chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Cough
Clinical narrative: Patient is a 68-year-old female with history of COPD, HFpEF, and other problems who presented from home with shortness of breath, cough, and fever.  She was found to have COVID-19 and likely concomitant upper respiratory tract infection.  She improved with oral steroids, but developed signs of URI/bronchitis and was placed on empiric antibiotics with further improvement in all of her symptoms.  She qualified for home oxygen likely on the basis of COVID-19 and her chronic bronchitis with acute component.  She improved and was clinically ready for discharge on Thursday, January 5.  She was released home in stable condition on oxygen.  She will complete a total 10-day course of dexamethasone for COVID, and a total 5-day course of antibiotics (p.o. azithromycin) for URI/bronchitis.  She will follow-up with her primary care physician in 1-2 weeks.   Acute hypoxemic respiratory failure COVID-19 infection URI/bronchitis  COPD exacerbation HFpEF, chronic -Hypoxic likely related to COVID, COPD and underlying heart failure with URI/bronchitis  - likely with superimposed upper respiratory tract infection URI - repeat CXR 1/3 with nonspecific hazy and linear opacities in the lung bases - COVID positive 12/31 (symptoms started 12/30); developed purulent sputum 1/2 - clinically improved, afebrile - received Rocephin/Azithro in the hospital, plan Azithromycin PO to complete total 5-day course of antibiotics at discharge -Complete 10-day course of dexamethasone 6 mg daily for COVID --Continue albuterol MDI, singulair, symbicort for COPD -Home oxygen was arranged, recommend 2 L around-the-clock and at nighttime while sleeping until she sees PCP for further follow-up.  Also follows with Dr. (OP pulm)    Unilateral RLE edema -Chronic per patient, noted per chart review since 6/2020. Unclear etiology, consider impaired RLE lymphatic drainage. -Prior RLE duplex 7/2020 without evidence of DVT. -Negative duplex this admission   Elevated creatinine, resolved - BUN 35 sCr 1.28 1/4; likely dehydration, acute illness -Creatinine 1.12 on 1/5.   Hypertension -Home regimen: coreg 25 mg BID,  - BP mostly acceptable here with some elevations in the setting of acute illness -Okay to resume home meds at discharge discharge today   Hyperlipidemia -Home lipitor 20 mg daily   Obesity -BMI 35.15, weight loss to be recommended
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Dehydration, Dyspnoea, Lung opacity, Oedema peripheral, Pyrexia
Clinical narrative: Patient is a 68-year-old female with history of COPD, HFpEF, and other problems who presented from home with shortness of breath, cough, and fever.  She was found to have COVID-19 and likely concomitant upper respiratory tract infection.  She improved with oral steroids, but developed signs of URI/bronchitis and was placed on empiric antibiotics with further improvement in all of her symptoms.  She qualified for home oxygen likely on the basis of COVID-19 and her chronic bronchitis with acute component.  She improved and was clinically ready for discharge on Thursday, January 5.  She was released home in stable condition on oxygen.  She will complete a total 10-day course of dexamethasone for COVID, and a total 5-day course of antibiotics (p.o. azithromycin) for URI/bronchitis.  She will follow-up with her primary care physician in 1-2 weeks.   Acute hypoxemic respiratory failure COVID-19 infection URI/bronchitis  COPD exacerbation HFpEF, chronic -Hypoxic likely related to COVID, COPD and underlying heart failure with URI/bronchitis  - likely with superimposed upper respiratory tract infection URI - repeat CXR 1/3 with nonspecific hazy and linear opacities in the lung bases - COVID positive 12/31 (symptoms started 12/30); developed purulent sputum 1/2 - clinically improved, afebrile - received Rocephin/Azithro in the hospital, plan Azithromycin PO to complete total 5-day course of antibiotics at discharge -Complete 10-day course of dexamethasone 6 mg daily for COVID --Continue albuterol MDI, singulair, symbicort for COPD -Home oxygen was arranged, recommend 2 L around-the-clock and at nighttime while sleeping until she sees PCP for further follow-up.  Also follows with Dr. (OP pulm)    Unilateral RLE edema -Chronic per patient, noted per chart review since 6/2020. Unclear etiology, consider impaired RLE lymphatic drainage. -Prior RLE duplex 7/2020 without evidence of DVT. -Negative duplex this admission   Elevated creatinine, resolved - BUN 35 sCr 1.28 1/4; likely dehydration, acute illness -Creatinine 1.12 on 1/5.   Hypertension -Home regimen: coreg 25 mg BID,  - BP mostly acceptable here with some elevations in the setting of acute illness -Okay to resume home meds at discharge discharge today   Hyperlipidemia -Home lipitor 20 mg daily   Obesity -BMI 35.15, weight loss to be recommended
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory symptom, SARS-CoV-2 test positive, Ultrasound Doppler normal, Upper respiratory tract infection
Clinical narrative: Patient is a 68-year-old female with history of COPD, HFpEF, and other problems who presented from home with shortness of breath, cough, and fever.  She was found to have COVID-19 and likely concomitant upper respiratory tract infection.  She improved with oral steroids, but developed signs of URI/bronchitis and was placed on empiric antibiotics with further improvement in all of her symptoms.  She qualified for home oxygen likely on the basis of COVID-19 and her chronic bronchitis with acute component.  She improved and was clinically ready for discharge on Thursday, January 5.  She was released home in stable condition on oxygen.  She will complete a total 10-day course of dexamethasone for COVID, and a total 5-day course of antibiotics (p.o. azithromycin) for URI/bronchitis.  She will follow-up with her primary care physician in 1-2 weeks.   