chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Central venous catheterisation, Chest X-ray abnormal
Clinical narrative: Narrative:  Admission Date: Oct 13,2021 Discharge Date: Oct 17,2021 Condition of patient at discharge: Deceased Primary Diagnosis during Admission/Treatment: COVID Pneumonia Secondary Diagnosis(es) during Admission/Treatment: Severe COPD, bacterial pneumonia 69yo male with past medical history of COPD (on 3L 02 at home), CAD s/p high risk PCI (1/14/20), HTN, HLD, PVD, CKD, hypothyroidism, tobacco abuse, depression and alcohol abuse presented to the Emergency Department with dyspnea and lightheadedness on 10/12/2021. Patient stated he has become progressively more dyspneic over the previous 48 hrs. EMS was called with reported sats in the 70's on arrival. Endorsed increased cough productive of green sputum, usually clear. Denies any fevers, chills, chest pain, wheezing, sick contacts, N/V, abdominal pain, leg pain/swelling, or diarrhea. In the Emergency Department, patient was afebrile, HR 104, RR 20, BP 81/58. Labs notable for WBC 10.88 with left shift, Cr 2.14 (b/l ~ 1.4), BNP 688, trop 0.3, lactic acid 0.9, COVID positive. Patient had received 2 doses of the moderna vaccine on 1/14/2021 and 2/11/2021 . CXR notable for left lung opacity suspicious for Pneumonia. Blood cx drawn in ED. Given 2L IVFs and started on cefepime and azithromycin. The patient was admitted 10/13/2021 for respiratory failure secondary to COPD exacerbation in addition to COVID Pneumonia and likely superimposed bacterial pneumonia given consolidative process on imaging with elevated procal to 5.81. Patient was started on broad spectrum antibiotics with cefepime and azithromycin and was further broadened to vancomycin and meropenem due to worsening respiratory status. Infectious workup including blood cultures were unremarkable. Started on treatment dose lovenox 80mg twice given concern for PE with elevated d-dimer and RLE DVT on doppler ultrasound. Patient was initially stable on nasal cannula, but had to be escalated to HFNC due to worsening oxygen requirements. Unfortunately, patient's respiratory status continued to decline despite substantial support in addition to worsening shock and levophed was used for blood pressure support. Patient became obtunded and developed worsening respiratory distress warranting consideration for intubation. Talked to next of kin who ultimately decided for comfort care due to declining status. Patient passed on 10/17/21 at 12:28pm. Symptoms:  & HOSPITALIZATION and DEATH from COVID pneumonia in fully vaccinated patient Treatment:
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Death, Deep vein thrombosis, Depressed level of consciousness
Clinical narrative: Narrative:  Admission Date: Oct 13,2021 Discharge Date: Oct 17,2021 Condition of patient at discharge: Deceased Primary Diagnosis during Admission/Treatment: COVID Pneumonia Secondary Diagnosis(es) during Admission/Treatment: Severe COPD, bacterial pneumonia 69yo male with past medical history of COPD (on 3L 02 at home), CAD s/p high risk PCI (1/14/20), HTN, HLD, PVD, CKD, hypothyroidism, tobacco abuse, depression and alcohol abuse presented to the Emergency Department with dyspnea and lightheadedness on 10/12/2021. Patient stated he has become progressively more dyspneic over the previous 48 hrs. EMS was called with reported sats in the 70's on arrival. Endorsed increased cough productive of green sputum, usually clear. Denies any fevers, chills, chest pain, wheezing, sick contacts, N/V, abdominal pain, leg pain/swelling, or diarrhea. In the Emergency Department, patient was afebrile, HR 104, RR 20, BP 81/58. Labs notable for WBC 10.88 with left shift, Cr 2.14 (b/l ~ 1.4), BNP 688, trop 0.3, lactic acid 0.9, COVID positive. Patient had received 2 doses of the moderna vaccine on 1/14/2021 and 2/11/2021 . CXR notable for left lung opacity suspicious for Pneumonia. Blood cx drawn in ED. Given 2L IVFs and started on cefepime and azithromycin. The patient was admitted 10/13/2021 for respiratory failure secondary to COPD exacerbation in addition to COVID Pneumonia and likely superimposed bacterial pneumonia given consolidative process on imaging with elevated procal to 5.81. Patient was started on broad spectrum antibiotics with cefepime and azithromycin and was further broadened to vancomycin and meropenem due to worsening respiratory status. Infectious workup including blood cultures were unremarkable. Started on treatment dose lovenox 80mg twice given concern for PE with elevated d-dimer and RLE DVT on doppler ultrasound. Patient was initially stable on nasal cannula, but had to be escalated to HFNC due to worsening oxygen requirements. Unfortunately, patient's respiratory status continued to decline despite substantial support in addition to worsening shock and levophed was used for blood pressure support. Patient became obtunded and developed worsening respiratory distress warranting consideration for intubation. Talked to next of kin who ultimately decided for comfort care due to declining status. Patient passed on 10/17/21 at 12:28pm. Symptoms:  & HOSPITALIZATION and DEATH from COVID pneumonia in fully vaccinated patient Treatment:
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dizziness, Dyspnoea, Fibrin D dimer increased, Hypoxia, Laboratory test normal
