chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 95.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cystitis, Dysuria, Nasal congestion, Procalcitonin decreased, Pyrexia
Clinical narrative: COVID+ 12/5/2022.  Vaccination status - pfizer x3 + pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: DO Admission Date: 12/5/2022 Discharge Date: Dec 7, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? COVID-19 12/06/2022 Unknown ? COVID-19 virus infection 12/05/2022 Yes ? Acute cystitis 12/05/2022 Yes ? Chronic diastolic congestive heart failure (HCC) 12/05/2022 Yes ? Persistent atrial fibrillation (HCC) 11/12/2021 Yes ? Primary hypertension 11/01/2021 Yes ? Stage 3a chronic kidney disease (HCC) 11/01/2021 Yes ? History of deep vein thrombosis (DVT) of lower extremity 11/01/2021 Yes ? History of pulmonary embolus (PE) 11/01/2021 Yes ? Presence of IVC filter   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute cystitis without hematuria [N30.00] Upper respiratory tract infection, unspecified type [J06.9] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE:   Pt is a 96 yr old F presented from PCP's office for worsening cough. She was recently started on Lisinopril and dose had been increased. Also known to recently have COVID infection on 10/6/22. Workup in the ED showed stable vitals, low procalcitonin, normal WBC, film array positive for COVID and UA concerning for UTI.    Pt complained of congestion, low grade fevers, couth and dysuria. Empirically started on IV Rocephin for UTI. She was symptomatically managed from her presumed re-infection of COVID given her nasal congestion, worsening cough (though this could also be secondary to Lisinopril). Her lisinopril was discontinued.   Patient did well in the hospital- did not require oxygen. PT recommended Home. Son requested COVID viral load but unfortunately, this test is not currently available per my discussion with the COVID team. Son wasn't convinced patient had re-infection with COVID. It is difficulty to determine however, given nasal congestion and cough - it would be in patient's best interest to continue to monitor closely.   Patient felt well to discharge home on 12/07/2022 in the care of her family. She is discharged home in stable condition. Patient and son requested starting Losartan - this was prescribed after discussion of risks/benefits and I recommended that they monitor blood pressures closely. COVID and VTE prevention added onto to discharge instructions
Age: 95.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive, Upper respiratory tract infection, Urine analysis abnormal, White blood cell count normal
Clinical narrative: COVID+ 12/5/2022.  Vaccination status - pfizer x3 + pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: DO Admission Date: 12/5/2022 Discharge Date: Dec 7, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? COVID-19 12/06/2022 Unknown ? COVID-19 virus infection 12/05/2022 Yes ? Acute cystitis 12/05/2022 Yes ? Chronic diastolic congestive heart failure (HCC) 12/05/2022 Yes ? Persistent atrial fibrillation (HCC) 11/12/2021 Yes ? Primary hypertension 11/01/2021 Yes ? Stage 3a chronic kidney disease (HCC) 11/01/2021 Yes ? History of deep vein thrombosis (DVT) of lower extremity 11/01/2021 Yes ? History of pulmonary embolus (PE) 11/01/2021 Yes ? Presence of IVC filter   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute cystitis without hematuria [N30.00] Upper respiratory tract infection, unspecified type [J06.9] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE:   Pt is a 96 yr old F presented from PCP's office for worsening cough. She was recently started on Lisinopril and dose had been increased. Also known to recently have COVID infection on 10/6/22. Workup in the ED showed stable vitals, low procalcitonin, normal WBC, film array positive for COVID and UA concerning for UTI.    Pt complained of congestion, low grade fevers, couth and dysuria. Empirically started on IV Rocephin for UTI. She was symptomatically managed from her presumed re-infection of COVID given her nasal congestion, worsening cough (though this could also be secondary to Lisinopril). Her lisinopril was discontinued.   Patient did well in the hospital- did not require oxygen. PT recommended Home. Son requested COVID viral load but unfortunately, this test is not currently available per my discussion with the COVID team. Son wasn't convinced patient had re-infection with COVID. It is difficulty to determine however, given nasal congestion and cough - it would be in patient's best interest to continue to monitor closely.   Patient felt well to discharge home on 12/07/2022 in the care of her family. She is discharged home in stable condition. Patient and son requested starting Losartan - this was prescribed after discussion of risks/benefits and I recommended that they monitor blood pressures closely. COVID and VTE prevention added onto to discharge instructions
