chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: U
Vaccine: COVID19
Symptoms: Therapeutic response unexpected
Clinical narrative: regaining some of my taste & smell; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP), Program ID: (005570). The reporter is the patient.  A patient (no qualifiers provided) received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown), as dose 3, (booster) single (Batch/Lot number: unknown) and as dose 4, (booster) single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "sinus infection" (unspecified if ongoing), notes: 8 years ago I lost my sense of taste & smell due to a sinus infection & bronchitis; "bronchitis" (unspecified if ongoing), notes: 8 years ago I lost my sense of taste & smell due to a sinus infection & bronchitis. The patient's concomitant medications were not reported. The following information was reported: THERAPEUTIC RESPONSE UNEXPECTED (non-serious), outcome "unknown", described as "regaining some of my taste & smell".  Additional information: Patient received all Pfizer shots & boosters. With that said, 8 years ago the patient lost the sense of taste & smell due to a sinus infection & bronchitis & treated with Levaquin. In the past few weeks, patient started regaining some of taste & smell. Very little but for patient it was outstanding. CEP Number: CEP 005570. Case Category: Patient Assistance Programs. Event Awareness Date: 20Jun2022. Date Sent to DSU: 20Jun2022  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Drug ineffective, Headache, Illness, Nasal congestion
Clinical narrative: Male patient in his 40?s with no underlying conditions was vaccinated and boosted ended up testing positive for COVID; Male patient in his 40?s with no underlying conditions was vaccinated and boosted ended up testing positive for COVID; fell ill again; headache; sore throat; congestion; This is a spontaneous report received from contactable reporter(s) (Physician) from a sales representative. The reporter is the patient.  A male patient in his 40's received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown) and as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant), outcome "unknown" and all described as "Male patient in his 40?s with no underlying conditions was vaccinated and boosted ended up testing positive for COVID"; ILLNESS (non-serious), outcome "unknown", described as "fell ill again"; HEADACHE (non-serious), outcome "unknown"; OROPHARYNGEAL PAIN (non-serious), outcome "unknown", described as "sore throat"; NASAL CONGESTION (non-serious), outcome "unknown", described as "congestion". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: Positive.Description of Event: The patient was vaccinated and boosted ended up testing positive for COVID. The patient was sick and symptomatic for about a week then started feeling better and then during the next week fell ill again. His symptoms were a sore throat, congestion, headache. Event took place after use of product.  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.; Sender's Comments: Based on the information provided in the narrative, a causal association between the suspect drug and the events cannot be completely excluded.
Sex: M
Vaccine: COVID19
Symptoms: Oropharyngeal pain, SARS-CoV-2 test
Clinical narrative: Male patient in his 40?s with no underlying conditions was vaccinated and boosted ended up testing positive for COVID; Male patient in his 40?s with no underlying conditions was vaccinated and boosted ended up testing positive for COVID; fell ill again; headache; sore throat; congestion; This is a spontaneous report received from contactable reporter(s) (Physician) from a sales representative. The reporter is the patient.  A male patient in his 40's received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown) and as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant), outcome "unknown" and all described as "Male patient in his 40?s with no underlying conditions was vaccinated and boosted ended up testing positive for COVID"; ILLNESS (non-serious), outcome "unknown", described as "fell ill again"; HEADACHE (non-serious), outcome "unknown"; OROPHARYNGEAL PAIN (non-serious), outcome "unknown", described as "sore throat"; NASAL CONGESTION (non-serious), outcome "unknown", described as "congestion". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: Positive.Description of Event: The patient was vaccinated and boosted ended up testing positive for COVID. The patient was sick and symptomatic for about a week then started feeling better and then during the next week fell ill again. His symptoms were a sore throat, congestion, headache. Event took place after use of product.  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.; Sender's Comments: Based on the information provided in the narrative, a causal association between the suspect drug and the events cannot be completely excluded.
