chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 1.33
Sex: M
Vaccine: DTAPIPVHIB, PNC13
Symptoms: Febrile convulsion, Immunisation reaction, Laboratory test normal, Pyrexia
Clinical narrative: Patient came into office on 3/22/2023 and received vaccines pentacel and prevanar at around 2:30PM. Mother states child started to get a fever early morning on 3/23/2023. Childs fever reached 104. Mother called EMS on 3/24/23 around 4 AM due to child having high fever and febrile seizure. Child was seen at local ED and all negative for everything. ED told mother that they feel  it was immunizations and to increase PO intake and to f/u with pediatrician. Mother contacted pediatric office on 3/24/2023 after discharged from ED.
Age: 57.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Dizziness, Fatigue, Foreign travel, Headache
Clinical narrative: I had a runny nose and congestion. I also experienced lightheadedness and fatigue. I took a COVID-19 home test for 3 days and they were negative.  My symptoms continued and I had a slight headache and sore throat. I tested for COVID-19 once more and it was positive. I contacted my doctor, and he said not to take Paxlovid. I took Nyquil and Dayquil to treat my symptoms. I got worse. I was getting more and more tired.  I went to the doctor on March 04, 2023, and received a breathing treatment. I was really fatigued. I tested negative on March 05, 2023. My symptoms lingered after I was negative. On Wednesday March 08, 2023, I flew out of the country, so I was unsure if the symptoms were from that or the COVID-19 symptoms. I was tired for another week.
Age: 57.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Malaise, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I had a runny nose and congestion. I also experienced lightheadedness and fatigue. I took a COVID-19 home test for 3 days and they were negative.  My symptoms continued and I had a slight headache and sore throat. I tested for COVID-19 once more and it was positive. I contacted my doctor, and he said not to take Paxlovid. I took Nyquil and Dayquil to treat my symptoms. I got worse. I was getting more and more tired.  I went to the doctor on March 04, 2023, and received a breathing treatment. I was really fatigued. I tested negative on March 05, 2023. My symptoms lingered after I was negative. On Wednesday March 08, 2023, I flew out of the country, so I was unsure if the symptoms were from that or the COVID-19 symptoms. I was tired for another week.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine was expired
Age: 83.0
Sex: F
Vaccine: VARZOS
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Patient reported injection site reaction of swelling, redness, and soreness. Patient's provider deemed it as cellulitis and treated with antibiotic.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Alopecia, Biopsy skin normal
Clinical narrative: I started loosing hair about 3 months after the vaccine, I had a biopsy and it didn't show anything. I went to the dermatologist and they haven't figured out why I am loosing hair. I am going to see more doctors to see if they can find a solution.
Age: 33.0
Sex: M
Vaccine: JEV1
Symptoms: Chills, Migraine, Pain, Pyrexia
Clinical narrative: Body aches, chills, high grade fever 104.7, migraine behind left eye
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Headache, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Had a headache, congestion and a deep cough, took the Home COVID-19 test and it was slightly positive. Called doctor and was advised to go the Emergency Room. At the Emergency Room I was given a PCR COVID-19 test and it was negative. Had congestion for at least a couple of weeks afterwards. Finally felt a little better and took another Home COVID-19 test and it was negative.
Age: 36.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chills, Dyspepsia, Headache, Nausea, Pyrexia
Clinical narrative: I experienced nausea, headaches, fever, chills and heartburn.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiac arrest, Death, SARS-CoV-2 test positive, Unresponsive to stimuli
Clinical narrative: 3RD DOSE COVID VACCINE, PFIZER, GIVEN 1/13/22, #FJ1614; pt had a positive COVID test at home on 9/29/22; family found pt unresponsive on 9/30/22 and called EMS; EMS confirmed asystole; pt passed away in his home
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Condition aggravated, Malaise, Pain in extremity, Rheumatoid arthritis
Clinical narrative: I did not have an adverse reaction to the vaccine. I tested positive for COVID-19 in 05/2022. I was prescribed Paxlovid and did not have any complications taking the medication. I was sick for about three weeks. Since the vaccine, my rheumatoid arthritis is worse in my hands and arms. The pain is hard to manage in my hands. The rheumatoid arthritis was manageable prior to the vaccine.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I did not have an adverse reaction to the vaccine. I tested positive for COVID-19 in 05/2022. I was prescribed Paxlovid and did not have any complications taking the medication. I was sick for about three weeks. Since the vaccine, my rheumatoid arthritis is worse in my hands and arms. The pain is hard to manage in my hands. The rheumatoid arthritis was manageable prior to the vaccine.
Age: 78.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Blood test, Laboratory test, Rash, Rash vesicular, Scratch
Clinical narrative: On 09/23/2022, I noticed a blistery rash, which I thought was shingles on my lower back just below the waistline around the spine. I scratched. I put oil on it. I went to the doctor for my regular check up a couple of months later. It was started to form on my arms and stomach. My doctor thought it was Alpha Gal again, so I went to my acupuncturist. She said it was not Alpha Gal, it was antibodies causing the reaction. She gave me a holistic spray and it cleared up.
