chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Renal cyst, Respiratory distress, Respiratory failure, Respiratory rate increased, Right ventricular dilatation
Clinical narrative: Still admitted (8) days. Patient is a 82 y.o. male with severe O2 dependent chronic obstructive pulmonary disease, who was hospitalized about 6 weeks ago for chronic obstructive pulmonary disease exacerbation with bronchitis.  He was doing well until yesterday when he developed cough productive of dark colored mucus, and fever.  During the night he woke up and was in respiratory distress and had severe weakness, and his wife called an ambulance and had him brought to the emergency room.  In the emergency department he was found to be hypoxemic at 84%.  He had tachycardia and increased respiratory rate, but normal blood pressure.  Labs revealed leukocytosis and bandemia, as well as lactic acidosis at 2.3.  D-dimer was elevated at 2000.  COVID PCR was positive.  Procalcitonin was significantly elevated at 6. Chest x-ray showed bilateral pulmonary infiltrates left greater than right.  CT angiogram of the chest excluded pulmonary embolism, and confirmed bilateral left greater than right pulmonary infiltrates.  ASSESSMENT / PLAN: * Bilateral pneumonia Assessment & Plan Community-acquired pneumonia with high risk for Gram-negative infection.  Recent MRSA screen was negative.  Treat with cefepime and doxycycline.  Mucinex and Acapella to help clear prominent pulmonary secretions.  Sputum culture requested   Severe sepsis  Assessment & Plan Severe sepsis criteria with sepsis parameters of tachycardia increased respiratory rate leukocytosis and bandemia, and severe sepsis criteria of lactic acidosis.  2 L saline bolus (30 mL/kg) and maintenance IV fluids.  Antibiotics for pneumonia   Acute on chronic respiratory failure with hypoxia  Assessment & Plan Patient is normally on 2 L of oxygen mainly at night, needing 2 L continuous now   COVID-19 virus infection Assessment & Plan COVID positive.  Checking inflammatory markers, but I believe this is not contributing to a lot of his symptoms.  Patient will receive IV Solu-Medrol for chronic obstructive pulmonary disease and COVID.  Also treat with remdesivir   COPD (chronic obstructive pulmonary disease)  Assessment & Plan Severe chronic obstructive pulmonary disease.  Do not appreciate wheezing on admission exam.  Treat with Solu-Medrol.  Treat with long and short-acting inhalers.   Coronary artery disease involving native coronary artery of native heart without angina pectoris Assessment & Plan Maintain aspirin and statin therapy     Essential hypertension Assessment & Plan On Hyzaar.  This will be held temporarily due to severe sepsis     Protein-calorie malnutrition, severe  Assessment & Plan Body mass index less than 20. To be followed by nutrition    Elevated d-dimer Assessment & Plan D-dimer 2000 on admission.  CTA of chest excluded pulmonary embolism.  Will add upper and lower extremity venous ultrasounds to screen for DVT.  DVT prophylaxis with Lovenox.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Scan with contrast abnormal, Sepsis, Sleep disorder, Spinal osteoarthritis
Clinical narrative: Still admitted (8) days. Patient is a 82 y.o. male with severe O2 dependent chronic obstructive pulmonary disease, who was hospitalized about 6 weeks ago for chronic obstructive pulmonary disease exacerbation with bronchitis.  He was doing well until yesterday when he developed cough productive of dark colored mucus, and fever.  During the night he woke up and was in respiratory distress and had severe weakness, and his wife called an ambulance and had him brought to the emergency room.  In the emergency department he was found to be hypoxemic at 84%.  He had tachycardia and increased respiratory rate, but normal blood pressure.  Labs revealed leukocytosis and bandemia, as well as lactic acidosis at 2.3.  D-dimer was elevated at 2000.  COVID PCR was positive.  Procalcitonin was significantly elevated at 6. Chest x-ray showed bilateral pulmonary infiltrates left greater than right.  CT angiogram of the chest excluded pulmonary embolism, and confirmed bilateral left greater than right pulmonary infiltrates.  ASSESSMENT / PLAN: * Bilateral pneumonia Assessment & Plan Community-acquired pneumonia with high risk for Gram-negative infection.  Recent MRSA screen was negative.  Treat with cefepime and doxycycline.  Mucinex and Acapella to help clear prominent pulmonary secretions.  Sputum culture requested   Severe sepsis  Assessment & Plan Severe sepsis criteria with sepsis parameters of tachycardia increased respiratory rate leukocytosis and bandemia, and severe sepsis criteria of lactic acidosis.  2 L saline bolus (30 mL/kg) and maintenance IV fluids.  Antibiotics for pneumonia   Acute on chronic respiratory failure with hypoxia  Assessment & Plan Patient is normally on 2 L of oxygen mainly at night, needing 2 L continuous now   COVID-19 virus infection Assessment & Plan COVID positive.  Checking inflammatory markers, but I believe this is not contributing to a lot of his symptoms.  Patient will receive IV Solu-Medrol for chronic obstructive pulmonary disease and COVID.  Also treat with remdesivir   COPD (chronic obstructive pulmonary disease)  Assessment & Plan Severe chronic obstructive pulmonary disease.  Do not appreciate wheezing on admission exam.  Treat with Solu-Medrol.  Treat with long and short-acting inhalers.   Coronary artery disease involving native coronary artery of native heart without angina pectoris Assessment & Plan Maintain aspirin and statin therapy     Essential hypertension Assessment & Plan On Hyzaar.  This will be held temporarily due to severe sepsis     Protein-calorie malnutrition, severe  Assessment & Plan Body mass index less than 20. To be followed by nutrition    Elevated d-dimer Assessment & Plan D-dimer 2000 on admission.  CTA of chest excluded pulmonary embolism.  Will add upper and lower extremity venous ultrasounds to screen for DVT.  DVT prophylaxis with Lovenox.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Staphylococcal infection, Staphylococcus test negative, Tachycardia, Ultrasound Doppler normal, Weight increased
