chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 101.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dysstasia, Enema administration, Faecaloma, Hypotension
Clinical narrative: Pfizer Dose 1 1/14/21 (NA) Pfizer Dose 2 2/4/21 (NA) Pfizer Dose 3 10/27/21 (FF2593) COVID Positive 1/15/22 COVID positive 2/6/22  2/5/22: Patient is a 101-year-old female with past medical history of arthritis, osteopenia, hypertension, and atrial fibrillation.  She presented to the emergency department on 02/05/2022 with chief complaint of loose stools and lower extremity edema.  Patient is extremely hard of hearing /essentially deaf and is also a poor historian.  Therefore, history is limited to my discussion with the ED provider. Patient's only complaint when I attempted to talk with her was generalized weakness.  She kept asking repeatedly why it was difficult for her to stand on her legs anymore. In the emergency department, her vital signs were normal and stable with the exception of some mildly low blood pressures.  Her lowest recorded blood pressure was 89/73 but this did improve.  X-rays of her lumbar spine were notable for osteopenia and unchanged compression deformities with no acute findings.  Chest x-ray was notable for bibasilar atelectasis or infiltrate.  CT abdomen and pelvis with contrast was most notable for fecal impaction creating colonic and small-bowel obstruction and pneumatosis of the cecum and ascending colon.  There were multiple other incidental findings as well.    Her lab work was otherwise unremarkable.  General surgery was consulted from the ED.  They recommended conservative management with laxative and enemas.  In the ED, the patient was administered ertapenem for possible colitis given the pneumatosis was mentioned on CT.  She was also administered a Fleet enema and 500 cc of NS.  She was admitted for further monitoring and management due to her old age, frail condition, and borderline hypotension.  2/6/22: Pt was admitted and was started on bowel protocol  She subsequently successfully had a large bowel movement  She remains vitally stable and voiced readiness to discharge back to the nursing home  Antibiotics for UTI  Discussed with her daughter over telephone  Code status DNR  f/u pcp within 3-5d  CBC, CMP post discharge
Age: 101.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test normal, Large intestinal obstruction, Lung infiltration, Oedema peripheral, Pneumatosis
Clinical narrative: Pfizer Dose 1 1/14/21 (NA) Pfizer Dose 2 2/4/21 (NA) Pfizer Dose 3 10/27/21 (FF2593) COVID Positive 1/15/22 COVID positive 2/6/22  2/5/22: Patient is a 101-year-old female with past medical history of arthritis, osteopenia, hypertension, and atrial fibrillation.  She presented to the emergency department on 02/05/2022 with chief complaint of loose stools and lower extremity edema.  Patient is extremely hard of hearing /essentially deaf and is also a poor historian.  Therefore, history is limited to my discussion with the ED provider. Patient's only complaint when I attempted to talk with her was generalized weakness.  She kept asking repeatedly why it was difficult for her to stand on her legs anymore. In the emergency department, her vital signs were normal and stable with the exception of some mildly low blood pressures.  Her lowest recorded blood pressure was 89/73 but this did improve.  X-rays of her lumbar spine were notable for osteopenia and unchanged compression deformities with no acute findings.  Chest x-ray was notable for bibasilar atelectasis or infiltrate.  CT abdomen and pelvis with contrast was most notable for fecal impaction creating colonic and small-bowel obstruction and pneumatosis of the cecum and ascending colon.  There were multiple other incidental findings as well.    Her lab work was otherwise unremarkable.  General surgery was consulted from the ED.  They recommended conservative management with laxative and enemas.  In the ED, the patient was administered ertapenem for possible colitis given the pneumatosis was mentioned on CT.  She was also administered a Fleet enema and 500 cc of NS.  She was admitted for further monitoring and management due to her old age, frail condition, and borderline hypotension.  2/6/22: Pt was admitted and was started on bowel protocol  She subsequently successfully had a large bowel movement  She remains vitally stable and voiced readiness to discharge back to the nursing home  Antibiotics for UTI  Discussed with her daughter over telephone  Code status DNR  f/u pcp within 3-5d  CBC, CMP post discharge
Age: 101.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Small intestinal obstruction, Spinal X-ray normal, Urinary tract infection
Clinical narrative: Pfizer Dose 1 1/14/21 (NA) Pfizer Dose 2 2/4/21 (NA) Pfizer Dose 3 10/27/21 (FF2593) COVID Positive 1/15/22 COVID positive 2/6/22  2/5/22: Patient is a 101-year-old female with past medical history of arthritis, osteopenia, hypertension, and atrial fibrillation.  She presented to the emergency department on 02/05/2022 with chief complaint of loose stools and lower extremity edema.  Patient is extremely hard of hearing /essentially deaf and is also a poor historian.  Therefore, history is limited to my discussion with the ED provider. Patient's only complaint when I attempted to talk with her was generalized weakness.  She kept asking repeatedly why it was difficult for her to stand on her legs anymore. In the emergency department, her vital signs were normal and stable with the exception of some mildly low blood pressures.  Her lowest recorded blood pressure was 89/73 but this did improve.  X-rays of her lumbar spine were notable for osteopenia and unchanged compression deformities with no acute findings.  