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Headache, Nasopharyngitis, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: On 01/03/203 I started to get a fever, cold like symptoms and headache. I tested Positive for Covid and contacted my doctor. I was prescribed Paxlovid for days and started to feel better. After testing negative for a few days I retested Positive for Covid-19 and symptoms returned.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Nasal congestion, Respiratory tract congestion, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: Woke with a scratchy throat on 12/20.  By 12/23 I had very bad nasal congestion.     Tested positive on an At Home COVID-19 test, spoke to doctor who proscribed Paxlovid.  Symptoms got much better after 2 days on Paxlovid.  Primary symptom and complaint was congestion, which cleared after 2 days on Paxlovid.  By 10 days after starting Paxlovid, all symptoms cleared up.
Age: 48.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: COVID-19, Chills, Oropharyngeal pain, SARS-CoV-2 test positive, Streptococcus test negative
Clinical narrative: The most painful sore throat I have ever had and chills, my throat felt like I was swallowing glass.
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Patient had a breakthrough infection and passed away.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Patient had a breakthrough infection and passed away.
Age: 66.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Incorrect product formulation administered, No adverse event, Vaccination error
Clinical narrative: Client received COVID Pfizer Bivalent 12+ as 1st dose in COVID series on 02/28/2023. Denies any adverse reactions. Presented to Clinic 03/24/23 to receive second dose. Error was noted 03/24/23. Client was given COVID Pfizer 12+ Monovalent vaccine as second dose in COVID series per CDC recommendations and guidelines on 03/24/2023.
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Nasal congestion, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I ran a little fever with coughing and a stuffy nose. The doctor immediately prescribed Paxlovid. The fever lasted a few days but then went away.
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: Cough, Influenza A virus test positive, Limb injury, Oropharyngeal pain, Pyrexia
Clinical narrative: My children came home sick, my oldest child woke up sick on 3/9 and then the youngest started coughing the next day. On the evening of 3/10 I started to develop a cough and that night I was up helping the kids and felt a sore throat developing. The next day 3/12, I developed a fever. Over the next week I had a fever that ranged from low grade up to 102 and had a very bad sore throat and cough. I went to urgent care on 3/15 because my PCP didn't have any appointments available. At the urgent care I tested negative for COVID19 and Strep but positive for Influenza A. I was outside the window for TAMIFLU. By 3/19 the fever had abated but I still had a pretty bad cough. Yesterday 3/23 I contacted my PCP about my cough and they prescribed TESSALON PERLES for the cough and an inhaled steroid. I want to mention that a few weeks before all of this I had a TDap vaccination at urgent care because I cut my finger and had to get stitches, and my Flu vaccine was in the fall.
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test negative, Streptococcus test negative, Suture insertion
Clinical narrative: My children came home sick, my oldest child woke up sick on 3/9 and then the youngest started coughing the next day. On the evening of 3/10 I started to develop a cough and that night I was up helping the kids and felt a sore throat developing. The next day 3/12, I developed a fever. Over the next week I had a fever that ranged from low grade up to 102 and had a very bad sore throat and cough. I went to urgent care on 3/15 because my PCP didn't have any appointments available. At the urgent care I tested negative for COVID19 and Strep but positive for Influenza A. I was outside the window for TAMIFLU. By 3/19 the fever had abated but I still had a pretty bad cough. Yesterday 3/23 I contacted my PCP about my cough and they prescribed TESSALON PERLES for the cough and an inhaled steroid. I want to mention that a few weeks before all of this I had a TDap vaccination at urgent care because I cut my finger and had to get stitches, and my Flu vaccine was in the fall.
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: Patient received a fifth covid vaccine in clinic.  Second dose of bivalent.
Age: 62.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Pyrexia, Sinusitis, Upper respiratory tract infection
Clinical narrative: 1/15/23 I had a fever of a little over 100 and sinus infection. I contacted my doctor and started taking Augmentin that day. In March I had an upper respiratory infection, maybe ears or sinus and I took Tetracycline.
Age: 43.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, COVID-19, Cough, Fatigue, Oropharyngeal pain
Clinical narrative: I was positive for COVID-19 on 01MAR2023, I was traveling and I had a sore throat and when I came home I tested and it was positive. I didn't have a fever or body aches but I did feel tired and joint pain. I did have a constant cough. I contacted my doctor and he prescribed me Paxlovid, I started feeling better 10 days after.