Clinical narrative: Narrative:  Admission Date: Oct 13,2021 Discharge Date: Oct 17,2021 Condition of patient at discharge: Deceased Primary Diagnosis during Admission/Treatment: COVID Pneumonia Secondary Diagnosis(es) during Admission/Treatment: Severe COPD, bacterial pneumonia 69yo male with past medical history of COPD (on 3L 02 at home), CAD s/p high risk PCI (1/14/20), HTN, HLD, PVD, CKD, hypothyroidism, tobacco abuse, depression and alcohol abuse presented to the Emergency Department with dyspnea and lightheadedness on 10/12/2021. Patient stated he has become progressively more dyspneic over the previous 48 hrs. EMS was called with reported sats in the 70's on arrival. Endorsed increased cough productive of green sputum, usually clear. Denies any fevers, chills, chest pain, wheezing, sick contacts, N/V, abdominal pain, leg pain/swelling, or diarrhea. In the Emergency Department, patient was afebrile, HR 104, RR 20, BP 81/58. Labs notable for WBC 10.88 with left shift, Cr 2.14 (b/l ~ 1.4), BNP 688, trop 0.3, lactic acid 0.9, COVID positive. Patient had received 2 doses of the moderna vaccine on 1/14/2021 and 2/11/2021 . CXR notable for left lung opacity suspicious for Pneumonia. Blood cx drawn in ED. Given 2L IVFs and started on cefepime and azithromycin. The patient was admitted 10/13/2021 for respiratory failure secondary to COPD exacerbation in addition to COVID Pneumonia and likely superimposed bacterial pneumonia given consolidative process on imaging with elevated procal to 5.81. Patient was started on broad spectrum antibiotics with cefepime and azithromycin and was further broadened to vancomycin and meropenem due to worsening respiratory status. Infectious workup including blood cultures were unremarkable. Started on treatment dose lovenox 80mg twice given concern for PE with elevated d-dimer and RLE DVT on doppler ultrasound. Patient was initially stable on nasal cannula, but had to be escalated to HFNC due to worsening oxygen requirements. Unfortunately, patient's respiratory status continued to decline despite substantial support in addition to worsening shock and levophed was used for blood pressure support. Patient became obtunded and developed worsening respiratory distress warranting consideration for intubation. Talked to next of kin who ultimately decided for comfort care due to declining status. Patient passed on 10/17/21 at 12:28pm. Symptoms:  & HOSPITALIZATION and DEATH from COVID pneumonia in fully vaccinated patient Treatment:
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung consolidation, Lung infiltration, Lung opacity, Pleural effusion, Pneumonia bacterial
Clinical narrative: Narrative:  Admission Date: Oct 13,2021 Discharge Date: Oct 17,2021 Condition of patient at discharge: Deceased Primary Diagnosis during Admission/Treatment: COVID Pneumonia Secondary Diagnosis(es) during Admission/Treatment: Severe COPD, bacterial pneumonia 69yo male with past medical history of COPD (on 3L 02 at home), CAD s/p high risk PCI (1/14/20), HTN, HLD, PVD, CKD, hypothyroidism, tobacco abuse, depression and alcohol abuse presented to the Emergency Department with dyspnea and lightheadedness on 10/12/2021. Patient stated he has become progressively more dyspneic over the previous 48 hrs. EMS was called with reported sats in the 70's on arrival. Endorsed increased cough productive of green sputum, usually clear. Denies any fevers, chills, chest pain, wheezing, sick contacts, N/V, abdominal pain, leg pain/swelling, or diarrhea. In the Emergency Department, patient was afebrile, HR 104, RR 20, BP 81/58. Labs notable for WBC 10.88 with left shift, Cr 2.14 (b/l ~ 1.4), BNP 688, trop 0.3, lactic acid 0.9, COVID positive. Patient had received 2 doses of the moderna vaccine on 1/14/2021 and 2/11/2021 . CXR notable for left lung opacity suspicious for Pneumonia. Blood cx drawn in ED. Given 2L IVFs and started on cefepime and azithromycin. The patient was admitted 10/13/2021 for respiratory failure secondary to COPD exacerbation in addition to COVID Pneumonia and likely superimposed bacterial pneumonia given consolidative process on imaging with elevated procal to 5.81. Patient was started on broad spectrum antibiotics with cefepime and azithromycin and was further broadened to vancomycin and meropenem due to worsening respiratory status. Infectious workup including blood cultures were unremarkable. Started on treatment dose lovenox 80mg twice given concern for PE with elevated d-dimer and RLE DVT on doppler ultrasound. Patient was initially stable on nasal cannula, but had to be escalated to HFNC due to worsening oxygen requirements. Unfortunately, patient's respiratory status continued to decline despite substantial support in addition to worsening shock and levophed was used for blood pressure support. Patient became obtunded and developed worsening respiratory distress warranting consideration for intubation. Talked to next of kin who ultimately decided for comfort care due to declining status. Patient passed on 10/17/21 at 12:28pm. Symptoms:  & HOSPITALIZATION and DEATH from COVID pneumonia in fully vaccinated patient Treatment:
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Procalcitonin, Productive cough, Pulmonary oedema, Respiratory distress, Respiratory failure
Clinical narrative: Narrative:  Admission Date: Oct 13,2021 Discharge Date: Oct 17,2021 Condition of patient at discharge: Deceased Primary Diagnosis during Admission/Treatment: COVID Pneumonia Secondary Diagnosis(es) during Admission/Treatment: Severe COPD, bacterial pneumonia 69yo male with past medical history of COPD (on 3L 02 at home), CAD s/p high risk PCI (1/14/20), HTN, HLD, PVD, CKD, hypothyroidism, tobacco abuse, depression and alcohol abuse presented to the Emergency Department with dyspnea and lightheadedness on 10/12/2021. Patient stated he has become progressively more dyspneic over the previous 48 hrs. EMS was called with reported sats in the 70's on arrival. Endorsed increased cough productive of green sputum, usually clear. Denies any fevers, chills, chest pain, wheezing, sick contacts, N/V, abdominal pain, leg pain/swelling, or diarrhea. In the Emergency Department, patient was afebrile, HR 104, RR 20, BP 81/58. Labs notable for WBC 10.88 with left shift, Cr 2.14 (b/l ~ 1.4), BNP 688, trop 0.3, lactic acid 0.9, COVID positive. Patient had received 2 doses of the moderna vaccine on 1/14/2021 and 2/11/2021 . CXR notable for left lung opacity suspicious for Pneumonia. Blood cx drawn in ED. Given 2L IVFs and started on cefepime and azithromycin. The patient was admitted 10/13/2021 for respiratory failure secondary to COPD exacerbation in addition to COVID Pneumonia and likely superimposed bacterial pneumonia given consolidative process on