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Hypoxia, Laboratory test
Clinical narrative: Patient with history of 4 COVID vaccines who admitted with hypoxia and COVID detected PCR.  Provider d/c note:  "Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures) treated for COVID-19 pneumonia, oxygenation gradually improved Acute Respiratory Failure due to COVID-19 pneumonia -clinically stable on 3 liters , labs stable, increase activity,prone positioning,  continue decadron, remdesivir day 4/5 - no known history of COPD or CHF - O2 saturation at 88% on RA, Initially needed 4 liter/nc, 96% with supplemental oxygen - dexamethasone, remdesivir, vitamin D3, remdesivir stopped on 11/29"
Age: 64.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient with history of 4 COVID vaccines who admitted with hypoxia and COVID detected PCR.  Provider d/c note:  "Brief Summary of Hospital Stay: (Include Significant Findings and Invasive Procedures) treated for COVID-19 pneumonia, oxygenation gradually improved Acute Respiratory Failure due to COVID-19 pneumonia -clinically stable on 3 liters , labs stable, increase activity,prone positioning,  continue decadron, remdesivir day 4/5 - no known history of COPD or CHF - O2 saturation at 88% on RA, Initially needed 4 liter/nc, 96% with supplemental oxygen - dexamethasone, remdesivir, vitamin D3, remdesivir stopped on 11/29"
Age: 50.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fatigue, Herpes zoster, Menstruation irregular, Myalgia, Nausea
Clinical narrative: Fatigue muscle aches and nausea 24 hours after dose and lasted 24 hours  Then I had 2 menstrual cycles 2 weeks apart.  I am normally very regular at every 26 days for my cycle.  I also had the shingles vaccine 4 days after this one. I am reporting for that 2.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19-2
Symptoms: Asymptomatic COVID-19, Exposure to SARS-CoV-2, Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: Patient up to date on COVID vaccines who tested detected for COVID during her stay.  Patients spouse had been visiting and called to report positive test.  Patient with sore throat at time. Received Remdesivir.  No hypoxia noted.  Asymptomatic at time of d/c.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Aspiration, Blood creatinine increased, Blood lactic acid, Blood urea increased, COVID-19
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Clostridium test, Communication disorder, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Culture urine positive, Diarrhoea, Drug withdrawal syndrome, Dysphagia, Dyspnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Endometrial thickening, General physical health deterioration, Hypophagia, Hyporesponsive to stimuli
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoxia, Lethargy, Leukocytosis, Lung disorder, Mental status changes
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal suctioning, Pneumonia, Procalcitonin, Proteus test positive, Pseudomonas test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Sepsis, Tachycardia, Tachypnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound pelvis abnormal, Urine analysis normal, Vaginal haemorrhage, Vomiting, White blood cell count increased
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 11/30/2022 Discharge Date: Dec 6, 2022 COVID positive date: 11/30/2022 PRESENTING PROBLEM: Severe sepsis (HCC)  Pneumonia due to organism    HOSPITAL COURSE: Patient is a 70-year-old female with PMH significant for CVA (02/2015) with right-sided weakness, type 2 diabetes, gastroparesis, neuropathy, GERD, dyslipidemia, chronic lower back pain, dysphagia, major depression, vascular dementia (patient is a long-term resident and has a guardian presents to the hospital 11/30 due to AMS, dyspnea and a COVID diagnosed about 9 days prior to presentation.  Patient had been slowly deteriorating, was noted to be hypoxic in the facility and was put on oxygen and was also noted to have decreased oral intake and decreased responsiveness.   In ER she was febrile 38.6, tachycardic 139, tachypneic 25 and hypoxic she was also lethargic and not very communicative.  Patient was started on broad-spectrum antibiotics Zosyn/vancomycin, imaging studies CT T/A/P showing-- bilateral airspace disease/pneumonia right greater than left, leukocytosis 14, BUN 36, creatinine 2, lactic acid 4.6 and procalcitonin 0.31.  COVID test was positive.  She was also noted to have a urinary tract infection.  Patient had 1 bilious emesis and needed nasopharyngeal suctioning in ER. EKG without ST-T changes and patient admitted for severe sepsis.   Patient admitted for severe sepsis related to pneumonia.  Aspiration was suspected, SLP evaluated and resumed dysphagia diet.  