Age: 43.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I was positive for COVID-19 on 01MAR2023, I was traveling and I had a sore throat and when I came home I tested and it was positive. I didn't have a fever or body aches but I did feel tired and joint pain. I did have a constant cough. I contacted my doctor and he prescribed me Paxlovid, I started feeling better 10 days after.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy skin, Rash, Rash pruritic
Clinical narrative: I noticed a rash on my arms, legs, and neck on November 21, 2022, I experienced itching from the rash I was using a steroid cream called Triamcinolone; Dexamethasone; for the symptoms. The still persist it has not cleared I'm also seeing a Dermatologist.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Bone pain, Cough, Laboratory test normal, SARS-CoV-2 test negative, Sleep disorder
Clinical narrative: After receiving my 1st dose I noticed that I developed a dry cough without mucus for 1 and half. I spoke with my doctor who changed my blood pressure medication 6-7 times within the years. She referred me to ENT. They checked and told me that everything was clear. I had nothing wrong. They even put a machine to check but found nothing wrong. Then I went to a Lung Specialist who told me my lungs were clear but I might have infection in my chest. He prescribed prednisone and promethazine. It helped with the cough for few days but after I finished the medication the dry cough came back. On the top of my breast bone is very painful. I can't even touch it. At this point nothing is ruled out. The cough is ongoing. It's bothering I can't sleep. I am getting worried. It is concerning. I will be going to a Gastroenterologist to see if they could rule out anything or where the cough is coming from.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Therapy change
Clinical narrative: After receiving my 1st dose I noticed that I developed a dry cough without mucus for 1 and half. I spoke with my doctor who changed my blood pressure medication 6-7 times within the years. She referred me to ENT. They checked and told me that everything was clear. I had nothing wrong. They even put a machine to check but found nothing wrong. Then I went to a Lung Specialist who told me my lungs were clear but I might have infection in my chest. He prescribed prednisone and promethazine. It helped with the cough for few days but after I finished the medication the dry cough came back. On the top of my breast bone is very painful. I can't even touch it. At this point nothing is ruled out. The cough is ongoing. It's bothering I can't sleep. I am getting worried. It is concerning. I will be going to a Gastroenterologist to see if they could rule out anything or where the cough is coming from.
Age: 50.0
Sex: F
Vaccine: COVID19-2
Symptoms: Culture urine, Gait disturbance, Muscle disorder, Pain, Urine analysis normal
Clinical narrative: I had left side pain and could barely walk. I had difficulty walking because it was so painful on the left side. I took a muscle relaxer and went to bed. Later in the night the pain had become more severe. 2 days later it was gone and it returned again yesterday March 24, 2023 on the same side in the same area. I saw a nurse practitioner who had me do several movements and discussed what I was doing when the pain came on. She completed a urinalysis and a urine culture. She diagnosed me with having a muscle sprain and prescribed ibuprofen and cyclobenzaprine for the pain. I have not yet taken the medication. My symptoms are not as bad today. They have eased up some. I can still feel it. It's like a nagging ache. My doctor advised that it would likely take a few weeks to recover from it.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulation drug level below therapeutic, Asthenia, COVID-19, Confusional state, Culture urine positive
Clinical narrative: Admission Date: 3/12/2023 Discharge Date: 03/23/2023   PRESENTING PROBLEM: Lethargy and Weakness   HOSPITAL COURSE: Patient is an 85-year-old female who was admitted on 03/12/2023 for acute weakness, lethargy, confusion for few days prior.  Patient was found to be COVID-19 positive and had a UA consistent with urinary tract infection.  Patient's diuretics were held and she was rehydrated, started on Rocephin from 3/12-3/15 though urine culture showed mixed flora consistent with contamination.  Believe metabolic encephalopathy secondary to COVID-19.  Patient improved 48 hours later.  PT/OT worked with the patient and recommending subacute rehab for deconditioning.  Placement was found patient has been medically stable.  Only changes to chronic disease management is Lasix reduced from 40 mg to 20 mg and subtherapeutic INR levels pharmacy recommended increasing warfarin dosing on Monday Wednesdays and Fridays from 0.5 mg to 1 mg.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Lethargy, Metabolic encephalopathy, Physical deconditioning, SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: Admission Date: 3/12/2023 Discharge Date: 03/23/2023   PRESENTING PROBLEM: Lethargy and Weakness   HOSPITAL COURSE: Patient is an 85-year-old female who was admitted on 03/12/2023 for acute weakness, lethargy, confusion for few days prior.  Patient was found to be COVID-19 positive and had a UA consistent with urinary tract infection.  Patient's diuretics were held and she was rehydrated, started on Rocephin from 3/12-3/15 though urine culture showed mixed flora consistent with contamination.  Believe metabolic encephalopathy secondary to COVID-19.  Patient improved 48 hours later.  PT/OT worked with the patient and recommending subacute rehab for deconditioning.  Placement was found patient has been medically stable.  Only changes to chronic disease management is Lasix reduced from 40 mg to 20 mg and subtherapeutic INR levels pharmacy recommended increasing warfarin dosing on Monday Wednesdays and Fridays from 0.5 mg to 1 mg.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Urine analysis abnormal