imaging with elevated procal to 5.81. Patient was started on broad spectrum antibiotics with cefepime and azithromycin and was further broadened to vancomycin and meropenem due to worsening respiratory status. Infectious workup including blood cultures were unremarkable. Started on treatment dose lovenox 80mg twice given concern for PE with elevated d-dimer and RLE DVT on doppler ultrasound. Patient was initially stable on nasal cannula, but had to be escalated to HFNC due to worsening oxygen requirements. Unfortunately, patient's respiratory status continued to decline despite substantial support in addition to worsening shock and levophed was used for blood pressure support. Patient became obtunded and developed worsening respiratory distress warranting consideration for intubation. Talked to next of kin who ultimately decided for comfort care due to declining status. Patient passed on 10/17/21 at 12:28pm. Symptoms:  & HOSPITALIZATION and DEATH from COVID pneumonia in fully vaccinated patient Treatment:
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Shift to the left, Shock, Sputum discoloured, Superinfection
Clinical narrative: Narrative:  Admission Date: Oct 13,2021 Discharge Date: Oct 17,2021 Condition of patient at discharge: Deceased Primary Diagnosis during Admission/Treatment: COVID Pneumonia Secondary Diagnosis(es) during Admission/Treatment: Severe COPD, bacterial pneumonia 69yo male with past medical history of COPD (on 3L 02 at home), CAD s/p high risk PCI (1/14/20), HTN, HLD, PVD, CKD, hypothyroidism, tobacco abuse, depression and alcohol abuse presented to the Emergency Department with dyspnea and lightheadedness on 10/12/2021. Patient stated he has become progressively more dyspneic over the previous 48 hrs. EMS was called with reported sats in the 70's on arrival. Endorsed increased cough productive of green sputum, usually clear. Denies any fevers, chills, chest pain, wheezing, sick contacts, N/V, abdominal pain, leg pain/swelling, or diarrhea. In the Emergency Department, patient was afebrile, HR 104, RR 20, BP 81/58. Labs notable for WBC 10.88 with left shift, Cr 2.14 (b/l ~ 1.4), BNP 688, trop 0.3, lactic acid 0.9, COVID positive. Patient had received 2 doses of the moderna vaccine on 1/14/2021 and 2/11/2021 . CXR notable for left lung opacity suspicious for Pneumonia. Blood cx drawn in ED. Given 2L IVFs and started on cefepime and azithromycin. The patient was admitted 10/13/2021 for respiratory failure secondary to COPD exacerbation in addition to COVID Pneumonia and likely superimposed bacterial pneumonia given consolidative process on imaging with elevated procal to 5.81. Patient was started on broad spectrum antibiotics with cefepime and azithromycin and was further broadened to vancomycin and meropenem due to worsening respiratory status. Infectious workup including blood cultures were unremarkable. Started on treatment dose lovenox 80mg twice given concern for PE with elevated d-dimer and RLE DVT on doppler ultrasound. Patient was initially stable on nasal cannula, but had to be escalated to HFNC due to worsening oxygen requirements. Unfortunately, patient's respiratory status continued to decline despite substantial support in addition to worsening shock and levophed was used for blood pressure support. Patient became obtunded and developed worsening respiratory distress warranting consideration for intubation. Talked to next of kin who ultimately decided for comfort care due to declining status. Patient passed on 10/17/21 at 12:28pm. Symptoms:  & HOSPITALIZATION and DEATH from COVID pneumonia in fully vaccinated patient Treatment:
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Troponin increased, Ultrasound Doppler abnormal, White blood cell count increased
Clinical narrative: Narrative:  Admission Date: Oct 13,2021 Discharge Date: Oct 17,2021 Condition of patient at discharge: Deceased Primary Diagnosis during Admission/Treatment: COVID Pneumonia Secondary Diagnosis(es) during Admission/Treatment: Severe COPD, bacterial pneumonia 69yo male with past medical history of COPD (on 3L 02 at home), CAD s/p high risk PCI (1/14/20), HTN, HLD, PVD, CKD, hypothyroidism, tobacco abuse, depression and alcohol abuse presented to the Emergency Department with dyspnea and lightheadedness on 10/12/2021. Patient stated he has become progressively more dyspneic over the previous 48 hrs. EMS was called with reported sats in the 70's on arrival. Endorsed increased cough productive of green sputum, usually clear. Denies any fevers, chills, chest pain, wheezing, sick contacts, N/V, abdominal pain, leg pain/swelling, or diarrhea. In the Emergency Department, patient was afebrile, HR 104, RR 20, BP 81/58. Labs notable for WBC 10.88 with left shift, Cr 2.14 (b/l ~ 1.4), BNP 688, trop 0.3, lactic acid 0.9, COVID positive. Patient had received 2 doses of the moderna vaccine on 1/14/2021 and 2/11/2021 . CXR notable for left lung opacity suspicious for Pneumonia. Blood cx drawn in ED. Given 2L IVFs and started on cefepime and azithromycin. The patient was admitted 10/13/2021 for respiratory failure secondary to COPD exacerbation in addition to COVID Pneumonia and likely superimposed bacterial pneumonia given consolidative process on imaging with elevated procal to 5.81. Patient was started on broad spectrum antibiotics with cefepime and azithromycin and was further broadened to vancomycin and meropenem due to worsening respiratory status. Infectious workup including blood cultures were unremarkable. Started on treatment dose lovenox 80mg twice given concern for PE with elevated d-dimer and RLE DVT on doppler ultrasound. Patient was initially stable on nasal cannula, but had to be escalated to HFNC due to worsening oxygen requirements. Unfortunately, patient's respiratory status continued to decline despite substantial support in addition to worsening shock and levophed was used for blood pressure support. Patient became obtunded and developed worsening respiratory distress warranting consideration for intubation. Talked to next of kin who ultimately decided for comfort care due to declining status. Patient passed on 10/17/21 at 12:28pm. Symptoms:  & HOSPITALIZATION and DEATH from COVID pneumonia in fully vaccinated patient Treatment:
