chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Appendicolith, Arthralgia, Atrial fibrillation, Barrett's oesophagus, Blood culture negative
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Bordetella test negative, COVID-19, COVID-19 pneumonia, Cardiac failure, Cardiac failure chronic
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Chest X-ray abnormal, Chlamydia test negative, Chronic hepatitis C, Chronic obstructive pulmonary disease
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram abdomen abnormal, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Condition aggravated, Coronavirus test negative
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Culture throat, Dyspnoea, Endotracheal intubation, Enterovirus test, Essential hypertension
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Gastrointestinal wall thickening, Gastrooesophageal reflux disease, Gout, Hepatic cirrhosis, Hilar lymphadenopathy
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Human metapneumovirus test, Human rhinovirus test, Humerus fracture, Hypoxia, Inflammation
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Intervertebral disc degeneration, Intervertebral disc space narrowing
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Leukocytosis, Lung infiltration, Lymphadenopathy mediastinal, Microcytic anaemia, Mixed anxiety and depressive disorder
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Mycoplasma test negative, Myocardial ischaemia, Pneumonia, Proteinuria, Pyrexia
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Renal cyst, Respiratory failure, Respiratory syncytial virus test, SARS-CoV-2 test positive, Scan with contrast abnormal
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Sepsis, Type V hyperlipidaemia, Ultrasound bladder normal, Ultrasound kidney normal
Clinical narrative: ED to Hosp-Admission Discharged 9/14/2021 - 9/19/2021 (5 days) Hospital Presenting Problem/History of Present Illness/Reason for Admission Shortness of breath [R06.02] Acute on chronic respiratory failure with hypoxia    Hospital Course   63 y.o. male with a PMHx of COPD not on home O2, HFpEF, A. fib on anticoagulation, hyperlipidemia, hypertension, GERD, anxiety presented on 9/14/2021 to Hospital because of shortness of breath. Patient was recently admitted to  Hospital on 8/9 for multifocal pneumonia, respiratory failure requiring intubation for 5 days, complicated by CVA and A. fib with RVR, completed IV antibiotics and course of steroids and discharged on 9/12. Patient was diagnosed with COVID-19, with supporting CXR and CTA Chest findings, no PE was found. He was placed on 6L O2 NC. Patient also met severe sepsis criteria, and was empirically started on Vancomycin and Cefepime. He was started on a 10-day course of Decadron, 5-day course of Remdesivir. Vancomycin and Cefipime were discontinued once blood cultures were negative at 48 hours. Patient completed 5-day course of Remdesivir, IV Decadron was transitioned to PO Decadron to be completed outpatient by 9/23/21. Patient was weaned off oxygen and breathing well on room air. PT recommended home with home health.    He will need follow up with the Heart Failure team, for which an appointment is already made for 10/15/21. He will also need follow up with Pulmonology to set up PFTs in 4-6 weeks. He will also need follow up with Gastroenterology to manage his untreated Hepatitis C and Barrett's Esophagus found on previous EGD. He has an AFP lab pending to screen.     Hospital Problems          POA    * (Principal) Acute respiratory failure with hypoxia  Yes         Mixed anxiety depressive disorder Yes         Chronic hepatitis C virus infection  Yes         Chronic obstructive pulmonary disease  Yes         Severe sepsis Yes         COVID-19 virus infection Yes         Leukocytosis Yes         Demand ischemia  Yes         Left shoulder pain Yes         Fracture of left humerus Yes         Gastroesophageal reflux disease without esophagitis Yes         Microcytic anemia Yes         Hx of gout Yes         Paroxysmal atrial fibrillation  Yes         On apixaban therapy Not Applicable         Essential hypertension Yes         Mixed hyperlipidemia Yes         Chronic heart failure with preserved ejection fraction  Yes         Barrett's esophagus Yes         Other cirrhosis of liver  Yes         Smoker unmotivated to quit Yes         Esophageal thickening Yes         Hilar lymphadenopathy Yes         Mediastinal lymphadenopathy Yes
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Cough, SARS-CoV-2 test positive
Clinical narrative: Pt lost her sense of taste and smell. She had a cough for the last several weeks, no diarrhea or GI complaints. Pt was transferred after being found to be COVID positive.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, COVID-19, Fall, Muscular weakness, Neck pain
Clinical narrative: Breakthrough covid + on 10/1/2021. First vaccine dose 4/9/2021, possible error with Lot # listed, correct number could be ER8737?  A 67 YO F presented to the  ED on 09/30 with complaints of multiple ground level falls in the past 2 days. Pt says that episodes feel like weakness where she sinks into the ground and her legs give out from underneath her. Pt endorses +urinary incontinence, neck pain, and ankle pain.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Urinary incontinence, Vaccine breakthrough infection
Clinical narrative: Breakthrough covid + on 10/1/2021. First vaccine dose 4/9/2021, possible error with Lot # listed, correct number could be ER8737?  A 67 YO F presented to the  ED on 09/30 with complaints of multiple ground level falls in the past 2 days. Pt says that episodes feel like weakness where she sinks into the ground and her legs give out from underneath her. Pt endorses +urinary incontinence, neck pain, and ankle pain.
