5mg TID. His BP remained stable on this regimen and he was still able to continue taking entresto for underlying heart failure. His symptoms resolved entirely prior to discharge. A limited echocardiogram was obtained but was a very poor study so unable to assess valves or LVEF. Would recommend being outpatient appointment for complete echo in April.  The patient worked with physical therapy and occupational therapy note that he is at his baseline and appropriate to discharge home.
Age: 1.0
Sex: M
Vaccine: HEPA, HIBV, MMRV, PNC13
Symptoms: Pyrexia, Rash, Varicella
Clinical narrative: Rash and fever began two days after administration of vaccines; diagnosed with chickenpox at local ER, confirmed with in office pediatrician
Age: 69.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Chills, Exposure to SARS-CoV-2, Fatigue, Headache
Clinical narrative: My husband was diagnosed with COVID-19 I would say 5 days prior around 01/05. He had a positive home test and we immediately occupied different rooms of our home. Five days went by and I had thought I wasn't going to get it. Then I had an onset of fatigue, achiness, headache, and chills on 01/08/2023. I tested that right away and I was positive. I knew to call for a prescription for Paxlovid. I called early the next morning and left a message. I got a response late that same afternoon on 01/09/2023. The prescription had been called in for me and I talked to my PCP. I started that medication that very day on 01/09. I started the Paxlovid within 24-48 hours after my first symptoms. I took that for the prescribed 5 days. My symptoms were dramatically improved the next morning. I felt 80% better. I did my isolation for 5 days, and I felt very good. I started going for walks outside after a few days. I never got anything else. I had no respiratory symptoms. It was over within just a few days.
Age: 69.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Pain, SARS-CoV-2 test positive
Clinical narrative: My husband was diagnosed with COVID-19 I would say 5 days prior around 01/05. He had a positive home test and we immediately occupied different rooms of our home. Five days went by and I had thought I wasn't going to get it. Then I had an onset of fatigue, achiness, headache, and chills on 01/08/2023. I tested that right away and I was positive. I knew to call for a prescription for Paxlovid. I called early the next morning and left a message. I got a response late that same afternoon on 01/09/2023. The prescription had been called in for me and I talked to my PCP. I started that medication that very day on 01/09. I started the Paxlovid within 24-48 hours after my first symptoms. I took that for the prescribed 5 days. My symptoms were dramatically improved the next morning. I felt 80% better. I did my isolation for 5 days, and I felt very good. I started going for walks outside after a few days. I never got anything else. I had no respiratory symptoms. It was over within just a few days.
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive
Clinical narrative: I was positive for COVID-19 on 21JAN2023, I didn't feel so well and I couldn't call the doctor because it was the weekend. On that Monday I called my doctor and I was feeling terrible. I was prescribed PAXLOVID, I started feeling so much better after only 2 doses of the medication.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Diarrhoea, Exposure to SARS-CoV-2, Oropharyngeal pain
Clinical narrative: Tested positive on 12/29/2022 after my daughter had tested positive. Began having extreme diarrhea on 12/29. That only last 10 hours. I then began having cough, congestion, sore throat, and low grade fever. Symptoms persisted and I called PCP. PCP prescribed PAXLOVID. Symptoms persisted for 3 weeks resolving slowly.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Tested positive on 12/29/2022 after my daughter had tested positive. Began having extreme diarrhea on 12/29. That only last 10 hours. I then began having cough, congestion, sore throat, and low grade fever. Symptoms persisted and I called PCP. PCP prescribed PAXLOVID. Symptoms persisted for 3 weeks resolving slowly.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood cholesterol increased, Blood test abnormal, Cerebrovascular accident, Chest X-ray normal, Computerised tomogram head normal
Clinical narrative: 9/30/22 I was taking a walk at 11:00AM and I started experiencing some numbness in my left hand and felt a little weird. I had a tingling in my left arm and left leg and felt slightly dizzy. I called my primary care physician. I had no other major stroke symptoms. They had me go to the emergency room and I was treated like a stroke victim. I had a CT with and without dye and found no bleeding. I had an EKG, normal. Echocardiogram, normal. Bloodwork was done and it showed high cholesterol, nothing else. I had all Neurological testing which was normal. I was cognitively fine. I stayed overnight to have an MRI of my brain. I had an MRI on 10/1/22 and it showed I had a very small stroke. It showed a small acute infarct in the right Thalamocapsular region. I had an MRI several years before and that was not present. There were no other risk factors for a stroke, they put me on atorvastatin. My cholesterol is now under control I spoke to my neurologist, and she said she had no idea why I had a stroke because I was not at risk. I have been fine since then, but I still have some numbness in my left hand and left foot. I have been switched to rosuvastatin.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Echocardiogram normal, Electrocardiogram normal, Feeling abnormal, Hypoaesthesia