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Alcohol use, Antisocial personality disorder, COVID-19, Drug abuse, Major depression
Clinical narrative: Narrative:  61yr male admitted to hospital for MH crisis and tested positive for COVID-19. Was asymptomatic for COVID-19 on admission though was placed on COVID ward due to test result. Did not require any COVID therapeutics during admission; hospitalization course was 3 days. PMH: history of antisocial personality disorder, MDD w/ prior suicide attempts, PTSD, polysubstance use who presents with suicidal ideation in the setting of cocaine and alcohol use. COVID Vaccination Status: Moderna 3/2 and Moderna 6/28 (~3.5 months time interval lapse between dose series)  Symptoms:   & COVID-19 infection Treatment:
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Mental disorder, SARS-CoV-2 test positive, Suicidal ideation
Clinical narrative: Narrative:  61yr male admitted to hospital for MH crisis and tested positive for COVID-19. Was asymptomatic for COVID-19 on admission though was placed on COVID ward due to test result. Did not require any COVID therapeutics during admission; hospitalization course was 3 days. PMH: history of antisocial personality disorder, MDD w/ prior suicide attempts, PTSD, polysubstance use who presents with suicidal ideation in the setting of cocaine and alcohol use. COVID Vaccination Status: Moderna 3/2 and Moderna 6/28 (~3.5 months time interval lapse between dose series)  Symptoms:   & COVID-19 infection Treatment:
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chills, Cough, Fatigue, Pyrexia
Clinical narrative: Narrative:  74yr patient hospitalized who was COVID symptomatic requiring oxygen supplementation in the ED at 2L via NC quickly escalated overnight to 5L NC. Initiated on dexamethasone plus remdesivir upon admission. Oxygen supplementation continued to escalate to HFNC; airvo 40L and 50%, spo2 90% by day 2 in ICU; baricitinib 4mg was started. Oxygen supplementation slowly was de-escalated by day 14 of hospitalization. Completed remdesivir course and received 9 doses of barcitinib before therapy was d'ced due to clinical improvement. Was discharged at day 15 with home oxygen at 2L NC keep o2 >90% along with respiratory therapy follow up. PMH: T2DM on meds (po metformin), OAB, Dyslipidemia COVID Vaccination Status: Pfizer x 2 (Feb 21 and March 21 at facility) Symptoms:   Fever, CoughWheeze & decrease taste, chills, fatigue Treatment:   REMDESIVIR 100 MG EVERY DAY ,DEXAMETHASONE 6 MG EVERY DAY ,BARICITINIB 4 MG EVERY DAY
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Taste disorder, Wheezing
Clinical narrative: Narrative:  74yr patient hospitalized who was COVID symptomatic requiring oxygen supplementation in the ED at 2L via NC quickly escalated overnight to 5L NC. Initiated on dexamethasone plus remdesivir upon admission. Oxygen supplementation continued to escalate to HFNC; airvo 40L and 50%, spo2 90% by day 2 in ICU; baricitinib 4mg was started. Oxygen supplementation slowly was de-escalated by day 14 of hospitalization. Completed remdesivir course and received 9 doses of barcitinib before therapy was d'ced due to clinical improvement. Was discharged at day 15 with home oxygen at 2L NC keep o2 >90% along with respiratory therapy follow up. PMH: T2DM on meds (po metformin), OAB, Dyslipidemia COVID Vaccination Status: Pfizer x 2 (Feb 21 and March 21 at facility) Symptoms:   Fever, CoughWheeze & decrease taste, chills, fatigue Treatment:   REMDESIVIR 100 MG EVERY DAY ,DEXAMETHASONE 6 MG EVERY DAY ,BARICITINIB 4 MG EVERY DAY
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Anticoagulant therapy, Atelectasis, Atrial fibrillation
Clinical narrative: Narrative:  Admission 10/9/2021 Discharge 10/15/2021. 58y M with history of beta-thalassemia trait, atrial fib/flutter (not on oral anticoagulation), OSA, COPD, COVID-19 Pneumonia in 12/2020 complicated by cryptogenic organizing pneumonia and presumed COVID related auto-immune hemolytic anemia presenting to the Emergency  Department for worsening cough, dyspnea, and hypoxia in setting of active COVID infection. He tested positive for COVID despite being vaccinated three times: 3/17/21, 4/8/21, 8/31/21 with negative antibody response perhaps not surprising in the setting of weekly Rituximab x 4 in July 2021. CT imaging with worsening diffuse bilateral interstitial and groundglass opacities worse than previous. Negative for PE. Admitted to ICU for AHRF and Afib w/ RVR. He received remdesivir, high dose prednisone and enoxparin as described above. He was ultimately discharged on 10/15/2021 with home O2 - 4L oxygen.  Symptoms:  & HOSPITALIZATION FOR COVID DESPITE FULL VACCINATION AND BOOSTER
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Narrative:  Admission 10/9/2021 Discharge 10/15/2021. 58y M with history of beta-thalassemia trait, atrial fib/flutter (not on oral anticoagulation), OSA, COPD, COVID-19 Pneumonia in 12/2020 complicated by cryptogenic organizing pneumonia and presumed COVID related auto-immune hemolytic anemia presenting to the Emergency  Department for worsening cough, dyspnea, and hypoxia in setting of active COVID infection. He tested positive for COVID despite being vaccinated three times: 3/17/21, 4/8/21, 8/31/21 with negative antibody response perhaps not surprising in the setting of weekly Rituximab x 4 in July 2021. CT imaging with worsening diffuse bilateral interstitial and groundglass opacities worse than previous. Negative for PE. Admitted to ICU for AHRF and Afib w/ RVR. He received remdesivir, high dose prednisone and enoxparin as described above. He was ultimately discharged on 10/15/2021 with home O2 - 4L oxygen.  Symptoms:  & HOSPITALIZATION FOR COVID DESPITE FULL VACCINATION AND BOOSTER