Age: 79.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Hypotension, SARS-CoV-2 test positive, Tachycardia
Clinical narrative: ;tested positive at a nursing home, symptoms include hypotension and tachycardia, unclear onset date Patient admitted to the hospital on 10/01/2021
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Encephalopathy, Laboratory test, Mobility decreased, Nervous system disorder, Pain
Clinical narrative: SEVERE NEUROLOGICAL AFFECTS, PAIN, LOSS OF MOBILITY - ENCEPHALOPATHY
Age: 49.0
Sex: M
Vaccine: UNK
Symptoms: Interchange of vaccine products
Clinical narrative: -there was no adverse event. this form is being filled out because the patient lost his vaccine card and informed us that he previously took the pfizer vaccine a long time ago and the vaccine is overdue to get the second dose. I asked if he received pfizer , he said yes so i proceeded to administer the second dose. After - I went to bill the vaccine and received a rejection stating that there was a vaccine already billed so I called to find out what was going on. They informed me august 20th the patient received a moderna vaccine, not pfizer. Patient received moderna on 08/20 and pfizer on 10/04.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Computerised tomogram, Echocardiogram, Electronystagmogram, Lumbar spinal stenosis
Clinical narrative: I started feeling chills, which I have never had before, pain in legs, and my whole body was sore. My first visit for that was in April. They did x-ray of my back, ENG, CAT scan, Echocardiogram. One of the tests showed I had lumbar spinal stenosis. Tomorrow I go see the doctor.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity, Spinal X-ray
Clinical narrative: I started feeling chills, which I have never had before, pain in legs, and my whole body was sore. My first visit for that was in April. They did x-ray of my back, ENG, CAT scan, Echocardiogram. One of the tests showed I had lumbar spinal stenosis. Tomorrow I go see the doctor.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac flutter, Pain in extremity
Clinical narrative: First day, no pain in the arm, second day a bit of pain in the arm. Later that second day, started feeling heart flutters. This has been my 4th day with heart flutters. Symptoms are becoming a little less. Aside from heart flutters, no other symptoms have been felt.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fall, Gait inability, Muscular weakness, Nausea
Clinical narrative: Patient came to hospital with fever and chills with right leg pain/soreness and nausea, after being vaccinated with the Pfizer Covid booster. She gradually developed right leg weakness and then left leg weakness, progressing to the point that she was unable to walk.  She feels that both legs are weak although she states right leg seems worse than the left.  She attempted to go to the bathroom but fell due to the inability to walk. Patient is being worked up for Guillian Barre.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Pyrexia
Clinical narrative: Patient came to hospital with fever and chills with right leg pain/soreness and nausea, after being vaccinated with the Pfizer Covid booster. She gradually developed right leg weakness and then left leg weakness, progressing to the point that she was unable to walk.  She feels that both legs are weak although she states right leg seems worse than the left.  She attempted to go to the bathroom but fell due to the inability to walk. Patient is being worked up for Guillian Barre.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Condition aggravated, Constipation, Decreased appetite, Fatigue
Clinical narrative: SEVERE fatigue, muscle pain, chills, temors, headache, constipation, naseau, flare up of Multiple Sclerosis symptoms, inability to walk unassisted, loss of appetite, change in taste of food, no interest in liquids (water), lasted 48 hours
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Gait disturbance, Headache, Multiple sclerosis relapse, Myalgia, Nausea
Clinical narrative: SEVERE fatigue, muscle pain, chills, temors, headache, constipation, naseau, flare up of Multiple Sclerosis symptoms, inability to walk unassisted, loss of appetite, change in taste of food, no interest in liquids (water), lasted 48 hours
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Taste disorder, Tremor
Clinical narrative: SEVERE fatigue, muscle pain, chills, temors, headache, constipation, naseau, flare up of Multiple Sclerosis symptoms, inability to walk unassisted, loss of appetite, change in taste of food, no interest in liquids (water), lasted 48 hours
