Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Blood bicarbonate normal, Blood fibrinogen normal, Blood gases abnormal, Blood pH normal, Brain natriuretic peptide increased
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 01/16, Pfizer, dose #1 02/06, Pfizer, dose #2 07/28 pt wife called cc: chest pain, cough, dyspnea, weakness. SOB, headache 08/04 COVID swab, result: detected 08/04 hospitalized dx. PNA 08/04 CXR impression: Bilateral pneumonia. 08/05 CXR impression: Persistent mixed interstitial and patchy airspace opacities in the mid and lower lungs bilaterally not significantly changed. Findings with patient's known history of COVID pneumonia. 08/09 Fungitell result <31 08/09 CXR impression: Stable chest radiograph since 4 days ago as above. 08/10 Tacrolimus result: 7.4 08/10 ESR 12 8/10 Fibrinogen/ DDIMER results: 261/ 1.11 8/10 CXR impression: Similar groundglass and interstitial opacities in the lungs, consistent with atypical pneumonia. 08/11 ESR 8 08/11 Fibrinogen/ DDIMER result: 230/ 0.99 08/11 CXR impression: Similar appearance of bilateral lung opacities. 08/12 ESR result: 6 08/12 Fibrinogen/ DDIMER result: 203/ 1.11 08/13 ESR result: 7 08/13 Fibrinogen/ DDIMER result: 216/ 1.16 08/14 Fungitel result: <31 08/14 ESR result: 12 08/14 Fibrinogen/ DDIMER result: 207/ 1.37 08/14 Procalcitonin result: 0.07 08/14 CXR impression: Underinflated lungs. Interval increase in bilateral opacities accentuated by differences in technique. 08/15 ESR result: 13 08/15 Fibrinogen/ DDIMER result: 212/ 1.08 08/15 CT Chest impressions: Multifocal bilateral groundglass opacities throughout both lungs with more confluent involvement at the posterior lung bases. This may reflect a nonspecific infectious/inflammatory process, including the possibility of viral pneumonia in the setting of known COVID positivity. Interlobular septal thickening is also present component of pulmonary edema may also be considered. Clinical correlation and attention on short-term follow-up is recommended to assess for clearance. 2. Oval nodular opacity at the posterior left upper lobe which may reflect nonspecific infection/inflammation with neoplasia not excluded. Attention on short-term follow-up is recommended. 3. Ectasia of the ascending thoracic measurement of 4.1 cm in diameter. 08/16 ESR result: 5 0816 Fibrinogen/ DDIMER result: 226/ 0.87 08/17 Fibrinogen/ DDIMER result: 230/ 0.98 08/17 ESR 11 08/17 Tacrolimus result: 2.1 08/18 ALT/AST result: 27/38 08/18 ESR result: 11 08/18 Fibrinogen/ DDIMER result: 226/ 1.22 8/18 ABG result: i-pH 7.41, i-PCO2 34.9, i-Po2 65, i-HCO3 22.1 8/18 C-Reactive result: 0.114 8/19 ESR result: 10 8/19 Fibrinogen/ DDIMER result: 216/ 1.87 8/20 BNP result: 136.3 8/20 ESR result: 14 8/20 Fibrinogen/ DDIMER result: 258/ 1.53 8/21 CXR Impression: Essentially stable chest radiography since 6 days ago with imaging findings most in keeping with ongoing COVID pneumonitis 8/21 Fibrinogen/ DDIMER result: 271/ 1.66 8/21 ALT/AST Result: 35/ 44 8/21 ferritin result: 2211 8/21 C-Reactive Protein result: 0.272 8/21 ESR 12 8/21 CXR Impression: Diffuse bilateral airspace opacities, mildly worsened. Low lung volumes. 8/22 Fibrinogen/ DDIMER Result: 296/ 2.08 8/22 ALT/AST result: 41/43 8/22 C-Reactive Protein result: 0.240 8/22 ESR 30 8/24 pt decease