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hypoxia, Imaging procedure artifact, Intensive care, Lung opacity, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Admission 10/9/2021 Discharge 10/15/2021. 58y M with history of beta-thalassemia trait, atrial fib/flutter (not on oral anticoagulation), OSA, COPD, COVID-19 Pneumonia in 12/2020 complicated by cryptogenic organizing pneumonia and presumed COVID related auto-immune hemolytic anemia presenting to the Emergency  Department for worsening cough, dyspnea, and hypoxia in setting of active COVID infection. He tested positive for COVID despite being vaccinated three times: 3/17/21, 4/8/21, 8/31/21 with negative antibody response perhaps not surprising in the setting of weekly Rituximab x 4 in July 2021. CT imaging with worsening diffuse bilateral interstitial and groundglass opacities worse than previous. Negative for PE. Admitted to ICU for AHRF and Afib w/ RVR. He received remdesivir, high dose prednisone and enoxparin as described above. He was ultimately discharged on 10/15/2021 with home O2 - 4L oxygen.  Symptoms:  & HOSPITALIZATION FOR COVID DESPITE FULL VACCINATION AND BOOSTER
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Scan with contrast abnormal
Clinical narrative: Narrative:  Admission 10/9/2021 Discharge 10/15/2021. 58y M with history of beta-thalassemia trait, atrial fib/flutter (not on oral anticoagulation), OSA, COPD, COVID-19 Pneumonia in 12/2020 complicated by cryptogenic organizing pneumonia and presumed COVID related auto-immune hemolytic anemia presenting to the Emergency  Department for worsening cough, dyspnea, and hypoxia in setting of active COVID infection. He tested positive for COVID despite being vaccinated three times: 3/17/21, 4/8/21, 8/31/21 with negative antibody response perhaps not surprising in the setting of weekly Rituximab x 4 in July 2021. CT imaging with worsening diffuse bilateral interstitial and groundglass opacities worse than previous. Negative for PE. Admitted to ICU for AHRF and Afib w/ RVR. He received remdesivir, high dose prednisone and enoxparin as described above. He was ultimately discharged on 10/15/2021 with home O2 - 4L oxygen.  Symptoms:  & HOSPITALIZATION FOR COVID DESPITE FULL VACCINATION AND BOOSTER
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myocardial infarction, Asthenia, Blood glucose increased, Bradycardia, Brain injury
Clinical narrative: Narrative:  87 yo M with h/o CAD s/p CABG (2012) and PCI (2018), severe AS s/p TAVR (2019), A-Fib (on apixaban), Factor V Leiden with DVT/PEs, SCC of lung s/p R upper lobe lobectomy (2015), COPD, DM2, and hypothyroidism. On 9/23/21, patient's Home Based Primary Care Nurse Practitioner visited his home for a checkup and noted that he was in a worse state of health than his baseline. Per note, "Primarily today he is dehydrated, hypotensive, tachypneic and tachycardic. He has been having worsened hyperglycemia and has been becoming more forgetful. has been too weak to eat or participate in ADLs or take meds since at least yesterday." Patient advised to go to ER. Patient presented to the agency ED the same day. In ED, patient was found to have newly reduced EF so taken to cath lab for NSTEMI. In the cath lab, patient went into cardiac arrest (PEA), an Impella was placed during the procedure. Patient was intubated, ROSC was eventually obtained and patient was transferred to the MSICU in critical condition. Per the 9/24/21 Medicine Discharge Summary: "In the MSCIU, patient was initially tenuously stable but then decompensated due to a probably internal bleed and groin hematoma, Hgb dropped from 12 to 6.5. Patient received IVF, was somewhat fluid responsive but no way to stop any coagulopathy and likely retroperitoneal bleeding due to the presence of the Impella (procoagulants would likely clot it off). Transfusion would be futile as bleeding could not be controlled." "MAPs downtrended down to the 30s and in the setting of poor organ perfusion, anoxic brain injury, and no further interventions that could improve patient status, the decision was made to make patient DNR and not initiate another code blue. MAPs decreased to 10s and patient eventually became bradycardic and eventually reached asystole." Patient's time of death was Sep 24,2021@00:41. Per Death note, immediate cause of death is listed as "acute non-ST elevation myocardial infarction." Of note, patient recently completed his COVID vaccination series. He received the Pfizer vaccines on 8/18/21 and 9/8/21. No known COVID contacts and covid-19 negative per test on 9/23/21. Unclear correlation between patient's passing and covid-19 vaccination. Reporting given proximity of the patient's death and COVID-19 vaccination. Symptoms:  Tachypnea, Tachycardia, HYPERglycemia & Dyspnea; NSTEMI; hospitalization Treatment:  EPINEPHRINE SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=16,000ng/ml; drip , VASOPRESSIN SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=0.24units/ml; drip
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide increased, Cardiac arrest, Cardiac failure, Coagulopathy, Death
Clinical narrative: Narrative:  87 yo M with h/o CAD s/p CABG (2012) and PCI (2018), severe AS s/p TAVR (2019), A-Fib (on apixaban), Factor V Leiden with DVT/PEs, SCC of lung s/p R upper lobe lobectomy (2015), COPD, DM2, and hypothyroidism. On 9/23/21, patient's Home Based Primary Care Nurse Practitioner visited his home for a checkup and noted that he was in a worse state of health than his baseline. Per note, "Primarily today he is dehydrated, hypotensive, tachypneic and tachycardic. He has been having worsened hyperglycemia and has been becoming more forgetful. has been too weak to eat or participate in ADLs or take meds since at least yesterday." Patient advised to go to ER. Patient presented to the agency ED the same day. In ED, patient was found to have newly reduced EF so taken to cath lab for NSTEMI. In the cath lab, patient went into cardiac arrest (PEA), an Impella was placed during the procedure. Patient was intubated, ROSC was eventually obtained and patient was transferred to the