Acute hypoxemic respiratory failure COVID-19 infection URI/bronchitis  COPD exacerbation HFpEF, chronic -Hypoxic likely related to COVID, COPD and underlying heart failure with URI/bronchitis  - likely with superimposed upper respiratory tract infection URI - repeat CXR 1/3 with nonspecific hazy and linear opacities in the lung bases - COVID positive 12/31 (symptoms started 12/30); developed purulent sputum 1/2 - clinically improved, afebrile - received Rocephin/Azithro in the hospital, plan Azithromycin PO to complete total 5-day course of antibiotics at discharge -Complete 10-day course of dexamethasone 6 mg daily for COVID --Continue albuterol MDI, singulair, symbicort for COPD -Home oxygen was arranged, recommend 2 L around-the-clock and at nighttime while sleeping until she sees PCP for further follow-up.  Also follows with Dr. (OP pulm)    Unilateral RLE edema -Chronic per patient, noted per chart review since 6/2020. Unclear etiology, consider impaired RLE lymphatic drainage. -Prior RLE duplex 7/2020 without evidence of DVT. -Negative duplex this admission   Elevated creatinine, resolved - BUN 35 sCr 1.28 1/4; likely dehydration, acute illness -Creatinine 1.12 on 1/5.   Hypertension -Home regimen: coreg 25 mg BID,  - BP mostly acceptable here with some elevations in the setting of acute illness -Okay to resume home meds at discharge discharge today   Hyperlipidemia -Home lipitor 20 mg daily   Obesity -BMI 35.15, weight loss to be recommended
Age: 48.0
Sex: M
Vaccine: COVID19-2
Symptoms: Bronchitis, COVID-19, Chest X-ray abnormal, Dyspnoea, Fatigue
Clinical narrative: On December 28, 2022, he was restless and unable to sleep.  On the 29th he had a low-grade fever.  He tested positive for COVID-19 on the 29th.  The doctor prescribed him an anti-viral and took that for 5 days.  He complained of pain in his legs and fatigue.  He had body aches.  In two weeks, he seemed to be feeling better.  But then he began to complain of difficulty breathing.  A month later he was still testing positive for COVID-19.  He was admitted to the hospital on January 23, 2023, and was discharged on January 29th but returned to the hospital today, January 31st, because of shortness of breath and high blood pressure.  He is still testing positive for COVID-19.  He is on a ventilator via mouth and nose.  They are treating him with antibiotics.
Age: 48.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hypertension, Insomnia, Mechanical ventilation, Pain, Pain in extremity
Clinical narrative: On December 28, 2022, he was restless and unable to sleep.  On the 29th he had a low-grade fever.  He tested positive for COVID-19 on the 29th.  The doctor prescribed him an anti-viral and took that for 5 days.  He complained of pain in his legs and fatigue.  He had body aches.  In two weeks, he seemed to be feeling better.  But then he began to complain of difficulty breathing.  A month later he was still testing positive for COVID-19.  He was admitted to the hospital on January 23, 2023, and was discharged on January 29th but returned to the hospital today, January 31st, because of shortness of breath and high blood pressure.  He is still testing positive for COVID-19.  He is on a ventilator via mouth and nose.  They are treating him with antibiotics.
Age: 48.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pyrexia, Restlessness, SARS-CoV-2 test positive
Clinical narrative: On December 28, 2022, he was restless and unable to sleep.  On the 29th he had a low-grade fever.  He tested positive for COVID-19 on the 29th.  The doctor prescribed him an anti-viral and took that for 5 days.  He complained of pain in his legs and fatigue.  He had body aches.  In two weeks, he seemed to be feeling better.  But then he began to complain of difficulty breathing.  A month later he was still testing positive for COVID-19.  He was admitted to the hospital on January 23, 2023, and was discharged on January 29th but returned to the hospital today, January 31st, because of shortness of breath and high blood pressure.  He is still testing positive for COVID-19.  He is on a ventilator via mouth and nose.  They are treating him with antibiotics.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Asthenia, Atelectasis
Clinical narrative: Patient is a 84 y.o. male patient of MD.   Patient presented to emergency room for generalized weakness.  Patient states that yesterday he became severely weak.  Patient also reports a cough.  Patient denies any chest pain or shortness of breath.  Patient denies any fever at home.  Patient does not use oxygen at baseline.  Hospital course as below.  Patient improved with medical treatment.  Patient weaned to room air on discharge.  Patient instructed to follow-up primary care provider within a week at discharge.    1. COVID PNA, +1/5, symptoms 1/5, vaccinated: -CXR with atelectasis versus infection -Remdesivir  -Decadron  -heparin SC DVT prophylaxis   2.  Acute hypoxic respiratory failure: -Secondary to above -Wean oxygen as able   3.  Generalized weakness: -Secondary to above -PT/OT -Social work for discharge needs   4. AKI: -monitor labs -IVF -hold home nephrotoxic meds
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest X-ray abnormal, Cough, Pneumonia
Clinical narrative: Patient is a 84 y.o. male patient of MD.   Patient presented to emergency room for generalized weakness.  Patient states that yesterday he became severely weak.  Patient also reports a cough.  Patient denies any chest pain or shortness of breath.  Patient denies any fever at home.  Patient does not use oxygen at baseline.  Hospital course as below.  Patient improved with medical treatment.  Patient weaned to room air on discharge.  Patient instructed to follow-up primary care provider within a week at discharge.    1. COVID PNA, +1/5, symptoms 1/5, vaccinated: -CXR with atelectasis versus infection -Remdesivir  -Decadron  -heparin SC DVT prophylaxis   2.  Acute hypoxic respiratory failure: -Secondary to above -Wean oxygen as able   3.  Generalized weakness: -Secondary to above -PT/OT -Social work for discharge needs   4. AKI: -monitor labs -IVF -hold home nephrotoxic meds
Age: 55.0
Sex: M
Vaccine: FLUC4
Symptoms: Injection site pain, Pain in extremity
Clinical narrative: Site: Pain at Injection Site-Severe, Additional Details: Pt. contacted the pharmacy on 1/28/2023 to indicate that he and his wife have been experiencing pain the arm of their vaccine. He described his pain as paralyzing. He also said that it comes and goes but has been happening since vaccine administration. He has not seen a Dr as of this time.
