chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Sleep disorder, Somnolence
Clinical narrative: Severe fatigue falling asleep low energy unable to get REM sleep  sleep cycle. destroyed severe fatigue unable to remain awake wake up tired no energy informed my PCP at Health Center but records incomplete gave this info to my PCP is not my allergies causing severe fatigue still trying to get medical care and was not informed about the adverse problems by Health Services as requested medical care but refused to file form or write to my medical record
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Emotional distress, Extra dose administered, Herpes zoster, Pain, Pruritus
Clinical narrative: After COVID19 Booster 9/15/21 developed "severe" Herpes Zoster 10/2/21 Left Rib Cage, circumferential around entire Left Ribs, 4inch x 20inches. As of 10/26/2021- still great pain and itch/distress
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dizziness, Dyspnoea, Hypophagia, Nausea
Clinical narrative: Two days after vaccination Pt began complaining of nausea which still persists intermittently to this  day. She now has difficulty eating from the nausea and lost 7 pounds. She also began experiencing dizziness, blurred vision and shortness of breath. On 10/16/2021 she went to hospital due to dizziness, blurred vision and chest pain when Dr. informed us she was having vertigo from the vaccine.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Vaccination complication, Vertigo, Vision blurred, Weight decreased
Clinical narrative: Two days after vaccination Pt began complaining of nausea which still persists intermittently to this  day. She now has difficulty eating from the nausea and lost 7 pounds. She also began experiencing dizziness, blurred vision and shortness of breath. On 10/16/2021 she went to hospital due to dizziness, blurred vision and chest pain when Dr. informed us she was having vertigo from the vaccine.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Atelectasis, Dizziness, Dyspnoea
Clinical narrative: Patient presented on 10/18/2021 with lightheadedness + shortness of breath for 3 weeks- was orthostatic Found t have + clot left greater saphenous + was started on anticoagulants
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Fibrin D dimer increased, Superficial vein thrombosis, Ultrasound Doppler abnormal
Clinical narrative: Patient presented on 10/18/2021 with lightheadedness + shortness of breath for 3 weeks- was orthostatic Found t have + clot left greater saphenous + was started on anticoagulants
Sex: U
Vaccine: COVID19, COVID19
Symptoms: Adverse drug reaction, Arthralgia, Balance disorder, Chest pain, Motor dysfunction
Clinical narrative: On 3/30/21 admitted to hosp. With possible stroke. Left side not functions. Received Prompt Care ER Transport admitted to hospital Recovered left side with 10 days therapy, full recovery w/o w/c. Possible Myocarditus 4/29/21 chkup for Macular Degen Received Dye Injection Violent Reaction - Tremors Chest shoulder pain Admitted to ER Complete chkup. No complications Possible Pericarditus Extreme loss of Balance Following to date 10/29
Sex: U
Vaccine: COVID19, COVID19
Symptoms: Tremor
Clinical narrative: On 3/30/21 admitted to hosp. With possible stroke. Left side not functions. Received Prompt Care ER Transport admitted to hospital Recovered left side with 10 days therapy, full recovery w/o w/c. Possible Myocarditus 4/29/21 chkup for Macular Degen Received Dye Injection Violent Reaction - Tremors Chest shoulder pain Admitted to ER Complete chkup. No complications Possible Pericarditus Extreme loss of Balance Following to date 10/29
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia, Trigeminal nerve disorder
Clinical narrative: Began to have paresthesia. Left face in  trigeminal 2 distribution, as well as lower extremity paresthesia from soles of feet to below knees bilaterally. Has been present from the evening after inoculation. Not worse but not resolving.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Palpitations
Clinical narrative: Patient stated that Right after she received Pfizer vaccine she experienced her heart racing and heart palpitations after that lasted for four months.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Anaphylactic reaction, Throat tightness
Clinical narrative: Narrative: Patient reported throat closing shortly after receiving Pfizer Covid vaccine and was taken to the emergency department where she was treated for anaphylaxis. She received a dose of epinephrine IM and methylprednisolone IV. Patient was able to be discharged from emergency department following treatment without additional intervention.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Hypersensitivity, Throat tightness