Chest x-ray was notable for bibasilar atelectasis or infiltrate.  CT abdomen and pelvis with contrast was most notable for fecal impaction creating colonic and small-bowel obstruction and pneumatosis of the cecum and ascending colon.  There were multiple other incidental findings as well.    Her lab work was otherwise unremarkable.  General surgery was consulted from the ED.  They recommended conservative management with laxative and enemas.  In the ED, the patient was administered ertapenem for possible colitis given the pneumatosis was mentioned on CT.  She was also administered a Fleet enema and 500 cc of NS.  She was admitted for further monitoring and management due to her old age, frail condition, and borderline hypotension.  2/6/22: Pt was admitted and was started on bowel protocol  She subsequently successfully had a large bowel movement  She remains vitally stable and voiced readiness to discharge back to the nursing home  Antibiotics for UTI  Discussed with her daughter over telephone  Code status DNR  f/u pcp within 3-5d  CBC, CMP post discharge
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anxiety, Asthenia, Blood creatinine increased, Blood lactic acid
Clinical narrative: Pfizer Dose 1 2/8/21 (EL1283) Pfizer Dose 2 3/2/21 (EN6200) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 2/17/21  2/19/22: Patient is 84-year-old male with past medical history of coronary artery disease status post triple bypass surgery, hypertension, dyslipidemia, CKD stage 3 and tobacco abuse.  Presented to the emergency room with a complaint of generalized weakness and fall. Patient was at the emergency room 2 days ago with a complaint of upper respiratory symptoms including sore throat, congestion, cough productive of sputum. Patient tested positive for COVID-19 despite being fully vaccinated and boosted. Patient was sent home with COVID-19 safe at home program. Since then, he has been having progressively worsening generalized weakness. He also reported exertional dyspnea. He also reported cough productive of scanty sputum, fever and shortness of breath. No chest pain or palpitations. He reported decreased appetite nausea but no vomiting. No urinary symptoms. No headache, blurring of vision or extremity weakness. Patient is a former smoker. He drinks alcohol occasionally. Earlier today, while he was trying to get up from recliner chair, he lost his balance and fell down on his left knee.  No report of head injury. No loss of consciousness. This prompted patient to come to the emergency room again today.  Upon evaluation at the emergency room, he was febrile with temperature of 101.1° F. He was maintaining saturation of 85% on room air. He was requiring 3 L of oxygen to maintain saturation.  Blood pressure was on the lower side with systolic blood pressure in the 90s but fluid responsive. Significant lab findings are creatinine of 1.46 higher than his baseline, lactic acid of 2.1 and proBNP of 892. Troponin was at 0.03. D-dimer was elevated at 2.33. CT chest with IV contrast was negative for pulmonary embolism but it revealed scattered bilateral areas of airspace disease likely representing multilobar pneumonia versus viral pneumonitis.  At the emergency room, patient received Levaquin 750 mg IV stat, and DuoNeb nebulization. He also received IV fluid per sepsis protocol  2/23/22: 84-year-old male with coronary artery disease status post CABG x3, hypertension, hyperlipidemia CKD stage 3 and tobacco abuse presented with cough, exertional dyspnea and generalized weakness, tested positive for COVID-19 on 02/17/22.  Patient admitted for acute hypoxic respiratory failure secondary to COVID-19 with superimposed bacterial pnd4reumonia.  On dexamethasone, ceftriaxone and azithromycin.  Did not receive remdesivir due to CKD and bradycardia.  Patient's symptoms resolved, weaned off oxygen to room air.  It has elevated blood pressure due to anxiety and steroids, amlodipine increased to 10 mg and continued on losartan.  Patient advised to monitor his blood pressure at home.  Therapy recommendation is for home with home health and was provided a walker as well. Patient discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Blood pressure increased, COVID-19, Computerised tomogram thorax abnormal, Decreased appetite, Dyspnoea
Clinical narrative: Pfizer Dose 1 2/8/21 (EL1283) Pfizer Dose 2 3/2/21 (EN6200) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 2/17/21  2/19/22: Patient is 84-year-old male with past medical history of coronary artery disease status post triple bypass surgery, hypertension, dyslipidemia, CKD stage 3 and tobacco abuse.  Presented to the emergency room with a complaint of generalized weakness and fall. Patient was at the emergency room 2 days ago with a complaint of upper respiratory symptoms including sore throat, congestion, cough productive of sputum. Patient tested positive for COVID-19 despite being fully vaccinated and boosted. Patient was sent home with COVID-19 safe at home program. Since then, he has been having progressively worsening generalized weakness. He also reported exertional dyspnea. He also reported cough productive of scanty sputum, fever and shortness of breath. No chest pain or palpitations. He reported decreased appetite nausea but no vomiting. No urinary symptoms. No headache, blurring of vision or extremity weakness. Patient is a former smoker. He drinks alcohol occasionally. Earlier today, while he was trying to get up from recliner chair, he lost his balance and fell down on his left knee.  No report of head injury. No loss of consciousness. This prompted patient to come to the emergency room again today.  