chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 95.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiomegaly, Chest X-ray abnormal, Confusional state, Cough
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 6/26/2022 Discharge Date: Jul 1, 2022  PRESENTING PROBLEM: Difficulty breathing [R06.89] Acute respiratory failure with hypoxia (HCC) [J96.01] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC) [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 95M  with Alzheimer's dementia, hearing loss, vertigo, previous stroke, sleep apnea, BPH, severe aortic stenosis status post TAVR, chronic systolic and diastolic heart failure and hypothyroidism who presented with a chief complaint of 1-2 days of fatigue/weakness and decreased appetite.   He was in his usual state of health until the day prior to presentation. He was out with family and when he returned, he had no appetite and did not eat dinner and this continued again in the morning. He also had an episode of diarrhea.   Upon arrival, he had a fever of 39° C and  mild leukocytosis of 11.19.  He had a mild nonproductive cough and his chest x-ray showed mild cardiomegaly and pulmonary vascular congestion, but no obvious infiltrate or pleural effusion.  Procalcitonin was negative (0.13). His SARS-CoV-2 PCR was negative. However, respiratory viral panel was sent and SARS-CoV-2 resulted positive there.   He was admitted for sepsis and acute respiratory failure due to COVID 19. He is fully vaccinated against COVID 19. CXR no infiltrate. CT angiogram thorax showing subsegmental right middle lobe pulmonary embolism no evidence of right heart strain. Echo with EF of 59% no WMA. He received remdesivir x5 days given acute hypoxemia. Levaquin started in ED but was not continued. He was weaned down to room air by discharge.   For his acute PE, he was transitioned from lovenox to eliquis with plan for 3 months of treatment. Home ASA 81 mg held while on eliquis to decrease bleeding risk.   He appeared to have a mild acute kidney injury compared to his previous baseline labs (0.89-- >1.06). UA negative for UTI. Renal function improved to baseline by discharge.   He did develop mild delirium/acute encephalopathy in the setting of known dementia. He has hearing loss which makes it harder to communicate. He is known to lip read which makes it harder for him to understand his care team with mask on. No treatment needed for his acute confusion. Frequent redirection, avoiding sedative/narcotics and encourage proper sleep wake cycle was re inforced.   PT/OT recommend SAR and he was discharged to facility in stable condition on 7/1/22
Age: 95.0
Sex: M
Vaccine: COVID19
Symptoms: Decreased appetite, Delirium, Diarrhoea, Dyspnoea, Echocardiogram
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 6/26/2022 Discharge Date: Jul 1, 2022  PRESENTING PROBLEM: Difficulty breathing [R06.89] Acute respiratory failure with hypoxia (HCC) [J96.01] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC) [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 95M  with Alzheimer's dementia, hearing loss, vertigo, previous stroke, sleep apnea, BPH, severe aortic stenosis status post TAVR, chronic systolic and diastolic heart failure and hypothyroidism who presented with a chief complaint of 1-2 days of fatigue/weakness and decreased appetite.   He was in his usual state of health until the day prior to presentation. He was out with family and when he returned, he had no appetite and did not eat dinner and this continued again in the morning. He also had an episode of diarrhea.   Upon arrival, he had a fever of 39° C and  mild leukocytosis of 11.19.  He had a mild nonproductive cough and his chest x-ray showed mild cardiomegaly and pulmonary vascular congestion, but no obvious infiltrate or pleural effusion.  Procalcitonin was negative (0.13). His SARS-CoV-2 PCR was negative. However, respiratory viral panel was sent and SARS-CoV-2 resulted positive there.   He was admitted for sepsis and acute respiratory failure due to COVID 19. He is fully vaccinated against COVID 19. CXR no infiltrate. CT angiogram thorax showing subsegmental right middle lobe pulmonary embolism no evidence of right heart strain. Echo with EF of 59% no WMA. He received remdesivir x5 days given acute hypoxemia. Levaquin started in ED but was not continued. He was weaned down to room air by discharge.   For his acute PE, he was transitioned from lovenox to eliquis with plan for 3 months of treatment. Home ASA 81 mg held while on eliquis to decrease bleeding risk.   He appeared to have a mild acute kidney injury compared to his previous baseline labs (0.89-- >1.06). UA negative for UTI. Renal function improved to baseline by discharge.   He did develop mild delirium/acute encephalopathy in the setting of known dementia. He has hearing loss which makes it harder to communicate. He is known to lip read which makes it harder for him to understand his care team with mask on. No treatment needed for his acute confusion. Frequent redirection, avoiding sedative/narcotics and encourage proper sleep wake cycle was re inforced.   PT/OT recommend SAR and he was discharged to facility in stable condition on 7/1/22
Age: 95.0
Sex: M
Vaccine: COVID19
Symptoms: Ejection fraction, Encephalopathy, Fatigue, Hypophagia, Hypoxia
