chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Hypoxia, Leukocytosis, SARS-CoV-2 test positive
Clinical narrative: 79 year old male with known atrial fibrillation (on AC and amiodarone), HTN came here with three weeks history of cough and two days of weakness with recent fall due to this weakness, no head trauma.    In the ED he was found to be profoundly weak and became hypoxemic with minimal exertion. Work-ups were significant for mild leukocytosis, chest x-ray unremarkable and patient tested positive for COVID-19.  Patient was admitted under hospitalist service.  Patient stayed in hospital for approximately 3 days.  Patient started on Decadron 6 mg daily.  Patient has been weaned off oxygen and 1st 24 hours of stay.  He was monitored and continued to be stable.  His CRP were monitored as well and down trended.  PTOT evaluation initially recommended subacute rehab but with the reassessment and patient much improved recommendations had changed to home health and patient discharged home stable.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Chest X-ray, Electroencephalogram, Generalised tonic-clonic seizure, Magnetic resonance imaging
Clinical narrative: On February 1, 2022, I had a grand mal seizure with no family history of seizures or epilepsy.  I had to have emergency intervention and went to the ER.  I then had a second seizure on April 12, 2022, and had to get on medication.  Having the Covid Booster on January 24, 2022 and then the seizure on February 1, 2022 seems a probable connection.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Seizure, Ultrasound Doppler
Clinical narrative: On February 1, 2022, I had a grand mal seizure with no family history of seizures or epilepsy.  I had to have emergency intervention and went to the ER.  I then had a second seizure on April 12, 2022, and had to get on medication.  Having the Covid Booster on January 24, 2022 and then the seizure on February 1, 2022 seems a probable connection.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy breast abnormal, Breast cancer female, Breast conserving surgery, Invasive ductal breast carcinoma, Mammogram
Clinical narrative: Breast Cancer Right Breast.  Received lumpectomy on January 26, 2022 3 weeks of radiation ending on April 13, 2022
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Radiotherapy, Ultrasound breast
Clinical narrative: Breast Cancer Right Breast.  Received lumpectomy on January 26, 2022 3 weeks of radiation ending on April 13, 2022
Age: 8.0
Sex: F
Vaccine: DTAPHEPBIP, HEPA, MMRV
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: We were notified of a vaccine error of DTaP given to patient over the age of 6. Pediarix was given after a review of records that the patient brought with her from her school requiring these vaccines as well as system records showing 1st shot was administered on 10/27/2021 and listed as valid. Pt has not reported any adverse events following the first dose and has also not reported any problems after second dose was administered on 06/02/2022.
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Injection site erythema, Injection site inflammation, Injection site warmth, Pain
Clinical narrative: Day 1 - 3 after vaccination: body aches, fatigue Day 3 painful, red hot inflammation below injection site developed, 2 x 3 inches in area, no blistering  Day 4 rash is not subsiding, fatigue continues. This is the day I am reporting side effects
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash
Clinical narrative: Day 1 - 3 after vaccination: body aches, fatigue Day 3 painful, red hot inflammation below injection site developed, 2 x 3 inches in area, no blistering  Day 4 rash is not subsiding, fatigue continues. This is the day I am reporting side effects
Sex: U
Vaccine: COVID19
Symptoms: Aphonia, Arthralgia, Bone pain, Computerised tomogram, Cyst
Clinical narrative: Cyst, open wound spots every on body, bones and joint hurt, hand an feet hurt, swelling. Numbing. Tingling, severe headaches, sinus issues, being testes for possible blood disorder/cancer, calcification in spine, bleeding from vaginal over 2 months, active infection in body, each day a new symptom shows up, swallowing issues. Lost voice,  loss of hearing, being tested for Rhamatoid arthritis and lupus, see mutiple specialist for all this.  Have not worked since 11/2021
Sex: U
Vaccine: COVID19
Symptoms: Deafness, Dysphagia, Electrocardiogram, Electromyogram, Headache