Upon evaluation at the emergency room, he was febrile with temperature of 101.1° F. He was maintaining saturation of 85% on room air. He was requiring 3 L of oxygen to maintain saturation.  Blood pressure was on the lower side with systolic blood pressure in the 90s but fluid responsive. Significant lab findings are creatinine of 1.46 higher than his baseline, lactic acid of 2.1 and proBNP of 892. Troponin was at 0.03. D-dimer was elevated at 2.33. CT chest with IV contrast was negative for pulmonary embolism but it revealed scattered bilateral areas of airspace disease likely representing multilobar pneumonia versus viral pneumonitis.  At the emergency room, patient received Levaquin 750 mg IV stat, and DuoNeb nebulization. He also received IV fluid per sepsis protocol  2/23/22: 84-year-old male with coronary artery disease status post CABG x3, hypertension, hyperlipidemia CKD stage 3 and tobacco abuse presented with cough, exertional dyspnea and generalized weakness, tested positive for COVID-19 on 02/17/22.  Patient admitted for acute hypoxic respiratory failure secondary to COVID-19 with superimposed bacterial pnd4reumonia.  On dexamethasone, ceftriaxone and azithromycin.  Did not receive remdesivir due to CKD and bradycardia.  Patient's symptoms resolved, weaned off oxygen to room air.  It has elevated blood pressure due to anxiety and steroids, amlodipine increased to 10 mg and continued on losartan.  Patient advised to monitor his blood pressure at home.  Therapy recommendation is for home with home health and was provided a walker as well. Patient discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea exertional, Fall, Fibrin D dimer increased, Hypotension, Inappropriate schedule of product administration
Clinical narrative: Pfizer Dose 1 2/8/21 (EL1283) Pfizer Dose 2 3/2/21 (EN6200) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 2/17/21  2/19/22: Patient is 84-year-old male with past medical history of coronary artery disease status post triple bypass surgery, hypertension, dyslipidemia, CKD stage 3 and tobacco abuse.  Presented to the emergency room with a complaint of generalized weakness and fall. Patient was at the emergency room 2 days ago with a complaint of upper respiratory symptoms including sore throat, congestion, cough productive of sputum. Patient tested positive for COVID-19 despite being fully vaccinated and boosted. Patient was sent home with COVID-19 safe at home program. Since then, he has been having progressively worsening generalized weakness. He also reported exertional dyspnea. He also reported cough productive of scanty sputum, fever and shortness of breath. No chest pain or palpitations. He reported decreased appetite nausea but no vomiting. No urinary symptoms. No headache, blurring of vision or extremity weakness. Patient is a former smoker. He drinks alcohol occasionally. Earlier today, while he was trying to get up from recliner chair, he lost his balance and fell down on his left knee.  No report of head injury. No loss of consciousness. This prompted patient to come to the emergency room again today.  Upon evaluation at the emergency room, he was febrile with temperature of 101.1° F. He was maintaining saturation of 85% on room air. He was requiring 3 L of oxygen to maintain saturation.  Blood pressure was on the lower side with systolic blood pressure in the 90s but fluid responsive. Significant lab findings are creatinine of 1.46 higher than his baseline, lactic acid of 2.1 and proBNP of 892. Troponin was at 0.03. D-dimer was elevated at 2.33. CT chest with IV contrast was negative for pulmonary embolism but it revealed scattered bilateral areas of airspace disease likely representing multilobar pneumonia versus viral pneumonitis.  At the emergency room, patient received Levaquin 750 mg IV stat, and DuoNeb nebulization. He also received IV fluid per sepsis protocol  2/23/22: 84-year-old male with coronary artery disease status post CABG x3, hypertension, hyperlipidemia CKD stage 3 and tobacco abuse presented with cough, exertional dyspnea and generalized weakness, tested positive for COVID-19 on 02/17/22.  Patient admitted for acute hypoxic respiratory failure secondary to COVID-19 with superimposed bacterial pnd4reumonia.  On dexamethasone, ceftriaxone and azithromycin.  Did not receive remdesivir due to CKD and bradycardia.  Patient's symptoms resolved, weaned off oxygen to room air.  It has elevated blood pressure due to anxiety and steroids, amlodipine increased to 10 mg and continued on losartan.  Patient advised to monitor his blood pressure at home.  Therapy recommendation is for home with home health and was provided a walker as well. Patient discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Joint injury, Lung disorder, Nausea, Oropharyngeal pain, Pneumonia
Clinical narrative: Pfizer Dose 1 2/8/21 (EL1283) Pfizer Dose 2 3/2/21 (EN6200) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 2/17/21  2/19/22: Patient is 84-year-old male with past medical history of coronary artery disease status post triple bypass surgery, hypertension, dyslipidemia, CKD stage 3 and tobacco abuse.  Presented to the emergency room with a complaint of generalized weakness and fall. Patient was at the emergency room 2 days ago with a complaint of upper respiratory symptoms including sore throat, congestion, cough productive of sputum. Patient tested positive for COVID-19 despite being fully vaccinated and boosted. Patient was sent home with COVID-19 safe at home program. Since then, he has been having progressively worsening generalized weakness. He also reported exertional dyspnea. He also reported cough productive of scanty sputum, fever and shortness of breath. No chest pain or palpitations. He reported decreased appetite nausea but no vomiting. No urinary symptoms. No headache, blurring of vision or extremity weakness. Patient is a former smoker. He drinks alcohol occasionally. Earlier today, while he was trying to get up from recliner chair, he lost his balance and fell down on his left knee.  