Clinical narrative: 9/30/22 I was taking a walk at 11:00AM and I started experiencing some numbness in my left hand and felt a little weird. I had a tingling in my left arm and left leg and felt slightly dizzy. I called my primary care physician. I had no other major stroke symptoms. They had me go to the emergency room and I was treated like a stroke victim. I had a CT with and without dye and found no bleeding. I had an EKG, normal. Echocardiogram, normal. Bloodwork was done and it showed high cholesterol, nothing else. I had all Neurological testing which was normal. I was cognitively fine. I stayed overnight to have an MRI of my brain. I had an MRI on 10/1/22 and it showed I had a very small stroke. It showed a small acute infarct in the right Thalamocapsular region. I had an MRI several years before and that was not present. There were no other risk factors for a stroke, they put me on atorvastatin. My cholesterol is now under control I spoke to my neurologist, and she said she had no idea why I had a stroke because I was not at risk. I have been fine since then, but I still have some numbness in my left hand and left foot. I have been switched to rosuvastatin.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Magnetic resonance imaging head abnormal, Neurological examination normal, Paraesthesia
Clinical narrative: 9/30/22 I was taking a walk at 11:00AM and I started experiencing some numbness in my left hand and felt a little weird. I had a tingling in my left arm and left leg and felt slightly dizzy. I called my primary care physician. I had no other major stroke symptoms. They had me go to the emergency room and I was treated like a stroke victim. I had a CT with and without dye and found no bleeding. I had an EKG, normal. Echocardiogram, normal. Bloodwork was done and it showed high cholesterol, nothing else. I had all Neurological testing which was normal. I was cognitively fine. I stayed overnight to have an MRI of my brain. I had an MRI on 10/1/22 and it showed I had a very small stroke. It showed a small acute infarct in the right Thalamocapsular region. I had an MRI several years before and that was not present. There were no other risk factors for a stroke, they put me on atorvastatin. My cholesterol is now under control I spoke to my neurologist, and she said she had no idea why I had a stroke because I was not at risk. I have been fine since then, but I still have some numbness in my left hand and left foot. I have been switched to rosuvastatin.
Age: 30.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Ear pain, Influenza virus test negative, Oropharyngeal pain, Respiratory syncytial virus test negative
Clinical narrative: I had a sore throat, ear pain, congestion, and a cough. This lasted for about two and a half weeks total. I went to the doctor and had a negative COVID-19, RSV, and Flu test. They prescribed Amoxicillin. I am feeling much better now.
Age: 30.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, SARS-CoV-2 test negative
Clinical narrative: I had a sore throat, ear pain, congestion, and a cough. This lasted for about two and a half weeks total. I went to the doctor and had a negative COVID-19, RSV, and Flu test. They prescribed Amoxicillin. I am feeling much better now.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Bronchitis, COVID-19, Chronic obstructive pulmonary disease
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Hypoxia  COPD exacerbation  Acute respiratory failure with hypoxia  COVID-19    HOSPITAL COURSE: Patient is a 73 y.o. female with past medical history significant for chronic obstructive pulmonary disease, sustained SVT, and tobacco use disorder who presented with shortness of breath and is found to have COVID-19 infection as well as evidence of acute bronchitis on CTA thorax.  No evidence of pulmonary embolism.  She was significantly wheezy and felt to be in exacerbation of chronic obstructive pulmonary disease.  She was given IV steroids and scheduled nebulizers with significant improvement.  She was additionally started on remdesivir and received 4 days of this.  She initially required 2 L nasal cannula and was intermittently able to wean down to 1 L. additionally on presentation she had nonsustained SVT.  Initial EKGs concerning for possible Wolff-Parkinson-White, electrophysiology team was consulted felt this was less likely.  She was started on diltiazem with significant improvement.  On day of discharge patient is feeling subjectively improved although still does require 1 L nasal cannula to maintain saturations greater than 92%.  Patient is subjectively dyspneic under 92%.  Patient does have oxygen at home as she has been using this nightly since her prior hospitalization.  She will continue to wean oxygen as able at home.  She will follow with our transition to home program.  Her daughter is very informed and was updated on plan day of discharge.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Dyspnoea, Electrocardiogram abnormal, Hypoxia, Supraventricular tachycardia