Clinical narrative: Still admitted (8) days. Patient is a 82 y.o. male with severe O2 dependent chronic obstructive pulmonary disease, who was hospitalized about 6 weeks ago for chronic obstructive pulmonary disease exacerbation with bronchitis.  He was doing well until yesterday when he developed cough productive of dark colored mucus, and fever.  During the night he woke up and was in respiratory distress and had severe weakness, and his wife called an ambulance and had him brought to the emergency room.  In the emergency department he was found to be hypoxemic at 84%.  He had tachycardia and increased respiratory rate, but normal blood pressure.  Labs revealed leukocytosis and bandemia, as well as lactic acidosis at 2.3.  D-dimer was elevated at 2000.  COVID PCR was positive.  Procalcitonin was significantly elevated at 6. Chest x-ray showed bilateral pulmonary infiltrates left greater than right.  CT angiogram of the chest excluded pulmonary embolism, and confirmed bilateral left greater than right pulmonary infiltrates.  ASSESSMENT / PLAN: * Bilateral pneumonia Assessment & Plan Community-acquired pneumonia with high risk for Gram-negative infection.  Recent MRSA screen was negative.  Treat with cefepime and doxycycline.  Mucinex and Acapella to help clear prominent pulmonary secretions.  Sputum culture requested   Severe sepsis  Assessment & Plan Severe sepsis criteria with sepsis parameters of tachycardia increased respiratory rate leukocytosis and bandemia, and severe sepsis criteria of lactic acidosis.  2 L saline bolus (30 mL/kg) and maintenance IV fluids.  Antibiotics for pneumonia   Acute on chronic respiratory failure with hypoxia  Assessment & Plan Patient is normally on 2 L of oxygen mainly at night, needing 2 L continuous now   COVID-19 virus infection Assessment & Plan COVID positive.  Checking inflammatory markers, but I believe this is not contributing to a lot of his symptoms.  Patient will receive IV Solu-Medrol for chronic obstructive pulmonary disease and COVID.  Also treat with remdesivir   COPD (chronic obstructive pulmonary disease)  Assessment & Plan Severe chronic obstructive pulmonary disease.  Do not appreciate wheezing on admission exam.  Treat with Solu-Medrol.  Treat with long and short-acting inhalers.   Coronary artery disease involving native coronary artery of native heart without angina pectoris Assessment & Plan Maintain aspirin and statin therapy     Essential hypertension Assessment & Plan On Hyzaar.  This will be held temporarily due to severe sepsis     Protein-calorie malnutrition, severe  Assessment & Plan Body mass index less than 20. To be followed by nutrition    Elevated d-dimer Assessment & Plan D-dimer 2000 on admission.  CTA of chest excluded pulmonary embolism.  Will add upper and lower extremity venous ultrasounds to screen for DVT.  DVT prophylaxis with Lovenox.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Aspiration pleural cavity, COVID-19, Confusional state, Dyspnoea, Extra dose administered
Clinical narrative: 71-year-old male with chronic COPD and CHF presents to the emergency room with worsening shortness of breath.  This is his fifth admission to the hospital for similar issues this past year.  Has been having increasing shortness of breath and accessory muscle use.  Started to have some increased confusion and family brought him into the emergency room.  Noted to be hypoxic with hypercapnia.  Received bronchodilator in the emergency room and placed on NIPPV.  Had COVID back in March and incidentally tests positive again here today.  No fevers, chills or purulent sputum at home.  He has a history of mechanical aortic valve replacement.  He was treated with Decadron and Remdesivir during hospital admission in March 2022 for COVID-19.  He required thoracentesis for bilateral pleural effusions.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Hypercapnia, Hypoxia, Interchange of vaccine products, Pleural effusion, SARS-CoV-2 test positive
Clinical narrative: 71-year-old male with chronic COPD and CHF presents to the emergency room with worsening shortness of breath.  This is his fifth admission to the hospital for similar issues this past year.  Has been having increasing shortness of breath and accessory muscle use.  Started to have some increased confusion and family brought him into the emergency room.  Noted to be hypoxic with hypercapnia.  Received bronchodilator in the emergency room and placed on NIPPV.  Had COVID back in March and incidentally tests positive again here today.  No fevers, chills or purulent sputum at home.  He has a history of mechanical aortic valve replacement.  He was treated with Decadron and Remdesivir during hospital admission in March 2022 for COVID-19.  He required thoracentesis for bilateral pleural effusions.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Use of accessory respiratory muscles
Clinical narrative: 71-year-old male with chronic COPD and CHF presents to the emergency room with worsening shortness of breath.  This is his fifth admission to the hospital for similar issues this past year.  Has been having increasing shortness of breath and accessory muscle use.  Started to have some increased confusion and family brought him into the emergency room.  Noted to be hypoxic with hypercapnia.  Received bronchodilator in the emergency room and placed on NIPPV.  Had COVID back in March and incidentally tests positive again here today.  No fevers, chills or purulent sputum at home.  He has a history of mechanical aortic valve replacement.  He was treated with Decadron and Remdesivir during hospital admission in March 2022 for COVID-19.  He required thoracentesis for bilateral pleural effusions.