Clinical narrative: Narrative: Patient developed chest and throat tightness following administration of Pfizer Covid vaccine and was transferred to community ED for evaluation for allergic reaction.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine normal, Blood culture, Body temperature increased, Brain natriuretic peptide normal, COVID-19
Clinical narrative: Narrative: 62 year old male patient with past medical history of mixed restrictive/obstructive lung disease, PE (on Eliquis), tobacco use disorder, alcohol use disorder, obesity, osteoarthritis, T2DM, BPH, and poor health literacy and poor medication compliance presenting with COVID pneumonia. He denies fever, chills, shortness of breath, chest pain, n/v/c/d. When asked why he came to the hospital before he knew he had COVID, he states that he was drinking like he usually does, and EMS found him and brought him here. He also states that his last drink was yesterday, and he states that he drinks hard liquor. Denies drug use. He states that he smokes too much but cannot further quantify. Per ED documentation, he presented to ED 6/7/2021 with dyspnea. Temp 100.4, HDS, SpO2 mid 90s on ROOM AIR. WBC 5K, Hb 13.7, Plt 142, Cr 1.1, BNP <100, cardiac markers negative. Blood cx drawn. CXR consistent with multifocal pneumonia. He was given albuterol nebulizer, azithromycin and ceftriaxone x1. Found to be COVID positive admitted. Admitted to floor 6/8, transferred to MICU 6/9 and intubated for increased oxygen requirements, extubated 6/16. Received tocilizumab 6/9, Dexamethasone (6/9 - 6/18), Remdesivir (6/8 - 6/18). Transferred to the floor 6/21 on 2L NC and weaned to room air on 6/23. Remained stable on room air for remainder of hospital course. Continued incentive spirometry. COVID IgG positive 6/19. Patient was discharged 6/25/2021 to Rehab facility but has had ongoing SOB ever since.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest X-ray abnormal, Dyspnoea, Endotracheal intubation, Haemoglobin decreased
Clinical narrative: Narrative: 62 year old male patient with past medical history of mixed restrictive/obstructive lung disease, PE (on Eliquis), tobacco use disorder, alcohol use disorder, obesity, osteoarthritis, T2DM, BPH, and poor health literacy and poor medication compliance presenting with COVID pneumonia. He denies fever, chills, shortness of breath, chest pain, n/v/c/d. When asked why he came to the hospital before he knew he had COVID, he states that he was drinking like he usually does, and EMS found him and brought him here. He also states that his last drink was yesterday, and he states that he drinks hard liquor. Denies drug use. He states that he smokes too much but cannot further quantify. Per ED documentation, he presented to ED 6/7/2021 with dyspnea. Temp 100.4, HDS, SpO2 mid 90s on ROOM AIR. WBC 5K, Hb 13.7, Plt 142, Cr 1.1, BNP <100, cardiac markers negative. Blood cx drawn. CXR consistent with multifocal pneumonia. He was given albuterol nebulizer, azithromycin and ceftriaxone x1. Found to be COVID positive admitted. Admitted to floor 6/8, transferred to MICU 6/9 and intubated for increased oxygen requirements, extubated 6/16. Received tocilizumab 6/9, Dexamethasone (6/9 - 6/18), Remdesivir (6/8 - 6/18). Transferred to the floor 6/21 on 2L NC and weaned to room air on 6/23. Remained stable on room air for remainder of hospital course. Continued incentive spirometry. COVID IgG positive 6/19. Patient was discharged 6/25/2021 to Rehab facility but has had ongoing SOB ever since.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Incentive spirometry, Intensive care, Laboratory test normal, Lung infiltration, Platelet count decreased
Clinical narrative: Narrative: 62 year old male patient with past medical history of mixed restrictive/obstructive lung disease, PE (on Eliquis), tobacco use disorder, alcohol use disorder, obesity, osteoarthritis, T2DM, BPH, and poor health literacy and poor medication compliance presenting with COVID pneumonia. He denies fever, chills, shortness of breath, chest pain, n/v/c/d. When asked why he came to the hospital before he knew he had COVID, he states that he was drinking like he usually does, and EMS found him and brought him here. He also states that his last drink was yesterday, and he states that he drinks hard liquor. Denies drug use. He states that he smokes too much but cannot further quantify. Per ED documentation, he presented to ED 6/7/2021 with dyspnea. Temp 100.4, HDS, SpO2 mid 90s on ROOM AIR. WBC 5K, Hb 13.7, Plt 142, Cr 1.1, BNP <100, cardiac markers negative. Blood cx drawn. CXR consistent with multifocal pneumonia. He was given albuterol nebulizer, azithromycin and ceftriaxone x1. Found to be COVID positive admitted. Admitted to floor 6/8, transferred to MICU 6/9 and intubated for increased oxygen requirements, extubated 6/16. Received tocilizumab 6/9, Dexamethasone (6/9 - 6/18), Remdesivir (6/8 - 6/18). Transferred to the floor 6/21 on 2L NC and weaned to room air on 6/23. Remained stable on room air for remainder of hospital course. Continued incentive spirometry. COVID IgG positive 6/19. Patient was discharged 6/25/2021 to Rehab facility but has had ongoing SOB ever since.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, White blood cell count normal
