chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic kidney disease, Death, Dehydration, Dysphagia, General physical health deterioration
Clinical narrative: Patient is a 90 y.o. female patient of MD with history of coronary artery disease status post CABG in 1996, type 2 diabetes, essential hypertension, hyperlipidemia, PAD status post left femoral-tibial bypass 5/2019 and recent hospitalization with discharge on 11/29/2022 following intubation secondary to acute metabolic encephalopathy of unclear etiology.  She was initially thought to have had a stroke, but MRI was negative.  She was diagnosed with VZV infection/Ramsay Hunt syndrome and treated with a course of steroids and antivirals.  She was discharged for rehab.  Reportedly she was diagnosed with COVID-pneumonia during that time.  She then had a steady decline over the next week with difficulty with p.o. intake.  She was found unresponsive the morning of 12/3 and was brought into the emergency department. On arrival to the emergency department blood pressure 50s systolic but following IV fluid bolus is 85/33 with subsequent reading of 74/34.  Respiratory rate is 27. Temperature is 99.1. She was 96% on room air. WBC 20,000. Creatinine 5.51. Sodium 151.  Chloride 119. Potassium 3.0. Troponin 111.  proBNP 2,068.  Lactic acid 2.5. Family requested no further radiologic or invasive testing. Condition was discussed by ED attending with the family who opted to proceed with DNR CC and be admitted for inpatient hospice. She had a slow decline over the course of her hospitalization and passed the away the morning of 12/7/22 with a time of death 0750.      Discharge diagnosis ? Viral sepsis due to COVID-19 pneumonia, POA COVID-19 pneumonia Acute metabolic encephalopathy Severe dehydration Hypernatremia/hyperchloremia NSTEMI Leukocytosis AKI on CKD  VZV infection/Ramsay Hunt syndrome Chronic left heel wound, unstageable Dysphagia Chronic HFpEF Essential hypertension Coronary artery disease Type 2 diabetes Peripheral arterial disease
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Herpes zoster oticus, Hyperchloraemia, Hypernatraemia, Hypophagia, Leukocytosis
Clinical narrative: Patient is a 90 y.o. female patient of MD with history of coronary artery disease status post CABG in 1996, type 2 diabetes, essential hypertension, hyperlipidemia, PAD status post left femoral-tibial bypass 5/2019 and recent hospitalization with discharge on 11/29/2022 following intubation secondary to acute metabolic encephalopathy of unclear etiology.  She was initially thought to have had a stroke, but MRI was negative.  She was diagnosed with VZV infection/Ramsay Hunt syndrome and treated with a course of steroids and antivirals.  She was discharged for rehab.  Reportedly she was diagnosed with COVID-pneumonia during that time.  She then had a steady decline over the next week with difficulty with p.o. intake.  She was found unresponsive the morning of 12/3 and was brought into the emergency department. On arrival to the emergency department blood pressure 50s systolic but following IV fluid bolus is 85/33 with subsequent reading of 74/34.  Respiratory rate is 27. Temperature is 99.1. She was 96% on room air. WBC 20,000. Creatinine 5.51. Sodium 151.  Chloride 119. Potassium 3.0. Troponin 111.  proBNP 2,068.  Lactic acid 2.5. Family requested no further radiologic or invasive testing. Condition was discussed by ED attending with the family who opted to proceed with DNR CC and be admitted for inpatient hospice. She had a slow decline over the course of her hospitalization and passed the away the morning of 12/7/22 with a time of death 0750.      Discharge diagnosis ? Viral sepsis due to COVID-19 pneumonia, POA COVID-19 pneumonia Acute metabolic encephalopathy Severe dehydration Hypernatremia/hyperchloremia NSTEMI Leukocytosis AKI on CKD  VZV infection/Ramsay Hunt syndrome Chronic left heel wound, unstageable Dysphagia Chronic HFpEF Essential hypertension Coronary artery disease Type 2 diabetes Peripheral arterial disease
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging normal, Prohormone brain natriuretic peptide increased, Troponin increased, Unresponsive to stimuli, Varicella zoster virus infection
Clinical narrative: Patient is a 90 y.o. female patient of MD with history of coronary artery disease status post CABG in 1996, type 2 diabetes, essential hypertension, hyperlipidemia, PAD status post left femoral-tibial bypass 5/2019 and recent hospitalization with discharge on 11/29/2022 following intubation secondary to acute metabolic encephalopathy of unclear etiology.  She was initially thought to have had a stroke, but MRI was negative.  She was diagnosed with VZV infection/Ramsay Hunt syndrome and treated with a course of steroids and antivirals.  She was discharged for rehab.  Reportedly she was diagnosed with COVID-pneumonia during that time.  She then had a steady decline over the next week with difficulty with p.o. intake.  She was found unresponsive the morning of 12/3 and was brought into the emergency department. On arrival to the emergency department blood pressure 50s systolic but following IV fluid bolus is 85/33 with subsequent reading of 74/34.  