Age: 60.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood chloride decreased, Blood creatinine increased, Blood glucose normal, Blood lactic acid, Blood potassium decreased
Clinical narrative: 1/20/22  Patient is a 60-year-old female who presents with cough which has been dry, shortness of breath, lightheadedness, generalized weakness and fatigue over the course of the past 17 days.  She was exposed to COVID on the third and since that time has had a cough with generalized fatigue.  She has not been tested for COVID.  She has had lightheadedness and generalized weakness as well.  Patient has had nausea with taste alteration over the past 5 days and has had very little to eat over the past 5 days.  She reports having not eaten anything over the past 2 to 3 days due to nausea and discomfort when eating.  She denies any abdominal pain.  No vomiting.  No diarrhea. Review of Systems  Constitutional: Positive for activity change, appetite change, chills and fatigue. Negative for fever.  HENT: Positive for congestion.        + ageusia   Respiratory: Positive for cough and shortness of breath.   Cardiovascular: Negative.   Gastrointestinal: Positive for nausea.  Genitourinary: Negative.   Musculoskeletal: Positive for myalgias.  Neurological: Positive for light-headedness.  All other systems reviewed and are negative.   CBC W/DIFF - Abnormal; Notable for the following components:     Result Value    White Blood Count 1.82     Lymphocyte % 13.1     Absolute Neutrophil Count 1.37     Neutrophil Abs 1.36     Lymphocyte-Absolute 0.24     Poikilocytosis 1+     Ovalocytes 1+     All other components within normal limits COMPREHENSIVE METABOLIC PANEL (CMP) - Abnormal; Notable for the following components:   Potassium 2.6     Chloride 94     Anion Gap 18     Glucose 133     Blood Urea Nitrogen (BUN) 44     Creatinine-Blood 2.27     Estimated GFR 22     Estimated GFR if (race) 27     Total Protein 8.1     AST/SGOT 37     All other components within normal limits TROPONIN - Abnormal; Notable for the following components:   Troponin 0.044     All other components within normal limits B-TYPE NATRIURETIC PEPTIDE - Abnormal; Notable for the following components:   B-Type Natriuretic Peptide 142.3     All other components within normal limits URINALYSIS - Abnormal; Notable for the following components:   Protein-Urine 100     Ketone-Urine 5     Urobilinogen-Urine 2.0    Leukocyte Esterase-Urine Large     RBC-Urine 32     WBC-Urine 35     Squamous Epithelial-Urine 12     Bacteria-Urine 2+     Mucus-Urine 3+     WBC Clumps-Urine 1+     Hyaline Cast-Urine 172     All other components within normal limits LACTIC ACID - Abnormal; Notable for the following components:   Lactic Acid  3.3     All other components within normal limits COVID-19, NOVEL CORONAVIRUS + FLU A/B PCR  1/21/22 Hospital Course:  Patient is a 60-year-old female with history of ovarian cancer on chemotherapy who came to the emergency room with decreased appetite, nausea, shortness of breath and dizziness who was exposed to somebody with COVID-19 earlier this month.  She had a dry cough and weakness.  She came to the emergency room for evaluation.  Her oxygen saturation was stable on room air.  Chest x-ray was clear.  COVID-19 was tested in the ER which  came back positive.  Lab work showed potassium 3.6 lactic acid 3.3 BUN 44 creatinine 2.27 troponin was 0.044 WBC 1800.  Patient was admitted for further management.  She received IV fluids.  Repeat troponin was negative.  She did not have any chest pain.  This morning she feels great and much better.  Weakness markedly improved.  She did have incidental UTI and received ceftriaxone in the hospital and will be going home on oral Levaquin for 5 days.  Currently renal functions have recovered and BUN is 21 with creatinine 1.17.  Potassium replaced and currently 3.6.  We will discontinue hydrochlorothiazide.  She is stable from a COVID standpoint and she is on room air with no respiratory distress