Clinical narrative: Admission Date: 3/12/2023 Discharge Date: 03/23/2023   PRESENTING PROBLEM: Lethargy and Weakness   HOSPITAL COURSE: Patient is an 85-year-old female who was admitted on 03/12/2023 for acute weakness, lethargy, confusion for few days prior.  Patient was found to be COVID-19 positive and had a UA consistent with urinary tract infection.  Patient's diuretics were held and she was rehydrated, started on Rocephin from 3/12-3/15 though urine culture showed mixed flora consistent with contamination.  Believe metabolic encephalopathy secondary to COVID-19.  Patient improved 48 hours later.  PT/OT worked with the patient and recommending subacute rehab for deconditioning.  Placement was found patient has been medically stable.  Only changes to chronic disease management is Lasix reduced from 40 mg to 20 mg and subtherapeutic INR levels pharmacy recommended increasing warfarin dosing on Monday Wednesdays and Fridays from 0.5 mg to 1 mg.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood pressure increased, Blood sodium decreased, Blood test abnormal, COVID-19, Condition aggravated
Clinical narrative: I started having normal flu symptoms-- body aches, fever, congestion, and coughing. I took an at-home COVID-19 on New Year's which came back positive. I was prescribed Paxlovid on the 01/02/2023 and began the treatment. On Friday, the 5th, I was unable to keep any food or drinks down and became delirious. My husband called the ambulance and took me to the hospital where I was admitted. A full panel of bloodwork and cultures were taken, and my blood pressure was extremely elevated with severely low sodium levels. I was in the hospital for 2 days and was released after. My blood pressure remained elevated for a couple of days later as my sodium levels slowly began to rise. My blood pressure prescriptions were changed slightly to help regulate my blood pressure better and faster.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Delirium, Influenza, Pain, Pyrexia
Clinical narrative: I started having normal flu symptoms-- body aches, fever, congestion, and coughing. I took an at-home COVID-19 on New Year's which came back positive. I was prescribed Paxlovid on the 01/02/2023 and began the treatment. On Friday, the 5th, I was unable to keep any food or drinks down and became delirious. My husband called the ambulance and took me to the hospital where I was admitted. A full panel of bloodwork and cultures were taken, and my blood pressure was extremely elevated with severely low sodium levels. I was in the hospital for 2 days and was released after. My blood pressure remained elevated for a couple of days later as my sodium levels slowly began to rise. My blood pressure prescriptions were changed slightly to help regulate my blood pressure better and faster.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive, Vomiting
Clinical narrative: I started having normal flu symptoms-- body aches, fever, congestion, and coughing. I took an at-home COVID-19 on New Year's which came back positive. I was prescribed Paxlovid on the 01/02/2023 and began the treatment. On Friday, the 5th, I was unable to keep any food or drinks down and became delirious. My husband called the ambulance and took me to the hospital where I was admitted. A full panel of bloodwork and cultures were taken, and my blood pressure was extremely elevated with severely low sodium levels. I was in the hospital for 2 days and was released after. My blood pressure remained elevated for a couple of days later as my sodium levels slowly began to rise. My blood pressure prescriptions were changed slightly to help regulate my blood pressure better and faster.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Hysterectomy, Ovarian epithelial cancer, Ovarian mass, Pathology test
Clinical narrative: A mass was first noticed 14SEP2022 through a regular exam. I had a mass on my ovary after a few months of follow up imaging. My oncologist recommended total removal  removal 12JAN2023 I had a total hysterectomy.  Stage 1A serous adenocarcinoma was diagnosed.
Age: 69.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Anticoagulant therapy, Aphasia, Computerised tomogram head abnormal, Dysgraphia, Lacunar stroke
Clinical narrative: I noticed I was having difficulty writing with my right hand, it was small and shaky. I was having trouble, thinking and organizing my thoughts internally, I felt like my words were garbled. Later that day, I had trouble typing. The symptoms started around 11AM in the morning and seemed to resolve by 7PM. I called my doctor the next day and she told me to go to the emergency room to get checked out. Once I was there, they ran a CAT scan and MRI. They found that I had, had and acute lacunar. I was kept in the observation area of the emergency room for 36-48 hours. Upon discharge I was given ELIQUIS and LIPITOR. I do not feel any residual effects.
Age: 69.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Magnetic resonance imaging head abnormal, Mental impairment, Tremor
Clinical narrative: I noticed I was having difficulty writing with my right hand, it was small and shaky. I was having trouble, thinking and organizing my thoughts internally, I felt like my words were garbled. Later that day, I had trouble typing. The symptoms started around 11AM in the morning and seemed to resolve by 7PM. I called my doctor the next day and she told me to go to the emergency room to get checked out. Once I was there, they ran a CAT scan and MRI. They found that I had, had and acute lacunar. I was kept in the observation area of the emergency room for 36-48 hours. Upon discharge I was given ELIQUIS and LIPITOR. I do not feel any residual effects.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Patient  age 75 Admit 3/7/2023 for respiratory failure. COVID positive 3/7/2023 Date of death 3/23/23. County: reported Medical center
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Sleep apnoea syndrome
Clinical narrative: Afib heart sleep apnea
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Heart rate increased, Laboratory test abnormal