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Aphasia, Chest X-ray normal, Computerised tomogram head, Confusional state, Electrocardiogram normal
Clinical narrative: The patient received his booster dose of Pfizer vaccine on 09/30/2021. His previous doses were received on 01/29/2021 and 02/19/2021 respectively, without incidence. On the evening of 09/30/2021, the client reports that he had a sore arm and went to bed. He failed to show up to work the next day and co-workers went to check on him at his residence as he lives alone. The patient was discovered in bed and acting very confused and unable to form rational sentences. He was immediately brought to the ER by a co-worker and a work-up was performed. At this time, he was also complaining about a severe headache and had profuse sweating. Imaging, EKG, and blood work were all performed and there was no notable abnormalities seen. He was later released from the hospital the same day, per his request. He notes that his headache has resolved but that he feels tired and fatigued. Also, he is still c/o abnormally profuse sweating.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Full blood count normal, Headache, Hyperhidrosis, Impaired work ability
Clinical narrative: The patient received his booster dose of Pfizer vaccine on 09/30/2021. His previous doses were received on 01/29/2021 and 02/19/2021 respectively, without incidence. On the evening of 09/30/2021, the client reports that he had a sore arm and went to bed. He failed to show up to work the next day and co-workers went to check on him at his residence as he lives alone. The patient was discovered in bed and acting very confused and unable to form rational sentences. He was immediately brought to the ER by a co-worker and a work-up was performed. At this time, he was also complaining about a severe headache and had profuse sweating. Imaging, EKG, and blood work were all performed and there was no notable abnormalities seen. He was later released from the hospital the same day, per his request. He notes that his headache has resolved but that he feels tired and fatigued. Also, he is still c/o abnormally profuse sweating.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Metabolic function test, Pain in extremity
Clinical narrative: The patient received his booster dose of Pfizer vaccine on 09/30/2021. His previous doses were received on 01/29/2021 and 02/19/2021 respectively, without incidence. On the evening of 09/30/2021, the client reports that he had a sore arm and went to bed. He failed to show up to work the next day and co-workers went to check on him at his residence as he lives alone. The patient was discovered in bed and acting very confused and unable to form rational sentences. He was immediately brought to the ER by a co-worker and a work-up was performed. At this time, he was also complaining about a severe headache and had profuse sweating. Imaging, EKG, and blood work were all performed and there was no notable abnormalities seen. He was later released from the hospital the same day, per his request. He notes that his headache has resolved but that he feels tired and fatigued. Also, he is still c/o abnormally profuse sweating.
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Limb mass, Neck mass
Clinical narrative: Lump on neck and shoulder.
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Chest X-ray, Computerised tomogram thorax abnormal, Laboratory test, Pneumonectomy
Clinical narrative: Blood clots right lung, fluid right lung Part of the right lung had to be removed after several attempts to remove the fluid was unsuccessful  Currently still in the hospital
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary thrombosis
Clinical narrative: Blood clots right lung, fluid right lung Part of the right lung had to be removed after several attempts to remove the fluid was unsuccessful  Currently still in the hospital
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Amnesia, Blood test normal, Chest X-ray normal, Confusional state, Electrocardiogram normal
Clinical narrative: Confusion, beginning the afternoon following the injection.   My mind became a complete and total blank, including not knowing my own name.  On 9/30/2031 I was hospitalized for 3 days.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Electroencephalogram normal, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal normal, Urine analysis normal
Clinical narrative: Confusion, beginning the afternoon following the injection.   My mind became a complete and total blank, including not knowing my own name.  On 9/30/2031 I was hospitalized for 3 days.