Age: 6.0
Sex: F
Vaccine: COVID19
Symptoms: Product preparation issue
Clinical narrative: Dose given undiluted
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Cluster headache, Condition aggravated, Heart rate increased, Hyperhidrosis
Clinical narrative: Starting right after receiving the vaccine, I had pain and swelling at the injection site. Then, I started getting a fast heart rate and they said that was okay. I stayed at the clinic for 30 min after receiving it to be monitored. I went back to work and a few hours later I developed back pain. I have arthritis so i didn't think to much about it at first. However, it got so much worse that it felt like I was in labor (10/10 pain) and I was instructed to go see the doctor. So I went back to the clinic (Dr.) and he gave me Naproxen 250mg to take and I was instructed to take 2 tablets 2x daily. I went home and laid in bed. I got full body sweats and I felt like I had a fever. I have never sweat so bad before. Then, the next day, I was okay after taking the naproxen. Just recently, 06/03/2022 I stayed home because I had a really bad migraine. I took the naproxen, benadryl and the motion sickness medicine and I stayed in bed all day. Since then, I have been having intermittent cluster headaches which I had following the 2nd COVID vaccine (Pfizer). Since I had the Pfizer COVID19 vaccines, I have developed migraines and they have gotten worse with each shot.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Injection site swelling, Migraine, Pyrexia
Clinical narrative: Starting right after receiving the vaccine, I had pain and swelling at the injection site. Then, I started getting a fast heart rate and they said that was okay. I stayed at the clinic for 30 min after receiving it to be monitored. I went back to work and a few hours later I developed back pain. I have arthritis so i didn't think to much about it at first. However, it got so much worse that it felt like I was in labor (10/10 pain) and I was instructed to go see the doctor. So I went back to the clinic (Dr.) and he gave me Naproxen 250mg to take and I was instructed to take 2 tablets 2x daily. I went home and laid in bed. I got full body sweats and I felt like I had a fever. I have never sweat so bad before. Then, the next day, I was okay after taking the naproxen. Just recently, 06/03/2022 I stayed home because I had a really bad migraine. I took the naproxen, benadryl and the motion sickness medicine and I stayed in bed all day. Since then, I have been having intermittent cluster headaches which I had following the 2nd COVID vaccine (Pfizer). Since I had the Pfizer COVID19 vaccines, I have developed migraines and they have gotten worse with each shot.
Age: 30.0
Sex: F
Vaccine: HEPAB, MMR, VARCEL
Symptoms: Dizziness, Feeling hot, Flushing, Hyperhidrosis, Hypotension
Clinical narrative: Pt reports experiencing dizziness before passing out at the counter. Pt had initial low blood pressure, flushed, and sweating. Pt was laid supine and came to within about15 seconds of the incident. Pt was able to respond appropriately and aware of person, place, and time. Patient was provided and ice pack, place behind the neck, and vitals were assessed.Initial blood pressure at 1135 was 81/45 1140 was 97/65 and 1143 118/80. Patient reported no additional pain but was "hot" and felt nauseous. Patient was transported to ER by EMS at 1146.
Age: 30.0
Sex: F
Vaccine: HEPAB, MMR, VARCEL
Symptoms: Loss of consciousness, Nausea
Clinical narrative: Pt reports experiencing dizziness before passing out at the counter. Pt had initial low blood pressure, flushed, and sweating. Pt was laid supine and came to within about15 seconds of the incident. Pt was able to respond appropriately and aware of person, place, and time. Patient was provided and ice pack, place behind the neck, and vitals were assessed.Initial blood pressure at 1135 was 81/45 1140 was 97/65 and 1143 118/80. Patient reported no additional pain but was "hot" and felt nauseous. Patient was transported to ER by EMS at 1146.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: no adverse reaction, patient was not of age yet.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, Chronic obstructive pulmonary disease, Chronic respiratory failure
Clinical narrative: pt had  a positive COVID test on 2/17/22, and was left with chronic hypoxic respiratory failure; 4/20/22 pt presents to Medical Center with acute on chronic dyspnea; increasing SOB, wheezing, non-productive cough x 1 wk; saw PCP (name not included in med records) and was treated with steroid and Bactrim; no improvement; increase in fatigue and malaise; severe COPD exacerbation with acute renal failure and hyperkalemia; treated with IV steroids, O2 supplementation, duoneb, pulmincort; dc'd to home on 4/22/22; pt passed away in her home on 5/8/22 with acute respiratory failure
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Death, Dyspnoea, Fatigue
Clinical narrative: pt had  a positive COVID test on 2/17/22, and was left with chronic hypoxic respiratory failure; 4/20/22 pt presents to Medical Center with acute on chronic dyspnea; increasing SOB, wheezing, non-productive cough x 1 wk; saw PCP (name not included in med records) and was treated with steroid and Bactrim; no improvement; increase in fatigue and malaise; severe COPD exacerbation with acute renal failure and hyperkalemia; treated with IV steroids, O2 supplementation, duoneb, pulmincort; dc'd to home on 4/22/22; pt passed away in her home on 5/8/22 with acute respiratory failure
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperkalaemia, Malaise, Respiratory failure, SARS-CoV-2 test positive, Wheezing
Clinical narrative: pt had  a positive COVID test on 2/17/22, and was left with chronic hypoxic respiratory failure; 4/20/22 pt presents to Medical Center with acute on chronic dyspnea; increasing SOB, wheezing, non-productive cough x 1 wk; saw PCP (name not included in med records) and was treated with steroid and Bactrim; no improvement; increase in fatigue and malaise; severe COPD exacerbation with acute renal failure and hyperkalemia; treated with IV steroids, O2 supplementation, duoneb, pulmincort; dc'd to home on 4/22/22; pt passed away in her home on 5/8/22 with acute respiratory failure