Age: 48.0
Sex: F
Vaccine: FLUC4
Symptoms: Injection site pain
Clinical narrative: Site: Pain at Injection Site-Medium, Additional Details: Patient's spouse called the pharmacy on 1/28/2023 and said that he and his wife had been experiencing pain in their arm since their vaccinations. He stated that the pain comes and goes. Neither one of them has seen a Dr. about this yet. They would like someone to reach out to them about this.
Age: 58.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: On1/24/2023 the patient in the office for office visit. Alerted nurse on  previous day 1/23/2023 that the patient needed a 4th  COVID booster vaccine upon doing chart prep. On 1/24/2023  PCP this nurse aware that the patient needed a COVID-Bivalent booster shot. Orders placed in chart by PCP. New vaccine card made for patient for 2nd bivalent booster injection.  Vaccine given in left deltoid without difficulty.
Age: 2.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: There is a possibility the patient may have received 0.25 ml of vaccine rather than the recommended 0.2 ml of the Moderna Bivalent presentation for 6 months to 5 years. A staff member was not aware of the correct dosing of the bivalent vaccine. The system in place for drawing up vaccine and administering vaccine may have allowed for staff member to have drawn up 0.25 ml and another staff member to give the vaccine. It cannot be determined if the correct or incorrect amount was drawn up or given. There has been no reported adverse reaction from the parents to date.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient should have received Moderna Bivalent but was given half-dose of Moderna primary series.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Fatigue, Headache, Injection site erythema, Injection site swelling
Clinical narrative: patient said she experienced redness and swelling at the injection site that did not resolve in a week. She also said she felt fatigue, body aches, shivers and had a headache. Recommended pain to use tylenol and to visit urgent care clinic. Patient stated she will see how she feels before going to urgent care.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain
Clinical narrative: patient said she experienced redness and swelling at the injection site that did not resolve in a week. She also said she felt fatigue, body aches, shivers and had a headache. Recommended pain to use tylenol and to visit urgent care clinic. Patient stated she will see how she feels before going to urgent care.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Blood magnesium decreased, Blood potassium decreased, COVID-19
Clinical narrative: Patient is a 69-year-old female history of hypertension, diabetes, hyperlipidemia and COPD who presented to the ED on 1/2 with shortness of breath, cough, vomiting and diarrhea.  On arrival, patient was hypoxic requiring 3 L nasal cannula and was hypertensive in the 140s.  Lab work was significant for hypokalemia with 2.4, hypomagnesemia of 0.8 and COVID positivity with otherwise unremarkable vitals.  Urinalysis consistent with UTI.  CTA of the chest was performed and negative for PE or other acute process but did show findings suggestive of pulmonary hypertension and COPD.  Patient was started on antibiotics, breathing treatments and electrolyte replacement with admission to the hospital. The following AM, 1/3, patient was started on decadron given her oxygen requirement and COVID positive status. Over the next 36 hours, patients Potassium and phosphors were replaced multiple times. She was able to be weaned off oxygen and was stable on room air on 1/4. Given ongoing hypokalemia, patient received multiple oral doses throughout the day 1/4.  Ultimately, patient was hemodynamically stable on room air with improving electrolytes and discharged home on 1/4.  She was provided a prescription for Decadron to complete a course for her hypoxia with COVID.  She was also provided a prescription for 20 mill equivalents of potassium daily to take for the next 5 days and a prescription for BMP in 7 days and was encouraged to follow-up with her PCP following her lab test.  Lastly, antibiotic for UTI was not prescribed on discharge. I called multiple times with no answer so a voicemail was left instructing the patient to pick up Keflex from her pharmacy. She will only require one more day to complete course for simple cystitis; urine cx pending           Discharge diagnosis   Acute hypoxic respiratory failure, resolved COPD exacerbation COVID-pneumonia Urinary tract infection, urine cx pending on discharge Nausea, vomiting and diarrhea, stool pcr negative  Hypomagnesemia Hypokalemia Hypophosphatemia Hypertension Diabetes
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Cystitis