Dysphagia/aspiration precautions should continue. Zosyn/vancomycin was subsequently transitioned over to Rocephin/doxycycline to finish 5-6 day course.  Symptomatically improved.  Patient was able to wean down to room air.   There was a suspected urinary tract infection at the time of presentation, cultures growing Proteus and Pseudomonas, however urinalysis itself was not impressive and urinary tract infection was felt to be ruled out. Patient subsequently had watery profuse diarrhea, C difficile was negative, was felt to be related to opioid withdrawal.  Patient was noted  to be on fentanyl patch chronically but not initially validated at admit and hence was not continued.  This was resumed at half dosage at 25 mcg.   Patient was noted to have low-grade vaginal bleeding, pelvic ultrasound showed endometrial thickening, requested following up with Gynecology as outpatient.   I assumed care for the patient on day of discharge (12/6) - she felt well with improved breathing and denied any concerns including no difficulty with swallowing, chest pain, dyspnea, N/V, or abdominal pain. Pt had transport set up at 9:30 am per my colleague. Patient's glucose level was uptitrated.   She is discharged in stable condition.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Anticoagulant therapy, Computerised tomogram thorax abnormal, Dyspnoea, Exercise tolerance decreased
Clinical narrative: Initially right after the shot I had a bad stomach ache and headache including  a big egg on my arm I felt very lethargic and could not do my regular activities like exercise I began to have pain in both legs and calves with cramps on October 18 2022 after waking up and brushing my teeth I had a major panic attack including the inability to breath I went to het help and passed out I was taken by ambulance to the hospital. I had a CT scan of my lungs and multiple embolisms were found in both the upper and lower cavities. It was both extremely painful and difficult to breath. I was given Heparin in the Hospital and was switched to Eliquis. I am still experiencing extreme fatigue and daily activities are very difficult to manage and I am still not near where I was.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Fibrin D dimer, Headache, Lethargy, Loss of consciousness
Clinical narrative: Initially right after the shot I had a bad stomach ache and headache including  a big egg on my arm I felt very lethargic and could not do my regular activities like exercise I began to have pain in both legs and calves with cramps on October 18 2022 after waking up and brushing my teeth I had a major panic attack including the inability to breath I went to het help and passed out I was taken by ambulance to the hospital. I had a CT scan of my lungs and multiple embolisms were found in both the upper and lower cavities. It was both extremely painful and difficult to breath. I was given Heparin in the Hospital and was switched to Eliquis. I am still experiencing extreme fatigue and daily activities are very difficult to manage and I am still not near where I was.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of personal independence in daily activities, Muscle spasms, Pain in extremity, Painful respiration, Panic attack
Clinical narrative: Initially right after the shot I had a bad stomach ache and headache including  a big egg on my arm I felt very lethargic and could not do my regular activities like exercise I began to have pain in both legs and calves with cramps on October 18 2022 after waking up and brushing my teeth I had a major panic attack including the inability to breath I went to het help and passed out I was taken by ambulance to the hospital. I had a CT scan of my lungs and multiple embolisms were found in both the upper and lower cavities. It was both extremely painful and difficult to breath. I was given Heparin in the Hospital and was switched to Eliquis. I am still experiencing extreme fatigue and daily activities are very difficult to manage and I am still not near where I was.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, Pulmonary embolism, Troponin
Clinical narrative: Initially right after the shot I had a bad stomach ache and headache including  a big egg on my arm I felt very lethargic and could not do my regular activities like exercise I began to have pain in both legs and calves with cramps on October 18 2022 after waking up and brushing my teeth I had a major panic attack including the inability to breath I went to het help and passed out I was taken by ambulance to the hospital. I had a CT scan of my lungs and multiple embolisms were found in both the upper and lower cavities. It was both extremely painful and difficult to breath. I was given Heparin in the Hospital and was switched to Eliquis. I am still experiencing extreme fatigue and daily activities are very difficult to manage and I am still not near where I was.