Respiratory rate is 27. Temperature is 99.1. She was 96% on room air. WBC 20,000. Creatinine 5.51. Sodium 151.  Chloride 119. Potassium 3.0. Troponin 111.  proBNP 2,068.  Lactic acid 2.5. Family requested no further radiologic or invasive testing. Condition was discussed by ED attending with the family who opted to proceed with DNR CC and be admitted for inpatient hospice. She had a slow decline over the course of her hospitalization and passed the away the morning of 12/7/22 with a time of death 0750.      Discharge diagnosis ? Viral sepsis due to COVID-19 pneumonia, POA COVID-19 pneumonia Acute metabolic encephalopathy Severe dehydration Hypernatremia/hyperchloremia NSTEMI Leukocytosis AKI on CKD  VZV infection/Ramsay Hunt syndrome Chronic left heel wound, unstageable Dysphagia Chronic HFpEF Essential hypertension Coronary artery disease Type 2 diabetes Peripheral arterial disease
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Viral sepsis, White blood cell count increased, Wound
Clinical narrative: Patient is a 90 y.o. female patient of MD with history of coronary artery disease status post CABG in 1996, type 2 diabetes, essential hypertension, hyperlipidemia, PAD status post left femoral-tibial bypass 5/2019 and recent hospitalization with discharge on 11/29/2022 following intubation secondary to acute metabolic encephalopathy of unclear etiology.  She was initially thought to have had a stroke, but MRI was negative.  She was diagnosed with VZV infection/Ramsay Hunt syndrome and treated with a course of steroids and antivirals.  She was discharged for rehab.  Reportedly she was diagnosed with COVID-pneumonia during that time.  She then had a steady decline over the next week with difficulty with p.o. intake.  She was found unresponsive the morning of 12/3 and was brought into the emergency department. On arrival to the emergency department blood pressure 50s systolic but following IV fluid bolus is 85/33 with subsequent reading of 74/34.  Respiratory rate is 27. Temperature is 99.1. She was 96% on room air. WBC 20,000. Creatinine 5.51. Sodium 151.  Chloride 119. Potassium 3.0. Troponin 111.  proBNP 2,068.  Lactic acid 2.5. Family requested no further radiologic or invasive testing. Condition was discussed by ED attending with the family who opted to proceed with DNR CC and be admitted for inpatient hospice. She had a slow decline over the course of her hospitalization and passed the away the morning of 12/7/22 with a time of death 0750.      Discharge diagnosis ? Viral sepsis due to COVID-19 pneumonia, POA COVID-19 pneumonia Acute metabolic encephalopathy Severe dehydration Hypernatremia/hyperchloremia NSTEMI Leukocytosis AKI on CKD  VZV infection/Ramsay Hunt syndrome Chronic left heel wound, unstageable Dysphagia Chronic HFpEF Essential hypertension Coronary artery disease Type 2 diabetes Peripheral arterial disease
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 53.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Injection site pain, Injection site swelling
Clinical narrative: My left arm where I had the vaccine was hurting, to me it does not look swollen but to my daughter she says it looks swollen. It is tender to the touch, pain from the middle upper arm to my shoulder. I can only lift a maximum of two pounds now. I went to see my doctor; he told me to ice it, but this had not helped. I have not rescheduled a visit as of yet.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Bradycardia, COVID-19, Cardiac arrest, Cardioversion
Clinical narrative: Patient is an 85-year-old male with past medical history of ischemic cardiomyopathy and heart failure with recovered EF, sick sinus syndrome status post pacemaker, dementia, hypertension, HLD who was admitted for septic shock presumed secondary to pneumonia and UTI.  Intubated shortly after arrival to the ED.  Patient was also profoundly hypotensive and started on vasopressor support that was quickly escalated to 3 medications.  COVID-positive.  Chest imaging showed bilateral airspace disease.  Started on broad-spectrum vancomycin and meropenem.  During admission, the patient was observed to have multiple intermittent ventricular tachyarrhythmias, causing his implanted defibrillator to release shocks multiple times.  He was started on amiodarone drip with improvement in heart rate and cardiology was consulted.  Lab work remarkable for AKI likely secondary to shock and hypokalemia.  The patient also appeared moderately malnourished with muscle wasting on exam.  Patient was noted to have no response to verbal or tactile stimuli when sedation was paused.  Patient's family arrived to hospital and is critical condition was discussed with them.  His 2 daughters are the decision-makers for the patient and they both agreed that his current condition is not conducive to his wishes.  They requested that the patient be liberated from the ventilator and any aggressive measures be discontinued including pressor support.  Patient was liberated from the ventilator, all drips were stopped.  Shortly after this occurred, the patient was noted to bradycardia to asystole.  ICU team was called to the bedside to pronounce the patient.  Time of death pronounced at 1119.   Condition at Discharge: Expired   Disposition:  Morgue