Clinical narrative: Narrative: 62 year old male patient with past medical history of mixed restrictive/obstructive lung disease, PE (on Eliquis), tobacco use disorder, alcohol use disorder, obesity, osteoarthritis, T2DM, BPH, and poor health literacy and poor medication compliance presenting with COVID pneumonia. He denies fever, chills, shortness of breath, chest pain, n/v/c/d. When asked why he came to the hospital before he knew he had COVID, he states that he was drinking like he usually does, and EMS found him and brought him here. He also states that his last drink was yesterday, and he states that he drinks hard liquor. Denies drug use. He states that he smokes too much but cannot further quantify. Per ED documentation, he presented to ED 6/7/2021 with dyspnea. Temp 100.4, HDS, SpO2 mid 90s on ROOM AIR. WBC 5K, Hb 13.7, Plt 142, Cr 1.1, BNP <100, cardiac markers negative. Blood cx drawn. CXR consistent with multifocal pneumonia. He was given albuterol nebulizer, azithromycin and ceftriaxone x1. Found to be COVID positive admitted. Admitted to floor 6/8, transferred to MICU 6/9 and intubated for increased oxygen requirements, extubated 6/16. Received tocilizumab 6/9, Dexamethasone (6/9 - 6/18), Remdesivir (6/8 - 6/18). Transferred to the floor 6/21 on 2L NC and weaned to room air on 6/23. Remained stable on room air for remainder of hospital course. Continued incentive spirometry. COVID IgG positive 6/19. Patient was discharged 6/25/2021 to Rehab facility but has had ongoing SOB ever since.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Cough, Death, Dyspnoea
Clinical narrative: Narrative: Presented to ER on 7/31/21 s/p syncope. Since syncopal episode had increased SOB, cough, headache and body aches. Dx with Acute Hypoxic Respiratory Failure due to COVID-19 Pneumonia and admitted as inpatient, transferred to MICU 7/25/21, and eventually intubated. Treated with Remdesivir x 5 days (completed 7/28/21), dexamethasone x 10 days (completed 8/1) and provided supportive care with supplemental O, vitamin C, zinc, benzonatate, and acetaminophen. Patient expired on 8/3/2021. Co-morbidities included cardiac arrhythmia, pacemaker placement, hx laryngeal cancer, obesity, chronic obstructive sleep apnea, and spondyloarthropathy (treated with tofacitinib + sulfasalazine).
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Endotracheal intubation, Headache, Intensive care, Pain, Syncope
Clinical narrative: Narrative: Presented to ER on 7/31/21 s/p syncope. Since syncopal episode had increased SOB, cough, headache and body aches. Dx with Acute Hypoxic Respiratory Failure due to COVID-19 Pneumonia and admitted as inpatient, transferred to MICU 7/25/21, and eventually intubated. Treated with Remdesivir x 5 days (completed 7/28/21), dexamethasone x 10 days (completed 8/1) and provided supportive care with supplemental O, vitamin C, zinc, benzonatate, and acetaminophen. Patient expired on 8/3/2021. Co-morbidities included cardiac arrhythmia, pacemaker placement, hx laryngeal cancer, obesity, chronic obstructive sleep apnea, and spondyloarthropathy (treated with tofacitinib + sulfasalazine).
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Vaccine breakthrough infection
Clinical narrative: Narrative:  Breakthrough COVID infection resulting in patient death
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chills, Headache, Hypovolaemic shock, Malaise
Clinical narrative: Narrative: 75yr patient direct transfer from facility concerning for hypovolemic shock. Tested positive for COVID one week later while inpatient with COVID symptoms (HA, malaise, chills, body aches, and fever 99.9). Received Moderna Vaccine 2/24/2021 and 6/1/2021. PMH: CAD, uncontrolled T2DM (A1c 13%), COPD GOLD stage III, CKD3, GERD, RA (on immunosuppressant therapy -daily prednisone 5mg and etanercept), and gout with BMI >25 (@32). Did not require dexamethasone or COVID therapeutics while hospitalized and only on RA with SpO2 92. Had a prolonged hospitalization course for non-COVID related condition (~4-5 weeks).