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest X-ray normal, Computerised tomogram thorax normal, Dyspnoea, Intensive care
Clinical narrative: Patient with 2 COVID vaccines who admitted with COVID complications and positive COVID PCR.  Provider d/c note:  "Hospital Course: Young man with prior traumatic tracheostomy who recently underwent tracheal reconstruction surgery and was recently placed on anticoagulation for superficial thrombosis presents with tracheostomy bleeding and dyspnea from partial airway obstruction.  He was admitted to the PCU and treated with cool mist and nebulized therapy; his anticoagulation was stopped.  He was found to have acute COVID; CXR and CT chest were negative for PE or respiratory disease.  Given his airway threatening bleeding on anticoagulation for superficial thrombosis without evidence of deep thrombosis, it was recommended that his anticoagulation be stopped.  Patient improved and requested discharge to home to follow up with ENT in the next several days."
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Obstructive airways disorder, Post procedural haemorrhage, SARS-CoV-2 test positive
Clinical narrative: Patient with 2 COVID vaccines who admitted with COVID complications and positive COVID PCR.  Provider d/c note:  "Hospital Course: Young man with prior traumatic tracheostomy who recently underwent tracheal reconstruction surgery and was recently placed on anticoagulation for superficial thrombosis presents with tracheostomy bleeding and dyspnea from partial airway obstruction.  He was admitted to the PCU and treated with cool mist and nebulized therapy; his anticoagulation was stopped.  He was found to have acute COVID; CXR and CT chest were negative for PE or respiratory disease.  Given his airway threatening bleeding on anticoagulation for superficial thrombosis without evidence of deep thrombosis, it was recommended that his anticoagulation be stopped.  Patient improved and requested discharge to home to follow up with ENT in the next several days."
Age: 11.0
Sex: F
Vaccine: DTAP
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: patient is 11 y/o she was suppose to get TDap instead she got DTap.
Age: 0.5
Sex: M
Vaccine: COVID19, DTPPVHBHPB, FLU4, PNC13, RV5
Symptoms: Expired product administered
Clinical narrative: After administration of COVID vaccine, it was discovered that the vaccine had expired. Vaccine diluted 11/30/22 at 11:35AM, expired 11/30/22 at 11:35PM. Vaccine administered 12/1/22 at 8:50PM, approximately 9 hours and 20 min after expiration. Pfizer contacted for stability report. No further information available. Pfizer recommending communicating with their supply chain department as they may have further stability report. Dr. called and informed mom of event. Pt doing well, no adverse symptoms. Received word from supply chain department that they do not have stability reports to support effectiveness of vaccine.  Called and spoke with mom. Pt is doing well and does not appear to have any adverse symptoms from vaccine.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cataract operation, Hyperventilation, SARS-CoV-2 test positive
Clinical narrative: In the early afternoon September 25 as I sat with my grandson doing crafts, he told me he could hear me breathing. I took my temperature, and it was 99 so I tested at home for COVID-19. I was positive so I called the county to report the findings and the next few days were really bad. I feel like the vaccine did keep me from getting really sick. I called my doctor and they prescribed TESSALON PERLES, and they were concerned about my cataract surgery that I had on September 21,2022. I felt like I just had a case of the flu.