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Endotracheal intubation, Hypokalaemia, Hypotension, Intensive care
Clinical narrative: Patient is an 85-year-old male with past medical history of ischemic cardiomyopathy and heart failure with recovered EF, sick sinus syndrome status post pacemaker, dementia, hypertension, HLD who was admitted for septic shock presumed secondary to pneumonia and UTI.  Intubated shortly after arrival to the ED.  Patient was also profoundly hypotensive and started on vasopressor support that was quickly escalated to 3 medications.  COVID-positive.  Chest imaging showed bilateral airspace disease.  Started on broad-spectrum vancomycin and meropenem.  During admission, the patient was observed to have multiple intermittent ventricular tachyarrhythmias, causing his implanted defibrillator to release shocks multiple times.  He was started on amiodarone drip with improvement in heart rate and cardiology was consulted.  Lab work remarkable for AKI likely secondary to shock and hypokalemia.  The patient also appeared moderately malnourished with muscle wasting on exam.  Patient was noted to have no response to verbal or tactile stimuli when sedation was paused.  Patient's family arrived to hospital and is critical condition was discussed with them.  His 2 daughters are the decision-makers for the patient and they both agreed that his current condition is not conducive to his wishes.  They requested that the patient be liberated from the ventilator and any aggressive measures be discontinued including pressor support.  Patient was liberated from the ventilator, all drips were stopped.  Shortly after this occurred, the patient was noted to bradycardia to asystole.  ICU team was called to the bedside to pronounce the patient.  Time of death pronounced at 1119.   Condition at Discharge: Expired   Disposition:  Morgue
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test abnormal, Lung disorder, Malnutrition, Mechanical ventilation, Muscle atrophy
Clinical narrative: Patient is an 85-year-old male with past medical history of ischemic cardiomyopathy and heart failure with recovered EF, sick sinus syndrome status post pacemaker, dementia, hypertension, HLD who was admitted for septic shock presumed secondary to pneumonia and UTI.  Intubated shortly after arrival to the ED.  Patient was also profoundly hypotensive and started on vasopressor support that was quickly escalated to 3 medications.  COVID-positive.  Chest imaging showed bilateral airspace disease.  Started on broad-spectrum vancomycin and meropenem.  During admission, the patient was observed to have multiple intermittent ventricular tachyarrhythmias, causing his implanted defibrillator to release shocks multiple times.  He was started on amiodarone drip with improvement in heart rate and cardiology was consulted.  Lab work remarkable for AKI likely secondary to shock and hypokalemia.  The patient also appeared moderately malnourished with muscle wasting on exam.  Patient was noted to have no response to verbal or tactile stimuli when sedation was paused.  Patient's family arrived to hospital and is critical condition was discussed with them.  His 2 daughters are the decision-makers for the patient and they both agreed that his current condition is not conducive to his wishes.  They requested that the patient be liberated from the ventilator and any aggressive measures be discontinued including pressor support.  Patient was liberated from the ventilator, all drips were stopped.  Shortly after this occurred, the patient was noted to bradycardia to asystole.  ICU team was called to the bedside to pronounce the patient.  Time of death pronounced at 1119.   Condition at Discharge: Expired   Disposition:  Morgue
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Pneumonia, Pulmonary imaging procedure abnormal, SARS-CoV-2 test positive, Sedation, Septic shock
Clinical narrative: Patient is an 85-year-old male with past medical history of ischemic cardiomyopathy and heart failure with recovered EF, sick sinus syndrome status post pacemaker, dementia, hypertension, HLD who was admitted for septic shock presumed secondary to pneumonia and UTI.  Intubated shortly after arrival to the ED.  Patient was also profoundly hypotensive and started on vasopressor support that was quickly escalated to 3 medications.  COVID-positive.  Chest imaging showed bilateral airspace disease.  Started on broad-spectrum vancomycin and meropenem.  During admission, the patient was observed to have multiple intermittent ventricular tachyarrhythmias, causing his implanted defibrillator to release shocks multiple times.  He was started on amiodarone drip with improvement in heart rate and cardiology was consulted.  Lab work remarkable for AKI likely secondary to shock and hypokalemia.  The patient also appeared moderately malnourished with muscle wasting on exam.  Patient was noted to have no response to verbal or tactile stimuli when sedation was paused.  Patient's family arrived to hospital and is critical condition was discussed with them.  His 2 daughters are the decision-makers for the patient and they both agreed that his current condition is not conducive to his wishes.  They requested that the patient be liberated from the ventilator and any aggressive measures be discontinued including pressor support.  Patient was liberated from the ventilator, all drips were stopped.  Shortly after this occurred, the patient was noted to bradycardia to asystole.  ICU team was called to the bedside to pronounce the patient.  Time of death pronounced at 1119.   Condition at Discharge: Expired   Disposition:  Morgue