No report of head injury. No loss of consciousness. This prompted patient to come to the emergency room again today.  Upon evaluation at the emergency room, he was febrile with temperature of 101.1° F. He was maintaining saturation of 85% on room air. He was requiring 3 L of oxygen to maintain saturation.  Blood pressure was on the lower side with systolic blood pressure in the 90s but fluid responsive. Significant lab findings are creatinine of 1.46 higher than his baseline, lactic acid of 2.1 and proBNP of 892. Troponin was at 0.03. D-dimer was elevated at 2.33. CT chest with IV contrast was negative for pulmonary embolism but it revealed scattered bilateral areas of airspace disease likely representing multilobar pneumonia versus viral pneumonitis.  At the emergency room, patient received Levaquin 750 mg IV stat, and DuoNeb nebulization. He also received IV fluid per sepsis protocol  2/23/22: 84-year-old male with coronary artery disease status post CABG x3, hypertension, hyperlipidemia CKD stage 3 and tobacco abuse presented with cough, exertional dyspnea and generalized weakness, tested positive for COVID-19 on 02/17/22.  Patient admitted for acute hypoxic respiratory failure secondary to COVID-19 with superimposed bacterial pnd4reumonia.  On dexamethasone, ceftriaxone and azithromycin.  Did not receive remdesivir due to CKD and bradycardia.  Patient's symptoms resolved, weaned off oxygen to room air.  It has elevated blood pressure due to anxiety and steroids, amlodipine increased to 10 mg and continued on losartan.  Patient advised to monitor his blood pressure at home.  Therapy recommendation is for home with home health and was provided a walker as well. Patient discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia bacterial, Pneumonia viral, Productive cough, Prohormone brain natriuretic peptide increased, Pyrexia
Clinical narrative: Pfizer Dose 1 2/8/21 (EL1283) Pfizer Dose 2 3/2/21 (EN6200) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 2/17/21  2/19/22: Patient is 84-year-old male with past medical history of coronary artery disease status post triple bypass surgery, hypertension, dyslipidemia, CKD stage 3 and tobacco abuse.  Presented to the emergency room with a complaint of generalized weakness and fall. Patient was at the emergency room 2 days ago with a complaint of upper respiratory symptoms including sore throat, congestion, cough productive of sputum. Patient tested positive for COVID-19 despite being fully vaccinated and boosted. Patient was sent home with COVID-19 safe at home program. Since then, he has been having progressively worsening generalized weakness. He also reported exertional dyspnea. He also reported cough productive of scanty sputum, fever and shortness of breath. No chest pain or palpitations. He reported decreased appetite nausea but no vomiting. No urinary symptoms. No headache, blurring of vision or extremity weakness. Patient is a former smoker. He drinks alcohol occasionally. Earlier today, while he was trying to get up from recliner chair, he lost his balance and fell down on his left knee.  No report of head injury. No loss of consciousness. This prompted patient to come to the emergency room again today.  Upon evaluation at the emergency room, he was febrile with temperature of 101.1° F. He was maintaining saturation of 85% on room air. He was requiring 3 L of oxygen to maintain saturation.  Blood pressure was on the lower side with systolic blood pressure in the 90s but fluid responsive. Significant lab findings are creatinine of 1.46 higher than his baseline, lactic acid of 2.1 and proBNP of 892. Troponin was at 0.03. D-dimer was elevated at 2.33. CT chest with IV contrast was negative for pulmonary embolism but it revealed scattered bilateral areas of airspace disease likely representing multilobar pneumonia versus viral pneumonitis.  At the emergency room, patient received Levaquin 750 mg IV stat, and DuoNeb nebulization. He also received IV fluid per sepsis protocol  2/23/22: 84-year-old male with coronary artery disease status post CABG x3, hypertension, hyperlipidemia CKD stage 3 and tobacco abuse presented with cough, exertional dyspnea and generalized weakness, tested positive for COVID-19 on 02/17/22.  Patient admitted for acute hypoxic respiratory failure secondary to COVID-19 with superimposed bacterial pnd4reumonia.  On dexamethasone, ceftriaxone and azithromycin.  Did not receive remdesivir due to CKD and bradycardia.  Patient's symptoms resolved, weaned off oxygen to room air.  It has elevated blood pressure due to anxiety and steroids, amlodipine increased to 10 mg and continued on losartan.  Patient advised to monitor his blood pressure at home.  Therapy recommendation is for home with home health and was provided a walker as well. Patient discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory symptom, Respiratory tract congestion, SARS-CoV-2 test positive, Scan with contrast normal, Superinfection