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Arthralgia, Asthenia, Atrial fibrillation, Atrial flutter
Clinical narrative: Presently admitted at (11) days. Patient is a 78 y.o. male patient with a past medical history of paroxysmal atrial fibrillation chronic anticoagulation with Xarelto coronary artery disease chronic kidney disease stage 3, seizure disorder, tobacco use kidney stones and generalized debilitation.  He was sent from his assisted living facility to the emergency department earlier in the day due to generalize weakness and a SARS-CoV-2 positive PCR test.  He was initially maintaining an SpO2 greater than 96% on room air however EMS placed him on 15 liters/minute via nasal cannula and he was maintaining an SpO2 100%.  After arriving in the emergency department he was placed back on room air and he continues to maintain an SpO2 95%.  He is not coughing and does not have increased sputum production but does complain of generalized myalgia and arthralgia.  He is afebrile with a temperature of 36.4 normal white blood cell count 4.01 and his venous venous gas shows a pH of 7.38 and pCO2 of 52. He does not appear septic and his lactic acid is 1.4.  His chest x-ray does not show any acute process.  It is unclear why a CT head was done but it did not show an acute process.  His electrocardiogram shows atrial flutter with a rate of 109 and only nonspecific ST segment changes.  He denies chest pain or pressure.  The patient would provide only minimal information and repeatedly yelled get out get out get out of my room making evaluation somewhat limited.  He was given 1 g of IV Tylenol and 5 mg of IV Lopressor in the emergency department and hospitalist service is asked to admit for his generalized weakness myalgia arthralgia and COVID infection.  SARS-CoV-2 infection: Contact and droplet precautions He is not hypoxic and does not appear in respiratory distress His chest x-ray does not show an infiltrate her other acute process He is not requiring supplemental oxygen Based on his lack of supplemental oxygen requirement he is not a candidate for Decadron, remdesivir or monoclonal antibody therapy. Continuous pulse oximetry ordered Continue Tylenol for fever myalgia arthralgia pain Normal saline at 75 mL/hour   Paroxysmal atrial fibrillation/flutter: Currently in atrial flutter with a rate of 109 He was given one dose of Lopressor 5 mg IVP Continue home dose of flecainide Continue home dose of Xarelto Continue telemetry Check magnesium level   Coronary artery disease He is not complaining of chest pain or pressure   Seizure disorder Continue home dose of Keppra   Chronic kidney disease stage 3 He appears to be at baseline Continue normal saline at 75 mL/hour   Chronic erythematous rash on feet He states he's had if to several months Does not appear like cellulitis   Admission status-observation Venous thromboemboli prophylaxis-currently on Xarelto Code status full/unknown  He will likely require less than 2 midnights of hospital admission but does require overnight observation given his worsening generalized weakness myalgia arthralgia and recent COVID-19 infection
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Blood culture negative, Blood lactic acid, Blood pH normal, COVID-19, Cardiac telemetry
Clinical narrative: Presently admitted at (11) days. Patient is a 78 y.o. male patient with a past medical history of paroxysmal atrial fibrillation chronic anticoagulation with Xarelto coronary artery disease chronic kidney disease stage 3, seizure disorder, tobacco use kidney stones and generalized debilitation.  He was sent from his assisted living facility to the emergency department earlier in the day due to generalize weakness and a SARS-CoV-2 positive PCR test.  He was initially maintaining an SpO2 greater than 96% on room air however EMS placed him on 15 liters/minute via nasal cannula and he was maintaining an SpO2 100%.  After arriving in the emergency department he was placed back on room air and he continues to maintain an SpO2 95%.  He is not coughing and does not have increased sputum production but does complain of generalized myalgia and arthralgia.  He is afebrile with a temperature of 36.4 normal white blood cell count 4.01 and his venous venous gas shows a pH of 7.38 and pCO2 of 52. He does not appear septic and his lactic acid is 1.4.  His chest x-ray does not show any acute process.  It is unclear why a CT head was done but it did not show an acute process.  His electrocardiogram shows atrial flutter with a rate of 109 and only nonspecific ST segment changes.  He denies chest pain or pressure.  The patient would provide only minimal information and repeatedly yelled get out get out get out of my room making evaluation somewhat limited.  He was given 1 g of IV Tylenol and 5 mg of IV Lopressor in the emergency department and hospitalist service is asked to admit for his generalized weakness myalgia arthralgia and COVID infection.  SARS-CoV-2 infection: Contact and droplet precautions He is not hypoxic and does not appear in respiratory distress His chest x-ray does not show an infiltrate her other acute process He is not requiring supplemental oxygen Based on his lack of supplemental oxygen requirement he is not a candidate for Decadron, remdesivir or monoclonal antibody therapy. Continuous pulse oximetry ordered Continue Tylenol for fever myalgia arthralgia pain Normal saline at 75 mL/hour   Paroxysmal atrial fibrillation/flutter: Currently in atrial flutter with a rate of 109 He was given one dose of Lopressor 5 mg IVP Continue home dose of flecainide Continue home dose of Xarelto Continue telemetry Check magnesium level   Coronary artery disease He is not complaining of chest pain or pressure   Seizure disorder Continue home dose of Keppra   Chronic kidney disease stage 3 He appears to be at baseline Continue normal saline at 75 mL/hour   Chronic erythematous rash on feet He states he's had if to several months Does not appear like cellulitis   Admission status-observation Venous thromboemboli prophylaxis-currently on Xarelto Code status full/unknown  He will likely require less than 2 midnights of hospital admission but does require overnight observation given his worsening generalized weakness myalgia arthralgia and recent COVID-19 infection