Clinical narrative: Cyst, open wound spots every on body, bones and joint hurt, hand an feet hurt, swelling. Numbing. Tingling, severe headaches, sinus issues, being testes for possible blood disorder/cancer, calcification in spine, bleeding from vaginal over 2 months, active infection in body, each day a new symptom shows up, swallowing issues. Lost voice,  loss of hearing, being tested for Rhamatoid arthritis and lupus, see mutiple specialist for all this.  Have not worked since 11/2021
Sex: U
Vaccine: COVID19
Symptoms: Hypoaesthesia, Hysterectomy, Infection, Laboratory test, Magnetic resonance imaging
Clinical narrative: Cyst, open wound spots every on body, bones and joint hurt, hand an feet hurt, swelling. Numbing. Tingling, severe headaches, sinus issues, being testes for possible blood disorder/cancer, calcification in spine, bleeding from vaginal over 2 months, active infection in body, each day a new symptom shows up, swallowing issues. Lost voice,  loss of hearing, being tested for Rhamatoid arthritis and lupus, see mutiple specialist for all this.  Have not worked since 11/2021
Sex: U
Vaccine: COVID19
Symptoms: Pain in extremity, Paraesthesia, Sinus disorder, Sinus operation, Spinal disorder
Clinical narrative: Cyst, open wound spots every on body, bones and joint hurt, hand an feet hurt, swelling. Numbing. Tingling, severe headaches, sinus issues, being testes for possible blood disorder/cancer, calcification in spine, bleeding from vaginal over 2 months, active infection in body, each day a new symptom shows up, swallowing issues. Lost voice,  loss of hearing, being tested for Rhamatoid arthritis and lupus, see mutiple specialist for all this.  Have not worked since 11/2021
Sex: U
Vaccine: COVID19
Symptoms: Swelling, Ultrasound scan, Urine analysis, Vaginal haemorrhage, Wound
Clinical narrative: Cyst, open wound spots every on body, bones and joint hurt, hand an feet hurt, swelling. Numbing. Tingling, severe headaches, sinus issues, being testes for possible blood disorder/cancer, calcification in spine, bleeding from vaginal over 2 months, active infection in body, each day a new symptom shows up, swallowing issues. Lost voice,  loss of hearing, being tested for Rhamatoid arthritis and lupus, see mutiple specialist for all this.  Have not worked since 11/2021
Sex: U
Vaccine: COVID19
Symptoms: X-ray
Clinical narrative: Cyst, open wound spots every on body, bones and joint hurt, hand an feet hurt, swelling. Numbing. Tingling, severe headaches, sinus issues, being testes for possible blood disorder/cancer, calcification in spine, bleeding from vaginal over 2 months, active infection in body, each day a new symptom shows up, swallowing issues. Lost voice,  loss of hearing, being tested for Rhamatoid arthritis and lupus, see mutiple specialist for all this.  Have not worked since 11/2021
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Blood test normal, Headache, Magnetic resonance imaging normal, Myalgia
Clinical narrative: I received my vaccine on 12/6/2021 and that evening I had a fever and muscle aches. I had a rash all over my body too not just at the injection. I took Motrin to help with the fever and muscle aches for a couple of days. I have had flare ups since the vaccine in February, April and June with high fever, headache, blurry vision and body/joint/muscle aches. I have been to the doctor and they have prescribed (unknown) medicine but it didn't help. I have alternated Tylenol and Motrin which helps with the fever and headache.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia, Rash, SARS-CoV-2 test negative, Vision blurred
Clinical narrative: I received my vaccine on 12/6/2021 and that evening I had a fever and muscle aches. I had a rash all over my body too not just at the injection. I took Motrin to help with the fever and muscle aches for a couple of days. I have had flare ups since the vaccine in February, April and June with high fever, headache, blurry vision and body/joint/muscle aches. I have been to the doctor and they have prescribed (unknown) medicine but it didn't help. I have alternated Tylenol and Motrin which helps with the fever and headache.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Incomplete course of vaccination
Clinical narrative: No symptoms
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Heart rate increased
Clinical narrative: Constant chest pain daily which gets worst when heart rate increases and shortness of breath.Treatment was tylenol, ibuprofen, lidocaine patches. None of the medications that was given to me ever helped the pain stayed persistent.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Chest X-ray abnormal, Cough, Death