Clinical narrative: I did not have an adverse reaction to the vaccine. My heart started beating really fast when I would lay down which lasted several days. I was out-of-town but when I returned home, I went to the doctor. I went through some test and was diagnosed with AFIB and rapid heartbeat. I am taking medication to control both. As of today, I am feeling better and less frequent episodes.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal distension, Acidosis, Aspiration, Blood creatine abnormal, Blood lactic acid
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 3/10/2023 PRESENTING PROBLEM: Septic shock (HCC) [A41.9, R65.21] Shock (HCC) [R57.9]   HOSPITAL COURSE: Patient is a 67-year-old female with past medical history of CAD (CABG 2016 with stemi 9/2022), dHF, HTN, HLD, CVA R MCA, hx RLE dvt (eliquis), and recent COVID infection a couple weeks ago who presents with difficulty breathing.  Transferred from outside hospital with concerns for septic shock on vasopressors, intubated for airway protection.   Patient initially presented from a skilled nursing facility.  Per their report, the patient vomited in the morning and did have an aspiration event. In the emergency department, patient was in respiratory distress and not protecting her airway so she was intubated.  Black emesis was noted in the posterior pharynx that was heme positive.  There is some abdominal distention and an OG tube was placed.  Vasopressors started for persistent hypotension.  Lactic acid 9.5, WBC 23, BNP 15000, initial pH 7.26. Patient was COVID positive but this was suspected to be secondary to previous infection.  Patient was started on vancomycin, cefepime, Flagyl. CT thorax, abdomen, pelvis without contrast showed diffuse alveolar infiltrates and increased consolidation left lower lobe, concern for possible colitis.  Stress dose steroids were added and patient was bolused with Protonix and started on a Protonix drip.  Patient was then transferred to intensive care unit for further management.   GI was consulted for GI bleed and repeat CT abdomen pelvis showed increased gallbladder distension, increased small amount of pelvic free fluid, and similar bowel distension.  While lactic acid was initially downtrending, it subsequently increased from 4.7 to 5.3.  The patient also was hyperkalemic, acidotic, and had worsening creatinine.  Insulin, calcium, lokelma, and started on a bicarb drip.   On 3/12 night, stroke code called and CT notable for large right ACA and MCA infarct. Cytotoxic cerebral edema with midline shift noted. Goals of care discussion were held with family, who decided against intervention and chose to pursue comfort care.    Patient died in hospital on 3/13 at 9:02 PM with husband and son present at bedside.    Medical Examiner Case Assessment Select Applicable Patient Criteria: Does not meet any of the listed criteria
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pH decreased, Brain natriuretic peptide increased, Brain oedema, COVID-19, Cerebral infarction
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 3/10/2023 PRESENTING PROBLEM: Septic shock (HCC) [A41.9, R65.21] Shock (HCC) [R57.9]   HOSPITAL COURSE: Patient is a 67-year-old female with past medical history of CAD (CABG 2016 with stemi 9/2022), dHF, HTN, HLD, CVA R MCA, hx RLE dvt (eliquis), and recent COVID infection a couple weeks ago who presents with difficulty breathing.  Transferred from outside hospital with concerns for septic shock on vasopressors, intubated for airway protection.   Patient initially presented from a skilled nursing facility.  Per their report, the patient vomited in the morning and did have an aspiration event. In the emergency department, patient was in respiratory distress and not protecting her airway so she was intubated.  Black emesis was noted in the posterior pharynx that was heme positive.  There is some abdominal distention and an OG tube was placed.  Vasopressors started for persistent hypotension.  Lactic acid 9.5, WBC 23, BNP 15000, initial pH 7.26. Patient was COVID positive but this was suspected to be secondary to previous infection.  Patient was started on vancomycin, cefepime, Flagyl. CT thorax, abdomen, pelvis without contrast showed diffuse alveolar infiltrates and increased consolidation left lower lobe, concern for possible colitis.  Stress dose steroids were added and patient was bolused with Protonix and started on a Protonix drip.  Patient was then transferred to intensive care unit for further management.   GI was consulted for GI bleed and repeat CT abdomen pelvis showed increased gallbladder distension, increased small amount of pelvic free fluid, and similar bowel distension.  While lactic acid was initially downtrending, it subsequently increased from 4.7 to 5.3.  The patient also was hyperkalemic, acidotic, and had worsening creatinine.  Insulin, calcium, lokelma, and started on a bicarb drip.   On 3/12 night, stroke code called and CT notable for large right ACA and MCA infarct. Cytotoxic cerebral edema with midline shift noted. Goals of care discussion were held with family, who decided against intervention and chose to pursue comfort care.    Patient died in hospital on 3/13 at 9:02 PM with husband and son present at bedside.    Medical Examiner Case Assessment Select Applicable Patient Criteria: Does not meet any of the listed criteria
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebral mass effect, Computerised tomogram abdomen abnormal, Computerised tomogram head abnormal, Computerised tomogram thorax abnormal, Death