Age: 37.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event, Product administration error
Clinical narrative: no adverse event bur required to report error in administration dose and lot
Age: 78.0
Sex: M
Vaccine: VARZOS
Symptoms: Gait disturbance
Clinical narrative: He got his vaccine, he was fine, and the next day he could not walk.  He was trying to go for a walk and he was shuffling his feet.  He was not doing this prior to the vaccine.  The following day he was back to being able to walk better, but not back to where he was prior to the vaccine.  He is back to where he was prior to the vaccine.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: 10/30/22 presents to EC ED for "nausea and vomiting". PMHx of "asthma, diabetes,htn"
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: No adverse events, expired vaccine administered
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Sciatica
Clinical narrative: Acute sciatica, right buttock, 2.5 days
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fatigue, Pain in extremity
Clinical narrative: Sore arm 7 days Excessive tiredness 3 days
Age: 92.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Asthenia, COVID-19, COVID-19 pneumonia, Hypophagia
Clinical narrative: COVID+ 12/1/2022.  Vaccination Status - pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: NP Admission Date: 12/1/2022 Discharge Date: Dec 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 12/01/2022 Unknown ? Community acquired bacterial pneumonia 12/01/2022 Unknown  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Renal insufficiency Pneumonia due to COVID-19 virus  Sepsis due to pneumonia   HOSPITAL COURSE: The patient is a 92 yo woman with PMH of DM2 on insulin, COPD, stroke, HTN, CKD3b, and GERD who presented to the emergency department 12/1 after her daughter found her very lethargic at home with generalized weakness. The patient was admitted with COVID 19 pneumonia with superimposed RML of treated pneumonia.  She was placed on empiric IV ceftriaxone and azithromycin.  Sputum culture, urine strep antigen & Legionella.  Strep antigen came back positive. Since she improved significantly , she was sent home with 7 day prescription for amoxicillin.  She was evaluated by PT/OT who recommended home with home health, PT and OT. She also had AKI this admission due to poor PO intake  which improved with IV fluids . Lisinopril dose decreased to 20 mg dose from 40 mg daily dose due to AKI and soft BPs.  Patient was discharged in stable condition. CONSULTS / RECOMMENDATION: None
Age: 92.0
Sex: F
Vaccine: COVID19-2
Symptoms: Legionella test, Lethargy, Pneumonia, Pneumonia bacterial, Renal failure
Clinical narrative: COVID+ 12/1/2022.  Vaccination Status - pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: NP Admission Date: 12/1/2022 Discharge Date: Dec 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 12/01/2022 Unknown ? Community acquired bacterial pneumonia 12/01/2022 Unknown  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Renal insufficiency Pneumonia due to COVID-19 virus  Sepsis due to pneumonia   HOSPITAL COURSE: The patient is a 92 yo woman with PMH of DM2 on insulin, COPD, stroke, HTN, CKD3b, and GERD who presented to the emergency department 12/1 after her daughter found her very lethargic at home with generalized weakness. The patient was admitted with COVID 19 pneumonia with superimposed RML of treated pneumonia.  She was placed on empiric IV ceftriaxone and azithromycin.  Sputum culture, urine strep antigen & Legionella.  Strep antigen came back positive. Since she improved significantly , she was sent home with 7 day prescription for amoxicillin.  She was evaluated by PT/OT who recommended home with home health, PT and OT. She also had AKI this admission due to poor PO intake  which improved with IV fluids . Lisinopril dose decreased to 20 mg dose from 40 mg daily dose due to AKI and soft BPs.  Patient was discharged in stable condition. CONSULTS / RECOMMENDATION: None
Age: 92.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sepsis, Sputum culture, Streptococcus test positive, Superinfection
Clinical narrative: COVID+ 12/1/2022.  Vaccination Status - pfizer x3 + Pfizer BIVALENT BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: NP Admission Date: 12/1/2022 Discharge Date: Dec 4, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Pneumonia due to COVID-19 virus 12/01/2022 Unknown ? Community acquired bacterial pneumonia 12/01/2022 Unknown  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Renal insufficiency Pneumonia due to COVID-19 virus  Sepsis due to pneumonia   HOSPITAL COURSE: The patient is a 92 yo woman with PMH of DM2 on insulin, COPD, stroke, HTN, CKD3b, and GERD who presented to the emergency department 12/1 after her daughter found her very lethargic at home with generalized weakness. The patient was admitted with COVID 19 pneumonia with superimposed RML of treated pneumonia.  She was placed on empiric IV ceftriaxone and azithromycin.  Sputum culture, urine strep antigen & Legionella.  Strep antigen came back positive. Since she improved significantly , she was sent home with 7 day prescription for amoxicillin.  She was evaluated by PT/OT who recommended home with home health, PT and OT. She also had AKI this admission due to poor PO intake  which improved with IV fluids . Lisinopril dose decreased to 20 mg dose from 40 mg daily dose due to AKI and soft BPs.  Patient was discharged in stable condition. CONSULTS / RECOMMENDATION: None
Age: 17.0
Sex: F
Vaccine: COVID19, HEP, HPV9, IPV, MMR, TD, VARCEL
Symptoms: No adverse event
Clinical narrative: Minor previously received 1st dose in HC on 6/2/22 and second dose of vaccine on 11/7/22. Minor received a third dose on 12/7/2022. No adverse reaction
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Injection site pain, Muscle spasms, Neck pain
Clinical narrative: Acute muscle cramping and pain in left shoulder & neck
Age: 69.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: After exposure over a week, I felt sore throat & tested positive for Covid, developing cough too, Dr. prescribed Paxlovid 11/29, which I started taking that evening. Symptoms peaked 11/30, then declined. Felt better and tested negative 12/5.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Caesarean section, Exposure during pregnancy, Vaccine breakthrough infection
Clinical narrative: I had a breakthrough case of Covid, delivered by C-section at 39 weeks, caught Covid, had to start an albuterol until the baby was delivered.