Clinical narrative: PFIZER COVID VACCINE #3 GIVEN 11/18/21, LOT #FF2593; pt came to hosp and was admitted on 4/24/22 with weakness, SOB, fever, cough, congestion, decrease in appetite; 4/25/22 positive COVID test; 80% O2 sat on RA; placed on O2 supplementation with improvement; CXR showed left lower lobe pneumonia; given ABX; pt passed away in the hospital the following day
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Dyspnoea, Pneumonia, Pyrexia, Respiratory tract congestion
Clinical narrative: PFIZER COVID VACCINE #3 GIVEN 11/18/21, LOT #FF2593; pt came to hosp and was admitted on 4/24/22 with weakness, SOB, fever, cough, congestion, decrease in appetite; 4/25/22 positive COVID test; 80% O2 sat on RA; placed on O2 supplementation with improvement; CXR showed left lower lobe pneumonia; given ABX; pt passed away in the hospital the following day
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: PFIZER COVID VACCINE #3 GIVEN 11/18/21, LOT #FF2593; pt came to hosp and was admitted on 4/24/22 with weakness, SOB, fever, cough, congestion, decrease in appetite; 4/25/22 positive COVID test; 80% O2 sat on RA; placed on O2 supplementation with improvement; CXR showed left lower lobe pneumonia; given ABX; pt passed away in the hospital the following day
Age: 18.0
Sex: F
Vaccine: MNQ
Symptoms: Product container issue, Product leakage
Clinical narrative: After giving the vaccine to the patient, I began cleaning up my vaccine area and picked up the empty vial to record the lot and expiration on our paperwork and the bottom of the vial completely came apart and glass shards were left on the countertop. After further inspection, there was no trace of residual vaccine and the counter wasn't wet. I next inspected the vial box and there were little tiny shards of glass in the box, barely visible to the naked eye. It is my assumption that the vial was damaged during shipment and all the vaccine leaked into the vial box and dried to the cardboard container.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Headache
Clinical narrative: I was exposed to Covid on 05/14/2022 at a funeral. I didn't realize that until I received a call on 05/17 when the pastor from the church called to inform me that 8 people had tested positive for Covid. On Monday, 5/16, I had a headache which is uncommon for me and I took extra strength TYLENOL. After I was informed of my exposure, on 5/17, I took an at home Covid test which was positive. That same afternoon my cousin who works in a health center, tested me for Covid and it was also positive. I spoke with my doctor that day who prescribed PAXLOVID which I took for 5 days. My symptoms began to improve after starting the anti-viral. My symptoms consisted of headache, congestion, fatigue, a cough, and a runny nose. All of my symptoms had basically cleared up after the 5 days on PAXLOVID. On 05/27, I took another at home Covid test and it was negative. On 05/31, however, I was tested at the local health department and my results were positive. The nurse informed me that it was possible to test positive for up to three months. I spoke with my doctor who advised that since I am no longer showing symptoms, and as long as I social distance and wear a mask when in public, I no longer needed to isolate. My doctor recommended that I receive my next Moderna booster on 07/12/2022 which I fully intent to do.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I was exposed to Covid on 05/14/2022 at a funeral. I didn't realize that until I received a call on 05/17 when the pastor from the church called to inform me that 8 people had tested positive for Covid. On Monday, 5/16, I had a headache which is uncommon for me and I took extra strength TYLENOL. After I was informed of my exposure, on 5/17, I took an at home Covid test which was positive. That same afternoon my cousin who works in a health center, tested me for Covid and it was also positive. I spoke with my doctor that day who prescribed PAXLOVID which I took for 5 days. My symptoms began to improve after starting the anti-viral. My symptoms consisted of headache, congestion, fatigue, a cough, and a runny nose. All of my symptoms had basically cleared up after the 5 days on PAXLOVID. On 05/27, I took another at home Covid test and it was negative. On 05/31, however, I was tested at the local health department and my results were positive. The nurse informed me that it was possible to test positive for up to three months. I spoke with my doctor who advised that since I am no longer showing symptoms, and as long as I social distance and wear a mask when in public, I no longer needed to isolate. My doctor recommended that I receive my next Moderna booster on 07/12/2022 which I fully intent to do.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Activated partial thromboplastin time shortened, Atelectasis, Blood chloride increased, Blood urea nitrogen/creatinine ratio, Chest X-ray abnormal