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Shock, Unresponsive to stimuli, Urinary tract infection, Ventricular tachyarrhythmia
Clinical narrative: Patient is an 85-year-old male with past medical history of ischemic cardiomyopathy and heart failure with recovered EF, sick sinus syndrome status post pacemaker, dementia, hypertension, HLD who was admitted for septic shock presumed secondary to pneumonia and UTI.  Intubated shortly after arrival to the ED.  Patient was also profoundly hypotensive and started on vasopressor support that was quickly escalated to 3 medications.  COVID-positive.  Chest imaging showed bilateral airspace disease.  Started on broad-spectrum vancomycin and meropenem.  During admission, the patient was observed to have multiple intermittent ventricular tachyarrhythmias, causing his implanted defibrillator to release shocks multiple times.  He was started on amiodarone drip with improvement in heart rate and cardiology was consulted.  Lab work remarkable for AKI likely secondary to shock and hypokalemia.  The patient also appeared moderately malnourished with muscle wasting on exam.  Patient was noted to have no response to verbal or tactile stimuli when sedation was paused.  Patient's family arrived to hospital and is critical condition was discussed with them.  His 2 daughters are the decision-makers for the patient and they both agreed that his current condition is not conducive to his wishes.  They requested that the patient be liberated from the ventilator and any aggressive measures be discontinued including pressor support.  Patient was liberated from the ventilator, all drips were stopped.  Shortly after this occurred, the patient was noted to bradycardia to asystole.  ICU team was called to the bedside to pronounce the patient.  Time of death pronounced at 1119.   Condition at Discharge: Expired   Disposition:  Morgue
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 4/1/21, 4/26/21, 11/15/21. Positive on 12/22/22
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Moderna 7/14/21, 8/17/21, 2/21/22. Positive on 12/22/22
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Feeling abnormal, Influenza, Malaise, Nasopharyngitis
Clinical narrative: 4/30/21  I woke up that morning feeling very sick like I had the flu or cold. I was congested, coughing, nauseous and felt terrible.  By the next day , I was fine.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Respiratory tract congestion
Clinical narrative: 4/30/21  I woke up that morning feeling very sick like I had the flu or cold. I was congested, coughing, nauseous and felt terrible.  By the next day , I was fine.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Anaemia, Asthenia, Biopsy, COVID-19, Chemotherapy
Clinical narrative: Patient is a 69 y.o. male patient of MD.   Report on admission: Patient is a 69 y.o. male presenting from home with c/o Patient with history of tonsillar carcinoma.  He recently had an EGD along with colonoscopy and PEG tube placement approximately 5 weeks ago by Dr.  here.  Patient has been doing okay getting chemo and radiation however the last 4 days he seems to have gotten worse with increasing weakness along with increasing trouble swallowing and increasing pain of the throat.  The EGD actually showed that the esophagus and the stomach.  To be normal.  This is mostly in the oropharynx cavity.Patient denies any obvious fever or chills  Hospital course as below.  Infectious disease and oncology followed patient during stay.  Patient was not a candidate for Paxil bed at this time.  Patient was treated accordingly with Decadron.  Patient was discharged home in stable condition and will follow-up with established oncologist as instructed.  1.  COVID: -Chest x-ray no acute abnormalities -Patient on room air, no indication for remdesivir -Decadron for symptomatic treatment -Infectious disease consulted, patient not candidate for paxlovid he cannot swallow pills -Lovenox DVT prophylaxis  2.  Pharyngitis, laryngeal edema: -Imaging reviewed by oncology outpatient -Symptomatic treatment with IV Decadron  3.Oropharynx neoplasm: -follows with oncology outpatient, receiving chemoradiation -9/9/22 underwent bx -Tentative plan was for resumption of radiation tomorrow  4.  Chronic dysphagia secondary to above: -Continue PEG feedings  5.  History of daily alcohol use: -pt states sober since CA diagnosis    6. Acute on chronic anemia: -HH monitoring  -10/13 EGD normal -10/13 c-scope with 2 polyps -received blood transfusion   7. Hypokalemia: -replace -monitor labs  8.  Other chronic medical conditions: Chronic anemia, CAD, hypertension
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Colonoscopy abnormal, Condition aggravated, Dysphagia, Gastrostomy