Clinical narrative: Pfizer Dose 1 2/8/21 (EL1283) Pfizer Dose 2 3/2/21 (EN6200) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 2/17/21  2/19/22: Patient is 84-year-old male with past medical history of coronary artery disease status post triple bypass surgery, hypertension, dyslipidemia, CKD stage 3 and tobacco abuse.  Presented to the emergency room with a complaint of generalized weakness and fall. Patient was at the emergency room 2 days ago with a complaint of upper respiratory symptoms including sore throat, congestion, cough productive of sputum. Patient tested positive for COVID-19 despite being fully vaccinated and boosted. Patient was sent home with COVID-19 safe at home program. Since then, he has been having progressively worsening generalized weakness. He also reported exertional dyspnea. He also reported cough productive of scanty sputum, fever and shortness of breath. No chest pain or palpitations. He reported decreased appetite nausea but no vomiting. No urinary symptoms. No headache, blurring of vision or extremity weakness. Patient is a former smoker. He drinks alcohol occasionally. Earlier today, while he was trying to get up from recliner chair, he lost his balance and fell down on his left knee.  No report of head injury. No loss of consciousness. This prompted patient to come to the emergency room again today.  Upon evaluation at the emergency room, he was febrile with temperature of 101.1° F. He was maintaining saturation of 85% on room air. He was requiring 3 L of oxygen to maintain saturation.  Blood pressure was on the lower side with systolic blood pressure in the 90s but fluid responsive. Significant lab findings are creatinine of 1.46 higher than his baseline, lactic acid of 2.1 and proBNP of 892. Troponin was at 0.03. D-dimer was elevated at 2.33. CT chest with IV contrast was negative for pulmonary embolism but it revealed scattered bilateral areas of airspace disease likely representing multilobar pneumonia versus viral pneumonitis.  At the emergency room, patient received Levaquin 750 mg IV stat, and DuoNeb nebulization. He also received IV fluid per sepsis protocol  2/23/22: 84-year-old male with coronary artery disease status post CABG x3, hypertension, hyperlipidemia CKD stage 3 and tobacco abuse presented with cough, exertional dyspnea and generalized weakness, tested positive for COVID-19 on 02/17/22.  Patient admitted for acute hypoxic respiratory failure secondary to COVID-19 with superimposed bacterial pnd4reumonia.  On dexamethasone, ceftriaxone and azithromycin.  Did not receive remdesivir due to CKD and bradycardia.  Patient's symptoms resolved, weaned off oxygen to room air.  It has elevated blood pressure due to anxiety and steroids, amlodipine increased to 10 mg and continued on losartan.  Patient advised to monitor his blood pressure at home.  Therapy recommendation is for home with home health and was provided a walker as well. Patient discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin
Clinical narrative: Pfizer Dose 1 2/8/21 (EL1283) Pfizer Dose 2 3/2/21 (EN6200) Pfizer Dose 3 10/25/21 (FF2593) COVID Positive 2/17/21  2/19/22: Patient is 84-year-old male with past medical history of coronary artery disease status post triple bypass surgery, hypertension, dyslipidemia, CKD stage 3 and tobacco abuse.  Presented to the emergency room with a complaint of generalized weakness and fall. Patient was at the emergency room 2 days ago with a complaint of upper respiratory symptoms including sore throat, congestion, cough productive of sputum. Patient tested positive for COVID-19 despite being fully vaccinated and boosted. Patient was sent home with COVID-19 safe at home program. Since then, he has been having progressively worsening generalized weakness. He also reported exertional dyspnea. He also reported cough productive of scanty sputum, fever and shortness of breath. No chest pain or palpitations. He reported decreased appetite nausea but no vomiting. No urinary symptoms. No headache, blurring of vision or extremity weakness. Patient is a former smoker. He drinks alcohol occasionally. Earlier today, while he was trying to get up from recliner chair, he lost his balance and fell down on his left knee.  No report of head injury. No loss of consciousness. This prompted patient to come to the emergency room again today.  Upon evaluation at the emergency room, he was febrile with temperature of 101.1° F. He was maintaining saturation of 85% on room air. He was requiring 3 L of oxygen to maintain saturation.  Blood pressure was on the lower side with systolic blood pressure in the 90s but fluid responsive. Significant lab findings are creatinine of 1.46 higher than his baseline, lactic acid of 2.1 and proBNP of 892. Troponin was at 0.03. D-dimer was elevated at 2.33. CT chest with IV contrast was negative for pulmonary embolism but it revealed scattered bilateral areas of airspace disease likely representing multilobar pneumonia versus viral pneumonitis.  At the emergency room, patient received Levaquin 750 mg IV stat, and DuoNeb nebulization. He also received IV fluid per sepsis protocol  2/23/22: 84-year-old male with coronary artery disease status post CABG x3, hypertension, hyperlipidemia CKD stage 3 and tobacco abuse presented with cough, exertional dyspnea and generalized weakness, tested positive for COVID-19 on 02/17/22.  Patient admitted for acute hypoxic respiratory failure secondary to COVID-19 with superimposed bacterial pnd4reumonia.  On dexamethasone, ceftriaxone and azithromycin.  Did not receive remdesivir due to CKD and bradycardia.  Patient's symptoms resolved, weaned off oxygen to room air.  It has elevated blood pressure due to anxiety and steroids, amlodipine increased to 10 mg and continued on losartan.  Patient advised to monitor his blood pressure at home.  Therapy recommendation is for home with home health and was provided a walker as well. Patient discharged home.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Fatigue, Injection site erythema, Injection site swelling, Pain
Clinical narrative: Day after vaccination: fever of 100.8, bad body aches, chills, sore arm, fatigue, redness and slight bump below injection site.  Day 2 &3--feeling better, but arm still very sore, with redness.