Clinical narrative: On April 23, 2022 started having shortness of breath and fatigue. By the 25th chest pain and tachycardia throughout week. Being followed by PCP who ordered cardiac monitor. Symptoms became emergent on April 30, 2022. Severe shortness of breath led to calling EMS. From April 23rd to April 30th all symptoms included shortness of breath, chest pain, tachycardia, fatigue, and trouble speaking sentences due to shortness of breath.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Differential white blood cell count, Dyspnoea, Electrocardiogram ST segment elevation, Fatigue
Clinical narrative: On April 23, 2022 started having shortness of breath and fatigue. By the 25th chest pain and tachycardia throughout week. Being followed by PCP who ordered cardiac monitor. Symptoms became emergent on April 30, 2022. Severe shortness of breath led to calling EMS. From April 23rd to April 30th all symptoms included shortness of breath, chest pain, tachycardia, fatigue, and trouble speaking sentences due to shortness of breath.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Full blood count, International normalised ratio, Lung infiltration, Metabolic function test, Mycoplasma test positive
Clinical narrative: On April 23, 2022 started having shortness of breath and fatigue. By the 25th chest pain and tachycardia throughout week. Being followed by PCP who ordered cardiac monitor. Symptoms became emergent on April 30, 2022. Severe shortness of breath led to calling EMS. From April 23rd to April 30th all symptoms included shortness of breath, chest pain, tachycardia, fatigue, and trouble speaking sentences due to shortness of breath.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Procalcitonin, Prothrombin time, Speech disorder, Tachycardia, White blood cell count increased
Clinical narrative: On April 23, 2022 started having shortness of breath and fatigue. By the 25th chest pain and tachycardia throughout week. Being followed by PCP who ordered cardiac monitor. Symptoms became emergent on April 30, 2022. Severe shortness of breath led to calling EMS. From April 23rd to April 30th all symptoms included shortness of breath, chest pain, tachycardia, fatigue, and trouble speaking sentences due to shortness of breath.
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient was administered a 12+ Pfizer COVID vaccine dose at age 11.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Dyspnoea, Mental status changes, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID infection. Patient admitted for altered mental status on 5/29/2022 and tested for COVID due to dyspnea on 6/4/2022
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Pain, Pyrexia, Vomiting
Clinical narrative: Fever of 104 for 3 days, vomiting, body aches and chills
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Aortic dilatation, Arteriosclerosis, Arteriosclerosis coronary artery
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: Asthenia, Atelectasis, Bandaemia, Blood lactic acid, Bronchial secretion retention
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: Bronchial wall thickening, Bronchitis, COVID-19, COVID-19 pneumonia, Cardiac failure congestive
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: Chest X-ray abnormal, Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal, Condition aggravated, Dyspnoea
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: Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction decreased, Emphysema, Fibrin D dimer 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: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Heart valve calcification, Hypoxia, Inappropriate schedule of product administration, Laboratory test abnormal, Lactic acidosis
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: Leukocytosis, Lung consolidation, Lung hyperinflation, Lung infiltration, Lung opacity
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: Mucosal discolouration, Nasopharyngitis, Osteoarthritis, Pleural effusion, Pneumonia
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: Pneumonia bacterial, Pneumonia viral, Positron emission tomogram, Procalcitonin increased, Productive cough
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: Pulmonary artery dilatation, Pulmonary fibrosis, Pulmonary hypertension, Pulmonary mass, Pyrexia
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.