Clinical narrative: Patient is a 69 y.o. male patient of MD.   Report on admission: Patient is a 69 y.o. male presenting from home with c/o Patient with history of tonsillar carcinoma.  He recently had an EGD along with colonoscopy and PEG tube placement approximately 5 weeks ago by Dr.  here.  Patient has been doing okay getting chemo and radiation however the last 4 days he seems to have gotten worse with increasing weakness along with increasing trouble swallowing and increasing pain of the throat.  The EGD actually showed that the esophagus and the stomach.  To be normal.  This is mostly in the oropharynx cavity.Patient denies any obvious fever or chills  Hospital course as below.  Infectious disease and oncology followed patient during stay.  Patient was not a candidate for Paxil bed at this time.  Patient was treated accordingly with Decadron.  Patient was discharged home in stable condition and will follow-up with established oncologist as instructed.  1.  COVID: -Chest x-ray no acute abnormalities -Patient on room air, no indication for remdesivir -Decadron for symptomatic treatment -Infectious disease consulted, patient not candidate for paxlovid he cannot swallow pills -Lovenox DVT prophylaxis  2.  Pharyngitis, laryngeal edema: -Imaging reviewed by oncology outpatient -Symptomatic treatment with IV Decadron  3.Oropharynx neoplasm: -follows with oncology outpatient, receiving chemoradiation -9/9/22 underwent bx -Tentative plan was for resumption of radiation tomorrow  4.  Chronic dysphagia secondary to above: -Continue PEG feedings  5.  History of daily alcohol use: -pt states sober since CA diagnosis    6. Acute on chronic anemia: -HH monitoring  -10/13 EGD normal -10/13 c-scope with 2 polyps -received blood transfusion   7. Hypokalemia: -replace -monitor labs  8.  Other chronic medical conditions: Chronic anemia, CAD, hypertension
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: General physical health deterioration, Haematocrit, Haemoglobin, Hypokalaemia, Imaging procedure abnormal
Clinical narrative: Patient is a 69 y.o. male patient of MD.   Report on admission: Patient is a 69 y.o. male presenting from home with c/o Patient with history of tonsillar carcinoma.  He recently had an EGD along with colonoscopy and PEG tube placement approximately 5 weeks ago by Dr.  here.  Patient has been doing okay getting chemo and radiation however the last 4 days he seems to have gotten worse with increasing weakness along with increasing trouble swallowing and increasing pain of the throat.  The EGD actually showed that the esophagus and the stomach.  To be normal.  This is mostly in the oropharynx cavity.Patient denies any obvious fever or chills  Hospital course as below.  Infectious disease and oncology followed patient during stay.  Patient was not a candidate for Paxil bed at this time.  Patient was treated accordingly with Decadron.  Patient was discharged home in stable condition and will follow-up with established oncologist as instructed.  1.  COVID: -Chest x-ray no acute abnormalities -Patient on room air, no indication for remdesivir -Decadron for symptomatic treatment -Infectious disease consulted, patient not candidate for paxlovid he cannot swallow pills -Lovenox DVT prophylaxis  2.  Pharyngitis, laryngeal edema: -Imaging reviewed by oncology outpatient -Symptomatic treatment with IV Decadron  3.Oropharynx neoplasm: -follows with oncology outpatient, receiving chemoradiation -9/9/22 underwent bx -Tentative plan was for resumption of radiation tomorrow  4.  Chronic dysphagia secondary to above: -Continue PEG feedings  5.  History of daily alcohol use: -pt states sober since CA diagnosis    6. Acute on chronic anemia: -HH monitoring  -10/13 EGD normal -10/13 c-scope with 2 polyps -received blood transfusion   7. Hypokalemia: -replace -monitor labs  8.  Other chronic medical conditions: Chronic anemia, CAD, hypertension
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Large intestine polyp, Laryngeal oedema, Oesophagogastroduodenoscopy normal, Oropharyngeal neoplasm, Oropharyngeal pain
Clinical narrative: Patient is a 69 y.o. male patient of MD.   Report on admission: Patient is a 69 y.o. male presenting from home with c/o Patient with history of tonsillar carcinoma.  He recently had an EGD along with colonoscopy and PEG tube placement approximately 5 weeks ago by Dr.  here.  Patient has been doing okay getting chemo and radiation however the last 4 days he seems to have gotten worse with increasing weakness along with increasing trouble swallowing and increasing pain of the throat.  The EGD actually showed that the esophagus and the stomach.  To be normal.  This is mostly in the oropharynx cavity.Patient denies any obvious fever or chills  Hospital course as below.  Infectious disease and oncology followed patient during stay.  Patient was not a candidate for Paxil bed at this time.  Patient was treated accordingly with Decadron.  Patient was discharged home in stable condition and will follow-up with established oncologist as instructed.  1.  COVID: -Chest x-ray no acute abnormalities -Patient on room air, no indication for remdesivir -Decadron for symptomatic treatment -Infectious disease consulted, patient not candidate for paxlovid he cannot swallow pills -Lovenox DVT prophylaxis  2.  Pharyngitis, laryngeal edema: -Imaging reviewed by oncology outpatient -Symptomatic treatment with IV Decadron  3.Oropharynx neoplasm: -follows with oncology outpatient, receiving chemoradiation -9/9/22 underwent bx -Tentative plan was for resumption of radiation tomorrow  4.  Chronic dysphagia secondary to above: -Continue PEG feedings  5.  History of daily alcohol use: -pt states sober since CA diagnosis    6. Acute on chronic anemia: -HH monitoring  -10/13 EGD normal -10/13 c-scope with 2 polyps -received blood transfusion   7. Hypokalemia: -replace -monitor labs  8.  Other chronic medical conditions: Chronic anemia, CAD, hypertension