Clinical narrative: Patient is a 69-year-old female history of hypertension, diabetes, hyperlipidemia and COPD who presented to the ED on 1/2 with shortness of breath, cough, vomiting and diarrhea.  On arrival, patient was hypoxic requiring 3 L nasal cannula and was hypertensive in the 140s.  Lab work was significant for hypokalemia with 2.4, hypomagnesemia of 0.8 and COVID positivity with otherwise unremarkable vitals.  Urinalysis consistent with UTI.  CTA of the chest was performed and negative for PE or other acute process but did show findings suggestive of pulmonary hypertension and COPD.  Patient was started on antibiotics, breathing treatments and electrolyte replacement with admission to the hospital. The following AM, 1/3, patient was started on decadron given her oxygen requirement and COVID positive status. Over the next 36 hours, patients Potassium and phosphors were replaced multiple times. She was able to be weaned off oxygen and was stable on room air on 1/4. Given ongoing hypokalemia, patient received multiple oral doses throughout the day 1/4.  Ultimately, patient was hemodynamically stable on room air with improving electrolytes and discharged home on 1/4.  She was provided a prescription for Decadron to complete a course for her hypoxia with COVID.  She was also provided a prescription for 20 mill equivalents of potassium daily to take for the next 5 days and a prescription for BMP in 7 days and was encouraged to follow-up with her PCP following her lab test.  Lastly, antibiotic for UTI was not prescribed on discharge. I called multiple times with no answer so a voicemail was left instructing the patient to pick up Keflex from her pharmacy. She will only require one more day to complete course for simple cystitis; urine cx pending           Discharge diagnosis   Acute hypoxic respiratory failure, resolved COPD exacerbation COVID-pneumonia Urinary tract infection, urine cx pending on discharge Nausea, vomiting and diarrhea, stool pcr negative  Hypomagnesemia Hypokalemia Hypophosphatemia Hypertension Diabetes
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Diabetes mellitus, Diarrhoea, Dyspnoea, Electrolyte substitution therapy, Hypertension
Clinical narrative: Patient is a 69-year-old female history of hypertension, diabetes, hyperlipidemia and COPD who presented to the ED on 1/2 with shortness of breath, cough, vomiting and diarrhea.  On arrival, patient was hypoxic requiring 3 L nasal cannula and was hypertensive in the 140s.  Lab work was significant for hypokalemia with 2.4, hypomagnesemia of 0.8 and COVID positivity with otherwise unremarkable vitals.  Urinalysis consistent with UTI.  CTA of the chest was performed and negative for PE or other acute process but did show findings suggestive of pulmonary hypertension and COPD.  Patient was started on antibiotics, breathing treatments and electrolyte replacement with admission to the hospital. The following AM, 1/3, patient was started on decadron given her oxygen requirement and COVID positive status. Over the next 36 hours, patients Potassium and phosphors were replaced multiple times. She was able to be weaned off oxygen and was stable on room air on 1/4. Given ongoing hypokalemia, patient received multiple oral doses throughout the day 1/4.  Ultimately, patient was hemodynamically stable on room air with improving electrolytes and discharged home on 1/4.  She was provided a prescription for Decadron to complete a course for her hypoxia with COVID.  She was also provided a prescription for 20 mill equivalents of potassium daily to take for the next 5 days and a prescription for BMP in 7 days and was encouraged to follow-up with her PCP following her lab test.  Lastly, antibiotic for UTI was not prescribed on discharge. I called multiple times with no answer so a voicemail was left instructing the patient to pick up Keflex from her pharmacy. She will only require one more day to complete course for simple cystitis; urine cx pending           Discharge diagnosis   Acute hypoxic respiratory failure, resolved COPD exacerbation COVID-pneumonia Urinary tract infection, urine cx pending on discharge Nausea, vomiting and diarrhea, stool pcr negative  Hypomagnesemia Hypokalemia Hypophosphatemia Hypertension Diabetes
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Hypokalaemia, Hypomagnesaemia, Hypophosphataemia, Hypoxia, Nausea
Clinical narrative: Patient is a 69-year-old female history of hypertension, diabetes, hyperlipidemia and COPD who presented to the ED on 1/2 with shortness of breath, cough, vomiting and diarrhea.  On arrival, patient was hypoxic requiring 3 L nasal cannula and was hypertensive in the 140s.  Lab work was significant for hypokalemia with 2.4, hypomagnesemia of 0.8 and COVID positivity with otherwise unremarkable vitals.  Urinalysis consistent with UTI.  CTA of the chest was performed and negative for PE or other acute process but did show findings suggestive of pulmonary hypertension and COPD.  Patient was started on antibiotics, breathing treatments and electrolyte replacement with admission to the hospital. The following AM, 1/3, patient was started on decadron given her oxygen requirement and COVID positive status. Over the next 36 hours, patients Potassium and phosphors were replaced multiple times. She was able to be weaned off oxygen and was stable on room air on 1/4. Given ongoing hypokalemia, patient received multiple oral doses throughout the day 1/4.  Ultimately, patient was hemodynamically stable on room air with improving electrolytes and discharged home on 1/4.  She was provided a prescription for Decadron to complete a course for her hypoxia with COVID.  She was also provided a prescription for 20 mill equivalents of potassium daily to take for the next 5 days and a prescription for BMP in 7 days and was encouraged to follow-up with her PCP following her lab test.  Lastly, antibiotic for UTI was not prescribed on discharge. I called multiple times with no answer so a voicemail was left instructing the patient to pick up Keflex from her pharmacy. She will only require one more day to complete course for simple cystitis; urine cx pending           Discharge diagnosis   Acute hypoxic respiratory failure, resolved COPD exacerbation COVID-pneumonia Urinary tract infection, urine cx pending on discharge Nausea, vomiting and diarrhea, stool pcr negative  Hypomagnesemia Hypokalemia Hypophosphatemia Hypertension Diabetes