Age: 34.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site pain, Injection site swelling
Clinical narrative: swelling and burning at injection next day
Age: 30.0
Sex: F
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Pt received 2nd dose of Pfizer bivalent vaccine.
Age: 52.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Headache, Nasal congestion, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: On 11/21/2022, I woke up with a scratchy throat and nasal congestion. I have allergies, so I have had these symptoms in the past and I assumed it was just that. It cleared up a bit throughout the day. I woke up on 11/22/2022, with the same symptoms but they were a lot more severe. I tested myself that morning for COVID-19 and it was positive. I was worried that my test may be old, so I tested again myself and it was positive. My primary care physician was on vacation and the urgent care clinic would not prescribe anything. I eventually was able to get in touch with a different doctor who set up a monoclonal antibody infusion on 11/22/2022. After that, my symptoms improved but I was still experiencing some bad congestion. I continued to test myself daily and tested negative on 11/25/2022. I tested negative again on 11/26/2022 and 11/27/2022. Overall, it all just felt like a bad head cold. I didn't get a cough or a bad fever or fatigue. Just some congestion and a mild headache at one point.
Age: 52.0
Sex: M
Vaccine: COVID19-2
Symptoms: Throat irritation
Clinical narrative: On 11/21/2022, I woke up with a scratchy throat and nasal congestion. I have allergies, so I have had these symptoms in the past and I assumed it was just that. It cleared up a bit throughout the day. I woke up on 11/22/2022, with the same symptoms but they were a lot more severe. I tested myself that morning for COVID-19 and it was positive. I was worried that my test may be old, so I tested again myself and it was positive. My primary care physician was on vacation and the urgent care clinic would not prescribe anything. I eventually was able to get in touch with a different doctor who set up a monoclonal antibody infusion on 11/22/2022. After that, my symptoms improved but I was still experiencing some bad congestion. I continued to test myself daily and tested negative on 11/25/2022. I tested negative again on 11/26/2022 and 11/27/2022. Overall, it all just felt like a bad head cold. I didn't get a cough or a bad fever or fatigue. Just some congestion and a mild headache at one point.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Alpha-1 anti-trypsin normal, Amyotrophic lateral sclerosis, Anti-NMDA antibody, Antibody test positive, Antinuclear antibody negative
Clinical narrative: Two days after he got his second Pfizer vaccination, he developed fasciculations in his left arm early April 2021. He sought a neurological exam, who sent him for a second opinion,  and he was diagnosed with motor neuron disease. Diagnosed with early onset ALS.  has developed anxiety and depression and cognitive issues.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Antiphospholipid antibodies negative, Anxiety, Blood cholesterol, Blood fibrinogen normal, CSF glucose normal
Clinical narrative: Two days after he got his second Pfizer vaccination, he developed fasciculations in his left arm early April 2021. He sought a neurological exam, who sent him for a second opinion,  and he was diagnosed with motor neuron disease. Diagnosed with early onset ALS.  has developed anxiety and depression and cognitive issues.