MSICU in critical condition. Per the 9/24/21 Medicine Discharge Summary: "In the MSCIU, patient was initially tenuously stable but then decompensated due to a probably internal bleed and groin hematoma, Hgb dropped from 12 to 6.5. Patient received IVF, was somewhat fluid responsive but no way to stop any coagulopathy and likely retroperitoneal bleeding due to the presence of the Impella (procoagulants would likely clot it off). Transfusion would be futile as bleeding could not be controlled." "MAPs downtrended down to the 30s and in the setting of poor organ perfusion, anoxic brain injury, and no further interventions that could improve patient status, the decision was made to make patient DNR and not initiate another code blue. MAPs decreased to 10s and patient eventually became bradycardic and eventually reached asystole." Patient's time of death was Sep 24,2021@00:41. Per Death note, immediate cause of death is listed as "acute non-ST elevation myocardial infarction." Of note, patient recently completed his COVID vaccination series. He received the Pfizer vaccines on 8/18/21 and 9/8/21. No known COVID contacts and covid-19 negative per test on 9/23/21. Unclear correlation between patient's passing and covid-19 vaccination. Reporting given proximity of the patient's death and COVID-19 vaccination. Symptoms:  Tachypnea, Tachycardia, HYPERglycemia & Dyspnea; NSTEMI; hospitalization Treatment:  EPINEPHRINE SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=16,000ng/ml; drip , VASOPRESSIN SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=0.24units/ml; drip
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dehydration, Ejection fraction decreased, Endotracheal intubation, Feeding disorder, General physical health deterioration
Clinical narrative: Narrative:  87 yo M with h/o CAD s/p CABG (2012) and PCI (2018), severe AS s/p TAVR (2019), A-Fib (on apixaban), Factor V Leiden with DVT/PEs, SCC of lung s/p R upper lobe lobectomy (2015), COPD, DM2, and hypothyroidism. On 9/23/21, patient's Home Based Primary Care Nurse Practitioner visited his home for a checkup and noted that he was in a worse state of health than his baseline. Per note, "Primarily today he is dehydrated, hypotensive, tachypneic and tachycardic. He has been having worsened hyperglycemia and has been becoming more forgetful. has been too weak to eat or participate in ADLs or take meds since at least yesterday." Patient advised to go to ER. Patient presented to the agency ED the same day. In ED, patient was found to have newly reduced EF so taken to cath lab for NSTEMI. In the cath lab, patient went into cardiac arrest (PEA), an Impella was placed during the procedure. Patient was intubated, ROSC was eventually obtained and patient was transferred to the MSICU in critical condition. Per the 9/24/21 Medicine Discharge Summary: "In the MSCIU, patient was initially tenuously stable but then decompensated due to a probably internal bleed and groin hematoma, Hgb dropped from 12 to 6.5. Patient received IVF, was somewhat fluid responsive but no way to stop any coagulopathy and likely retroperitoneal bleeding due to the presence of the Impella (procoagulants would likely clot it off). Transfusion would be futile as bleeding could not be controlled." "MAPs downtrended down to the 30s and in the setting of poor organ perfusion, anoxic brain injury, and no further interventions that could improve patient status, the decision was made to make patient DNR and not initiate another code blue. MAPs decreased to 10s and patient eventually became bradycardic and eventually reached asystole." Patient's time of death was Sep 24,2021@00:41. Per Death note, immediate cause of death is listed as "acute non-ST elevation myocardial infarction." Of note, patient recently completed his COVID vaccination series. He received the Pfizer vaccines on 8/18/21 and 9/8/21. No known COVID contacts and covid-19 negative per test on 9/23/21. Unclear correlation between patient's passing and covid-19 vaccination. Reporting given proximity of the patient's death and COVID-19 vaccination. Symptoms:  Tachypnea, Tachycardia, HYPERglycemia & Dyspnea; NSTEMI; hospitalization Treatment:  EPINEPHRINE SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=16,000ng/ml; drip , VASOPRESSIN SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=0.24units/ml; drip
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Haematoma, Haemoglobin decreased, Hyperglycaemia, Hypoperfusion, Hypotension
Clinical narrative: Narrative:  87 yo M with h/o CAD s/p CABG (2012) and PCI (2018), severe AS s/p TAVR (2019), A-Fib (on apixaban), Factor V Leiden with DVT/PEs, SCC of lung s/p R upper lobe lobectomy (2015), COPD, DM2, and hypothyroidism. On 9/23/21, patient's Home Based Primary Care Nurse Practitioner visited his home for a checkup and noted that he was in a worse state of health than his baseline. Per note, "Primarily today he is dehydrated, hypotensive, tachypneic and tachycardic. He has been having worsened hyperglycemia and has been becoming more forgetful. has been too weak to eat or participate in ADLs or take meds since at least yesterday." Patient advised to go to ER. Patient presented to the agency ED the same day. In ED, patient was found to have newly reduced EF so taken to cath lab for NSTEMI. In the cath lab, patient went into cardiac arrest (PEA), an Impella was placed during the procedure. Patient was intubated, ROSC was eventually obtained and patient was transferred to the MSICU in critical condition. Per the 9/24/21 Medicine Discharge Summary: "In the MSCIU, patient was initially tenuously stable but then decompensated due to a probably internal bleed and groin hematoma, Hgb dropped from 12 to 6.5. Patient received IVF, was somewhat fluid responsive but no way to stop any coagulopathy and likely retroperitoneal bleeding due to the presence of the Impella (procoagulants would likely clot it off). Transfusion would be futile as bleeding could not be controlled." "MAPs downtrended down to the 30s and in the setting of poor