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary hypertension, SARS-CoV-2 test positive, Stool analysis normal, Urinary tract infection, Urine analysis abnormal
Clinical narrative: Patient is a 69-year-old female history of hypertension, diabetes, hyperlipidemia and COPD who presented to the ED on 1/2 with shortness of breath, cough, vomiting and diarrhea.  On arrival, patient was hypoxic requiring 3 L nasal cannula and was hypertensive in the 140s.  Lab work was significant for hypokalemia with 2.4, hypomagnesemia of 0.8 and COVID positivity with otherwise unremarkable vitals.  Urinalysis consistent with UTI.  CTA of the chest was performed and negative for PE or other acute process but did show findings suggestive of pulmonary hypertension and COPD.  Patient was started on antibiotics, breathing treatments and electrolyte replacement with admission to the hospital. The following AM, 1/3, patient was started on decadron given her oxygen requirement and COVID positive status. Over the next 36 hours, patients Potassium and phosphors were replaced multiple times. She was able to be weaned off oxygen and was stable on room air on 1/4. Given ongoing hypokalemia, patient received multiple oral doses throughout the day 1/4.  Ultimately, patient was hemodynamically stable on room air with improving electrolytes and discharged home on 1/4.  She was provided a prescription for Decadron to complete a course for her hypoxia with COVID.  She was also provided a prescription for 20 mill equivalents of potassium daily to take for the next 5 days and a prescription for BMP in 7 days and was encouraged to follow-up with her PCP following her lab test.  Lastly, antibiotic for UTI was not prescribed on discharge. I called multiple times with no answer so a voicemail was left instructing the patient to pick up Keflex from her pharmacy. She will only require one more day to complete course for simple cystitis; urine cx pending           Discharge diagnosis   Acute hypoxic respiratory failure, resolved COPD exacerbation COVID-pneumonia Urinary tract infection, urine cx pending on discharge Nausea, vomiting and diarrhea, stool pcr negative  Hypomagnesemia Hypokalemia Hypophosphatemia Hypertension Diabetes
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Patient is a 69-year-old female history of hypertension, diabetes, hyperlipidemia and COPD who presented to the ED on 1/2 with shortness of breath, cough, vomiting and diarrhea.  On arrival, patient was hypoxic requiring 3 L nasal cannula and was hypertensive in the 140s.  Lab work was significant for hypokalemia with 2.4, hypomagnesemia of 0.8 and COVID positivity with otherwise unremarkable vitals.  Urinalysis consistent with UTI.  CTA of the chest was performed and negative for PE or other acute process but did show findings suggestive of pulmonary hypertension and COPD.  Patient was started on antibiotics, breathing treatments and electrolyte replacement with admission to the hospital. The following AM, 1/3, patient was started on decadron given her oxygen requirement and COVID positive status. Over the next 36 hours, patients Potassium and phosphors were replaced multiple times. She was able to be weaned off oxygen and was stable on room air on 1/4. Given ongoing hypokalemia, patient received multiple oral doses throughout the day 1/4.  Ultimately, patient was hemodynamically stable on room air with improving electrolytes and discharged home on 1/4.  She was provided a prescription for Decadron to complete a course for her hypoxia with COVID.  She was also provided a prescription for 20 mill equivalents of potassium daily to take for the next 5 days and a prescription for BMP in 7 days and was encouraged to follow-up with her PCP following her lab test.  Lastly, antibiotic for UTI was not prescribed on discharge. I called multiple times with no answer so a voicemail was left instructing the patient to pick up Keflex from her pharmacy. She will only require one more day to complete course for simple cystitis; urine cx pending           Discharge diagnosis   Acute hypoxic respiratory failure, resolved COPD exacerbation COVID-pneumonia Urinary tract infection, urine cx pending on discharge Nausea, vomiting and diarrhea, stool pcr negative  Hypomagnesemia Hypokalemia Hypophosphatemia Hypertension Diabetes
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Patient had a Moderna Bivalent COVID vaccine on 9/22/2022.  He was given another dose today (1/31/2023) by mistake.  When I spoke with him today at 3:35pm he denied any problems.  I will plan to f/u with him tomorrow afternoon.