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 6/26/2022 Discharge Date: Jul 1, 2022  PRESENTING PROBLEM: Difficulty breathing [R06.89] Acute respiratory failure with hypoxia (HCC) [J96.01] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC) [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 95M  with Alzheimer's dementia, hearing loss, vertigo, previous stroke, sleep apnea, BPH, severe aortic stenosis status post TAVR, chronic systolic and diastolic heart failure and hypothyroidism who presented with a chief complaint of 1-2 days of fatigue/weakness and decreased appetite.   He was in his usual state of health until the day prior to presentation. He was out with family and when he returned, he had no appetite and did not eat dinner and this continued again in the morning. He also had an episode of diarrhea.   Upon arrival, he had a fever of 39° C and  mild leukocytosis of 11.19.  He had a mild nonproductive cough and his chest x-ray showed mild cardiomegaly and pulmonary vascular congestion, but no obvious infiltrate or pleural effusion.  Procalcitonin was negative (0.13). His SARS-CoV-2 PCR was negative. However, respiratory viral panel was sent and SARS-CoV-2 resulted positive there.   He was admitted for sepsis and acute respiratory failure due to COVID 19. He is fully vaccinated against COVID 19. CXR no infiltrate. CT angiogram thorax showing subsegmental right middle lobe pulmonary embolism no evidence of right heart strain. Echo with EF of 59% no WMA. He received remdesivir x5 days given acute hypoxemia. Levaquin started in ED but was not continued. He was weaned down to room air by discharge.   For his acute PE, he was transitioned from lovenox to eliquis with plan for 3 months of treatment. Home ASA 81 mg held while on eliquis to decrease bleeding risk.   He appeared to have a mild acute kidney injury compared to his previous baseline labs (0.89-- >1.06). UA negative for UTI. Renal function improved to baseline by discharge.   He did develop mild delirium/acute encephalopathy in the setting of known dementia. He has hearing loss which makes it harder to communicate. He is known to lip read which makes it harder for him to understand his care team with mask on. No treatment needed for his acute confusion. Frequent redirection, avoiding sedative/narcotics and encourage proper sleep wake cycle was re inforced.   PT/OT recommend SAR and he was discharged to facility in stable condition on 7/1/22
Age: 95.0
Sex: M
Vaccine: COVID19
Symptoms: Leukocytosis, Procalcitonin, Pulmonary congestion, Pulmonary embolism, Pyrexia
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 6/26/2022 Discharge Date: Jul 1, 2022  PRESENTING PROBLEM: Difficulty breathing [R06.89] Acute respiratory failure with hypoxia (HCC) [J96.01] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC) [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 95M  with Alzheimer's dementia, hearing loss, vertigo, previous stroke, sleep apnea, BPH, severe aortic stenosis status post TAVR, chronic systolic and diastolic heart failure and hypothyroidism who presented with a chief complaint of 1-2 days of fatigue/weakness and decreased appetite.   He was in his usual state of health until the day prior to presentation. He was out with family and when he returned, he had no appetite and did not eat dinner and this continued again in the morning. He also had an episode of diarrhea.   Upon arrival, he had a fever of 39° C and  mild leukocytosis of 11.19.  He had a mild nonproductive cough and his chest x-ray showed mild cardiomegaly and pulmonary vascular congestion, but no obvious infiltrate or pleural effusion.  Procalcitonin was negative (0.13). His SARS-CoV-2 PCR was negative. However, respiratory viral panel was sent and SARS-CoV-2 resulted positive there.   He was admitted for sepsis and acute respiratory failure due to COVID 19. He is fully vaccinated against COVID 19. CXR no infiltrate. CT angiogram thorax showing subsegmental right middle lobe pulmonary embolism no evidence of right heart strain. Echo with EF of 59% no WMA. He received remdesivir x5 days given acute hypoxemia. Levaquin started in ED but was not continued. He was weaned down to room air by discharge.   For his acute PE, he was transitioned from lovenox to eliquis with plan for 3 months of treatment. Home ASA 81 mg held while on eliquis to decrease bleeding risk.   He appeared to have a mild acute kidney injury compared to his previous baseline labs (0.89-- >1.06). UA negative for UTI. Renal function improved to baseline by discharge.   He did develop mild delirium/acute encephalopathy in the setting of known dementia. He has hearing loss which makes it harder to communicate. He is known to lip read which makes it harder for him to understand his care team with mask on. No treatment needed for his acute confusion. Frequent redirection, avoiding sedative/narcotics and encourage proper sleep wake cycle was re inforced.   PT/OT recommend SAR and he was discharged to facility in stable condition on 7/1/22
Age: 95.0
Sex: M
Vaccine: COVID19
Symptoms: Renal impairment, SARS-CoV-2 test positive, Sepsis, Urine analysis normal
Clinical narrative: Discharge Provider:  MD Primary Care Provider:  MD Admission Date: 6/26/2022 Discharge Date: Jul 1, 2022  PRESENTING PROBLEM: Difficulty breathing [R06.89] Acute respiratory failure with hypoxia (HCC) [J96.01] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC) [A41.9] COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 95M  with Alzheimer's dementia, hearing loss, vertigo, previous stroke, sleep apnea, BPH, severe aortic stenosis status post TAVR, chronic systolic and diastolic heart failure and hypothyroidism who presented with a chief complaint of 1-2 days of fatigue/weakness and decreased appetite.   He was in his usual state of health until the day prior to presentation. He was out with family and when he returned, he had no appetite and did not eat dinner and this continued again in the morning. He also had an episode of diarrhea.   Upon arrival, he had a fever of 39° C and  mild leukocytosis of 11.19.  He had a mild nonproductive cough and his chest x-ray showed mild cardiomegaly and pulmonary vascular congestion, but no obvious infiltrate or pleural effusion.  Procalcitonin was negative (0.13). His SARS-CoV-2 PCR was negative. However, respiratory viral panel was sent and SARS-CoV-2 resulted positive there.   He was admitted for sepsis and acute respiratory failure due to COVID 19. He is fully vaccinated against COVID 19. CXR no infiltrate. CT angiogram thorax showing subsegmental right middle lobe pulmonary embolism no evidence of right heart strain. Echo with EF of 59% no WMA. He received remdesivir x5 days given acute hypoxemia. Levaquin started in ED but was not continued. He was weaned down to room air by discharge.   For his acute PE, he was transitioned from lovenox to eliquis with plan for 3 months of treatment. Home ASA 81 mg held while on eliquis to decrease bleeding risk.   He appeared to have a mild acute kidney injury compared to his previous baseline labs (0.89-- >1.06). UA negative for UTI. Renal function improved to baseline by discharge.   He did develop mild delirium/acute encephalopathy in the setting of known dementia. He has hearing loss which makes it harder to communicate. He is known to lip read which makes it harder for him to understand his care team with mask on. No treatment needed for his acute confusion. Frequent redirection, avoiding sedative/narcotics and encourage proper sleep wake cycle was re inforced.   PT/OT recommend SAR and he was discharged to facility in stable condition on 7/1/22