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Pharyngitis, Radiotherapy, Transfusion
Clinical narrative: Patient is a 69 y.o. male patient of MD.   Report on admission: Patient is a 69 y.o. male presenting from home with c/o Patient with history of tonsillar carcinoma.  He recently had an EGD along with colonoscopy and PEG tube placement approximately 5 weeks ago by Dr.  here.  Patient has been doing okay getting chemo and radiation however the last 4 days he seems to have gotten worse with increasing weakness along with increasing trouble swallowing and increasing pain of the throat.  The EGD actually showed that the esophagus and the stomach.  To be normal.  This is mostly in the oropharynx cavity.Patient denies any obvious fever or chills  Hospital course as below.  Infectious disease and oncology followed patient during stay.  Patient was not a candidate for Paxil bed at this time.  Patient was treated accordingly with Decadron.  Patient was discharged home in stable condition and will follow-up with established oncologist as instructed.  1.  COVID: -Chest x-ray no acute abnormalities -Patient on room air, no indication for remdesivir -Decadron for symptomatic treatment -Infectious disease consulted, patient not candidate for paxlovid he cannot swallow pills -Lovenox DVT prophylaxis  2.  Pharyngitis, laryngeal edema: -Imaging reviewed by oncology outpatient -Symptomatic treatment with IV Decadron  3.Oropharynx neoplasm: -follows with oncology outpatient, receiving chemoradiation -9/9/22 underwent bx -Tentative plan was for resumption of radiation tomorrow  4.  Chronic dysphagia secondary to above: -Continue PEG feedings  5.  History of daily alcohol use: -pt states sober since CA diagnosis    6. Acute on chronic anemia: -HH monitoring  -10/13 EGD normal -10/13 c-scope with 2 polyps -received blood transfusion   7. Hypokalemia: -replace -monitor labs  8.  Other chronic medical conditions: Chronic anemia, CAD, hypertension
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Inadvertent administration past the 30-day Use by Date of the Moderna vaccine. No Symptoms to report as no adverse event was reported.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Exposure to SARS-CoV-2, Glucose tolerance impaired
Clinical narrative: I tested positive for COVID-19 on 12/22/2021. I didn't have symptoms at the time, but I knew that I had been exposed and decided to test. Later on, I developed loss of taste and smell. I was not prescribed medications for this health event. I also did not take any over-the-counter medications.  I had these symptoms for about a month and a half. I still have altered smell and taste. Everything smells and taste kind of like onions. I have also developed high blood pressure and I am pre-diabetic. That does not run in my family or anything, so it is kind of strange to me.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertension, Parosmia, SARS-CoV-2 test positive, Taste disorder
Clinical narrative: I tested positive for COVID-19 on 12/22/2021. I didn't have symptoms at the time, but I knew that I had been exposed and decided to test. Later on, I developed loss of taste and smell. I was not prescribed medications for this health event. I also did not take any over-the-counter medications.  I had these symptoms for about a month and a half. I still have altered smell and taste. Everything smells and taste kind of like onions. I have also developed high blood pressure and I am pre-diabetic. That does not run in my family or anything, so it is kind of strange to me.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 3/24/21, 4/14/21. Positive on 12/25/22
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Breast cyst, COVID-19, Colonoscopy abnormal, Condition aggravated
Clinical narrative: I had underlying health conditions I was seeing the doctor for before the vaccine. They were amplified after the vaccine, and I got shingles. I been dealing with symptoms like rashes that have not really been explained, and I feel like my immune system was lowered because of the vaccine. I already had several immune system problems but now they are worse. Now recently I been working with my doctor and I have a parasite on my knee, and an unusual spot that doctors are investigating in my colon, and a cyst in my breast, and lesions in my liver.  I did contract COVID this year and reacted pretty well to the Paxlovid treatment. I also have tacycardia now, or if I had it before, its gotten worse.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram, Gastrointestinal disorder, Hepatic lesion, Herpes zoster, Immune system disorder