Age: 0.17
Sex: F
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Autopsy, Death
Clinical narrative: Death
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dermatitis atopic, Eczema
Clinical narrative: Atopic dermatitis, aka eczema over 80% of body.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Atelectasis, COVID-19, Cardiomegaly
Clinical narrative: Patient is a 37 y.o. male patient of MD with history of anxiety, depression, DM-1 with neuropathy, ESRD on HD, former smoker, generalized epilepsy, GERD, HTN, hyperlipidemia, iron deficiency anemia, obesity, retinal hemorrhage and vit D deficiency who presented with chest pain and was found to be hypoxic and COVID +.   Acute respiratory failure with hypoxia He reported pleuritic chest pain as presenting sx Requiring 2L NC in ED (none at baseline) CTPA -- no PE, cardiomegaly with small b/l pleural effusions, atelectasis COVID-19+ Scheduled albuterol MD, IV dexamethasone Wean O2 as tolerated, pulm toilet Continue to wean off O2 as outpatient    Covid-19 Virus Infection Date of onset of symptoms: 1/4 Symptoms present on admission: chest pain Date of covid positive test: 1/6/23 Vaccination status: vaccinated Imaging: as above Oxygen requirements on admission: 2L  Current oxygen requirements: 3L  Medical therapy: steroids Consultants following: None Anticipated special isolation end date: 1/14   ESRD Previously CKD 4 but recently started on hemodialysis S/p HD on 1/5 and 1/7 -- > declined extra UF Nephrology consulted  Last HD on 1/9 Transition to MWF schedule for outpatient covid chair time    Elevated troponin due to demand ischemia Pleuritic chest pain in setting of COVID; now resolved  Troponin 141 >> 142 >> 160 in the setting of ESRD EKG (reviewed) -- non-ischemic  Iron deficiency anemia Hb 8.1 (it's been 10-11 in the past 3-4 months at clinic) No active bleeding reported History of IDA per records Iron studies normal with mildly elevated TIBC   DM-1 with neuropathy, uncontrolled with hyperglycemia Steroid-induced hyperglycemia Glucose >400 during admission A1c 7.9 (9/2022) -- > repeat 6.4% on admission Titrate lantus and SSI for steroid induced hyperglycemia Change to diabetic diet Monitor blood glucose
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Electrocardiogram abnormal, Glycosylated haemoglobin increased, Haemoglobin decreased, Hyperglycaemia
Clinical narrative: Patient is a 37 y.o. male patient of MD with history of anxiety, depression, DM-1 with neuropathy, ESRD on HD, former smoker, generalized epilepsy, GERD, HTN, hyperlipidemia, iron deficiency anemia, obesity, retinal hemorrhage and vit D deficiency who presented with chest pain and was found to be hypoxic and COVID +.   Acute respiratory failure with hypoxia He reported pleuritic chest pain as presenting sx Requiring 2L NC in ED (none at baseline) CTPA -- no PE, cardiomegaly with small b/l pleural effusions, atelectasis COVID-19+ Scheduled albuterol MD, IV dexamethasone Wean O2 as tolerated, pulm toilet Continue to wean off O2 as outpatient    Covid-19 Virus Infection Date of onset of symptoms: 1/4 Symptoms present on admission: chest pain Date of covid positive test: 1/6/23 Vaccination status: vaccinated Imaging: as above Oxygen requirements on admission: 2L  Current oxygen requirements: 3L  Medical therapy: steroids Consultants following: None Anticipated special isolation end date: 1/14   ESRD Previously CKD 4 but recently started on hemodialysis S/p HD on 1/5 and 1/7 -- > declined extra UF Nephrology consulted  Last HD on 1/9 Transition to MWF schedule for outpatient covid chair time    Elevated troponin due to demand ischemia Pleuritic chest pain in setting of COVID; now resolved  Troponin 141 >> 142 >> 160 in the setting of ESRD EKG (reviewed) -- non-ischemic  Iron deficiency anemia Hb 8.1 (it's been 10-11 in the past 3-4 months at clinic) No active bleeding reported History of IDA per records Iron studies normal with mildly elevated TIBC   DM-1 with neuropathy, uncontrolled with hyperglycemia Steroid-induced hyperglycemia Glucose >400 during admission A1c 7.9 (9/2022) -- > repeat 6.4% on admission Titrate lantus and SSI for steroid induced hyperglycemia Change to diabetic diet Monitor blood glucose
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Iron binding capacity total increased, Malaise, Myocardial ischaemia, Pleural effusion
Clinical narrative: Patient is a 37 y.o. male patient of MD with history of anxiety, depression, DM-1 with neuropathy, ESRD on HD, former smoker, generalized epilepsy, GERD, HTN, hyperlipidemia, iron deficiency anemia, obesity, retinal hemorrhage and vit D deficiency who presented with chest pain and was found to be hypoxic and COVID +.   Acute respiratory failure with hypoxia He reported pleuritic chest pain as presenting sx Requiring 2L NC in ED (none at baseline) CTPA -- no PE, cardiomegaly with small b/l pleural effusions, atelectasis COVID-19+ Scheduled albuterol MD, IV dexamethasone Wean O2 as tolerated, pulm toilet Continue to wean off O2 as outpatient    Covid-19 Virus Infection Date of onset of symptoms: 1/4 Symptoms present on admission: chest pain Date of covid positive test: 1/6/23 Vaccination status: vaccinated Imaging: as above Oxygen requirements on admission: 2L  Current oxygen requirements: 3L  Medical therapy: steroids Consultants following: None Anticipated special isolation end date: 1/14   ESRD Previously CKD 4 but recently started on hemodialysis S/p HD on 1/5 and 1/7 -- > declined extra UF Nephrology consulted  Last HD on 1/9 Transition to MWF schedule for outpatient covid chair time    Elevated troponin due to demand ischemia Pleuritic chest pain in setting of COVID; now resolved  Troponin 141 >> 142 >> 160 in the setting of ESRD EKG (reviewed) -- non-ischemic  Iron deficiency anemia Hb 8.1 (it's been 10-11 in the past 3-4 months at clinic) No active bleeding reported History of IDA per records Iron studies normal with mildly elevated TIBC   DM-1 with neuropathy, uncontrolled with hyperglycemia Steroid-induced hyperglycemia Glucose >400 during admission A1c 7.9 (9/2022) -- > repeat 6.4% on admission Titrate lantus and SSI for steroid induced hyperglycemia Change to diabetic diet Monitor blood glucose
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Pleuritic pain, SARS-CoV-2 test positive, Troponin increased