Sex: M
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: got a rash around his entire right side of his upper body from just above the waste line to his shoulder; This is a spontaneous report received from non-contactable reporter(s) (Consumer or other non HCP) from a sales representative. The reporter is the patient.  A male patient in his 20's received BNT162b2 (BNT162B2), as dose number unknown (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Primary Immunization series complete; unknown manufacturer), for Covid-19 Immunization. The following information was reported: RASH (non-serious), outcome "unknown", described as "got a rash around his entire right side of his upper body from just above the waste line to his shoulder". Therapeutic measures were taken as a result of rash.  Additional information: The patient received his Pfizer BioNTech COVID 19 vaccine booster and got a rash around his entire right side of his upper body from just above the waste line to his shoulder. The patient took Benadryl. Event took place after use of product.  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.
Sex: U
Vaccine: COVID19
Symptoms: Injury
Clinical narrative: permanent injuries; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP), Program ID: The reporter is the patient.  A patient (no qualifiers provided) received BNT162b2 (BNT162B2), in Apr2021 as dose number unknown, single (Batch/Lot number: unknown) for covid-19 immunization. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: INJURY (non-serious) with onset Apr2021, outcome "unknown", described as "permanent injuries".  Additional information: The patient reported that I have permanent injuries caused by the Covid-19 pfizer vaccine and I can provide any and all medical information needed to move forward.   The information on the batch/lot number for [BNT162B2] has been requested and will be submitted if and when received.
Sex: F
Vaccine: COVID19
Symptoms: Drug ineffective, Suspected COVID-19
Clinical narrative: My husband and I had three doses of the Covid vaccine, and we contracted COVID anyway/I have no faith any longer that the Covid vaccine is effective; My husband and I had three doses of the Covid vaccine, and we contracted COVID anyway/I have no faith any longer that the Covid vaccine is effective; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). The reporter is the patient.  A female patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown), as dose 2, single (Batch/Lot number: unknown) and as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), SUSPECTED COVID-19 (medically significant), outcome "unknown" and all described as "My husband and I had three doses of the Covid vaccine, and we contracted COVID anyway/I have no faith any longer that the Covid vaccine is effective".  Clinical course: Dear Sir, My husband and I had three doses of the Covid vaccine, and we contracted COVID anyway. (He contracted it first, and I got it from him.) My sister, on the other hand, never took the vaccine and had milder symptoms than both of us when she contracted Covid. I've been having a pretty rough week. I have no faith any longer that the Covid vaccine is effective. I feel misled by your company (and (Physician Name withheld) who touted this vaccine.)  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202200859385 same reporter/product/event, different patient;
Sex: U
Vaccine: COVID19
Symptoms: Therapeutic response unexpected
Clinical narrative: after my second shot in Apr2021, my psoriasis cleared right up; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP), Program. The reporter is the patient.  A patient (no qualifiers provided) received BNT162b2 (BNT162B2), in Apr2021 as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Dose 1, Manufacturer unknown), for COVID-19 Immunization. The following information was reported: THERAPEUTIC RESPONSE UNEXPECTED (non-serious), outcome "unknown", described as "after my second shot in Apr2021, my psoriasis cleared right up".  Additional information: Patient just wanted to know about an exciting side effect patient had from your shots: after my second shot in Apr2021, my psoriasis cleared right up! It lasted through my first booster patient received in Oct2021. In May2022, the psoriasis returned. patient just got second booster yesterday and am hoping for the same psoriasis remission. Obviously, the shot is boosting my immune system. Seems like this is something that would be of great help to us psoriasis suffers Cheers.   Follow-up attempts are completed. No further information is expected.