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Fatigue, Headache, Pyrexia, SARS-CoV-2 test
Clinical narrative: I have a lot of allergies so when I awoke on June 12, 2022with a headache and sinus drainage I thought it was just my allergies. Later that day I called my doctor and had a telehealth visit after having taken a home COVID-19 test once my symptoms had progressed to fatigue, cough with a fever. He prescribed Paxlovid that I started taking the next day for five days. I have been feeling much better.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Sinus operation
Clinical narrative: I have a lot of allergies so when I awoke on June 12, 2022with a headache and sinus drainage I thought it was just my allergies. Later that day I called my doctor and had a telehealth visit after having taken a home COVID-19 test once my symptoms had progressed to fatigue, cough with a fever. He prescribed Paxlovid that I started taking the next day for five days. I have been feeling much better.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Patient developed COVID-19 post vaccinations.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Flushing, Nasal congestion, Nasopharyngitis
Clinical narrative: I had COVID-19. Symptoms were like a head cold. The day after I showed symptoms on the 21st, I felt flush with a fever of 100 degrees so I took the home COVID-19 test and it was positive. I then went to the pharmacy and had their test and it was positive. The hole time I had a very little once in a while cough, and was a bit nasal. Symptoms were very mild.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I had COVID-19. Symptoms were like a head cold. The day after I showed symptoms on the 21st, I felt flush with a fever of 100 degrees so I took the home COVID-19 test and it was positive. I then went to the pharmacy and had their test and it was positive. The hole time I had a very little once in a while cough, and was a bit nasal. Symptoms were very mild.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Blister, Burning sensation, Erythema, Fatigue, Paraesthesia
Clinical narrative: After taking our dog on a long evening walk (and commenting on the large numbers if bugs/mosquitoes out), on 7/5, I noticed several large, swollen, reddened, itchy areas on my lower legs & the back of my right upper arm - consistent with bug bites. On 7/6, the area on my right upper arm had multiple small bumps and was both itchy and had an odd tingling/burning sensation. I tried to ignore it, but by 8:00 PM, it was worsening. I reached back to feel the site and found a large blister that looks very much like a shingles blister. I don?t have a fever, but am fatigued which is odd, given I?ve been off of work for several days & have slept well.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Pruritus, Swelling
Clinical narrative: After taking our dog on a long evening walk (and commenting on the large numbers if bugs/mosquitoes out), on 7/5, I noticed several large, swollen, reddened, itchy areas on my lower legs & the back of my right upper arm - consistent with bug bites. On 7/6, the area on my right upper arm had multiple small bumps and was both itchy and had an odd tingling/burning sensation. I tried to ignore it, but by 8:00 PM, it was worsening. I reached back to feel the site and found a large blister that looks very much like a shingles blister. I don?t have a fever, but am fatigued which is odd, given I?ve been off of work for several days & have slept well.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Anal abscess, Angiogram pulmonary abnormal, Anticoagulant therapy, Asthenia, Blood lactic acid normal
Clinical narrative: Pfizer Dose 1 3/23/21 (ER8727 Pfizer Dose 2 4/21/21 (ER8731) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 1/25/22  1/25/22: This is a 67 y.o. female with multiple comorbidities who presented to the ED via EMS due to generalized weakness.  Duration about 2 weeks, worsening in the last 24 hours. Reports being fatigued and not being able to walk.  Associated symptoms include feeling feverish, chills, and chest pain.  She also reports increasing right buttock pain.  Notable PMH include severe COPD on home oxygen at 2-3 liters per minute, and chronic pilonidal cyst/infection of the right buttock.  Referral for evaluation per general surgery had been placed at her annual exam.  She had not recently been on antibiotics. Endorses possible COVID exposure.  Endorses COVID vaccination status + booster.  1/30/22: Patient is a pleasant 67 yo F who presented with worsening generalized weakness with associated fever//chils, chest pain, and right buttock pain. Pertinent history of chronic pilonidal cyst/infection of right buttock. Not on recent antibiotics. Patient noted to be satting in the 80's, normotensive, 100.4 F. Placed on oxygen supplementation. Labs showed low Mg2+, no leukocytosis, mild thrombocytopenia. Lactate normal. Troponin negative. UA + leuk est. COVID rapid antigen was positive. CXR showed cardiomegaly and pulmonary vascular congestion. CT Abdomen/Pelvis notable for perianal cellulitis/abscess. Patient was given Mag rider and vancomycin in the ED. Of note, D-dimer was elevated and thus prompted CTA that showed new PE on right side. Heparin gtt started. Of note, patient was already on Xarelto for Afib. Thus, pulmonology consulted, but pulmonology then consulted heme/onc given new PE on anticoagulation. Heme/Onc recommended transition from heparin to Lovenox and to continue x 4 weeks, ordered APL workup, with plan to transition to warfarin if positive. General Surgery was consulted for perianal abscess. On 1/27, right perirectal abscess spontaneously drained with improvement in patient's pain. Given the PE on anticoagulation and perirectal area improving, surgery decided to hold off on any type of surgical intervention. Doxycycline 100 mg IV BID was started 1/27. Patient was treated with remdesivir, dexamethasone and Lovenox for COVID-19 treatment. Patient's oxygen was weaned down from 6 to 4 L with saturations in 90's. On 1/30/22, patient was deemed stable for discharge home with close follow-up with PCP, and surgery and heme/onc.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Blood magnesium decreased, COVID-19, Cardiomegaly, Cellulitis, Chest X-ray abnormal