Clinical narrative: Patient is a 37 y.o. male patient of MD with history of anxiety, depression, DM-1 with neuropathy, ESRD on HD, former smoker, generalized epilepsy, GERD, HTN, hyperlipidemia, iron deficiency anemia, obesity, retinal hemorrhage and vit D deficiency who presented with chest pain and was found to be hypoxic and COVID +.   Acute respiratory failure with hypoxia He reported pleuritic chest pain as presenting sx Requiring 2L NC in ED (none at baseline) CTPA -- no PE, cardiomegaly with small b/l pleural effusions, atelectasis COVID-19+ Scheduled albuterol MD, IV dexamethasone Wean O2 as tolerated, pulm toilet Continue to wean off O2 as outpatient    Covid-19 Virus Infection Date of onset of symptoms: 1/4 Symptoms present on admission: chest pain Date of covid positive test: 1/6/23 Vaccination status: vaccinated Imaging: as above Oxygen requirements on admission: 2L  Current oxygen requirements: 3L  Medical therapy: steroids Consultants following: None Anticipated special isolation end date: 1/14   ESRD Previously CKD 4 but recently started on hemodialysis S/p HD on 1/5 and 1/7 -- > declined extra UF Nephrology consulted  Last HD on 1/9 Transition to MWF schedule for outpatient covid chair time    Elevated troponin due to demand ischemia Pleuritic chest pain in setting of COVID; now resolved  Troponin 141 >> 142 >> 160 in the setting of ESRD EKG (reviewed) -- non-ischemic  Iron deficiency anemia Hb 8.1 (it's been 10-11 in the past 3-4 months at clinic) No active bleeding reported History of IDA per records Iron studies normal with mildly elevated TIBC   DM-1 with neuropathy, uncontrolled with hyperglycemia Steroid-induced hyperglycemia Glucose >400 during admission A1c 7.9 (9/2022) -- > repeat 6.4% on admission Titrate lantus and SSI for steroid induced hyperglycemia Change to diabetic diet Monitor blood glucose
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Abnormal behaviour, Acute respiratory failure, Asthenia, Blood creatinine increased, Blood glucose increased
Clinical narrative: 85 years old with past medical history of diabetes, hypertension, hyperlipidemia, dementia presented to local Medical Center with a complaint of generalized weakness and hyperglycemia.  From the ER chart it appears the home health nurse went to check on the patient and she found that he was not acting like himself.  She is unsure when his symptoms have started.  When she checked his blood glucose it was 500.  On presentation to the ER his blood glucose was 202.  Patient is currently confused and is only alert and oriented x1.  The patient's son was at bedside at Medical Center.  He indicated to ER that patient has been getting weaker and more confused over the last couple days.  He was tested for COVID and was found to be positive.  He had a chest x-ray which was negative.  On presentation blood work was done which showed a creatinine level of 1.58.  I reviewed blood work in care everywhere and patient appears to have a creatinine baseline around 1.6.  In July 2021 he had a creatinine of 1.66. In December 2021 he had a creatinine of 1.59.  He had a urinalysis done which was significant for scary protein otherwise unremarkable.  He had a CT of the brain which was negative. Patient is on insulin at home.  Patient is poor historian.  Most of the history was collected from the ER chart and care everywhere. When seen, patient was resting in bed comfortably.  No acute distress.  Patient follows commands appropriately.  Conversing normally but would not answer questions correctly.   Clinical Summary PT/OT evaluation and therapy provided.  Patient qualified for Express Care but family expressed that they would prefer to take him home for care at home.  Home health was provided.  Supportive care provided for viral illness.  Keppra was adjusted due to renal function.  Tolerating room air on day of discharge.  Dietary support provided throughout the admission.   Discharge diagnosis COVID infection Acute hypoxic respiratory failure Toxic metabolic encephalopathy Acute on chronic encephalopathy  Chronic severe protein calorie malnutrition with cachexia, present on admission Dementia Failure to thrive Generalized weakness Chronic kidney disease stage IIIa Hypertension Hyperlipidemia History of seizure
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cachexia, Chest X-ray normal, Computerised tomogram head normal, Confusional state
Clinical narrative: 85 years old with past medical history of diabetes, hypertension, hyperlipidemia, dementia presented to local Medical Center with a complaint of generalized weakness and hyperglycemia.  From the ER chart it appears the home health nurse went to check on the patient and she found that he was not acting like himself.  She is unsure when his symptoms have started.  When she checked his blood glucose it was 500.  On presentation to the ER his blood glucose was 202.  Patient is currently confused and is only alert and oriented x1.  The patient's son was at bedside at Medical Center.  He indicated to ER that patient has been getting weaker and more confused over the last couple days.  He was tested for COVID and was found to be positive.  He had a chest x-ray which was negative.  On presentation blood work was done which showed a creatinine level of 1.58.  I reviewed blood work in care everywhere and patient appears to have a creatinine baseline around 1.6.  In July 2021 he had a creatinine of 1.66. In December 2021 he had a creatinine of 1.59.  He had a urinalysis done which was significant for scary protein otherwise unremarkable.  He had a CT of the brain which was negative. Patient is on insulin at home.  Patient is poor historian.  Most of the history was collected from the ER chart and care everywhere. When seen, patient was resting in bed comfortably.  No acute distress.  Patient follows commands appropriately.  Conversing normally but would not answer questions correctly.   Clinical Summary PT/OT evaluation and therapy provided.  Patient qualified for Express Care but family expressed that they would prefer to take him home for care at home.  Home health was provided.  Supportive care provided for viral illness.  Keppra was adjusted due to renal function.  Tolerating room air on day of discharge.  Dietary support provided throughout the admission.   Discharge diagnosis COVID infection Acute hypoxic respiratory failure Toxic metabolic encephalopathy Acute on chronic encephalopathy  Chronic severe protein calorie malnutrition with cachexia, present on admission Dementia Failure to thrive Generalized weakness Chronic kidney disease stage IIIa Hypertension Hyperlipidemia History of seizure
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Encephalopathy, Failure to thrive, Hyperglycaemia, Language disorder, Malnutrition