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Hypoxia  COPD exacerbation  Acute respiratory failure with hypoxia  COVID-19    HOSPITAL COURSE: Patient is a 73 y.o. female with past medical history significant for chronic obstructive pulmonary disease, sustained SVT, and tobacco use disorder who presented with shortness of breath and is found to have COVID-19 infection as well as evidence of acute bronchitis on CTA thorax.  No evidence of pulmonary embolism.  She was significantly wheezy and felt to be in exacerbation of chronic obstructive pulmonary disease.  She was given IV steroids and scheduled nebulizers with significant improvement.  She was additionally started on remdesivir and received 4 days of this.  She initially required 2 L nasal cannula and was intermittently able to wean down to 1 L. additionally on presentation she had nonsustained SVT.  Initial EKGs concerning for possible Wolff-Parkinson-White, electrophysiology team was consulted felt this was less likely.  She was started on diltiazem with significant improvement.  On day of discharge patient is feeling subjectively improved although still does require 1 L nasal cannula to maintain saturations greater than 92%.  Patient is subjectively dyspneic under 92%.  Patient does have oxygen at home as she has been using this nightly since her prior hospitalization.  She will continue to wean oxygen as able at home.  She will follow with our transition to home program.  Her daughter is very informed and was updated on plan day of discharge.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Wheezing
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: Mar 23, 2023  PRESENTING PROBLEM: Hypoxia  COPD exacerbation  Acute respiratory failure with hypoxia  COVID-19    HOSPITAL COURSE: Patient is a 73 y.o. female with past medical history significant for chronic obstructive pulmonary disease, sustained SVT, and tobacco use disorder who presented with shortness of breath and is found to have COVID-19 infection as well as evidence of acute bronchitis on CTA thorax.  No evidence of pulmonary embolism.  She was significantly wheezy and felt to be in exacerbation of chronic obstructive pulmonary disease.  She was given IV steroids and scheduled nebulizers with significant improvement.  She was additionally started on remdesivir and received 4 days of this.  She initially required 2 L nasal cannula and was intermittently able to wean down to 1 L. additionally on presentation she had nonsustained SVT.  Initial EKGs concerning for possible Wolff-Parkinson-White, electrophysiology team was consulted felt this was less likely.  She was started on diltiazem with significant improvement.  On day of discharge patient is feeling subjectively improved although still does require 1 L nasal cannula to maintain saturations greater than 92%.  Patient is subjectively dyspneic under 92%.  Patient does have oxygen at home as she has been using this nightly since her prior hospitalization.  She will continue to wean oxygen as able at home.  She will follow with our transition to home program.  Her daughter is very informed and was updated on plan day of discharge.
Age: 51.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site pain
Clinical narrative: sore and sensitive, redness at injection site, - so far has lasted  4+ days still very noticeable on Monday mid-day and shot was administered on Wednesday
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Anaemia, Atrial fibrillation, COVID-19, COVID-19 pneumonia
Clinical narrative: pt brought to ED via EMS with SOB; DNR/DNI; in respiratory distress, fever, Atrial Fibrillation, anemia, AKI; positive for COVID; COVID pneumonia; family decided to transition pt in ED to comfort measures; pt passed away in the ED at Medical Center.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Dyspnoea, Pyrexia, Respiratory distress, SARS-CoV-2 test positive
Clinical narrative: pt brought to ED via EMS with SOB; DNR/DNI; in respiratory distress, fever, Atrial Fibrillation, anemia, AKI; positive for COVID; COVID pneumonia; family decided to transition pt in ED to comfort measures; pt passed away in the ED at Medical Center.
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: patient hospitalized
Age: 54.0
Sex: M
Vaccine: COVID19-2
Symptoms: Axillary pain, Injection site pain, Injection site warmth, Myalgia, Pain
Clinical narrative: Warm to hot feeling during injection. Sharp pain more than previous injection. Right deltoid soar but expected. Soarness never went away. Certain movements can cause debilitating sharp pain. Pain radiates throug deltoid muscle and under arm at times. Time over 2.5 months
Age: 55.0
Sex: M
Vaccine: COVID19-2
Symptoms: Amnesia
Clinical narrative: I experienced memory loss, I have problems memorizing names and words.