Clinical narrative: Pfizer Dose 1 3/23/21 (ER8727 Pfizer Dose 2 4/21/21 (ER8731) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 1/25/22  1/25/22: This is a 67 y.o. female with multiple comorbidities who presented to the ED via EMS due to generalized weakness.  Duration about 2 weeks, worsening in the last 24 hours. Reports being fatigued and not being able to walk.  Associated symptoms include feeling feverish, chills, and chest pain.  She also reports increasing right buttock pain.  Notable PMH include severe COPD on home oxygen at 2-3 liters per minute, and chronic pilonidal cyst/infection of the right buttock.  Referral for evaluation per general surgery had been placed at her annual exam.  She had not recently been on antibiotics. Endorses possible COVID exposure.  Endorses COVID vaccination status + booster.  1/30/22: Patient is a pleasant 67 yo F who presented with worsening generalized weakness with associated fever//chils, chest pain, and right buttock pain. Pertinent history of chronic pilonidal cyst/infection of right buttock. Not on recent antibiotics. Patient noted to be satting in the 80's, normotensive, 100.4 F. Placed on oxygen supplementation. Labs showed low Mg2+, no leukocytosis, mild thrombocytopenia. Lactate normal. Troponin negative. UA + leuk est. COVID rapid antigen was positive. CXR showed cardiomegaly and pulmonary vascular congestion. CT Abdomen/Pelvis notable for perianal cellulitis/abscess. Patient was given Mag rider and vancomycin in the ED. Of note, D-dimer was elevated and thus prompted CTA that showed new PE on right side. Heparin gtt started. Of note, patient was already on Xarelto for Afib. Thus, pulmonology consulted, but pulmonology then consulted heme/onc given new PE on anticoagulation. Heme/Onc recommended transition from heparin to Lovenox and to continue x 4 weeks, ordered APL workup, with plan to transition to warfarin if positive. General Surgery was consulted for perianal abscess. On 1/27, right perirectal abscess spontaneously drained with improvement in patient's pain. Given the PE on anticoagulation and perirectal area improving, surgery decided to hold off on any type of surgical intervention. Doxycycline 100 mg IV BID was started 1/27. Patient was treated with remdesivir, dexamethasone and Lovenox for COVID-19 treatment. Patient's oxygen was weaned down from 6 to 4 L with saturations in 90's. On 1/30/22, patient was deemed stable for discharge home with close follow-up with PCP, and surgery and heme/onc.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Chills, Computerised tomogram abdomen abnormal, Fatigue, Fibrin D dimer increased
Clinical narrative: Pfizer Dose 1 3/23/21 (ER8727 Pfizer Dose 2 4/21/21 (ER8731) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 1/25/22  1/25/22: This is a 67 y.o. female with multiple comorbidities who presented to the ED via EMS due to generalized weakness.  Duration about 2 weeks, worsening in the last 24 hours. Reports being fatigued and not being able to walk.  Associated symptoms include feeling feverish, chills, and chest pain.  She also reports increasing right buttock pain.  Notable PMH include severe COPD on home oxygen at 2-3 liters per minute, and chronic pilonidal cyst/infection of the right buttock.  Referral for evaluation per general surgery had been placed at her annual exam.  She had not recently been on antibiotics. Endorses possible COVID exposure.  Endorses COVID vaccination status + booster.  1/30/22: Patient is a pleasant 67 yo F who presented with worsening generalized weakness with associated fever//chils, chest pain, and right buttock pain. Pertinent history of chronic pilonidal cyst/infection of right buttock. Not on recent antibiotics. Patient noted to be satting in the 80's, normotensive, 100.4 F. Placed on oxygen supplementation. Labs showed low Mg2+, no leukocytosis, mild thrombocytopenia. Lactate normal. Troponin negative. UA + leuk est. COVID rapid antigen was positive. CXR showed cardiomegaly and pulmonary vascular congestion. CT Abdomen/Pelvis notable for perianal cellulitis/abscess. Patient was given Mag rider and vancomycin in the ED. Of note, D-dimer was elevated and thus prompted CTA that showed new PE on right side. Heparin gtt started. Of note, patient was already on Xarelto for Afib. Thus, pulmonology consulted, but pulmonology then consulted heme/onc given new PE on anticoagulation. Heme/Onc recommended transition from heparin to Lovenox and to continue x 4 weeks, ordered APL workup, with plan to transition to warfarin if positive. General Surgery was consulted for perianal abscess. On 1/27, right perirectal abscess spontaneously drained with improvement in patient's pain. Given the PE on anticoagulation and perirectal area improving, surgery decided to hold off on any type of surgical intervention. Doxycycline 100 mg IV BID was started 1/27. Patient was treated with remdesivir, dexamethasone and Lovenox for COVID-19 treatment. Patient's oxygen was weaned down from 6 to 4 L with saturations in 90's. On 1/30/22, patient was deemed stable for discharge home with close follow-up with PCP, and surgery and heme/onc.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Gait inability, Inappropriate schedule of product administration, Laboratory test abnormal, Musculoskeletal pain, Pain