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 3/10/2023 PRESENTING PROBLEM: Septic shock (HCC) [A41.9, R65.21] Shock (HCC) [R57.9]   HOSPITAL COURSE: Patient is a 67-year-old female with past medical history of CAD (CABG 2016 with stemi 9/2022), dHF, HTN, HLD, CVA R MCA, hx RLE dvt (eliquis), and recent COVID infection a couple weeks ago who presents with difficulty breathing.  Transferred from outside hospital with concerns for septic shock on vasopressors, intubated for airway protection.   Patient initially presented from a skilled nursing facility.  Per their report, the patient vomited in the morning and did have an aspiration event. In the emergency department, patient was in respiratory distress and not protecting her airway so she was intubated.  Black emesis was noted in the posterior pharynx that was heme positive.  There is some abdominal distention and an OG tube was placed.  Vasopressors started for persistent hypotension.  Lactic acid 9.5, WBC 23, BNP 15000, initial pH 7.26. Patient was COVID positive but this was suspected to be secondary to previous infection.  Patient was started on vancomycin, cefepime, Flagyl. CT thorax, abdomen, pelvis without contrast showed diffuse alveolar infiltrates and increased consolidation left lower lobe, concern for possible colitis.  Stress dose steroids were added and patient was bolused with Protonix and started on a Protonix drip.  Patient was then transferred to intensive care unit for further management.   GI was consulted for GI bleed and repeat CT abdomen pelvis showed increased gallbladder distension, increased small amount of pelvic free fluid, and similar bowel distension.  While lactic acid was initially downtrending, it subsequently increased from 4.7 to 5.3.  The patient also was hyperkalemic, acidotic, and had worsening creatinine.  Insulin, calcium, lokelma, and started on a bicarb drip.   On 3/12 night, stroke code called and CT notable for large right ACA and MCA infarct. Cytotoxic cerebral edema with midline shift noted. Goals of care discussion were held with family, who decided against intervention and chose to pursue comfort care.    Patient died in hospital on 3/13 at 9:02 PM with husband and son present at bedside.    Medical Examiner Case Assessment Select Applicable Patient Criteria: Does not meet any of the listed criteria
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Discoloured vomit, Dyspnoea, Endotracheal intubation, Gallbladder disorder, Gastrointestinal haemorrhage
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 3/10/2023 PRESENTING PROBLEM: Septic shock (HCC) [A41.9, R65.21] Shock (HCC) [R57.9]   HOSPITAL COURSE: Patient is a 67-year-old female with past medical history of CAD (CABG 2016 with stemi 9/2022), dHF, HTN, HLD, CVA R MCA, hx RLE dvt (eliquis), and recent COVID infection a couple weeks ago who presents with difficulty breathing.  Transferred from outside hospital with concerns for septic shock on vasopressors, intubated for airway protection.   Patient initially presented from a skilled nursing facility.  Per their report, the patient vomited in the morning and did have an aspiration event. In the emergency department, patient was in respiratory distress and not protecting her airway so she was intubated.  Black emesis was noted in the posterior pharynx that was heme positive.  There is some abdominal distention and an OG tube was placed.  Vasopressors started for persistent hypotension.  Lactic acid 9.5, WBC 23, BNP 15000, initial pH 7.26. Patient was COVID positive but this was suspected to be secondary to previous infection.  Patient was started on vancomycin, cefepime, Flagyl. CT thorax, abdomen, pelvis without contrast showed diffuse alveolar infiltrates and increased consolidation left lower lobe, concern for possible colitis.  Stress dose steroids were added and patient was bolused with Protonix and started on a Protonix drip.  Patient was then transferred to intensive care unit for further management.   GI was consulted for GI bleed and repeat CT abdomen pelvis showed increased gallbladder distension, increased small amount of pelvic free fluid, and similar bowel distension.  While lactic acid was initially downtrending, it subsequently increased from 4.7 to 5.3.  The patient also was hyperkalemic, acidotic, and had worsening creatinine.  Insulin, calcium, lokelma, and started on a bicarb drip.   On 3/12 night, stroke code called and CT notable for large right ACA and MCA infarct. Cytotoxic cerebral edema with midline shift noted. Goals of care discussion were held with family, who decided against intervention and chose to pursue comfort care.    Patient died in hospital on 3/13 at 9:02 PM with husband and son present at bedside.    Medical Examiner Case Assessment Select Applicable Patient Criteria: Does not meet any of the listed criteria
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Gastrointestinal tube insertion, Hyperkalaemia, Hypotension, Intensive care, Intestinal dilatation
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 3/10/2023 PRESENTING PROBLEM: Septic shock (HCC) [A41.9, R65.21] Shock (HCC) [R57.9]   HOSPITAL COURSE: Patient is a 67-year-old female with past medical history of CAD (CABG 2016 with stemi 9/2022), dHF, HTN, HLD, CVA R MCA, hx RLE dvt (eliquis), and recent COVID infection a couple weeks ago who presents with difficulty breathing.  Transferred from outside hospital with concerns for septic shock on vasopressors, intubated for airway protection.   Patient initially presented from a skilled nursing facility.  Per their report, the patient vomited in the morning and did have an aspiration event. In the emergency department, patient was in respiratory distress and not protecting her airway so she was intubated.  Black emesis was noted in the posterior pharynx that was heme positive.  There is some abdominal distention and an OG tube was placed.  Vasopressors started for persistent hypotension.  Lactic acid 9.5, WBC 23, BNP 15000, initial pH 7.26. Patient was COVID positive but this was suspected to be secondary to previous infection.  Patient was started on vancomycin, cefepime, Flagyl. CT thorax, abdomen, pelvis without contrast showed diffuse alveolar infiltrates and increased consolidation left lower lobe, concern for possible colitis.  Stress dose steroids were added and patient was bolused with Protonix and started on a Protonix drip.  Patient was then transferred to intensive care unit for further management.   GI was consulted for GI bleed and repeat CT abdomen pelvis showed increased gallbladder distension, increased small amount of pelvic free fluid, and similar bowel distension.  While lactic acid was initially downtrending, it subsequently increased from 4.7 to 5.3.  The patient also was hyperkalemic, acidotic, and had worsening creatinine.  Insulin, calcium, lokelma, and started on a bicarb drip.   On 3/12 night, stroke code called and CT notable for large right ACA and MCA infarct. Cytotoxic cerebral edema with midline shift noted. Goals of care discussion were held with family, who decided against intervention and chose to pursue comfort care.    Patient died in hospital on 3/13 at 9:02 PM with husband and son present at bedside.    Medical Examiner Case Assessment Select Applicable Patient Criteria: Does not meet any of the listed criteria