Age: 1.0
Sex: F
Vaccine: VARCEL
Symptoms: Injection site erythema, Swelling
Clinical narrative: Redness at vaccine injection site, some localized swelling, relieved with benadryl.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: COVID VACCINE INAPPROPRIATELY GIVEN TO A UNDERAGE PATIENT. NO TREATMENTS NECCESSARY, NO OUTCOMES OR SYMPTOMS OBSERVED
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Back pain, Diarrhoea, Headache, Pain in extremity
Clinical narrative: I had a sore arm for about two days. I developed pain on the left side of back and I have been waking up with headaches. I have also had diarrhea. Currently I am taking TYLENOL and lay down on the heating pad. I have an upcoming appointment on 04/12/2023.
Age: 56.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Cough, Fatigue, Impaired work ability, Pain
Clinical narrative: I had a stuffy head and runny nose I was just kind of tired. I waited a day to test at home and it was positive. They really hit on the third day, I developed a cough and body ache. Laying down was painful. My family contacted a local pharmacy, and they prescribed a PAXLOVID. I was feeling better by that Friday the 16th. I feel good now but, occasionally I have this deep cough. I have tested negative and went back to work.
Age: 56.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I had a stuffy head and runny nose I was just kind of tired. I waited a day to test at home and it was positive. They really hit on the third day, I developed a cough and body ache. Laying down was painful. My family contacted a local pharmacy, and they prescribed a PAXLOVID. I was feeling better by that Friday the 16th. I feel good now but, occasionally I have this deep cough. I have tested negative and went back to work.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Bladder catheterisation, COVID-19, Chest X-ray abnormal, Complication associated with device
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/23/2023  PRESENTING PROBLEM: Sepsis Bacterial lobar pneumonia  Urinary tract infection with hematuria, site unspecified  Altered mental status, unspecified altered mental status type  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  COVID-19    HOSPITAL COURSE: Patient is a 68 y.o. man with DM2, HTN, hyperlipidemia, and metastatic RCC (with metastases to the bones, skin, likely lungs) receiving treatment with axitinib/nivolumab now admitted with altered mental status likely in the setting of infection.   In the ED was found to be febrile, altered mental status, hyponatremia, hyperlipidemia, AHRF and be COVID positive.  Furthermore he was found to be tachycardic tachypneic with no leukocytosis.  CXR significant for R lower lobe pneumonia.  He was started on Zosyn and vancomycin in the emergency department.   During his hospital course his infectious workup was negative for MRSA, strep, Legionella, influenza A/B and respiratory panel film array. His sepsis and altered mental status had resolved after 2 L of IV fluids.  Per his CAP, the abx was switched to ceftriaxone for targeted coverage. He was  transitioned to Augmentin prior to SAR discharge to complete 5 day course. Per patient's COVID status he remained asymptomatic and satting 100% on room air.  He was treated with remdesivir for 3 days. On his arrival to the medicine floor patient was found to have pressure injuries. Type 1 to coccyx and patient offloading of pressure was prioritized. Type 2 to urethra likely secondary to chronic foley. Photos were uploaded to media tab. Patient denied any pain to these locations.   Patient discharged in stable condition back to his SAR facility. With plan for close PCP follow up.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Decubitus ulcer, Haematuria, Hyperlipidaemia, Hyponatraemia
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/23/2023  PRESENTING PROBLEM: Sepsis Bacterial lobar pneumonia  Urinary tract infection with hematuria, site unspecified  Altered mental status, unspecified altered mental status type  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  COVID-19    HOSPITAL COURSE: Patient is a 68 y.o. man with DM2, HTN, hyperlipidemia, and metastatic RCC (with metastases to the bones, skin, likely lungs) receiving treatment with axitinib/nivolumab now admitted with altered mental status likely in the setting of infection.   In the ED was found to be febrile, altered mental status, hyponatremia, hyperlipidemia, AHRF and be COVID positive.  Furthermore he was found to be tachycardic tachypneic with no leukocytosis.  CXR significant for R lower lobe pneumonia.  He was started on Zosyn and vancomycin in the emergency department.   During his hospital course his infectious workup was negative for MRSA, strep, Legionella, influenza A/B and respiratory panel film array. His sepsis and altered mental status had resolved after 2 L of IV fluids.  Per his CAP, the abx was switched to ceftriaxone for targeted coverage. He was  transitioned to Augmentin prior to SAR discharge to complete 5 day course. Per patient's COVID status he remained asymptomatic and satting 100% on room air.  He was treated with remdesivir for 3 days. On his arrival to the medicine floor patient was found to have pressure injuries. Type 1 to coccyx and patient offloading of pressure was prioritized. Type 2 to urethra likely secondary to chronic foley. Photos were uploaded to media tab. Patient denied any pain to these locations.   Patient discharged in stable condition back to his SAR facility. With plan for close PCP follow up.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Infection, Influenza A virus test negative, Influenza B virus test, Legionella test, Mental status changes