Clinical narrative: Pfizer Dose 1 3/23/21 (ER8727 Pfizer Dose 2 4/21/21 (ER8731) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 1/25/22  1/25/22: This is a 67 y.o. female with multiple comorbidities who presented to the ED via EMS due to generalized weakness.  Duration about 2 weeks, worsening in the last 24 hours. Reports being fatigued and not being able to walk.  Associated symptoms include feeling feverish, chills, and chest pain.  She also reports increasing right buttock pain.  Notable PMH include severe COPD on home oxygen at 2-3 liters per minute, and chronic pilonidal cyst/infection of the right buttock.  Referral for evaluation per general surgery had been placed at her annual exam.  She had not recently been on antibiotics. Endorses possible COVID exposure.  Endorses COVID vaccination status + booster.  1/30/22: Patient is a pleasant 67 yo F who presented with worsening generalized weakness with associated fever//chils, chest pain, and right buttock pain. Pertinent history of chronic pilonidal cyst/infection of right buttock. Not on recent antibiotics. Patient noted to be satting in the 80's, normotensive, 100.4 F. Placed on oxygen supplementation. Labs showed low Mg2+, no leukocytosis, mild thrombocytopenia. Lactate normal. Troponin negative. UA + leuk est. COVID rapid antigen was positive. CXR showed cardiomegaly and pulmonary vascular congestion. CT Abdomen/Pelvis notable for perianal cellulitis/abscess. Patient was given Mag rider and vancomycin in the ED. Of note, D-dimer was elevated and thus prompted CTA that showed new PE on right side. Heparin gtt started. Of note, patient was already on Xarelto for Afib. Thus, pulmonology consulted, but pulmonology then consulted heme/onc given new PE on anticoagulation. Heme/Onc recommended transition from heparin to Lovenox and to continue x 4 weeks, ordered APL workup, with plan to transition to warfarin if positive. General Surgery was consulted for perianal abscess. On 1/27, right perirectal abscess spontaneously drained with improvement in patient's pain. Given the PE on anticoagulation and perirectal area improving, surgery decided to hold off on any type of surgical intervention. Doxycycline 100 mg IV BID was started 1/27. Patient was treated with remdesivir, dexamethasone and Lovenox for COVID-19 treatment. Patient's oxygen was weaned down from 6 to 4 L with saturations in 90's. On 1/30/22, patient was deemed stable for discharge home with close follow-up with PCP, and surgery and heme/onc.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary congestion, Pulmonary embolism, Pyrexia, SARS-CoV-2 test positive, Thrombocytopenia
Clinical narrative: Pfizer Dose 1 3/23/21 (ER8727 Pfizer Dose 2 4/21/21 (ER8731) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 1/25/22  1/25/22: This is a 67 y.o. female with multiple comorbidities who presented to the ED via EMS due to generalized weakness.  Duration about 2 weeks, worsening in the last 24 hours. Reports being fatigued and not being able to walk.  Associated symptoms include feeling feverish, chills, and chest pain.  She also reports increasing right buttock pain.  Notable PMH include severe COPD on home oxygen at 2-3 liters per minute, and chronic pilonidal cyst/infection of the right buttock.  Referral for evaluation per general surgery had been placed at her annual exam.  She had not recently been on antibiotics. Endorses possible COVID exposure.  Endorses COVID vaccination status + booster.  1/30/22: Patient is a pleasant 67 yo F who presented with worsening generalized weakness with associated fever//chils, chest pain, and right buttock pain. Pertinent history of chronic pilonidal cyst/infection of right buttock. Not on recent antibiotics. Patient noted to be satting in the 80's, normotensive, 100.4 F. Placed on oxygen supplementation. Labs showed low Mg2+, no leukocytosis, mild thrombocytopenia. Lactate normal. Troponin negative. UA + leuk est. COVID rapid antigen was positive. CXR showed cardiomegaly and pulmonary vascular congestion. CT Abdomen/Pelvis notable for perianal cellulitis/abscess. Patient was given Mag rider and vancomycin in the ED. Of note, D-dimer was elevated and thus prompted CTA that showed new PE on right side. Heparin gtt started. Of note, patient was already on Xarelto for Afib. Thus, pulmonology consulted, but pulmonology then consulted heme/onc given new PE on anticoagulation. Heme/Onc recommended transition from heparin to Lovenox and to continue x 4 weeks, ordered APL workup, with plan to transition to warfarin if positive. General Surgery was consulted for perianal abscess. On 1/27, right perirectal abscess spontaneously drained with improvement in patient's pain. Given the PE on anticoagulation and perirectal area improving, surgery decided to hold off on any type of surgical intervention. Doxycycline 100 mg IV BID was started 1/27. Patient was treated with remdesivir, dexamethasone and Lovenox for COVID-19 treatment. Patient's oxygen was weaned down from 6 to 4 L with saturations in 90's. On 1/30/22, patient was deemed stable for discharge home with close follow-up with PCP, and surgery and heme/onc.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin normal, Urine analysis abnormal, Urine leukocyte esterase positive