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiomegaly, Cerebral arteriosclerosis, Cerebral atrophy, Cerebral small vessel ischaemic disease, Chest X-ray normal
Clinical narrative: Presently admitted at (11) days. Patient is a 78 y.o. male patient with a past medical history of paroxysmal atrial fibrillation chronic anticoagulation with Xarelto coronary artery disease chronic kidney disease stage 3, seizure disorder, tobacco use kidney stones and generalized debilitation.  He was sent from his assisted living facility to the emergency department earlier in the day due to generalize weakness and a SARS-CoV-2 positive PCR test.  He was initially maintaining an SpO2 greater than 96% on room air however EMS placed him on 15 liters/minute via nasal cannula and he was maintaining an SpO2 100%.  After arriving in the emergency department he was placed back on room air and he continues to maintain an SpO2 95%.  He is not coughing and does not have increased sputum production but does complain of generalized myalgia and arthralgia.  He is afebrile with a temperature of 36.4 normal white blood cell count 4.01 and his venous venous gas shows a pH of 7.38 and pCO2 of 52. He does not appear septic and his lactic acid is 1.4.  His chest x-ray does not show any acute process.  It is unclear why a CT head was done but it did not show an acute process.  His electrocardiogram shows atrial flutter with a rate of 109 and only nonspecific ST segment changes.  He denies chest pain or pressure.  The patient would provide only minimal information and repeatedly yelled get out get out get out of my room making evaluation somewhat limited.  He was given 1 g of IV Tylenol and 5 mg of IV Lopressor in the emergency department and hospitalist service is asked to admit for his generalized weakness myalgia arthralgia and COVID infection.  SARS-CoV-2 infection: Contact and droplet precautions He is not hypoxic and does not appear in respiratory distress His chest x-ray does not show an infiltrate her other acute process He is not requiring supplemental oxygen Based on his lack of supplemental oxygen requirement he is not a candidate for Decadron, remdesivir or monoclonal antibody therapy. Continuous pulse oximetry ordered Continue Tylenol for fever myalgia arthralgia pain Normal saline at 75 mL/hour   Paroxysmal atrial fibrillation/flutter: Currently in atrial flutter with a rate of 109 He was given one dose of Lopressor 5 mg IVP Continue home dose of flecainide Continue home dose of Xarelto Continue telemetry Check magnesium level   Coronary artery disease He is not complaining of chest pain or pressure   Seizure disorder Continue home dose of Keppra   Chronic kidney disease stage 3 He appears to be at baseline Continue normal saline at 75 mL/hour   Chronic erythematous rash on feet He states he's had if to several months Does not appear like cellulitis   Admission status-observation Venous thromboemboli prophylaxis-currently on Xarelto Code status full/unknown  He will likely require less than 2 midnights of hospital admission but does require overnight observation given his worsening generalized weakness myalgia arthralgia and recent COVID-19 infection
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram head abnormal, Dyspnoea, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Mental status changes
Clinical narrative: Presently admitted at (11) days. Patient is a 78 y.o. male patient with a past medical history of paroxysmal atrial fibrillation chronic anticoagulation with Xarelto coronary artery disease chronic kidney disease stage 3, seizure disorder, tobacco use kidney stones and generalized debilitation.  He was sent from his assisted living facility to the emergency department earlier in the day due to generalize weakness and a SARS-CoV-2 positive PCR test.  He was initially maintaining an SpO2 greater than 96% on room air however EMS placed him on 15 liters/minute via nasal cannula and he was maintaining an SpO2 100%.  After arriving in the emergency department he was placed back on room air and he continues to maintain an SpO2 95%.  He is not coughing and does not have increased sputum production but does complain of generalized myalgia and arthralgia.  He is afebrile with a temperature of 36.4 normal white blood cell count 4.01 and his venous venous gas shows a pH of 7.38 and pCO2 of 52. He does not appear septic and his lactic acid is 1.4.  His chest x-ray does not show any acute process.  It is unclear why a CT head was done but it did not show an acute process.  His electrocardiogram shows atrial flutter with a rate of 109 and only nonspecific ST segment changes.  He denies chest pain or pressure.  The patient would provide only minimal information and repeatedly yelled get out get out get out of my room making evaluation somewhat limited.  He was given 1 g of IV Tylenol and 5 mg of IV Lopressor in the emergency department and hospitalist service is asked to admit for his generalized weakness myalgia arthralgia and COVID infection.  SARS-CoV-2 infection: Contact and droplet precautions He is not hypoxic and does not appear in respiratory distress His chest x-ray does not show an infiltrate her other acute process He is not requiring supplemental oxygen Based on his lack of supplemental oxygen requirement he is not a candidate for Decadron, remdesivir or monoclonal antibody therapy. Continuous pulse oximetry ordered Continue Tylenol for fever myalgia arthralgia pain Normal saline at 75 mL/hour   Paroxysmal atrial fibrillation/flutter: Currently in atrial flutter with a rate of 109 He was given one dose of Lopressor 5 mg IVP Continue home dose of flecainide Continue home dose of Xarelto Continue telemetry Check magnesium level   Coronary artery disease He is not complaining of chest pain or pressure   Seizure disorder Continue home dose of Keppra   Chronic kidney disease stage 3 He appears to be at baseline Continue normal saline at 75 mL/hour   Chronic erythematous rash on feet He states he's had if to several months Does not appear like cellulitis   Admission status-observation Venous thromboemboli prophylaxis-currently on Xarelto Code status full/unknown  He will likely require less than 2 midnights of hospital admission but does require overnight observation given his worsening generalized weakness myalgia arthralgia and recent COVID-19 infection