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pain, SARS-CoV-2 test positive
Clinical narrative: Narrative: 75yr patient direct transfer from facility concerning for hypovolemic shock. Tested positive for COVID one week later while inpatient with COVID symptoms (HA, malaise, chills, body aches, and fever 99.9). Received Moderna Vaccine 2/24/2021 and 6/1/2021. PMH: CAD, uncontrolled T2DM (A1c 13%), COPD GOLD stage III, CKD3, GERD, RA (on immunosuppressant therapy -daily prednisone 5mg and etanercept), and gout with BMI >25 (@32). Did not require dexamethasone or COVID therapeutics while hospitalized and only on RA with SpO2 92. Had a prolonged hospitalization course for non-COVID related condition (~4-5 weeks).
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Aortic arteriosclerosis, Aortic disorder, Asthenia, Blood creatinine increased, Blood gases abnormal
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood pH normal, Blood urine present, Bradycardia, Brain natriuretic peptide increased, COVID-19
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19 pneumonia, Chest X-ray abnormal, Chest pain, Computerised tomogram head abnormal, Decreased appetite
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Diuretic therapy, Dizziness, Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Ejection fraction normal, Electrocardiogram PR interval, Electrocardiogram QRS complex, Electrocardiogram abnormal, Gait disturbance
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hyperglycaemia, Lung disorder, Lung opacity, Oedema peripheral, Oxygen saturation decreased
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: PCO2 decreased, PO2 decreased, Pneumonia, Pneumonia bacterial, Procalcitonin increased
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Productive cough, Right atrial dilatation, Right ventricular dilatation, SARS-CoV-2 test positive, Sinus congestion
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Sinus rhythm, Sputum discoloured, Syncope, Tachycardia, Troponin normal
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 90.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Urine analysis abnormal, Ventricular extrasystoles, Walking distance test
Clinical narrative: Narrative: 90 yo male with history of Type 2 DM, CAD, PVD, HTN presents to the Emergency department on 8/7/21 with a chief complaint of intermittent CP with chest and sinus congestion for a week, worsening SOB with exertion, decrease appetite, dizziness, syncope and productive yellow cough also for a week. He also had lower extremity swelling that is worse. Patient was taking 20mg of lasix for lower extremity edema but no history of CHF. EKG with Normal Sinus rhythm with PVC, rate 88, PR 258, QRS 126. In the ED he had desaturating event to the mid 90s on RA (saturating well on room air when stationary, but requiring 2L NC to reach mid 90s sats when mobile). He had elevated BNP to 159, so was diuresed with 40 IV Lasix. Creatinine 1.82 (BL ~1.5, but unsure), troponins negative, UA with trace blood. CT head w no acute intracranial abnormality, mild abnormal hypoattenuation in the subcortical and periventricular white matter of the bilateral cerebral hemispheres, which can be seen with chronic ischemic small vessel gliosis, prior inflammation/infection, vasculopathy, or other etiologies. He was found to be COVID positive with CXR c/f mild/early PNA in left lung base. He was transferred to the floor and started on CAP coverage with ceftriaxone and Azithromycin and started on 6 mg dexamethasone daily. While on the floor he had recurring episodes of bradycardia into the 40s and tachycardia into the 140s, he remained asymptomatic. No known history of arrhythmia on file. TTE with EF of 56% and mildly dilated RV and moderately enlarged RA, otherwise unremarkable. His O2 needs continued to rise, and patient was unable to remain in prone position. ABG on 8/9 with pH 7.43/pCO2 33.5/pO2 59. On 8/10 he was transitioned to 8L oximyzer. Repeat CXR showed worsening patchy and groundglass midlung and lower lung opacification consistent with worsening COVID pneumonia-most extensive in the left lung base. On 8/10 procal was elevated to 5.44 and antibiotics were escalated to cefepime 2g q24h IV. Patient was started on remdesivir (received 200mg the first day, 100mg for 4 days thereafter) and completed a 7-day course of bacterial pneumonia coverage. Over the next days, oxygen requirements started to decrease (patient did not require oxygen supplementation on 8/14), and on 8/14 walk test showed: resting SPO2 on room air 92; patient ambulating for 1 minute on room air with lowest SPO2% 91, patient unable to fully ambulate in the room for 1 minute due to weakness. Patient received 8 doses of dexamethasone (8/8 through 8/15) due to concerns for weakness when ambulating as well as hyperglycemia events. Ultimately, patient was discharged to home on 8/16.