organ perfusion, anoxic brain injury, and no further interventions that could improve patient status, the decision was made to make patient DNR and not initiate another code blue. MAPs decreased to 10s and patient eventually became bradycardic and eventually reached asystole." Patient's time of death was Sep 24,2021@00:41. Per Death note, immediate cause of death is listed as "acute non-ST elevation myocardial infarction." Of note, patient recently completed his COVID vaccination series. He received the Pfizer vaccines on 8/18/21 and 9/8/21. No known COVID contacts and covid-19 negative per test on 9/23/21. Unclear correlation between patient's passing and covid-19 vaccination. Reporting given proximity of the patient's death and COVID-19 vaccination. Symptoms:  Tachypnea, Tachycardia, HYPERglycemia & Dyspnea; NSTEMI; hospitalization Treatment:  EPINEPHRINE SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=16,000ng/ml; drip , VASOPRESSIN SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=0.24units/ml; drip
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Intensive care, Internal haemorrhage, Loss of personal independence in daily activities, Mean arterial pressure decreased, Memory impairment
Clinical narrative: Narrative:  87 yo M with h/o CAD s/p CABG (2012) and PCI (2018), severe AS s/p TAVR (2019), A-Fib (on apixaban), Factor V Leiden with DVT/PEs, SCC of lung s/p R upper lobe lobectomy (2015), COPD, DM2, and hypothyroidism. On 9/23/21, patient's Home Based Primary Care Nurse Practitioner visited his home for a checkup and noted that he was in a worse state of health than his baseline. Per note, "Primarily today he is dehydrated, hypotensive, tachypneic and tachycardic. He has been having worsened hyperglycemia and has been becoming more forgetful. has been too weak to eat or participate in ADLs or take meds since at least yesterday." Patient advised to go to ER. Patient presented to the agency ED the same day. In ED, patient was found to have newly reduced EF so taken to cath lab for NSTEMI. In the cath lab, patient went into cardiac arrest (PEA), an Impella was placed during the procedure. Patient was intubated, ROSC was eventually obtained and patient was transferred to the MSICU in critical condition. Per the 9/24/21 Medicine Discharge Summary: "In the MSCIU, patient was initially tenuously stable but then decompensated due to a probably internal bleed and groin hematoma, Hgb dropped from 12 to 6.5. Patient received IVF, was somewhat fluid responsive but no way to stop any coagulopathy and likely retroperitoneal bleeding due to the presence of the Impella (procoagulants would likely clot it off). Transfusion would be futile as bleeding could not be controlled." "MAPs downtrended down to the 30s and in the setting of poor organ perfusion, anoxic brain injury, and no further interventions that could improve patient status, the decision was made to make patient DNR and not initiate another code blue. MAPs decreased to 10s and patient eventually became bradycardic and eventually reached asystole." Patient's time of death was Sep 24,2021@00:41. Per Death note, immediate cause of death is listed as "acute non-ST elevation myocardial infarction." Of note, patient recently completed his COVID vaccination series. He received the Pfizer vaccines on 8/18/21 and 9/8/21. No known COVID contacts and covid-19 negative per test on 9/23/21. Unclear correlation between patient's passing and covid-19 vaccination. Reporting given proximity of the patient's death and COVID-19 vaccination. Symptoms:  Tachypnea, Tachycardia, HYPERglycemia & Dyspnea; NSTEMI; hospitalization Treatment:  EPINEPHRINE SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=16,000ng/ml; drip , VASOPRESSIN SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=0.24units/ml; drip
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pulseless electrical activity, Retroperitoneal haemorrhage, SARS-CoV-2 test negative, Tachycardia, Tachypnoea
Clinical narrative: Narrative:  87 yo M with h/o CAD s/p CABG (2012) and PCI (2018), severe AS s/p TAVR (2019), A-Fib (on apixaban), Factor V Leiden with DVT/PEs, SCC of lung s/p R upper lobe lobectomy (2015), COPD, DM2, and hypothyroidism. On 9/23/21, patient's Home Based Primary Care Nurse Practitioner visited his home for a checkup and noted that he was in a worse state of health than his baseline. Per note, "Primarily today he is dehydrated, hypotensive, tachypneic and tachycardic. He has been having worsened hyperglycemia and has been becoming more forgetful. has been too weak to eat or participate in ADLs or take meds since at least yesterday." Patient advised to go to ER. Patient presented to the agency ED the same day. In ED, patient was found to have newly reduced EF so taken to cath lab for NSTEMI. In the cath lab, patient went into cardiac arrest (PEA), an Impella was placed during the procedure. Patient was intubated, ROSC was eventually obtained and patient was transferred to the MSICU in critical condition. Per the 9/24/21 Medicine Discharge Summary: "In the MSCIU, patient was initially tenuously stable but then decompensated due to a probably internal bleed and groin hematoma, Hgb dropped from 12 to 6.5. Patient received IVF, was somewhat fluid responsive but no way to stop any coagulopathy and likely retroperitoneal bleeding due to the presence of the Impella (procoagulants would likely clot it off). Transfusion would be futile as bleeding could not be controlled." "MAPs downtrended down to the 30s and in the setting of poor organ perfusion, anoxic brain injury, and no further interventions that could improve patient status, the decision was made to make patient DNR and not initiate another code blue. MAPs decreased to 10s and patient eventually became bradycardic and eventually reached asystole." Patient's time of death was Sep 24,2021@00:41. Per Death note, immediate cause of death is listed as "acute non-ST elevation myocardial infarction." Of note, patient recently completed his COVID vaccination series. He received the Pfizer vaccines on 8/18/21 and 9/8/21. No known COVID contacts and covid-19 negative per test on 9/23/21. Unclear correlation between patient's passing and covid-19 vaccination. Reporting given proximity of the patient's death and COVID-19 vaccination. Symptoms:  Tachypnea, Tachycardia, HYPERglycemia & Dyspnea; NSTEMI; hospitalization Treatment:  EPINEPHRINE SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=16,000ng/ml; drip , VASOPRESSIN SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=0.24units/ml; drip