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Myalgia, PCO2 increased, Rash erythematous, SARS-CoV-2 test positive, Screaming
Clinical narrative: Presently admitted at (11) days. Patient is a 78 y.o. male patient with a past medical history of paroxysmal atrial fibrillation chronic anticoagulation with Xarelto coronary artery disease chronic kidney disease stage 3, seizure disorder, tobacco use kidney stones and generalized debilitation.  He was sent from his assisted living facility to the emergency department earlier in the day due to generalize weakness and a SARS-CoV-2 positive PCR test.  He was initially maintaining an SpO2 greater than 96% on room air however EMS placed him on 15 liters/minute via nasal cannula and he was maintaining an SpO2 100%.  After arriving in the emergency department he was placed back on room air and he continues to maintain an SpO2 95%.  He is not coughing and does not have increased sputum production but does complain of generalized myalgia and arthralgia.  He is afebrile with a temperature of 36.4 normal white blood cell count 4.01 and his venous venous gas shows a pH of 7.38 and pCO2 of 52. He does not appear septic and his lactic acid is 1.4.  His chest x-ray does not show any acute process.  It is unclear why a CT head was done but it did not show an acute process.  His electrocardiogram shows atrial flutter with a rate of 109 and only nonspecific ST segment changes.  He denies chest pain or pressure.  The patient would provide only minimal information and repeatedly yelled get out get out get out of my room making evaluation somewhat limited.  He was given 1 g of IV Tylenol and 5 mg of IV Lopressor in the emergency department and hospitalist service is asked to admit for his generalized weakness myalgia arthralgia and COVID infection.  SARS-CoV-2 infection: Contact and droplet precautions He is not hypoxic and does not appear in respiratory distress His chest x-ray does not show an infiltrate her other acute process He is not requiring supplemental oxygen Based on his lack of supplemental oxygen requirement he is not a candidate for Decadron, remdesivir or monoclonal antibody therapy. Continuous pulse oximetry ordered Continue Tylenol for fever myalgia arthralgia pain Normal saline at 75 mL/hour   Paroxysmal atrial fibrillation/flutter: Currently in atrial flutter with a rate of 109 He was given one dose of Lopressor 5 mg IVP Continue home dose of flecainide Continue home dose of Xarelto Continue telemetry Check magnesium level   Coronary artery disease He is not complaining of chest pain or pressure   Seizure disorder Continue home dose of Keppra   Chronic kidney disease stage 3 He appears to be at baseline Continue normal saline at 75 mL/hour   Chronic erythematous rash on feet He states he's had if to several months Does not appear like cellulitis   Admission status-observation Venous thromboemboli prophylaxis-currently on Xarelto Code status full/unknown  He will likely require less than 2 midnights of hospital admission but does require overnight observation given his worsening generalized weakness myalgia arthralgia and recent COVID-19 infection
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cell count decreased
Clinical narrative: Presently admitted at (11) days. Patient is a 78 y.o. male patient with a past medical history of paroxysmal atrial fibrillation chronic anticoagulation with Xarelto coronary artery disease chronic kidney disease stage 3, seizure disorder, tobacco use kidney stones and generalized debilitation.  He was sent from his assisted living facility to the emergency department earlier in the day due to generalize weakness and a SARS-CoV-2 positive PCR test.  He was initially maintaining an SpO2 greater than 96% on room air however EMS placed him on 15 liters/minute via nasal cannula and he was maintaining an SpO2 100%.  After arriving in the emergency department he was placed back on room air and he continues to maintain an SpO2 95%.  He is not coughing and does not have increased sputum production but does complain of generalized myalgia and arthralgia.  He is afebrile with a temperature of 36.4 normal white blood cell count 4.01 and his venous venous gas shows a pH of 7.38 and pCO2 of 52. He does not appear septic and his lactic acid is 1.4.  His chest x-ray does not show any acute process.  It is unclear why a CT head was done but it did not show an acute process.  His electrocardiogram shows atrial flutter with a rate of 109 and only nonspecific ST segment changes.  He denies chest pain or pressure.  The patient would provide only minimal information and repeatedly yelled get out get out get out of my room making evaluation somewhat limited.  He was given 1 g of IV Tylenol and 5 mg of IV Lopressor in the emergency department and hospitalist service is asked to admit for his generalized weakness myalgia arthralgia and COVID infection.  