Clinical narrative: Pfizer Dose 1 3/23/21 (ER8727 Pfizer Dose 2 4/21/21 (ER8731) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 1/25/22  1/25/22: This is a 67 y.o. female with multiple comorbidities who presented to the ED via EMS due to generalized weakness.  Duration about 2 weeks, worsening in the last 24 hours. Reports being fatigued and not being able to walk.  Associated symptoms include feeling feverish, chills, and chest pain.  She also reports increasing right buttock pain.  Notable PMH include severe COPD on home oxygen at 2-3 liters per minute, and chronic pilonidal cyst/infection of the right buttock.  Referral for evaluation per general surgery had been placed at her annual exam.  She had not recently been on antibiotics. Endorses possible COVID exposure.  Endorses COVID vaccination status + booster.  1/30/22: Patient is a pleasant 67 yo F who presented with worsening generalized weakness with associated fever//chils, chest pain, and right buttock pain. Pertinent history of chronic pilonidal cyst/infection of right buttock. Not on recent antibiotics. Patient noted to be satting in the 80's, normotensive, 100.4 F. Placed on oxygen supplementation. Labs showed low Mg2+, no leukocytosis, mild thrombocytopenia. Lactate normal. Troponin negative. UA + leuk est. COVID rapid antigen was positive. CXR showed cardiomegaly and pulmonary vascular congestion. CT Abdomen/Pelvis notable for perianal cellulitis/abscess. Patient was given Mag rider and vancomycin in the ED. Of note, D-dimer was elevated and thus prompted CTA that showed new PE on right side. Heparin gtt started. Of note, patient was already on Xarelto for Afib. Thus, pulmonology consulted, but pulmonology then consulted heme/onc given new PE on anticoagulation. Heme/Onc recommended transition from heparin to Lovenox and to continue x 4 weeks, ordered APL workup, with plan to transition to warfarin if positive. General Surgery was consulted for perianal abscess. On 1/27, right perirectal abscess spontaneously drained with improvement in patient's pain. Given the PE on anticoagulation and perirectal area improving, surgery decided to hold off on any type of surgical intervention. Doxycycline 100 mg IV BID was started 1/27. Patient was treated with remdesivir, dexamethasone and Lovenox for COVID-19 treatment. Patient's oxygen was weaned down from 6 to 4 L with saturations in 90's. On 1/30/22, patient was deemed stable for discharge home with close follow-up with PCP, and surgery and heme/onc.
Age: 5.0
Sex: M
Vaccine: VARCEL
Symptoms: Expired product administered, No adverse event
Clinical narrative: Immunization given outside the expiration date, patient did not have any symptoms or reaction of any kind.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood lactic acid, Bronchoscopy, COVID-19, Chest X-ray abnormal
Clinical narrative: Discharge Provider: (name withheld) Primary Care Provider: (name withheld) Admission Date: 6/27/2022 Discharge Date: Jul 4, 2022  PRESENTING PROBLEM: Acute respiratory failure with hypoxia  Hypoxia  COVID-19    HOSPITAL COURSE:  a 54-year-old male with history of neuromuscular disorder, hypertension, DVT/PE on Eliquis, neurogenic bladder, RLS and OSA who presented with fever, cough and shortness of breath.  He initially presented to Hospital, where he was noted to be febrile tachypneic and hypoxemic.  He was placed on 6 L oxygen.  Labs showed a WBC count of 9.03, procalcitonin 0.08 lactic acid 2.7.  COVID was negative on film array, but positive on PCR.  Chest x-ray showed right-sided airspace disease, improved on the right, but worse on the left.  He was given IV vancomycin and IV Zosyn.  CT thorax without contrast was then done, and showed increasing moderate patchy airspace disease, concerning for worsening multifocal pneumonia.  Patient was transferred to Hospital for further care.   Upon admission, the patient was placed on nasal cannula oxygen.  He had rather rapid deterioration on the morning of 6/28, and was requiring 100% non-rebreather.  He was transferred to the intensive care unit at that time, and placed on high-flow nasal cannula.  He was started on Decadron 6 mg daily as well as IV remdesivir.  Infectious Disease and pulmonology services were consulted.  He was started on Bactrim DS 2 tabs three times daily due to concern for possible Pneumocystis pneumonia.  Pulmonology performed bronchoscopy on 06/29/2022.  Infectious Disease also recommended treatment with convalescent plasma, which could only be done at Hospital.  He was transferred to Hospital for this therapy.  His respiratory status had improved by time of transfer, and was felt appropriate for general medical floor at hospital. Patient was transferred to hospital where he received convalescent plasma, he was able to wean his O2 and he completed 7 days of zosyn and 5 days of remdesivir. Patient was started on 10 days of decadron before resuming his home O2. Bronchoscopy results were negative aside from COVID-19. Patient did require O2 with activity at the time of discharge. He also was continued on PJP prophylaxis per ID recommendation. Patient was instructed on signs and symptoms of when to return to the ER. He was then considered stable for discharge home. Patient was given a referral for the hospital at home program.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Convalescent plasma transfusion, Cough, Dyspnoea, General physical health deterioration
Clinical narrative: Discharge Provider: (name withheld) Primary Care Provider: (name withheld) Admission Date: 6/27/2022 Discharge Date: Jul 4, 2022  PRESENTING PROBLEM: Acute respiratory failure with hypoxia  Hypoxia  COVID-19    HOSPITAL COURSE:  a 54-year-old male with history of neuromuscular disorder, hypertension, DVT/PE on Eliquis, neurogenic bladder, RLS and OSA who presented with fever, cough and shortness of breath.  He initially presented to Hospital, where he was noted to be febrile tachypneic and hypoxemic.  He was placed on 6 L oxygen.  Labs showed a WBC count of 9.03, procalcitonin 0.08 lactic acid 2.7.  COVID was negative on film array, but positive on PCR.  Chest x-ray showed right-sided airspace disease, improved on the right, but worse on the left.  He was given IV vancomycin and IV Zosyn.  CT thorax without contrast was then done, and showed increasing moderate patchy airspace disease, concerning for worsening multifocal pneumonia.  Patient was transferred to Hospital for further care.   Upon admission, the patient was placed on nasal cannula oxygen.  He had rather rapid deterioration on the morning of 6/28, and was requiring 100% non-rebreather.  He was transferred to the intensive care unit at that time, and placed on high-flow nasal cannula.  He was started on Decadron 6 mg daily as well as IV remdesivir.  Infectious Disease and pulmonology services were consulted.  He was started on Bactrim DS 2 tabs three times daily due to concern for possible Pneumocystis pneumonia.  