Clinical narrative: 85 years old with past medical history of diabetes, hypertension, hyperlipidemia, dementia presented to local Medical Center with a complaint of generalized weakness and hyperglycemia.  From the ER chart it appears the home health nurse went to check on the patient and she found that he was not acting like himself.  She is unsure when his symptoms have started.  When she checked his blood glucose it was 500.  On presentation to the ER his blood glucose was 202.  Patient is currently confused and is only alert and oriented x1.  The patient's son was at bedside at Medical Center.  He indicated to ER that patient has been getting weaker and more confused over the last couple days.  He was tested for COVID and was found to be positive.  He had a chest x-ray which was negative.  On presentation blood work was done which showed a creatinine level of 1.58.  I reviewed blood work in care everywhere and patient appears to have a creatinine baseline around 1.6.  In July 2021 he had a creatinine of 1.66. In December 2021 he had a creatinine of 1.59.  He had a urinalysis done which was significant for scary protein otherwise unremarkable.  He had a CT of the brain which was negative. Patient is on insulin at home.  Patient is poor historian.  Most of the history was collected from the ER chart and care everywhere. When seen, patient was resting in bed comfortably.  No acute distress.  Patient follows commands appropriately.  Conversing normally but would not answer questions correctly.   Clinical Summary PT/OT evaluation and therapy provided.  Patient qualified for Express Care but family expressed that they would prefer to take him home for care at home.  Home health was provided.  Supportive care provided for viral illness.  Keppra was adjusted due to renal function.  Tolerating room air on day of discharge.  Dietary support provided throughout the admission.   Discharge diagnosis COVID infection Acute hypoxic respiratory failure Toxic metabolic encephalopathy Acute on chronic encephalopathy  Chronic severe protein calorie malnutrition with cachexia, present on admission Dementia Failure to thrive Generalized weakness Chronic kidney disease stage IIIa Hypertension Hyperlipidemia History of seizure
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Protein urine present, Renal impairment, SARS-CoV-2 test positive, Toxic encephalopathy, Urine analysis abnormal
Clinical narrative: 85 years old with past medical history of diabetes, hypertension, hyperlipidemia, dementia presented to local Medical Center with a complaint of generalized weakness and hyperglycemia.  From the ER chart it appears the home health nurse went to check on the patient and she found that he was not acting like himself.  She is unsure when his symptoms have started.  When she checked his blood glucose it was 500.  On presentation to the ER his blood glucose was 202.  Patient is currently confused and is only alert and oriented x1.  The patient's son was at bedside at Medical Center.  He indicated to ER that patient has been getting weaker and more confused over the last couple days.  He was tested for COVID and was found to be positive.  He had a chest x-ray which was negative.  On presentation blood work was done which showed a creatinine level of 1.58.  I reviewed blood work in care everywhere and patient appears to have a creatinine baseline around 1.6.  In July 2021 he had a creatinine of 1.66. In December 2021 he had a creatinine of 1.59.  He had a urinalysis done which was significant for scary protein otherwise unremarkable.  He had a CT of the brain which was negative. Patient is on insulin at home.  Patient is poor historian.  Most of the history was collected from the ER chart and care everywhere. When seen, patient was resting in bed comfortably.  No acute distress.  Patient follows commands appropriately.  Conversing normally but would not answer questions correctly.   Clinical Summary PT/OT evaluation and therapy provided.  Patient qualified for Express Care but family expressed that they would prefer to take him home for care at home.  Home health was provided.  Supportive care provided for viral illness.  Keppra was adjusted due to renal function.  Tolerating room air on day of discharge.  Dietary support provided throughout the admission.   Discharge diagnosis COVID infection Acute hypoxic respiratory failure Toxic metabolic encephalopathy Acute on chronic encephalopathy  Chronic severe protein calorie malnutrition with cachexia, present on admission Dementia Failure to thrive Generalized weakness Chronic kidney disease stage IIIa Hypertension Hyperlipidemia History of seizure
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Disability, Gait disturbance, Joint swelling, Pain in extremity
Clinical narrative: I had mild gout in the past. Shortly after getting the vax, my foot swelled up and looked like a water balloon. It was very tender and I could not walk. The pain was unbearable. I could hardly walk to the bathroom. The pain was from my knee, down to my foot, although the bad swelling was only from my ankle, throughout my foot.  I had to go out on  short term disability and I was back and forth to my PCP, Urgent Care and the emergency room. One doctor at the E.R was concerned about blood clots and they gave me an ultra sound (?) to test for them.  I also got. A referral to a Rhumatologist and he prescribed steroids, but was never able to come up with a diagnosis.  I have had several instances of swelling in different joints, including both feet, ankles, and knees.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Peripheral swelling, Tenderness, Ultrasound Doppler, Urine uric acid normal
Clinical narrative: I had mild gout in the past. Shortly after getting the vax, my foot swelled up and looked like a water balloon. It was very tender and I could not walk. The pain was unbearable. I could hardly walk to the bathroom. The pain was from my knee, down to my foot, although the bad swelling was only from my ankle, throughout my foot.  I had to go out on  short term disability and I was back and forth to my PCP, Urgent Care and the emergency room. One doctor at the E.R was concerned about blood clots and they gave me an ultra sound (?) to test for them.  I also got. A referral to a Rhumatologist and he prescribed steroids, but was never able to come up with a diagnosis.  I have had several instances of swelling in different joints, including both feet, ankles, and knees.