Age: 36.0
Sex: F
Vaccine: FLUR4
Symptoms: Chills, Injection site cellulitis, Injection site erythema, Injection site reaction, Injection site warmth
Clinical narrative: Patient received two vaccines ( FLUBLOK ) and the Pnuemovax 23(  LOT: TO21485)  on the same arm ( right arm) on September 25th 2021. Patient stated that the evening of the 25th she started to feel soreness and had a low grade fever and chills,  these symptoms worsened the following day. Patient saw her PCP to get the injection sight inspected and was prescribed Bactrim on 09/27/2021. At this doctors appointment, doctor did an outline of the injection site reaction that appeared red and warm to touch. The following day on September 28th, the injection site worsened which spread beyond the outlined mark the day before. Patient at this point went to the emergency room. At the emergency room, per patient, she was admitted from  September 28th and released on October 1st 2021. She was treated for a cellulitis infection that per patient may have been caused by vaccine administration as the area of concern was where the two vaccines had been administered. Patient was released and prescribed Cefdinir 300mg for a 10 day course treatment.
Age: 36.0
Sex: F
Vaccine: FLUR4
Symptoms: Pain, Pyrexia
Clinical narrative: Patient received two vaccines ( FLUBLOK ) and the Pnuemovax 23(  LOT: TO21485)  on the same arm ( right arm) on September 25th 2021. Patient stated that the evening of the 25th she started to feel soreness and had a low grade fever and chills,  these symptoms worsened the following day. Patient saw her PCP to get the injection sight inspected and was prescribed Bactrim on 09/27/2021. At this doctors appointment, doctor did an outline of the injection site reaction that appeared red and warm to touch. The following day on September 28th, the injection site worsened which spread beyond the outlined mark the day before. Patient at this point went to the emergency room. At the emergency room, per patient, she was admitted from  September 28th and released on October 1st 2021. She was treated for a cellulitis infection that per patient may have been caused by vaccine administration as the area of concern was where the two vaccines had been administered. Patient was released and prescribed Cefdinir 300mg for a 10 day course treatment.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Pain
Clinical narrative: Severe body aches and joint pain in entire body.   Received my shot 2 weeks ago and still have the same severe pain.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Fatigue
Clinical narrative: I experienced a bad cough, I also was very tired.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Adenovirus test, Anticoagulant therapy, Bordetella test negative, COVID-19, Chest X-ray abnormal
Clinical narrative: 9/13/2021 - 9/20/2021 (7 days)     Last attending ? Treatment team Acute cystitis without hematuria  Principal problem     * (Principal) Acute cystitis without hematuria Yes       Non-ST elevation MI (NSTEMI)  Yes       Acute on chronic kidney failure Yes       COVID-19 virus infection Yes       Generalized weakness Yes       Coronary artery disease Yes       Anemia Yes       Status post fall Not Applicable            Medical Problems        Plan: 84-year-old gentleman presents with multiple's complaints and he has non-ST elevation MI, acute on chronic kidney failure COVID-19 infection with hypoxemia and generalized weakness.  At this point he is going to be admitted, I will give him IV heparin aspirin beta blockers and nitrates.  We will cycle his troponins and he will be seen by cardiology.  Cardiologist was informed from emergency room and since there are no beds available in the surrounding hospitals he will be kept here.  I will hold off on his statin and check patient's CPK.  If CPK is acceptable we will continue statin.  At the same time urine will be cultured and patient be on Rocephin.  For the Covid patient will be supplied with oxygen, will put home on dexamethasone.  Until kidney function improves remdesivir is not indicated.  Will give cautious IV hydration especially with underlying MI.  I reviewed his records in February his EF was normal.  Will continue IV fluid and monitor kidney function. I discussed patient's CODE STATUS with him given with all this medical active issues.  He wants to be full code.  Eventually PT OT for placement. Note, patient's knee x-rays are not read by radiologist.  Grossly there not showing any fracture.  If there is any issues orthopedic services should be involved.   VTE prophylaxis: IV heparin Full Code