chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain
Clinical narrative: Acute back pain started day after shot. Acute back pain remains as current as today, 09/05/21. Acute back pain in same spot, approximately bra line area) daily.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site pruritus, Injection site swelling
Clinical narrative: Moderna COVID-19 Vaccine EUA. 7 days after receiving first dose I developed a large red spot at the injection site that was itchy like a bug bite and swollen. The skin felt very hard and hot to the touch. The next day the spot had more than tripled in size and covered most of my upper arm. It didn't cause much pain but it did ache and hurt if I touched it. The skin was very hard and hot to the touch, the itching was mild. Today is the third day since the reaction started and the swelling seems to have lessened, but the red spot is still there and itches.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site warmth
Clinical narrative: Moderna COVID-19 Vaccine EUA. 7 days after receiving first dose I developed a large red spot at the injection site that was itchy like a bug bite and swollen. The skin felt very hard and hot to the touch. The next day the spot had more than tripled in size and covered most of my upper arm. It didn't cause much pain but it did ache and hurt if I touched it. The skin was very hard and hot to the touch, the itching was mild. Today is the third day since the reaction started and the swelling seems to have lessened, but the red spot is still there and itches.
Age: 56.0
Sex: F
Vaccine: VARZOS
Symptoms: Headache, Immediate post-injection reaction, Injection site pain, Injection site pruritus, Pain
Clinical narrative: Immediate Itching at site , tingling in fingers on right hand within 10 mins, tingling in right side -including face and tongue?a few hours after injection, headache evening of injections, body aches through the night, headache continues next day, soreness at injection site
Age: 56.0
Sex: F
Vaccine: VARZOS
Symptoms: Paraesthesia
Clinical narrative: Immediate Itching at site , tingling in fingers on right hand within 10 mins, tingling in right side -including face and tongue?a few hours after injection, headache evening of injections, body aches through the night, headache continues next day, soreness at injection site
Age: 52.0
Sex: F
Vaccine: FLU4, HEP, VARZOS
Symptoms: Injection site erythema, Injection site pruritus, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
Clinical narrative: Extreme soreness, itching, redness, swelling, and heat on right arm at shingles vaccination site. Area of swelling approx 3 inch diameter. I am not certain which Hep B vaccine I received; my paperwork doesn't say so I just picked one.
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Axillary pain, Oedema peripheral
Clinical narrative: patient reports painful swelling in the armpit starting the day after vaccination and lasting for a total of 2 days
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Asthma, Condition aggravated, Dizziness, Headache, Wheezing
Clinical narrative: Light headed, headache, severe wheezing, multiple asthma attacks, used nebulizer treatments, rescue haler did not work to alleviate asthma attacks or severe wheezing.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Agitation, Angiogram pulmonary abnormal, Anticoagulant therapy, Anxiety, Bilevel positive airway pressure
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood gases, Blood pressure decreased, COVID-19, Cardiac arrest, Condition aggravated
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Confusional state, Death, Dyspnoea, Echocardiogram, Emphysema
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Endotracheal intubation, Gastrointestinal tube insertion, Haemoglobin decreased, Haemoptysis, Infection
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Intensive care, Mechanical ventilation, Oxygen saturation decreased, Packed red blood cell transfusion, Patient restraint
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pulmonary embolism, Pulmonary mass, SARS-CoV-2 test positive, Treatment noncompliance
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Agitation, Angiogram pulmonary abnormal, Anticoagulant therapy, Anxiety, Blood gases
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood pressure decreased, Blood pressure measurement, COVID-19, Cardiac arrest, Coma scale
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram, Condition aggravated, Confusional state, Death, Dyspnoea
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Echocardiogram, Emphysema, Endotracheal intubation, Fraction of inspired oxygen, Gastrointestinal tube insertion
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Haemoglobin, Haemoglobin decreased, Haemoptysis, Heart rate, Infection
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Intensive care, Mechanical ventilation, Oxygen saturation, Oxygen saturation decreased, Packed red blood cell transfusion
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Patient restraint, Positive airway pressure therapy, Pulmonary embolism, Pulmonary mass, SARS-CoV-2 test
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Treatment noncompliance, Ultrasound scan, Vaccination failure