Clinical narrative: I had underlying health conditions I was seeing the doctor for before the vaccine. They were amplified after the vaccine, and I got shingles. I been dealing with symptoms like rashes that have not really been explained, and I feel like my immune system was lowered because of the vaccine. I already had several immune system problems but now they are worse. Now recently I been working with my doctor and I have a parasite on my knee, and an unusual spot that doctors are investigating in my colon, and a cyst in my breast, and lesions in my liver.  I did contract COVID this year and reacted pretty well to the Paxlovid treatment. I also have tacycardia now, or if I had it before, its gotten worse.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Infection parasitic, Magnetic resonance imaging, Mammogram abnormal, Rash, Tachycardia
Clinical narrative: I had underlying health conditions I was seeing the doctor for before the vaccine. They were amplified after the vaccine, and I got shingles. I been dealing with symptoms like rashes that have not really been explained, and I feel like my immune system was lowered because of the vaccine. I already had several immune system problems but now they are worse. Now recently I been working with my doctor and I have a parasite on my knee, and an unusual spot that doctors are investigating in my colon, and a cyst in my breast, and lesions in my liver.  I did contract COVID this year and reacted pretty well to the Paxlovid treatment. I also have tacycardia now, or if I had it before, its gotten worse.
Age: 57.0
Sex: F
Vaccine: FLU4
Symptoms: Chills, Dyspnoea, Pain, Vomiting
Clinical narrative: horrible body aches, chills, shortness of breath, and was throwing up last night
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Moderna 2/19/21, 3/19/21, 10/24/21, 3/31/22, 9/16/22. Positive on 12/24/22
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: Brain neoplasm, COVID-19, Condition aggravated, Death, Oedema
Clinical narrative: 3RD DOSE MODERNA COVID VACCINE GIVEN 11/27/2021, LOT #004F21A; Pt resides at Senior Living; had a positive COVID test on 12/27/22; follow up in facility showed O2 not required; oral intake good; no chest congestion; on steroids for edema associated with the brain tumor; pt on hospice; DNR; hospice provider; pt passed away in the facility
Age: 92.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 3RD DOSE MODERNA COVID VACCINE GIVEN 11/27/2021, LOT #004F21A; Pt resides at Senior Living; had a positive COVID test on 12/27/22; follow up in facility showed O2 not required; oral intake good; no chest congestion; on steroids for edema associated with the brain tumor; pt on hospice; DNR; hospice provider; pt passed away in the facility
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chest discomfort, Cough, Feeling abnormal, Nasal congestion
Clinical narrative: I started feeling poorly around 11/06/2022. I assumed I was just getting a cold. My sinuses and glands were tender. I was supposed to leave that Monday morning, 11/07/2022 on a three-day hiking trip, so I took an at home COVID-19 test that day and it was positive. I was feeling so poorly at that point that I expected those results. I called my doctor's office that day as well. Based on my symptoms, they were confident that I had COVID-19. They prescribed PAXLOVID. I picked that up an hour or two later and began taking it. I completed the five-day course. They informed me that it may not make me feel better, but it would prevent hospitalization. Monday my nose was runny and stuffy, and I coughed all day long. Oddly enough, I slept through the night that night and every night following. Tuesday was the same with painful sinuses and coughing. I also had a small amount of achiness that day. I never felt like I ran a fever those days. Wednesday morning, I started out feeling around the same, but around 10:00AM or so, I noticed some improvement. Each day after that, I felt a little bit better until my symptoms were gone on 11/14/2022. However, 11/15/2022, I felt just as bad as I did the previous Monday with all day coughing and sinus issues. A nurse from a local hospital called me based on a response to a text message that was tracking my COVID-19. She advised that I monitor my symptoms and use MUCINEX. Around mid-day on 11/16/2022, I began to vomit. When I indicated new symptoms on the message from the local hospital, I was called by a nurse again. I was throwing up from noon that day until 10:00PM ET. I had trouble keeping food and liquids down all day. I slowly made improvements each day after that. I was still having at least six coughing spells every day. Around 12/09/2022. the coughing had totally stopped, but some days I would feel great and other days I would feel just not 100%. I was feeling a heaviness in my chest, especially when I was laying down. My sinuses and glands were also still tender to the touch. On 12/19/2022, I had a video visit with the nurse from the local hospital. They prescribed a six-day course of prednisone and a ten-day course of doxycycline. Yesterday, I sent a message to the nurse practitioner informing them that I don't feel any different from before and I'm actually having sinus headaches as well. I have not heard back from them yet.