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/23/2023  PRESENTING PROBLEM: Sepsis Bacterial lobar pneumonia  Urinary tract infection with hematuria, site unspecified  Altered mental status, unspecified altered mental status type  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  COVID-19    HOSPITAL COURSE: Patient is a 68 y.o. man with DM2, HTN, hyperlipidemia, and metastatic RCC (with metastases to the bones, skin, likely lungs) receiving treatment with axitinib/nivolumab now admitted with altered mental status likely in the setting of infection.   In the ED was found to be febrile, altered mental status, hyponatremia, hyperlipidemia, AHRF and be COVID positive.  Furthermore he was found to be tachycardic tachypneic with no leukocytosis.  CXR significant for R lower lobe pneumonia.  He was started on Zosyn and vancomycin in the emergency department.   During his hospital course his infectious workup was negative for MRSA, strep, Legionella, influenza A/B and respiratory panel film array. His sepsis and altered mental status had resolved after 2 L of IV fluids.  Per his CAP, the abx was switched to ceftriaxone for targeted coverage. He was  transitioned to Augmentin prior to SAR discharge to complete 5 day course. Per patient's COVID status he remained asymptomatic and satting 100% on room air.  He was treated with remdesivir for 3 days. On his arrival to the medicine floor patient was found to have pressure injuries. Type 1 to coccyx and patient offloading of pressure was prioritized. Type 2 to urethra likely secondary to chronic foley. Photos were uploaded to media tab. Patient denied any pain to these locations.   Patient discharged in stable condition back to his SAR facility. With plan for close PCP follow up.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia, Pneumonia bacterial, Pyrexia, Respiratory pathogen panel, SARS-CoV-2 test positive
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/23/2023  PRESENTING PROBLEM: Sepsis Bacterial lobar pneumonia  Urinary tract infection with hematuria, site unspecified  Altered mental status, unspecified altered mental status type  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  COVID-19    HOSPITAL COURSE: Patient is a 68 y.o. man with DM2, HTN, hyperlipidemia, and metastatic RCC (with metastases to the bones, skin, likely lungs) receiving treatment with axitinib/nivolumab now admitted with altered mental status likely in the setting of infection.   In the ED was found to be febrile, altered mental status, hyponatremia, hyperlipidemia, AHRF and be COVID positive.  Furthermore he was found to be tachycardic tachypneic with no leukocytosis.  CXR significant for R lower lobe pneumonia.  He was started on Zosyn and vancomycin in the emergency department.   During his hospital course his infectious workup was negative for MRSA, strep, Legionella, influenza A/B and respiratory panel film array. His sepsis and altered mental status had resolved after 2 L of IV fluids.  Per his CAP, the abx was switched to ceftriaxone for targeted coverage. He was  transitioned to Augmentin prior to SAR discharge to complete 5 day course. Per patient's COVID status he remained asymptomatic and satting 100% on room air.  He was treated with remdesivir for 3 days. On his arrival to the medicine floor patient was found to have pressure injuries. Type 1 to coccyx and patient offloading of pressure was prioritized. Type 2 to urethra likely secondary to chronic foley. Photos were uploaded to media tab. Patient denied any pain to these locations.   Patient discharged in stable condition back to his SAR facility. With plan for close PCP follow up.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Sepsis, Spinal column injury, Staphylococcus test negative, Streptococcus test negative, Tachycardia