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Troponin I increased, Ventricular assist device insertion
Clinical narrative: Narrative:  87 yo M with h/o CAD s/p CABG (2012) and PCI (2018), severe AS s/p TAVR (2019), A-Fib (on apixaban), Factor V Leiden with DVT/PEs, SCC of lung s/p R upper lobe lobectomy (2015), COPD, DM2, and hypothyroidism. On 9/23/21, patient's Home Based Primary Care Nurse Practitioner visited his home for a checkup and noted that he was in a worse state of health than his baseline. Per note, "Primarily today he is dehydrated, hypotensive, tachypneic and tachycardic. He has been having worsened hyperglycemia and has been becoming more forgetful. has been too weak to eat or participate in ADLs or take meds since at least yesterday." Patient advised to go to ER. Patient presented to the agency ED the same day. In ED, patient was found to have newly reduced EF so taken to cath lab for NSTEMI. In the cath lab, patient went into cardiac arrest (PEA), an Impella was placed during the procedure. Patient was intubated, ROSC was eventually obtained and patient was transferred to the MSICU in critical condition. Per the 9/24/21 Medicine Discharge Summary: "In the MSCIU, patient was initially tenuously stable but then decompensated due to a probably internal bleed and groin hematoma, Hgb dropped from 12 to 6.5. Patient received IVF, was somewhat fluid responsive but no way to stop any coagulopathy and likely retroperitoneal bleeding due to the presence of the Impella (procoagulants would likely clot it off). Transfusion would be futile as bleeding could not be controlled." "MAPs downtrended down to the 30s and in the setting of poor organ perfusion, anoxic brain injury, and no further interventions that could improve patient status, the decision was made to make patient DNR and not initiate another code blue. MAPs decreased to 10s and patient eventually became bradycardic and eventually reached asystole." Patient's time of death was Sep 24,2021@00:41. Per Death note, immediate cause of death is listed as "acute non-ST elevation myocardial infarction." Of note, patient recently completed his COVID vaccination series. He received the Pfizer vaccines on 8/18/21 and 9/8/21. No known COVID contacts and covid-19 negative per test on 9/23/21. Unclear correlation between patient's passing and covid-19 vaccination. Reporting given proximity of the patient's death and COVID-19 vaccination. Symptoms:  Tachypnea, Tachycardia, HYPERglycemia & Dyspnea; NSTEMI; hospitalization Treatment:  EPINEPHRINE SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=16,000ng/ml; drip , VASOPRESSIN SODIUM CHLORIDE 0.9% IV SOLN INJ,SOLN 250 ml IV Conc=0.24units/ml; drip
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Narrative:  Patient with Breakthrough COVID infection after 2 doses of Moderna Vaccine Symptoms:  & COVID Breakthrough Infection Treatment:  CASIRIVIMAB/IMDEVIMAB (EUA) 600mg/600mg MG ONCE
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Narrative:  Patient with breakthrough COVID infection after vaccination with 2 doses of Moderna COVID vaccine Symptoms:  & covid breakthrough infection Treatment:  CASIRIVIMAB/IMDEVIMAB (EUA) 600mg/600mg MG ONCE
Age: 68.0
Sex: M
Vaccine: COVID19, FLUA4
Symptoms: Rash, Urticaria
Clinical narrative: Patient received Pfizer Covid-19 booster shot and a flu shot together on 10/7/2021 around 10:15 am and by 10/8 at 1500, patient experienced widespread hives in his underarm and groin area. He self treated with benadryl at an unknown dose and an unknown topical. No other adverse effects noted. Symptoms: Rash
Age: 97.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative:  Patient received COVID Moderna vaccine # 1 on 8/10/2021. A note was entered on 9/10/21 to say that the patient was in the hospital, but no further notes after that. No scanned records from that hospitalization are available either. A date of death was recorded as 9/19/21. There were 40 days from vaccine #1 to date of death. Symptoms:  & death Treatment:
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Atrial fibrillation, COVID-19, Chest X-ray normal, Chest discomfort
Clinical narrative: Narrative:  Admission: 9/23/2021 Discharge 10/11/2021 DISCHARGE DIAGNOSIS: COVID, Atrial Fibrillation 86 yo M with past medical history of essential tremor, restless legs syndrome, CAD, Atrial fibrillation (on apixaban), COPD, HLD, HTN, and Type 2 Diabetes who presented to the Emergency Department for diarrhea, poor po intake, cough, increased SOB, and generalized weakness for the previous 5-7 days and was found to be COVID positive (despite being fully vaccinated with the Pfizer vaccine (April and May) and in Afib with a rapid ventricular rate (RVR). Over the previous few days to a week he was feeling fatigued and dizzy, especially when standing. He felt too weak to walk. He also endorses a productive cough with clear sputum, increased SOB/DOE, decreased appetite, and intermittent diarrhea. He had been experiencing intermittent R sided chest pressure and palpitations as well. He had been around his son who tested positive for COVID one week ago. Patient initially had to be admitted to the ICU for Afib with RVR in the setting of a COVID infection. CXR without signs of active COVID Pneumonia. Initially satting well on room air, though placed on 2L NC intermittently. He was eventually discharged in stable condition. Symptoms:  & HOSPITALIZATION FOR COVID DESPITE FULL VACCINATON X 2 Treatment:  CASIRIVIMAB/IMDEVIMAB (EUA) 1200 MG ONCE