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Lung consolidation, Lung infiltration, Pelvic fluid collection, Respiratory distress, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 3/10/2023 PRESENTING PROBLEM: Septic shock (HCC) [A41.9, R65.21] Shock (HCC) [R57.9]   HOSPITAL COURSE: Patient is a 67-year-old female with past medical history of CAD (CABG 2016 with stemi 9/2022), dHF, HTN, HLD, CVA R MCA, hx RLE dvt (eliquis), and recent COVID infection a couple weeks ago who presents with difficulty breathing.  Transferred from outside hospital with concerns for septic shock on vasopressors, intubated for airway protection.   Patient initially presented from a skilled nursing facility.  Per their report, the patient vomited in the morning and did have an aspiration event. In the emergency department, patient was in respiratory distress and not protecting her airway so she was intubated.  Black emesis was noted in the posterior pharynx that was heme positive.  There is some abdominal distention and an OG tube was placed.  Vasopressors started for persistent hypotension.  Lactic acid 9.5, WBC 23, BNP 15000, initial pH 7.26. Patient was COVID positive but this was suspected to be secondary to previous infection.  Patient was started on vancomycin, cefepime, Flagyl. CT thorax, abdomen, pelvis without contrast showed diffuse alveolar infiltrates and increased consolidation left lower lobe, concern for possible colitis.  Stress dose steroids were added and patient was bolused with Protonix and started on a Protonix drip.  Patient was then transferred to intensive care unit for further management.   GI was consulted for GI bleed and repeat CT abdomen pelvis showed increased gallbladder distension, increased small amount of pelvic free fluid, and similar bowel distension.  While lactic acid was initially downtrending, it subsequently increased from 4.7 to 5.3.  The patient also was hyperkalemic, acidotic, and had worsening creatinine.  Insulin, calcium, lokelma, and started on a bicarb drip.   On 3/12 night, stroke code called and CT notable for large right ACA and MCA infarct. Cytotoxic cerebral edema with midline shift noted. Goals of care discussion were held with family, who decided against intervention and chose to pursue comfort care.    Patient died in hospital on 3/13 at 9:02 PM with husband and son present at bedside.    Medical Examiner Case Assessment Select Applicable Patient Criteria: Does not meet any of the listed criteria
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Scan with contrast abnormal, Septic shock, Shock, Vomiting, White blood cell count increased
Clinical narrative: Discharge Provider: MD Primary Care Physician at Discharge: None Physician, DO None Admission Date: 3/10/2023 PRESENTING PROBLEM: Septic shock (HCC) [A41.9, R65.21] Shock (HCC) [R57.9]   HOSPITAL COURSE: Patient is a 67-year-old female with past medical history of CAD (CABG 2016 with stemi 9/2022), dHF, HTN, HLD, CVA R MCA, hx RLE dvt (eliquis), and recent COVID infection a couple weeks ago who presents with difficulty breathing.  Transferred from outside hospital with concerns for septic shock on vasopressors, intubated for airway protection.   Patient initially presented from a skilled nursing facility.  Per their report, the patient vomited in the morning and did have an aspiration event. In the emergency department, patient was in respiratory distress and not protecting her airway so she was intubated.  Black emesis was noted in the posterior pharynx that was heme positive.  There is some abdominal distention and an OG tube was placed.  Vasopressors started for persistent hypotension.  Lactic acid 9.5, WBC 23, BNP 15000, initial pH 7.26. Patient was COVID positive but this was suspected to be secondary to previous infection.  Patient was started on vancomycin, cefepime, Flagyl. CT thorax, abdomen, pelvis without contrast showed diffuse alveolar infiltrates and increased consolidation left lower lobe, concern for possible colitis.  Stress dose steroids were added and patient was bolused with Protonix and started on a Protonix drip.  Patient was then transferred to intensive care unit for further management.   GI was consulted for GI bleed and repeat CT abdomen pelvis showed increased gallbladder distension, increased small amount of pelvic free fluid, and similar bowel distension.  While lactic acid was initially downtrending, it subsequently increased from 4.7 to 5.3.  The patient also was hyperkalemic, acidotic, and had worsening creatinine.  Insulin, calcium, lokelma, and started on a bicarb drip.   On 3/12 night, stroke code called and CT notable for large right ACA and MCA infarct. Cytotoxic cerebral edema with midline shift noted. Goals of care discussion were held with family, who decided against intervention and chose to pursue comfort care.    Patient died in hospital on 3/13 at 9:02 PM with husband and son present at bedside.    Medical Examiner Case Assessment Select Applicable Patient Criteria: Does not meet any of the listed criteria
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Chest X-ray abnormal, Cough, Malaise, Nasopharyngitis