SARS-CoV-2 infection: Contact and droplet precautions He is not hypoxic and does not appear in respiratory distress His chest x-ray does not show an infiltrate her other acute process He is not requiring supplemental oxygen Based on his lack of supplemental oxygen requirement he is not a candidate for Decadron, remdesivir or monoclonal antibody therapy. Continuous pulse oximetry ordered Continue Tylenol for fever myalgia arthralgia pain Normal saline at 75 mL/hour   Paroxysmal atrial fibrillation/flutter: Currently in atrial flutter with a rate of 109 He was given one dose of Lopressor 5 mg IVP Continue home dose of flecainide Continue home dose of Xarelto Continue telemetry Check magnesium level   Coronary artery disease He is not complaining of chest pain or pressure   Seizure disorder Continue home dose of Keppra   Chronic kidney disease stage 3 He appears to be at baseline Continue normal saline at 75 mL/hour   Chronic erythematous rash on feet He states he's had if to several months Does not appear like cellulitis   Admission status-observation Venous thromboemboli prophylaxis-currently on Xarelto Code status full/unknown  He will likely require less than 2 midnights of hospital admission but does require overnight observation given his worsening generalized weakness myalgia arthralgia and recent COVID-19 infection
Age: 19.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Visual impairment
Clinical narrative: Patient reported feeling faint, dizzy, and seeing black soon after the vaccine was administered
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Influenza A virus test, Influenza B virus test
Clinical narrative: Breakthrough COVID infection. Patient reports onset fatigue and cough roughly 3 weeks prior to 6/6/2022. Unsure of exact onset.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID infection. Patient reports onset fatigue and cough roughly 3 weeks prior to 6/6/2022. Unsure of exact onset.
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Client was given Pfizer for 12 years and older instead of the Pfizer 5-11 vaccine.  Medical director notified.  Parent notified.  Client states that child had no reaction to the vaccine.
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product preparation issue
Clinical narrative: Patient received under diluted dose of covid 19 vaccine 5-11.  No adverse event reported by parent.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy skin, Condition aggravated, Lichen planus, Pyrexia, Rash
Clinical narrative: Fever the following day + worsening of lichen planus rash (which patient had developed 2 months prior and was getting better)
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Arthritis, Back pain, Blood test, Condition aggravated
Clinical narrative: Dose 2 Feb 2021 - starting within 1 week got rapid arthritis in both hands; trigger finger in 6 fingers; severe pain in right shoulder. Treated all as symptoms including 3 courses- 5 injections steroids in hands prescribed by physician; with treatments the shoulder pain subsided.   Since all adverse reactions to vaccines had been suppressed by healthcare, media, Big Tech as "vaccine hesitancy", I did not recognize these issues as adverse reactions.    I received DOSE 3 on Nov 1, 2021 not suspecting any sensitivity to the covid vaccine; Immediately within a week, the arthritis returned in hands and trigger fingers returned. The right shoulder immediately began with pain. Doctor prescribed physical therapy for shoulder, but it only got worse.    Over next 3-5 months both shoulders grew in horrible pain, that spread down biceps, triceps and forearms.  The lower back and right leg began to ache horribly in that course.  Because I read that the vaccines did not have adverse reactions, I suspected I had pulled muscles in my back and leg.    Pain in the shoulder and back were bad I could not do much of anything.  Pain was worse at night and could not get out of bed. I could not even lift my arms above the horizontal; could not lift a toilet seat or even lift a coffee pot with one hand.    Doctor prescribed anti-inflammatory pills and creams suspecting some rapid form of osteo-arthritis.  The pills alleviate the lower back and leg pain, but did nothing for shoulders.    Doctor Finally injected steroid directly into the 2 shoulders and within days-weeks , everything cleared up and went back to normal.   A scan of the shoulders note degenerative damage to the should sockets.  Likely due to the inflammation.
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Mobility decreased, Osteoarthritis, Pain in extremity, Scan abnormal, Trigger finger
Clinical narrative: Dose 2 Feb 2021 - starting within 1 week got rapid arthritis in both hands; trigger finger in 6 fingers; severe pain in right shoulder. Treated all as symptoms including 3 courses- 5 injections steroids in hands prescribed by physician; with treatments the shoulder pain subsided.   Since all adverse reactions to vaccines had been suppressed by healthcare, media, Big Tech as "vaccine hesitancy", I did not recognize these issues as adverse reactions.    I received DOSE 3 on Nov 1, 2021 not suspecting any sensitivity to the covid vaccine; Immediately within a week, the arthritis returned in hands and trigger fingers returned. The right shoulder immediately began with pain. Doctor prescribed physical therapy for shoulder, but it only got worse.    Over next 3-5 months both shoulders grew in horrible pain, that spread down biceps, triceps and forearms.  The lower back and right leg began to ache horribly in that course.  Because I read that the vaccines did not have adverse reactions, I suspected I had pulled muscles in my back and leg.    Pain in the shoulder and back were bad I could not do much of anything.  Pain was worse at night and could not get out of bed. I could not even lift my arms above the horizontal; could not lift a toilet seat or even lift a coffee pot with one hand.    Doctor prescribed anti-inflammatory pills and creams suspecting some rapid form of osteo-arthritis.  The pills alleviate the lower back and leg pain, but did nothing for shoulders.    Doctor Finally injected steroid directly into the 2 shoulders and within days-weeks , everything cleared up and went back to normal.   A scan of the shoulders note degenerative damage to the should sockets.  Likely due to the inflammation.