Pulmonology performed bronchoscopy on 06/29/2022.  Infectious Disease also recommended treatment with convalescent plasma, which could only be done at Hospital.  He was transferred to Hospital for this therapy.  His respiratory status had improved by time of transfer, and was felt appropriate for general medical floor at hospital. Patient was transferred to hospital where he received convalescent plasma, he was able to wean his O2 and he completed 7 days of zosyn and 5 days of remdesivir. Patient was started on 10 days of decadron before resuming his home O2. Bronchoscopy results were negative aside from COVID-19. Patient did require O2 with activity at the time of discharge. He also was continued on PJP prophylaxis per ID recommendation. Patient was instructed on signs and symptoms of when to return to the ER. He was then considered stable for discharge home. Patient was given a referral for the hospital at home program.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Intensive care, Lung disorder, Procalcitonin, Pyrexia
Clinical narrative: Discharge Provider: (name withheld) Primary Care Provider: (name withheld) Admission Date: 6/27/2022 Discharge Date: Jul 4, 2022  PRESENTING PROBLEM: Acute respiratory failure with hypoxia  Hypoxia  COVID-19    HOSPITAL COURSE:  a 54-year-old male with history of neuromuscular disorder, hypertension, DVT/PE on Eliquis, neurogenic bladder, RLS and OSA who presented with fever, cough and shortness of breath.  He initially presented to Hospital, where he was noted to be febrile tachypneic and hypoxemic.  He was placed on 6 L oxygen.  Labs showed a WBC count of 9.03, procalcitonin 0.08 lactic acid 2.7.  COVID was negative on film array, but positive on PCR.  Chest x-ray showed right-sided airspace disease, improved on the right, but worse on the left.  He was given IV vancomycin and IV Zosyn.  CT thorax without contrast was then done, and showed increasing moderate patchy airspace disease, concerning for worsening multifocal pneumonia.  Patient was transferred to Hospital for further care.   Upon admission, the patient was placed on nasal cannula oxygen.  He had rather rapid deterioration on the morning of 6/28, and was requiring 100% non-rebreather.  He was transferred to the intensive care unit at that time, and placed on high-flow nasal cannula.  He was started on Decadron 6 mg daily as well as IV remdesivir.  Infectious Disease and pulmonology services were consulted.  He was started on Bactrim DS 2 tabs three times daily due to concern for possible Pneumocystis pneumonia.  Pulmonology performed bronchoscopy on 06/29/2022.  Infectious Disease also recommended treatment with convalescent plasma, which could only be done at Hospital.  He was transferred to Hospital for this therapy.  His respiratory status had improved by time of transfer, and was felt appropriate for general medical floor at hospital. Patient was transferred to hospital where he received convalescent plasma, he was able to wean his O2 and he completed 7 days of zosyn and 5 days of remdesivir. Patient was started on 10 days of decadron before resuming his home O2. Bronchoscopy results were negative aside from COVID-19. Patient did require O2 with activity at the time of discharge. He also was continued on PJP prophylaxis per ID recommendation. Patient was instructed on signs and symptoms of when to return to the ER. He was then considered stable for discharge home. Patient was given a referral for the hospital at home program.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Tachypnoea, White blood cell count normal
Clinical narrative: Discharge Provider: (name withheld) Primary Care Provider: (name withheld) Admission Date: 6/27/2022 Discharge Date: Jul 4, 2022  PRESENTING PROBLEM: Acute respiratory failure with hypoxia  Hypoxia  COVID-19    HOSPITAL COURSE:  a 54-year-old male with history of neuromuscular disorder, hypertension, DVT/PE on Eliquis, neurogenic bladder, RLS and OSA who presented with fever, cough and shortness of breath.  He initially presented to Hospital, where he was noted to be febrile tachypneic and hypoxemic.  He was placed on 6 L oxygen.  Labs showed a WBC count of 9.03, procalcitonin 0.08 lactic acid 2.7.  COVID was negative on film array, but positive on PCR.  Chest x-ray showed right-sided airspace disease, improved on the right, but worse on the left.  He was given IV vancomycin and IV Zosyn.  CT thorax without contrast was then done, and showed increasing moderate patchy airspace disease, concerning for worsening multifocal pneumonia.  Patient was transferred to Hospital for further care.   Upon admission, the patient was placed on nasal cannula oxygen.  He had rather rapid deterioration on the morning of 6/28, and was requiring 100% non-rebreather.  He was transferred to the intensive care unit at that time, and placed on high-flow nasal cannula.  He was started on Decadron 6 mg daily as well as IV remdesivir.  Infectious Disease and pulmonology services were consulted.  He was started on Bactrim DS 2 tabs three times daily due to concern for possible Pneumocystis pneumonia.  Pulmonology performed bronchoscopy on 06/29/2022.  Infectious Disease also recommended treatment with convalescent plasma, which could only be done at Hospital.  He was transferred to Hospital for this therapy.  His respiratory status had improved by time of transfer, and was felt appropriate for general medical floor at hospital. Patient was transferred to hospital where he received convalescent plasma, he was able to wean his O2 and he completed 7 days of zosyn and 5 days of remdesivir. Patient was started on 10 days of decadron before resuming his home O2. Bronchoscopy results were negative aside from COVID-19. Patient did require O2 with activity at the time of discharge. He also was continued on PJP prophylaxis per ID recommendation. Patient was instructed on signs and symptoms of when to return to the ER. He was then considered stable for discharge home. Patient was given a referral for the hospital at home program.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Developed COVID-19 post vaccinations for such.