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/23/2023  PRESENTING PROBLEM: Sepsis Bacterial lobar pneumonia  Urinary tract infection with hematuria, site unspecified  Altered mental status, unspecified altered mental status type  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  COVID-19    HOSPITAL COURSE: Patient is a 68 y.o. man with DM2, HTN, hyperlipidemia, and metastatic RCC (with metastases to the bones, skin, likely lungs) receiving treatment with axitinib/nivolumab now admitted with altered mental status likely in the setting of infection.   In the ED was found to be febrile, altered mental status, hyponatremia, hyperlipidemia, AHRF and be COVID positive.  Furthermore he was found to be tachycardic tachypneic with no leukocytosis.  CXR significant for R lower lobe pneumonia.  He was started on Zosyn and vancomycin in the emergency department.   During his hospital course his infectious workup was negative for MRSA, strep, Legionella, influenza A/B and respiratory panel film array. His sepsis and altered mental status had resolved after 2 L of IV fluids.  Per his CAP, the abx was switched to ceftriaxone for targeted coverage. He was  transitioned to Augmentin prior to SAR discharge to complete 5 day course. Per patient's COVID status he remained asymptomatic and satting 100% on room air.  He was treated with remdesivir for 3 days. On his arrival to the medicine floor patient was found to have pressure injuries. Type 1 to coccyx and patient offloading of pressure was prioritized. Type 2 to urethra likely secondary to chronic foley. Photos were uploaded to media tab. Patient denied any pain to these locations.   Patient discharged in stable condition back to his SAR facility. With plan for close PCP follow up.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Tachypnoea, Urethral injury, Urinary tract infection
Clinical narrative: Admission Date: 3/20/2023 Discharge Date: 3/23/2023  PRESENTING PROBLEM: Sepsis Bacterial lobar pneumonia  Urinary tract infection with hematuria, site unspecified  Altered mental status, unspecified altered mental status type  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present  COVID-19    HOSPITAL COURSE: Patient is a 68 y.o. man with DM2, HTN, hyperlipidemia, and metastatic RCC (with metastases to the bones, skin, likely lungs) receiving treatment with axitinib/nivolumab now admitted with altered mental status likely in the setting of infection.   In the ED was found to be febrile, altered mental status, hyponatremia, hyperlipidemia, AHRF and be COVID positive.  Furthermore he was found to be tachycardic tachypneic with no leukocytosis.  CXR significant for R lower lobe pneumonia.  He was started on Zosyn and vancomycin in the emergency department.   During his hospital course his infectious workup was negative for MRSA, strep, Legionella, influenza A/B and respiratory panel film array. His sepsis and altered mental status had resolved after 2 L of IV fluids.  Per his CAP, the abx was switched to ceftriaxone for targeted coverage. He was  transitioned to Augmentin prior to SAR discharge to complete 5 day course. Per patient's COVID status he remained asymptomatic and satting 100% on room air.  He was treated with remdesivir for 3 days. On his arrival to the medicine floor patient was found to have pressure injuries. Type 1 to coccyx and patient offloading of pressure was prioritized. Type 2 to urethra likely secondary to chronic foley. Photos were uploaded to media tab. Patient denied any pain to these locations.   Patient discharged in stable condition back to his SAR facility. With plan for close PCP follow up.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Brain oedema, COVID-19, Central nervous system lesion, Computerised tomogram abdomen abnormal, Computerised tomogram head abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: PA Admission Date: 3/20/2023 Discharge Date: 3/22/2023   PRESENTING PROBLEM: Abnormal CT of the head [R93.0] COVID-19 [U07.1]   HOSPITAL COURSE: 93-year-old female presented to the emergency department after sustaining a fall at home.  Fall was unwitnessed and patient's daughter was concerned patient may have hit her head.  Patient was having some mild confusion so daughter had patient brought in to rule out possible concussion.  Patient did have some mild lightheadedness prior to the fall but otherwise had no further complaints.  Of note patient daughter and family have had recent COVID-19 infections.  Patient did test positive for COVID-19 in the emergency department.  Emergency department patient underwent CT scan of the cervical spine which showed no acute fracture.  A CT of the head did show the presence of a focal lesion within the left parietal area worrisome for vasogenic edema and possible neoplastic process.  There is also hyper low intensity noted within the right cerebellum.  Case was discussed with neuro surgery patient underwent MRI without contrast which again showed similar findings.  Neurosurgery wanted an MRI with contrast which again showed similar findings.  Patient with a 4 cm area of edema within the left temporal parietal occipital white matter concerning for neoplastic process.  There also separate areas of enhancement noted.  These findings were discussed with neuro surgery and they recommended a CT scan of the chest abdomen and pelvis.  This was done which did show evidence of a 4 mm lesion in the right lower lobe.   Results to testing discussed with patient, daughter, and son.  They are all in agreement that patient does not want aggressive intervention.  They will follow-up with primary care physician.  If warranted they can follow-up with Medical Oncology.  If patient's clinical condition continues to worsen then hospice referral would be appropriate.        Patient is clinically stable for discharge home with 24 hour care.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram spine normal, Computerised tomogram thorax abnormal, Confusional state, Dizziness, Exposure to SARS-CoV-2