Age: 59.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain in extremity, Pyrexia
Clinical narrative: Day after vaccination: fever of 100.8, bad body aches, chills, sore arm, fatigue, redness and slight bump below injection site.  Day 2 &3--feeling better, but arm still very sore, with redness.
Age: 3.0
Sex: F
Vaccine: COVID19
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: 8 days after vaccine, developed swelling redness and pain at injection site, spreading and more painful over next 24 hrs, treated for cellulitis with antibiotic
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure decreased, Feeling abnormal, Hypotension, Malaise, Nausea
Clinical narrative: I was feeling very nauseous and sick during the evening of the vaccination. The next morning around the nausea was extreme. At around 2pm I started vomiting and had to take my clothes off.  My blood pressure dropped; I had a hypotensive event. I had to undress and yelled for ice and something to cool me off. I was vomiting a lot. I just laid in the bed until the ice cooled me off after serval hours. I finally felt around 8pm that night I felt that I could eat some crackers. That evening I was starting to feel better It was very gradual, I did not feel totally normal until 24 hours after that event.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: I was feeling very nauseous and sick during the evening of the vaccination. The next morning around the nausea was extreme. At around 2pm I started vomiting and had to take my clothes off.  My blood pressure dropped; I had a hypotensive event. I had to undress and yelled for ice and something to cool me off. I was vomiting a lot. I just laid in the bed until the ice cooled me off after serval hours. I finally felt around 8pm that night I felt that I could eat some crackers. That evening I was starting to feel better It was very gradual, I did not feel totally normal until 24 hours after that event.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Renal failure
Clinical narrative: Patient hospitalized 6/21/22 - 6/24/22 with weakness, Covid, renal failure
Age: 19.0
Sex: F
Vaccine: HEP
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse reaction at this time. Age 19 when admin  Engerix B 20+ yrs old
Age: 79.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Patient had breakthrough infection and passed away.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Arm became red swollen and hot reaction was localized to the vaccine area on the left arm she said she had not had anything like it to her other vaccines as they were all moderna
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood creatinine increased, Blood culture, Blood potassium increased
Clinical narrative: Moderna Dose 1 1/19/21 (041L20A) Moderna Dose 2 2/15/21 (011M20A) COVID Positive 1/6/22 COVID Positive 1/10/22  1/10/22: Patient is a 53-year-old female, with a history of schizoaffective disorder, chronic respiratory failure on 3 L of home oxygen, severe pulmonary hypertension, right-sided heart failure, mild-to-moderate tricuspid regurgitation, asthma, and sickle cell trait, who presented to the ED via EMS on 1/10/2022 with weakness and lethargy.  Patient currently resides at the facility and tested positive for COVID Thursday 1/6.  EMS was called today due to altered mental status and hypoxia.  Per EMS, patient was noted to be 75% on 3 L.  She was placed on 10 L and saturations improved greater than 90%.  She was noted to be hypotensive, 3 L saline was given however no significant improvement therefore she was started on Levophed infusion.  Blood cultures were drawn.  EKG showed normal sinus rhythm QTC 469. Potassium elevated 5.8, BUN and creatinine elevated, creatinine 3.03.  ED staff attempted to place RIJ central line yet was unable to advance guidewire, RN attempting to place midline. Patient was admitted with COVID pneumonia, acute kidney injury, hyperkalemia in septic shock.  At this time Pulmonary/Critical Care consultation is being requested  Records received from Dr.'s last office visit during last hospitalization.  Records revealed that her last sleep study was in 2007 and she has had significant weight gain since that time, Dr. recommended a repeat sleep study for titration of her Bipap however she refused this as well.  Following a hospitalization in 4/2019 she was discharged with 3L NC which she has been using.  His note mentions she has a home Bipap with settings of 24/20 and she has been wearing consistently at HS.  His note mentions that her psychiatric comorbidity has complicated her Pulmonary care.   Patient was seen while in the ED.  ED staff had medicated her with Versed prior to attempting to place a central line therefore patient was difficult to arouse and could not answer questions or verify information.  1/28/22: This patient from a long-term care facility was admitted on 01/10 for weakness, shortness of breath and hypoxemia.  She tested positive for COVID-19, required supplemental oxygen and IV anti viral medications.  She did not require intubation.  She is considered COVID recovered at this time.  She has a history of schizophrenia and bipolar disorder.  We had continued the valproic acid during the hospital stay, but because of hypotension had held the intramuscular haldol and oral ziprasidone.  We have been tapering the prednisone and restarting her psychiatric medications.  She was on metformin and Januvia for diabetes before the hospitalization, she is currently on Lantus, Humalog and correction dose.  Her PCP will need to monitor the medications and make adjustments once she returns the long-term care facility.  Her oxygen requirements are improving every day.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Blood urea increased, COVID-19, COVID-19 pneumonia, Depressed level of consciousness, Dyspnoea