Sex: F
Vaccine: COVID19
Symptoms: Anaphylactic shock
Clinical narrative: anaphylactic shock; This is a spontaneous report received from contactable reporter(s) (Other HCP) from a sales representative. The reporter is the patient.  A female patient received BNT162b2 (BNT162B2), as dose number unknown, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "anaphylaxis shock" (unspecified if ongoing), notes: historical risk of anaphylaxis shock after receiving vaccines. The patient's concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Manufacturer: Johnson and Johnson, DOSE NUMBER UNKNOWN, SINGLE), for Covid-19 immunization. The following information was reported: ANAPHYLACTIC SHOCK (hospitalization, medically significant), outcome "unknown".  Clinical course of the events: patient was a female medical assistant in a medical group that she call on. She reported time that she took the Johnson and Johnson Covid-19 vaccine due to her historical risk of anaphylaxis shock after receiving vaccines. She took the Pfizer BioNTech Covid 19 vaccine in the hospital and ended up going into anaphylactic shock. She was taken care of in the hospital and this incident has been reported to VAERS. Event took place after use of product.  The information on the batch/lot number for BNT162b2 has been requested and will be submitted if and when received.; Sender's Comments: As there is limited information in the case provided, the causal association between the event anaphylactic shock and the suspect drug BNT162B2 cannot be excluded. The case will be reassessed once new information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.
Sex: U
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Drug ineffective, SARS-CoV-2 test
Clinical narrative: Tested positive for COVID on 20Jun22; Tested positive for COVID on 20Jun22; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP). The reporter is the patient.  A patient (no qualifiers provided) received BNT162b2 (COMIRNATY), as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation; coviD-19 vaccine (COVID-19 VACCINE), as dose 1, single (Batch/Lot number: unknown) and as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant) all with onset 20Jun2022, outcome "unknown" and all described as "Tested positive for COVID on 20Jun22". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: (20Jun2022) Positive.  Clinical course: Received three doses of the COVID 19 vaccine - the most recent being on 05Nov. Symptoms are mild and allergy-like. No fever reported.  The information on the batch/lot number for [COMIRNATY] has been requested and will be submitted if and when received.
Sex: U
Vaccine: COVID19
Symptoms: Illness
Clinical narrative: sick; This is a spontaneous report received from non-contactable reporter(s) (Consumer or other non HCP), Program ID: A patient (no qualifiers provided) received BNT162b2 (BNT162B2), as dose number unknown, booster (Batch/Lot number: unknown) for covid-19 immunization. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Primary Immunization series complete; unknown manufacturer), for Covid-19 Immunization. The following information was reported: ILLNESS (non-serious), outcome "unknown", described as "sick". Follow-up attempts are not needed. No further information is expected.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Allergy test negative, Biopsy skin abnormal, Borrelia test negative, Full blood count normal, Rash
Clinical narrative: Rash over chest and back
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Angiogram pulmonary abnormal, Aspartate aminotransferase increased, Atrial fibrillation, Blood creatine phosphokinase increased
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine increased, Blood glucose increased, Blood lactate dehydrogenase increased, Blood lactic acid, Blood potassium normal
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Blood sodium normal, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Candida test positive
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Catheter site haemorrhage, Central venous catheterisation, Computerised tomogram head normal, Computerised tomogram spine, Culture positive
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Depressed level of consciousness, Dysphagia, Endotracheal intubation, Fall, Femur fracture
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Fibrin D dimer, Fungal test positive, Gastrointestinal tube insertion, Gastrostomy, Haemoglobin decreased
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Haemostasis, Hip fracture, Intensive care, Intentional medical device removal by patient, International normalised ratio increased
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Medical device implantation, Memory impairment, Mental status changes, Pneumonia bacterial, Positive airway pressure therapy