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: PA Admission Date: 3/20/2023 Discharge Date: 3/22/2023   PRESENTING PROBLEM: Abnormal CT of the head [R93.0] COVID-19 [U07.1]   HOSPITAL COURSE: 93-year-old female presented to the emergency department after sustaining a fall at home.  Fall was unwitnessed and patient's daughter was concerned patient may have hit her head.  Patient was having some mild confusion so daughter had patient brought in to rule out possible concussion.  Patient did have some mild lightheadedness prior to the fall but otherwise had no further complaints.  Of note patient daughter and family have had recent COVID-19 infections.  Patient did test positive for COVID-19 in the emergency department.  Emergency department patient underwent CT scan of the cervical spine which showed no acute fracture.  A CT of the head did show the presence of a focal lesion within the left parietal area worrisome for vasogenic edema and possible neoplastic process.  There is also hyper low intensity noted within the right cerebellum.  Case was discussed with neuro surgery patient underwent MRI without contrast which again showed similar findings.  Neurosurgery wanted an MRI with contrast which again showed similar findings.  Patient with a 4 cm area of edema within the left temporal parietal occipital white matter concerning for neoplastic process.  There also separate areas of enhancement noted.  These findings were discussed with neuro surgery and they recommended a CT scan of the chest abdomen and pelvis.  This was done which did show evidence of a 4 mm lesion in the right lower lobe.   Results to testing discussed with patient, daughter, and son.  They are all in agreement that patient does not want aggressive intervention.  They will follow-up with primary care physician.  If warranted they can follow-up with Medical Oncology.  If patient's clinical condition continues to worsen then hospice referral would be appropriate.        Patient is clinically stable for discharge home with 24 hour care.
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Fall, Lung disorder, Magnetic resonance imaging head abnormal, SARS-CoV-2 test positive, Scan with contrast abnormal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: PA Admission Date: 3/20/2023 Discharge Date: 3/22/2023   PRESENTING PROBLEM: Abnormal CT of the head [R93.0] COVID-19 [U07.1]   HOSPITAL COURSE: 93-year-old female presented to the emergency department after sustaining a fall at home.  Fall was unwitnessed and patient's daughter was concerned patient may have hit her head.  Patient was having some mild confusion so daughter had patient brought in to rule out possible concussion.  Patient did have some mild lightheadedness prior to the fall but otherwise had no further complaints.  Of note patient daughter and family have had recent COVID-19 infections.  Patient did test positive for COVID-19 in the emergency department.  Emergency department patient underwent CT scan of the cervical spine which showed no acute fracture.  A CT of the head did show the presence of a focal lesion within the left parietal area worrisome for vasogenic edema and possible neoplastic process.  There is also hyper low intensity noted within the right cerebellum.  Case was discussed with neuro surgery patient underwent MRI without contrast which again showed similar findings.  Neurosurgery wanted an MRI with contrast which again showed similar findings.  Patient with a 4 cm area of edema within the left temporal parietal occipital white matter concerning for neoplastic process.  There also separate areas of enhancement noted.  These findings were discussed with neuro surgery and they recommended a CT scan of the chest abdomen and pelvis.  This was done which did show evidence of a 4 mm lesion in the right lower lobe.   Results to testing discussed with patient, daughter, and son.  They are all in agreement that patient does not want aggressive intervention.  They will follow-up with primary care physician.  If warranted they can follow-up with Medical Oncology.  If patient's clinical condition continues to worsen then hospice referral would be appropriate.        Patient is clinically stable for discharge home with 24 hour care.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary mass
Clinical narrative: Nodules in lungs appearing rapidly
Age: 71.0
Sex: M
Vaccine: COVID19-2, FLUX
Symptoms: Back pain, Computerised tomogram, Nephrolithiasis
Clinical narrative: It was a kidney stone on my right kidney. I found out on January 30th, 2023, I went to urgent care clinic. I had severe pain in my lower right back, I was prescribed tamsulosin and TYLENOL.