Clinical narrative: Moderna Dose 1 1/19/21 (041L20A) Moderna Dose 2 2/15/21 (011M20A) COVID Positive 1/6/22 COVID Positive 1/10/22  1/10/22: Patient is a 53-year-old female, with a history of schizoaffective disorder, chronic respiratory failure on 3 L of home oxygen, severe pulmonary hypertension, right-sided heart failure, mild-to-moderate tricuspid regurgitation, asthma, and sickle cell trait, who presented to the ED via EMS on 1/10/2022 with weakness and lethargy.  Patient currently resides at the facility and tested positive for COVID Thursday 1/6.  EMS was called today due to altered mental status and hypoxia.  Per EMS, patient was noted to be 75% on 3 L.  She was placed on 10 L and saturations improved greater than 90%.  She was noted to be hypotensive, 3 L saline was given however no significant improvement therefore she was started on Levophed infusion.  Blood cultures were drawn.  EKG showed normal sinus rhythm QTC 469. Potassium elevated 5.8, BUN and creatinine elevated, creatinine 3.03.  ED staff attempted to place RIJ central line yet was unable to advance guidewire, RN attempting to place midline. Patient was admitted with COVID pneumonia, acute kidney injury, hyperkalemia in septic shock.  At this time Pulmonary/Critical Care consultation is being requested  Records received from Dr.'s last office visit during last hospitalization.  Records revealed that her last sleep study was in 2007 and she has had significant weight gain since that time, Dr. recommended a repeat sleep study for titration of her Bipap however she refused this as well.  Following a hospitalization in 4/2019 she was discharged with 3L NC which she has been using.  His note mentions she has a home Bipap with settings of 24/20 and she has been wearing consistently at HS.  His note mentions that her psychiatric comorbidity has complicated her Pulmonary care.   Patient was seen while in the ED.  ED staff had medicated her with Versed prior to attempting to place a central line therefore patient was difficult to arouse and could not answer questions or verify information.  1/28/22: This patient from a long-term care facility was admitted on 01/10 for weakness, shortness of breath and hypoxemia.  She tested positive for COVID-19, required supplemental oxygen and IV anti viral medications.  She did not require intubation.  She is considered COVID recovered at this time.  She has a history of schizophrenia and bipolar disorder.  We had continued the valproic acid during the hospital stay, but because of hypotension had held the intramuscular haldol and oral ziprasidone.  We have been tapering the prednisone and restarting her psychiatric medications.  She was on metformin and Januvia for diabetes before the hospitalization, she is currently on Lantus, Humalog and correction dose.  Her PCP will need to monitor the medications and make adjustments once she returns the long-term care facility.  Her oxygen requirements are improving every day.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Hyperkalaemia, Hypotension, Hypoxia, Lethargy
Clinical narrative: Moderna Dose 1 1/19/21 (041L20A) Moderna Dose 2 2/15/21 (011M20A) COVID Positive 1/6/22 COVID Positive 1/10/22  1/10/22: Patient is a 53-year-old female, with a history of schizoaffective disorder, chronic respiratory failure on 3 L of home oxygen, severe pulmonary hypertension, right-sided heart failure, mild-to-moderate tricuspid regurgitation, asthma, and sickle cell trait, who presented to the ED via EMS on 1/10/2022 with weakness and lethargy.  Patient currently resides at the facility and tested positive for COVID Thursday 1/6.  EMS was called today due to altered mental status and hypoxia.  Per EMS, patient was noted to be 75% on 3 L.  She was placed on 10 L and saturations improved greater than 90%.  She was noted to be hypotensive, 3 L saline was given however no significant improvement therefore she was started on Levophed infusion.  Blood cultures were drawn.  EKG showed normal sinus rhythm QTC 469. Potassium elevated 5.8, BUN and creatinine elevated, creatinine 3.03.  ED staff attempted to place RIJ central line yet was unable to advance guidewire, RN attempting to place midline. Patient was admitted with COVID pneumonia, acute kidney injury, hyperkalemia in septic shock.  At this time Pulmonary/Critical Care consultation is being requested  Records received from Dr.'s last office visit during last hospitalization.  Records revealed that her last sleep study was in 2007 and she has had significant weight gain since that time, Dr. recommended a repeat sleep study for titration of her Bipap however she refused this as well.  Following a hospitalization in 4/2019 she was discharged with 3L NC which she has been using.  His note mentions she has a home Bipap with settings of 24/20 and she has been wearing consistently at HS.  His note mentions that her psychiatric comorbidity has complicated her Pulmonary care.   Patient was seen while in the ED.  ED staff had medicated her with Versed prior to attempting to place a central line therefore patient was difficult to arouse and could not answer questions or verify information.  1/28/22: This patient from a long-term care facility was admitted on 01/10 for weakness, shortness of breath and hypoxemia.  She tested positive for COVID-19, required supplemental oxygen and IV anti viral medications.  She did not require intubation.  She is considered COVID recovered at this time.  She has a history of schizophrenia and bipolar disorder.  We had continued the valproic acid during the hospital stay, but because of hypotension had held the intramuscular haldol and oral ziprasidone.  We have been tapering the prednisone and restarting her psychiatric medications.  She was on metformin and Januvia for diabetes before the hospitalization, she is currently on Lantus, Humalog and correction dose.  Her PCP will need to monitor the medications and make adjustments once she returns the long-term care facility.  Her oxygen requirements are improving every day.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Mental status changes, Positive airway pressure therapy, Refusal of treatment by patient, SARS-CoV-2 test positive, Septic shock
