Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Blood fibrinogen increased, Blood gases abnormal, Blood lactic acid, Blood pH decreased, Blood pH increased
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 01/25, Pfizer, dose #1 02/16, Pfizer, dose #2 08/28 COVID swab, result: detected 08/28 CXR impression: Findings most compatible with multifocal-Covid pneumonia given the patient's history. 08/28 pt cc: headache, abdominal pain, diarrhea, chest pain exposure: unknown 08/28 SARS-COV-2 Variant Sequencing result: pending 08/28 ESR 16 08/28 TROPONIN I 0.023 08/28 PROCALCITONIN 0.06 08/28 CT ABD & PELVIS Impression: No acute finding in the abdomen and pelvis. 2. Patchy groundglass and reticular opacities in the visualized lung bases with peripheral predominance. Differential considerations include multifocal infection, including Covid infection. 08/28 PT/INR result: 14.2/1.27 09/01 FIBRINOGEN: 528 09/01 DDIMER: 0.84 09/01 ESR 8 09/01 CTA PE IMPRESSION: Negative study for pulmonary embolism. 2. Diffuse, patchy and confluent regions of bilateral lung opacification, most severely involving the upper lobes. In a patient with a history of positive COVID-19 infection findings are consistent with evolving COVID-19 pneumonia. 09/02 ESR 9 09/02 FIBRINOGEN: 449 09/02 DDIMER: 0.94 09/03 ESR 2 09/08 FIBRINOGEN: 281 09/08 DDIMER: 6.83 09/08 ESR 7 09/09 FIBRINOGEN: 300 09/09 DDIMER: 5.67 09/09 ESR 4 09/09 ABG result: i-pH 7.52, i-PC02 31.4, i-P02 73, I-HCO3 25.9 09/10 FIBRINOGEN: 331 09/10 DDIMER: 2.31 09/10 ESR 10 09/11 ESR 12 09/11 PROCALCITONIN <0.05 09/11 FIBRINOGEN 342 09/11 DDIMER 1.54 09/12 ESR 23 09/12 FERRITIN 582.1 09/12 CRP 4.674 09/13 ESR 29 09/13 FIBRINOGEN 469 09/13 FERRITIN 865.0 09/13 CXR impression: Similar appearance of a typical pneumonia/ARDS. 2. Similar mild cardiomegaly. 09/13 CRP 5.861 09/13 DDIMER 1.06 09/14 FIBRINOGEN: 645 09/14 DDIMER: 0.910 09/14 ESR 27 09/15 ABG result: i-pH 7.54, i-PC02 32.3, i-P02 44, i-HCO3 27.7 09/15 ESR result: 22 09/15 FIBRINOGEN result: 391 09/15 DDIMER result: 1.30 09/15 TROPONIN I result: 0.045 09/15 ABG result: i-pH 7.33, i-PC02 57.3, i-P02 67, i-HCO3 30.3 09/15 ABG result: i-pH 7.45, i-PC02 43.5, i-P02 57, i-HCO3 29.9 09/16 FIBRINOGEN: 515 09/16 DDIMER: 1.14 09/16 ESR 34 09/16 ABG result: i-pH 7.20 i-PC02 84.4, i-P02 77, i-HCO3 32.9 09/16 PNEUMOCYSTIS JIROVECHI result: NOT DETECTED 09/16 VIRAL RESP: RESULT Negative for Influenza virus, types A and B, Parainfluenza viruses 1,2 # 3, Adenovirus, and Respiratory Syncytial virus. Reference range: Negative 09/18 FIBRINOGEN: 449 09/18 DDIMER: 1.83 09/18 ESR 35 09/18 ABG result: i-pH 7.42, i-PC02 55.0, i-P02 67, i-HCO3 35.7 09/19 FIBRINOGEN: 308 09/19 DDIMER: 5.49 09/19 ESR 9 09/19 ABG result: i-pH 7.37, i-PC02 59.6, i-P02 70, i-HCO3 34.2 09/20 FIBRINOGEN: 198 09/20 DDIMER: 14.48 09/20 ESR 4 09/20 ABG result: i-pH 7.34, i-PC02 68.4, i-P02 66, i-HCO3 37.3 09/20 ABG result: i-pH 7.22, i-PC02 96.5, i-P02 79, i-HCO3 39.8 09/20 CXR impression: No significant interval change. 09/21 FIBRINOGEN: 160 09/21 DDIMER: 14.96 09/21 ESR 4 09/21 ABG result: i-pH 7.36, i-PC02 63.7, i-P02 5, i-HCO3 36.3 09/21 CXR impression: No significant interval change. 09/22 FIBRINOGEN: 145 09/22 CXR impression: No significant change. 09/22DDIMER: 3.72 09/22 ESR 1 09/22 ABG result: i-pH 7.40, i-PC02 61.5, i-P02 73, i-HCO3 37.8 09/22 abdomen US impression: Nonobstructive bowel gas pattern. 09/23 ABG result: i-pH 7.31, i-PC02 72.9, i-P02 76, i-HCO3 36.6 09/23 FIBRINOGEN: 149 09/23 DDIMER: 4.03 09/23 ESR 2 09/23 LACTIC ACID result: 1.86 09/24 ESR result: 5 09/24 ABG result: i-pH 7.33, i-PC02 69.5, i-P02 58, i-HCO3 35.4 09/24 ABG result: i-pH 7.30, i-PC02 81.9, i-P02 48, i-HCO3 40.2 09/24 CXR impression: Stable chest radiography since 2 days ago as above. 09/24 pt deceased