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: X-ray limb
Clinical narrative: Dose 2 Feb 2021 - starting within 1 week got rapid arthritis in both hands; trigger finger in 6 fingers; severe pain in right shoulder. Treated all as symptoms including 3 courses- 5 injections steroids in hands prescribed by physician; with treatments the shoulder pain subsided.   Since all adverse reactions to vaccines had been suppressed by healthcare, media, Big Tech as "vaccine hesitancy", I did not recognize these issues as adverse reactions.    I received DOSE 3 on Nov 1, 2021 not suspecting any sensitivity to the covid vaccine; Immediately within a week, the arthritis returned in hands and trigger fingers returned. The right shoulder immediately began with pain. Doctor prescribed physical therapy for shoulder, but it only got worse.    Over next 3-5 months both shoulders grew in horrible pain, that spread down biceps, triceps and forearms.  The lower back and right leg began to ache horribly in that course.  Because I read that the vaccines did not have adverse reactions, I suspected I had pulled muscles in my back and leg.    Pain in the shoulder and back were bad I could not do much of anything.  Pain was worse at night and could not get out of bed. I could not even lift my arms above the horizontal; could not lift a toilet seat or even lift a coffee pot with one hand.    Doctor prescribed anti-inflammatory pills and creams suspecting some rapid form of osteo-arthritis.  The pills alleviate the lower back and leg pain, but did nothing for shoulders.    Doctor Finally injected steroid directly into the 2 shoulders and within days-weeks , everything cleared up and went back to normal.   A scan of the shoulders note degenerative damage to the should sockets.  Likely due to the inflammation.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Headache
Clinical narrative: I had a scratchy throat, congestion, headache and cough. Lightly achy for about a day, fatigue. It lasted probably 6 days. And mostly it was mild but there was a day or two where it was worse than that. I was directly exposed to somebody who had a positive Covid test and is why I took a test. I received monoclonal antibodies.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Respiratory tract congestion, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: I had a scratchy throat, congestion, headache and cough. Lightly achy for about a day, fatigue. It lasted probably 6 days. And mostly it was mild but there was a day or two where it was worse than that. I was directly exposed to somebody who had a positive Covid test and is why I took a test. I received monoclonal antibodies.
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product preparation issue
Clinical narrative: Patient received under diluted dose of Covid 5-11 vaccine. No adverse effect reported by parent.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Appetite disorder, Asthma, COVID-19, Carditis, Chest X-ray normal
Clinical narrative: Please see previous notes for outbreak information. (Did have typical symptoms after second and third injections, but they lasted 2-3 days).
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Chills, Condition aggravated, Confusional state, Dehydration
Clinical narrative: Please see previous notes for outbreak information. (Did have typical symptoms after second and third injections, but they lasted 2-3 days).
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Electrocardiogram normal, Feeling abnormal, Headache, Infusion site pain
Clinical narrative: Please see previous notes for outbreak information. (Did have typical symptoms after second and third injections, but they lasted 2-3 days).
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Infusion site swelling, Insomnia, Malaise, Oropharyngeal pain, Pain
Clinical narrative: Please see previous notes for outbreak information. (Did have typical symptoms after second and third injections, but they lasted 2-3 days).
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Parosmia, Pneumonitis, Productive cough, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Please see previous notes for outbreak information. (Did have typical symptoms after second and third injections, but they lasted 2-3 days).
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Sinus congestion, Somnolence, Vaccine breakthrough infection
Clinical narrative: Please see previous notes for outbreak information. (Did have typical symptoms after second and third injections, but they lasted 2-3 days).
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Abortion spontaneous, COVID-19, Pregnancy, SARS-CoV-2 test positive, Ultrasound foetal abnormal
Clinical narrative: I did not have an adverse reaction to the vaccine but I tested positive for Covid 19 on 01/31/2022. I did a Covid 19 home test plus a test at work that confirmed I was positive on 01/31/2022. I found out I was pregnant on 01/31/2022 too. At the end of February I had an ultra sound done and found that I had miscarried. On March 24, we found out we where pregnant. Three weeks ago, May 17, I had an ultrasound and found out we miscarried. I had to have an emergency DNC.  Please note we have five children.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Uterine dilation and curettage
Clinical narrative: I did not have an adverse reaction to the vaccine but I tested positive for Covid 19 on 01/31/2022. I did a Covid 19 home test plus a test at work that confirmed I was positive on 01/31/2022. I found out I was pregnant on 01/31/2022 too. At the end of February I had an ultra sound done and found that I had miscarried. On March 24, we found out we where pregnant. Three weeks ago, May 17, I had an ultrasound and found out we miscarried. I had to have an emergency DNC.  Please note we have five children.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cerebrovascular accident, Death, Hypophagia, Hypotension
Clinical narrative: pt in HCF after a stroke; had a positive COVID test on 1/24/22; on 2/1/22 pt was lethargic and hard to awaken; low BP; poor po intake x 4 days; refusing medications; pt passed away in the HCF on 2/8/22