Age: 3.0
Sex: M
Vaccine: FLU4
Symptoms: Crying, Fall, Haematoma, Head injury, Loss of consciousness
Clinical narrative: A couple of minutes after receiving a flu vaccine, Patient was sitting in a chair. RN and mom ehard a "thud" on the heater vent and patient was on the floor. Mom immediately picked him up and he started to cry. Mom believes his head hit the vent and floor. Patient was alert and oriented, answering questions appropriately. Ice was placed on his forehead. Mom thinks he looked like he passed out. RN did not witness the fall to to position in the room. Patient had a hematoma on his forehead.
Age: 1.42
Sex: F
Vaccine: MMR
Symptoms: Pyrexia, Seizure
Clinical narrative: Patient received MMR vaccine on June 13 2022 . Mother Called and left a voicemail on June 23 2022, stating that daughter had developed a fever of 102 F in the morning of June 22, 2022 and that later in the evening around 7:00 pm daughter developed a seizure. This Nurse called and left voicemail to call back to discuss adverse event, and instructed mom to give medication to keep fever down.   On June 30th mom left a voicemail stating, Patient had another seizure on Thursday, June 23, 2022 as well.  Mother stated that she had went to PCP Friday June 24th and was instructed to give Tylenol and Motrin to keep fever down and prevent any more fibril seizures from occurring. per mother child is doing well and back to normal.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Deafness unilateral, Hypoacusis, Sudden hearing loss
Clinical narrative: He got his vaccine, at approximately 4 or 5 in the afternoon he noticed that his right ear was stopping up like a ball of wax obstructing it.  He is totally deaf in his left ear and has been so since the age of 4, so he thought it was wax.  He tried to use peroxide and mineral oil to get the wax out and didn't notice any bubbling from that and knew it wasn't wax.  On the 18th he saw an ENT who diagnosed him as sudden frequency loss in his ear and put him on steroids.  In the process of doing that he also went and did hyperbaric oxygen therapy treatment to save his hearing, the first was on 5/24/22 and had 10 of those every day for the 10 days.  He has gotten back a lot of his hearing, but does not know if it was from the Prednisone or from the oxygen.  He also saw an ENT at the Hospital and then went to another one who put him on Prednisone.    When this started he could hear some things and the frequency of some of them sounded like the "comic background talking".  Also could hear the music of some of his favorite type of music, but not the lyrics of what was being said.  He is scheduled to have an MRI this evening to see if he has a tumor.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Chronic kidney disease, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 6/22/2022 Discharge Date: Jul 2, 2022  PRESENTING PROBLEM: Gait instability [R26.81] COPD exacerbation [J44.1] Acute and chronic respiratory failure with hypoxia[J96.21] Injury of head, initial encounter [S09.90XA] Stage 3b chronic kidney disease [N18.32]   HOSPITAL COURSE: Patient is a 79 year old women admitted to the hospital after coming in for right sided headache, blurred vision in her right eye and weakness after falling and hitting her head 2 weeks prior to presentation. She has baseline right sided weakness in her right arm from a stroke in the past. She had a CT head in the ED which was negative for any acute changes. She has been having some shortness of breath with exertion over this 2 week period as well. She was wheezing and diagnosed with a COPD exacerbation. She normally uses 2L nc of oxygen and was requiring more than this during her stay but then weaned down to her home supplemental oxygen. She was treated with steroids and duo-nebs. She received a course of azithromycin for her COPD. She was evaluated by PT/OT who recommended SAR. She was screened for COVID-19 prior to be accepted to SAR but tested positive. Placement then took several more days. During her stay she complained of continued headache. She also felt that her right eye was burning and the vision was blurred in it. Her intraocular pressure was 18.5mmHg (normal). She had slight conjunctival injection. She at baseline has no vision in her left eye since an injury in childhood. A referral to ophthalmology was placed at discharge.