Clinical narrative: Recently I had a bad cold that developed into pneumonia. 03/16/2023, It was like a head cold with congestion. It developed into a hacking cough with wheezing. I contacted my doctor. He suggested a lung x-ray. They found it was pneumonia in the bottom of one lung. I was prescribed several medication benzonatate, prednisone and doxycycline. I feel good now, just a touch of a cold and congestion not much. In October I contracted COVID-19 from a cruise and came back with it. I felt pretty sick thinking it was a cold. It was congestion and coughing. I was taking VICK'S NYQUIL at night. We did get tested at a pharmacy. We stayed home and took it easy. I think my symptoms lasted for about 5 days.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pneumonia, Respiratory tract congestion, SARS-CoV-2 test positive, Wheezing
Clinical narrative: Recently I had a bad cold that developed into pneumonia. 03/16/2023, It was like a head cold with congestion. It developed into a hacking cough with wheezing. I contacted my doctor. He suggested a lung x-ray. They found it was pneumonia in the bottom of one lung. I was prescribed several medication benzonatate, prednisone and doxycycline. I feel good now, just a touch of a cold and congestion not much. In October I contracted COVID-19 from a cruise and came back with it. I felt pretty sick thinking it was a cold. It was congestion and coughing. I was taking VICK'S NYQUIL at night. We did get tested at a pharmacy. We stayed home and took it easy. I think my symptoms lasted for about 5 days.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Headache, Nasopharyngitis, Pain, Pyrexia
Clinical narrative: 03/06/2023 I had mild cold symptoms, I took a home COVID-19 test and it was positive. I reached out to urgent care and was prescribed a course of PAXLOVID. On 03/18/2023 I had a rebound case of COVID-19 these symptoms were much worst than the first time that I had COVID-19. I had a fever, body aches, headache, runny nose and tooth pain this lasted for about 12 hours and tested negative on 03/22/2023.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Toothache
Clinical narrative: 03/06/2023 I had mild cold symptoms, I took a home COVID-19 test and it was positive. I reached out to urgent care and was prescribed a course of PAXLOVID. On 03/18/2023 I had a rebound case of COVID-19 these symptoms were much worst than the first time that I had COVID-19. I had a fever, body aches, headache, runny nose and tooth pain this lasted for about 12 hours and tested negative on 03/22/2023.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram thorax abnormal
Clinical narrative: Discharge Physician: MD Primary Care Clinician at Discharge: MD   Admission Date: 3/8/2023 Discharge Date: 3/12/2023 PRESENTING PROBLEM: Acute respiratory failure with hypoxia [J96.01] Acute cough [R05.1] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 79 y.o. female with a past medical history of atrial fibrillation with anticoagulation on apixaban, type 2 diabetes, hypertension, hyperlipidemia who presented with hypoxic respiratory failure secondary to COVID-19  She was recently exposed to COVID, however was fully vaccinated.  In the emergency department patient was afebrile, oxygen saturation was in the low 90s on room air, however with ambulation to the commode patient became hypoxic with an O2 saturation of 87%, she was placed on supplemental oxygen.   Chest x-ray and CT chest was performed which showed multiple areas of ill-defined ground-glass opacity throughout the lung parenchyma.  Patient received Decadron and albuterol, as well as Rocephin.  Due to concerns of hypoxia secondary to COVID-19, patient was admitted to hospitalist service for further workup, evaluation and management.  Dexamethasone/remdesivir was continued.  Urine cultures revealed greater than 100K CFU/mL Enterococcus faecalis.  She was given fosfomycin with improvement of her symptoms.  Her respiratory status improved and oxygen support was weaned to ambient air.  She is afebrile and hemodynamically stable.  She was discharged on 03/12/2023.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Culture urine positive, Enterococcus test positive, Exposure to SARS-CoV-2, Lung opacity
Clinical narrative: Discharge Physician: MD Primary Care Clinician at Discharge: MD   Admission Date: 3/8/2023 Discharge Date: 3/12/2023 PRESENTING PROBLEM: Acute respiratory failure with hypoxia [J96.01] Acute cough [R05.1] Pneumonia due to COVID-19 virus [U07.1, J12.82] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 79 y.o. female with a past medical history of atrial fibrillation with anticoagulation on apixaban, type 2 diabetes, hypertension, hyperlipidemia who presented with hypoxic respiratory failure secondary to COVID-19  She was recently exposed to COVID, however was fully vaccinated.  In the emergency department patient was afebrile, oxygen saturation was in the low 90s on room air, however with ambulation to the commode patient became hypoxic with an O2 saturation of 87%, she was placed on supplemental oxygen.   Chest x-ray and CT chest was performed which showed multiple areas of ill-defined ground-glass opacity throughout the lung parenchyma.  Patient received Decadron and albuterol, as well as Rocephin.  Due to concerns of hypoxia secondary to COVID-19, patient was admitted to hospitalist service for further workup, evaluation and management.  Dexamethasone/remdesivir was continued.  Urine cultures revealed greater than 100K CFU/mL Enterococcus faecalis.  She was given fosfomycin with improvement of her symptoms.  Her respiratory status improved and oxygen support was weaned to ambient air.  She is afebrile and hemodynamically stable.  She was discharged on 03/12/2023.
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Headache, Malaise, Oropharyngeal pain, Respiratory tract congestion
Clinical narrative: On 03/10/2023 I was experiencing sore throat, headache and congestion. I tested positive for Covid-19. After reaching out to health care provider I was prescribed molnupiravir for 5 days. Symptoms lasted a week.
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: On 03/10/2023 I was experiencing sore throat, headache and congestion. I tested positive for Covid-19. After reaching out to health care provider I was prescribed molnupiravir for 5 days. Symptoms lasted a week.