Clinical narrative: Patient required hospitalization due to breakthrough infection. He received J&J vaccine on 03/12/21. Hospitalized from 08/18/21 - 08/30/21. Below is copied from discharge (death) summary:   Hospital Course:  HPI: Patient is a 70 year old male with a PMHx of COPD / Emphysema with home O2 dependence recently increased to 3L/NC, HFrEF, recent Dx of PE one month ago on Eliquis and depression who presented to the ED for worsening shortness of breath and hemoptysis. He is Covid positive and did receive the J&J vaccine. He was admitted to the Hospitalist's Service. He has worsening shortness of breath and increased oxygen demand and work of breathing. He is transferred to the ICU for increased level of care.    8/22: CTA Chest negative for PE but showed severe centrilobular emphysema, left lung apex cavitary lesion (infxn vs. Malignancy). Echo pending. Patient on BiPAP 10/5, 70% FiO2. No other concerns.   8/23: Holding off Baricitinib given concern for CAP. Given Lasix 40 IV x 1 and will resume home Lasix BID in AM for HFrEF. Currently on BiPAP 10/6, 80%. Weaning to HFNC +/- NRB as tolerated.   8/24: Pt with high level of anxiety prn yesterday for which Buspar was effective. He has been anxious overnight. Remains on HFNC.   8/25: Over day time transitioned to bipap with improvement in oxygenation. Reports no change in respiratory status.    8/26: Patient had several episodes of removing HFNC or BiPAP. Placed in restraints w/mittens on HFNC + NRB. Patient with more confusion recently as well. Started on Seroquel. Currently on HFNC + NRB 60L/100%.   8/27: Patient with confusion/agitation yesterday. CT head ordered but patient unable to cooperate even w/Ativan. Patient maxed out on Precedex gtt and still agitated. Added ketamine gtt w/improvement in sedation and patient able to tolerate BiPAP. NG placed.   8/28: Patient with increasing O2 demands last night, patient subsequently intubated and placed on PRVC.  Today, patient changed from PRVC to PS with improvements in oxygenation.  Patient on 14/10 75% PS satting mid 90's.   8/29: Overnight patients blood pressure dropping despite being on Levo and Vaso infusions.  Neosynephrine infusion added.  Bedside ultrasound performed showing ~50% collapse of IVC on inspiration - patient bolused 1L IVF with minimal improvement of blood pressure.  Patient with increasing O2 requirements.  ABG performed showing Hgb 6.5.  Patient type & screened, crossmatched, transfused 1u PRBC's.  Vancomycin added for broad spectrum antibiotic coverage.  Spoke with patients significant other who came in to the hospital to see patient - she confirms status of DNR with being ok for intubation.   1957:  Maxed on 4 vasopressors.  GCS 3T.  HR trended down to asystole.  No heart tones auscultated.  Time of death 1957.  Significant other notified.       Discharged Condition: deceased
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Dizziness, Nervousness
Clinical narrative: PT WAS FINE IMMEDIATELY FOLLOWING VACCINE. ABOUT 5 MINUTES LATER, STATED HE WAS FEELING A BIT LIGHT HEADED.  WE HAD HIM LIE DOWN FOR A FEW MINUTES. HE STATED THAT HE DOES GET NERVOUS/ ANXIOUS WITH SHOTS AND THIS HAS HAPPENED TO HIM BEFORE FOLLOWING HIS FLU SHOTS. HE REPORTED NO TACHYCARDIA, SWEATING, SWELLING OF THROAT/MOUTH, ETC. HE ALSO STATED HE DID NOT EAT YET TODAY. HE DRANK SOME WATER AND HAD A PIECE OF CANDY. WE CHECKED HIS BLOOD PRESSURE WHICH WAS NORMAL AT 121/79. HEART RATE WAS ALSO NORMAL AT 68. HE SAT IN VIEW OF THE PHARMACY FOR ABOUT 10 MORE MINUTES AND STATED HE FELT FINE AT THAT POINT. I DID CALL HIM ABOUT 45 MINUTES LATER. HIS MOTHER SAID HE WAS GETTING SOMETHING TO EAT AND THAT HE FELT FINE. NO FURTHER FOLLOW UP NEEDED.
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Pain in extremity, Palpitations
Clinical narrative: woke up with heart palpitations. felt chest pain and pain in right arm from shoulder to wrist
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Eye pain, Headache, Pain, Pain in extremity
Clinical narrative: Zoster Vaccine Recomb,Adjuvanted (IM) - Arm pain for days.  Fever, aches, Chills for 2-3 days.  Severe pain behind left eye (overnight) - shooting pain behind  eye when I coughed or sneezed for several hours.  Headache finally went away by noon the next day.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Pyrexia
Clinical narrative: Zoster Vaccine Recomb,Adjuvanted (IM) - Arm pain for days.  Fever, aches, Chills for 2-3 days.  Severe pain behind left eye (overnight) - shooting pain behind  eye when I coughed or sneezed for several hours.  Headache finally went away by noon the next day.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Hypersensitivity, Pruritus
Clinical narrative: Vaccinated March 17, 2021.  In July I started noticing allergic reactio on hands. (Itching).  In August I was stung by a honey bee and had allergic reaction.  Had to take epinephrine.  Never before in 68 years have I ever had any allergies.   Don't know if related to vaccine or not.  Just thought it was notable.
Age: 74.0
Sex: F
Vaccine: VARZOS
Symptoms: Abdominal pain upper, Asthenia, Chills, Fatigue, Headache
Clinical narrative: Chills, bad headache, fairly large rash  on upper arm with soreness and swelling.  Stomach pain, fatigue and weakness.  Lasted 5 days.
Age: 74.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain in extremity, Peripheral swelling, Rash
Clinical narrative: Chills, bad headache, fairly large rash  on upper arm with soreness and swelling.  Stomach pain, fatigue and weakness.  Lasted 5 days.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Gait inability, Muscle spasms, Pain in extremity
Clinical narrative: Severe leg cramp from left toes up to hip at 11:00 am lasting approximately 3 minutes.  Relaxed again to wake to another severe cramp on right side leg that lasted approximately 1 1/2 minute. Made it to bathroom where I could not even sit. Still pain in calf area today and unable to walk steps normally. I am finally able to move foot and toes on both legs today.