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Procalcitonin increased, Respiratory distress, Rhabdomyolysis, SARS-CoV-2 test positive, Serum ferritin increased
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Somnolence, Staphylococcus test negative, Superinfection, Syncope, Troponin increased
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cell count increased, X-ray abnormal
Clinical narrative: Pt was admitted on 2/11/2022 for femur fracture following syncopal episode and fall with prolonged downtime and rhabdomyolysis, Covid 19 PNA with superimposed bacterial PNA.  . He denied any headache, chest pain, shortness of breath, dizziness, nausea, vomiting, neck or back pain. He did not remember falling or why he fell. He denied any change in medications, recent illness, fever, or chills.    On arrival to the emergency department his vitals were: blood pressure 118/66, heart rate 121, temperature 99.9, respiratory rate 22, pulse ox 95% on room air.     Patient was shown to have a left hip fracture on X-ray and orthopedic surgery was consulted by the ED. Patient  underwent a left hip screw placement 2/12/22. He developed atrial fibrillation at this time in the hospital.  02/17 patient developed increasing respiratory distress and mental status changes, so critical care consulted. Patient intubated and transferred to ICU. Extubation was done on 02/21. Patient was weaned down oxygen supplementation from 4L nasal canula with biPAP at night to 2L nasal canula on 02/23. He was transferred out of ICU.  For COVID pneumonia, ID was consulted. Patient received various courses of antibiotics including ceftriaxone (received 3 days after started 2/11, then restarted 2/26), azithromycin (received 3 days after started 2/11), cefazolin (x1 dose on 2/12 and 2/17), vancomycin (x1 dose 2/17, discontinued after MRSA negative). Dexamethasone course and taper completed.  Fungitell collected 3/1/22 resulted positive and respiratory cultures collected 2/19 grew candida albicans. Micafungin started and ceftriaxone discontinued 3/3/22. Patient to complete 2 weeks total antifungal therapy, transitioned to voriconazole to be administered via G tube through 3/17. Cefepime discontinued and ceftriaxone resumed due to concern for metabolic encephalopathy. Patient self-discontinued his right IJ central line, bleeding controlled with direct pressure, hemostasis obtained. He also repeatedly pulled out his NG tubes requiring bilateral mitt placement. Mental status improved as of 3/2/22 and patient more alert, able to participate in therapy activities though still occasionally drowsy and requiring redirection/ reorientation.   NG tube was placed 2/17/22 while in ICU and patient received nutrition via this. After extubation and transfer out of the ICU, patient had difficulty with swallowing so was followed by SLP.  Patient not a candidate for MBS per SLP due to ongoing confusion.  3/1/22 after discussion with patient's wife, consult to surgery. PEG tube placed 3/4/22.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy, Pain
Clinical narrative: Systemic: Body Aches Generalized-Mild, Systemic: Lymph Node Swelling-Medium
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Cardiac failure, Cardiac failure acute
Clinical narrative: Patient's symptoms began 1 week prior to presentation and were worsening. She had associated wheezing, lower extremity edema, and intermittent cough. BNP was elevated. CXR showed bilateral interstitial pneumonia and she was found to be positive for Covid-19. Patient  was not hypoxic. She was started on IV diuresis which was increased.  Patient continued to diurese well and was transitioned to Bumex 2 mg p.o. B.i.d.  The day of discharge patient's hemoglobin was trending within a stable fashion as was her kidney function.  Patient is being discharged home on February 8, 2022 in stable condition.  Discharge  Diagnoses:   1. Acute on chronic Heart failure with preserved ejection fraction exacerbation 2. Severe pulmonary hypertension 3. COVID-19 pneumonia without hypoxia
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Cough, Haemoglobin normal, Interstitial lung disease, Oedema peripheral
Clinical narrative: Patient's symptoms began 1 week prior to presentation and were worsening. She had associated wheezing, lower extremity edema, and intermittent cough. BNP was elevated. CXR showed bilateral interstitial pneumonia and she was found to be positive for Covid-19. Patient  was not hypoxic. She was started on IV diuresis which was increased.  Patient continued to diurese well and was transitioned to Bumex 2 mg p.o. B.i.d.  The day of discharge patient's hemoglobin was trending within a stable fashion as was her kidney function.  Patient is being discharged home on February 8, 2022 in stable condition.  Discharge  Diagnoses:   1. Acute on chronic Heart failure with preserved ejection fraction exacerbation 2. Severe pulmonary hypertension 3. COVID-19 pneumonia without hypoxia