Clinical narrative: Moderna Dose 1 1/19/21 (041L20A) Moderna Dose 2 2/15/21 (011M20A) COVID Positive 1/6/22 COVID Positive 1/10/22  1/10/22: Patient is a 53-year-old female, with a history of schizoaffective disorder, chronic respiratory failure on 3 L of home oxygen, severe pulmonary hypertension, right-sided heart failure, mild-to-moderate tricuspid regurgitation, asthma, and sickle cell trait, who presented to the ED via EMS on 1/10/2022 with weakness and lethargy.  Patient currently resides at the facility and tested positive for COVID Thursday 1/6.  EMS was called today due to altered mental status and hypoxia.  Per EMS, patient was noted to be 75% on 3 L.  She was placed on 10 L and saturations improved greater than 90%.  She was noted to be hypotensive, 3 L saline was given however no significant improvement therefore she was started on Levophed infusion.  Blood cultures were drawn.  EKG showed normal sinus rhythm QTC 469. Potassium elevated 5.8, BUN and creatinine elevated, creatinine 3.03.  ED staff attempted to place RIJ central line yet was unable to advance guidewire, RN attempting to place midline. Patient was admitted with COVID pneumonia, acute kidney injury, hyperkalemia in septic shock.  At this time Pulmonary/Critical Care consultation is being requested  Records received from Dr.'s last office visit during last hospitalization.  Records revealed that her last sleep study was in 2007 and she has had significant weight gain since that time, Dr. recommended a repeat sleep study for titration of her Bipap however she refused this as well.  Following a hospitalization in 4/2019 she was discharged with 3L NC which she has been using.  His note mentions she has a home Bipap with settings of 24/20 and she has been wearing consistently at HS.  His note mentions that her psychiatric comorbidity has complicated her Pulmonary care.   Patient was seen while in the ED.  ED staff had medicated her with Versed prior to attempting to place a central line therefore patient was difficult to arouse and could not answer questions or verify information.  1/28/22: This patient from a long-term care facility was admitted on 01/10 for weakness, shortness of breath and hypoxemia.  She tested positive for COVID-19, required supplemental oxygen and IV anti viral medications.  She did not require intubation.  She is considered COVID recovered at this time.  She has a history of schizophrenia and bipolar disorder.  We had continued the valproic acid during the hospital stay, but because of hypotension had held the intramuscular haldol and oral ziprasidone.  We have been tapering the prednisone and restarting her psychiatric medications.  She was on metformin and Januvia for diabetes before the hospitalization, she is currently on Lantus, Humalog and correction dose.  Her PCP will need to monitor the medications and make adjustments once she returns the long-term care facility.  Her oxygen requirements are improving every day.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Weight increased
Clinical narrative: Moderna Dose 1 1/19/21 (041L20A) Moderna Dose 2 2/15/21 (011M20A) COVID Positive 1/6/22 COVID Positive 1/10/22  1/10/22: Patient is a 53-year-old female, with a history of schizoaffective disorder, chronic respiratory failure on 3 L of home oxygen, severe pulmonary hypertension, right-sided heart failure, mild-to-moderate tricuspid regurgitation, asthma, and sickle cell trait, who presented to the ED via EMS on 1/10/2022 with weakness and lethargy.  Patient currently resides at the facility and tested positive for COVID Thursday 1/6.  EMS was called today due to altered mental status and hypoxia.  Per EMS, patient was noted to be 75% on 3 L.  She was placed on 10 L and saturations improved greater than 90%.  She was noted to be hypotensive, 3 L saline was given however no significant improvement therefore she was started on Levophed infusion.  Blood cultures were drawn.  EKG showed normal sinus rhythm QTC 469. Potassium elevated 5.8, BUN and creatinine elevated, creatinine 3.03.  ED staff attempted to place RIJ central line yet was unable to advance guidewire, RN attempting to place midline. Patient was admitted with COVID pneumonia, acute kidney injury, hyperkalemia in septic shock.  At this time Pulmonary/Critical Care consultation is being requested  Records received from Dr.'s last office visit during last hospitalization.  Records revealed that her last sleep study was in 2007 and she has had significant weight gain since that time, Dr. recommended a repeat sleep study for titration of her Bipap however she refused this as well.  Following a hospitalization in 4/2019 she was discharged with 3L NC which she has been using.  His note mentions she has a home Bipap with settings of 24/20 and she has been wearing consistently at HS.  His note mentions that her psychiatric comorbidity has complicated her Pulmonary care.   Patient was seen while in the ED.  ED staff had medicated her with Versed prior to attempting to place a central line therefore patient was difficult to arouse and could not answer questions or verify information.  1/28/22: This patient from a long-term care facility was admitted on 01/10 for weakness, shortness of breath and hypoxemia.  She tested positive for COVID-19, required supplemental oxygen and IV anti viral medications.  She did not require intubation.  She is considered COVID recovered at this time.  She has a history of schizophrenia and bipolar disorder.  We had continued the valproic acid during the hospital stay, but because of hypotension had held the intramuscular haldol and oral ziprasidone.  We have been tapering the prednisone and restarting her psychiatric medications.  She was on metformin and Januvia for diabetes before the hospitalization, she is currently on Lantus, Humalog and correction dose.  Her PCP will need to monitor the medications and make adjustments once she returns the long-term care facility.  Her oxygen requirements are improving every day.