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood test abnormal, Chest X-ray abnormal, Cough, Norovirus infection, Paranasal sinus discomfort
Clinical narrative: I had cough, sinus pressure, mucus, phlegm. I went to the doctor on 02/21/2023 where they performed a lung x-ray to ensure it wasn't pneumonia and bloodwork; later, I was told I had norovirus. It lasted for about 4 weeks. I was prescribed codeine cough syrup for recovery. As of now, I'm doing well and much better.
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Productive cough, Secretion discharge
Clinical narrative: I had cough, sinus pressure, mucus, phlegm. I went to the doctor on 02/21/2023 where they performed a lung x-ray to ensure it wasn't pneumonia and bloodwork; later, I was told I had norovirus. It lasted for about 4 weeks. I was prescribed codeine cough syrup for recovery. As of now, I'm doing well and much better.
Age: 69.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Atrial fibrillation, COVID-19, Chest discomfort, Dyspnoea, Feeling abnormal
Clinical narrative: My COVID-19 symptoms started on 01/24/2023 in the morning. I felt achy, nausea, nasal congestions.  I wasn't feeling good. I took 2 rapid tests one on 01/24/2023 and 01/25/2023 which were negative. I had elevated heart rate doing simple tasks then it resolved within few minutes.  I did a PCR test on 01/26/2023 which was positive. I called my doctor on 01/25/2023 and did a telehealth. He prescribe me Lagevrio 2 times a day for 5 days. The first time I had Atrial Fibrillation was on  01/19/2023 I was at the ER   for few hours and the second time I had Atrial Fibrillation  was on  02/23/2023. I was admitted at the hospital for 2 days and I was discharged the next day. My heart was racing. I had difficulty breathing and tightness in my chest. They changed my medication to Diltiazem. They did tests that showed possibility of blood clot. They transferred me over to the hospital to get other testes done. As of today I have recovered from Atrial Fibrillation and COVID-19 symptoms.
Age: 69.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Heart rate increased, Laboratory test abnormal, Malaise, Nasal congestion, Nausea
Clinical narrative: My COVID-19 symptoms started on 01/24/2023 in the morning. I felt achy, nausea, nasal congestions.  I wasn't feeling good. I took 2 rapid tests one on 01/24/2023 and 01/25/2023 which were negative. I had elevated heart rate doing simple tasks then it resolved within few minutes.  I did a PCR test on 01/26/2023 which was positive. I called my doctor on 01/25/2023 and did a telehealth. He prescribe me Lagevrio 2 times a day for 5 days. The first time I had Atrial Fibrillation was on  01/19/2023 I was at the ER   for few hours and the second time I had Atrial Fibrillation  was on  02/23/2023. I was admitted at the hospital for 2 days and I was discharged the next day. My heart was racing. I had difficulty breathing and tightness in my chest. They changed my medication to Diltiazem. They did tests that showed possibility of blood clot. They transferred me over to the hospital to get other testes done. As of today I have recovered from Atrial Fibrillation and COVID-19 symptoms.
Age: 69.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Pain, Palpitations, SARS-CoV-2 test positive
Clinical narrative: My COVID-19 symptoms started on 01/24/2023 in the morning. I felt achy, nausea, nasal congestions.  I wasn't feeling good. I took 2 rapid tests one on 01/24/2023 and 01/25/2023 which were negative. I had elevated heart rate doing simple tasks then it resolved within few minutes.  I did a PCR test on 01/26/2023 which was positive. I called my doctor on 01/25/2023 and did a telehealth. He prescribe me Lagevrio 2 times a day for 5 days. The first time I had Atrial Fibrillation was on  01/19/2023 I was at the ER   for few hours and the second time I had Atrial Fibrillation  was on  02/23/2023. I was admitted at the hospital for 2 days and I was discharged the next day. My heart was racing. I had difficulty breathing and tightness in my chest. They changed my medication to Diltiazem. They did tests that showed possibility of blood clot. They transferred me over to the hospital to get other testes done. As of today I have recovered from Atrial Fibrillation and COVID-19 symptoms.