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood creatinine normal, Blood magnesium, Brain natriuretic peptide increased, Bundle branch block right
Clinical narrative: Narrative: 86 yo male with history of COPD (on 3L home O2), severe pulmonary HTN (type II & III),  HFpEF EF 62%, NYHA Class IV, DM2, HTN, HLD, OSA on home CPAP presented with fever, chills, dyspnea for 5 days. Five days prior to admission, the patient began noticing progressively worsening shortness of breath with associated fever and chills and myalgias. Before the fever, he took two Bumex 2mg PO as he thought he was having a heart failure exacerbation. However, he felt as though he did not improve with diuresis and continued to have progressively worsening SOB. In the ED, patient was afebrile HDS with somewhat soft pressures in 90s systolic up to 113/70s. COVID + despite full vaccination with Pfizer vaccine 1/25/21 and 2/17/2021. Labs were significant for Trop 0.26 which subsequently downtrended to 0.14, BNP 280, Cr 1.1, mag 1.6. WBC 3.85, plt 130s. CXR with mild interstitial pulmonary edema. EKG with NSR, RBBB, LAD, PVCs. The patient was admitted 8/7/21. Procalcitonin within normal limits, repeat CXR notable for pulmonary edema, no concern for superimposed bacterial PNA. Started on standard treatment for COVID: received 10 day course of dexamethasone 6mg daily, 5 day course remdesivir. Per latest evidence, covid patients benefit from full anticoagulation until off O2 or at baseline O2 requirements. Patient started on enoxaparin 40mg SQ BID until back to baseline O2 (3 days), then increased to 70mg SQ BID until hospital discharge. Continued Albuterol MDI q4h prn, Symbicort MDI daily, Tiotropium MDI daily (2.5mcg). D Dimer downtrended to 0.43 (from 0.93) and CRP to 2.9 (from 4.01). At discharge, back to baseline oxygen requirements (on 3L at home), stable for discharge home 8/16/2021.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: C-reactive protein increased, COVID-19, Cardiomegaly, Chest X-ray abnormal, Chest pain
Clinical narrative: Narrative: 86 yo male with history of COPD (on 3L home O2), severe pulmonary HTN (type II & III),  HFpEF EF 62%, NYHA Class IV, DM2, HTN, HLD, OSA on home CPAP presented with fever, chills, dyspnea for 5 days. Five days prior to admission, the patient began noticing progressively worsening shortness of breath with associated fever and chills and myalgias. Before the fever, he took two Bumex 2mg PO as he thought he was having a heart failure exacerbation. However, he felt as though he did not improve with diuresis and continued to have progressively worsening SOB. In the ED, patient was afebrile HDS with somewhat soft pressures in 90s systolic up to 113/70s. COVID + despite full vaccination with Pfizer vaccine 1/25/21 and 2/17/2021. Labs were significant for Trop 0.26 which subsequently downtrended to 0.14, BNP 280, Cr 1.1, mag 1.6. WBC 3.85, plt 130s. CXR with mild interstitial pulmonary edema. EKG with NSR, RBBB, LAD, PVCs. The patient was admitted 8/7/21. Procalcitonin within normal limits, repeat CXR notable for pulmonary edema, no concern for superimposed bacterial PNA. Started on standard treatment for COVID: received 10 day course of dexamethasone 6mg daily, 5 day course remdesivir. Per latest evidence, covid patients benefit from full anticoagulation until off O2 or at baseline O2 requirements. Patient started on enoxaparin 40mg SQ BID until back to baseline O2 (3 days), then increased to 70mg SQ BID until hospital discharge. Continued Albuterol MDI q4h prn, Symbicort MDI daily, Tiotropium MDI daily (2.5mcg). D Dimer downtrended to 0.43 (from 0.93) and CRP to 2.9 (from 4.01). At discharge, back to baseline oxygen requirements (on 3L at home), stable for discharge home 8/16/2021.