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain, Rhinorrhoea, SARS-CoV-2 test positive, Sinus headache, Sinus pain
Clinical narrative: I started feeling poorly around 11/06/2022. I assumed I was just getting a cold. My sinuses and glands were tender. I was supposed to leave that Monday morning, 11/07/2022 on a three-day hiking trip, so I took an at home COVID-19 test that day and it was positive. I was feeling so poorly at that point that I expected those results. I called my doctor's office that day as well. Based on my symptoms, they were confident that I had COVID-19. They prescribed PAXLOVID. I picked that up an hour or two later and began taking it. I completed the five-day course. They informed me that it may not make me feel better, but it would prevent hospitalization. Monday my nose was runny and stuffy, and I coughed all day long. Oddly enough, I slept through the night that night and every night following. Tuesday was the same with painful sinuses and coughing. I also had a small amount of achiness that day. I never felt like I ran a fever those days. Wednesday morning, I started out feeling around the same, but around 10:00AM or so, I noticed some improvement. Each day after that, I felt a little bit better until my symptoms were gone on 11/14/2022. However, 11/15/2022, I felt just as bad as I did the previous Monday with all day coughing and sinus issues. A nurse from a local hospital called me based on a response to a text message that was tracking my COVID-19. She advised that I monitor my symptoms and use MUCINEX. Around mid-day on 11/16/2022, I began to vomit. When I indicated new symptoms on the message from the local hospital, I was called by a nurse again. I was throwing up from noon that day until 10:00PM ET. I had trouble keeping food and liquids down all day. I slowly made improvements each day after that. I was still having at least six coughing spells every day. Around 12/09/2022. the coughing had totally stopped, but some days I would feel great and other days I would feel just not 100%. I was feeling a heaviness in my chest, especially when I was laying down. My sinuses and glands were also still tender to the touch. On 12/19/2022, I had a video visit with the nurse from the local hospital. They prescribed a six-day course of prednisone and a ten-day course of doxycycline. Yesterday, I sent a message to the nurse practitioner informing them that I don't feel any different from before and I'm actually having sinus headaches as well. I have not heard back from them yet.
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Tenderness, Vomiting
Clinical narrative: I started feeling poorly around 11/06/2022. I assumed I was just getting a cold. My sinuses and glands were tender. I was supposed to leave that Monday morning, 11/07/2022 on a three-day hiking trip, so I took an at home COVID-19 test that day and it was positive. I was feeling so poorly at that point that I expected those results. I called my doctor's office that day as well. Based on my symptoms, they were confident that I had COVID-19. They prescribed PAXLOVID. I picked that up an hour or two later and began taking it. I completed the five-day course. They informed me that it may not make me feel better, but it would prevent hospitalization. Monday my nose was runny and stuffy, and I coughed all day long. Oddly enough, I slept through the night that night and every night following. Tuesday was the same with painful sinuses and coughing. I also had a small amount of achiness that day. I never felt like I ran a fever those days. Wednesday morning, I started out feeling around the same, but around 10:00AM or so, I noticed some improvement. Each day after that, I felt a little bit better until my symptoms were gone on 11/14/2022. However, 11/15/2022, I felt just as bad as I did the previous Monday with all day coughing and sinus issues. A nurse from a local hospital called me based on a response to a text message that was tracking my COVID-19. She advised that I monitor my symptoms and use MUCINEX. Around mid-day on 11/16/2022, I began to vomit. When I indicated new symptoms on the message from the local hospital, I was called by a nurse again. I was throwing up from noon that day until 10:00PM ET. I had trouble keeping food and liquids down all day. I slowly made improvements each day after that. I was still having at least six coughing spells every day. Around 12/09/2022. the coughing had totally stopped, but some days I would feel great and other days I would feel just not 100%. I was feeling a heaviness in my chest, especially when I was laying down. My sinuses and glands were also still tender to the touch. On 12/19/2022, I had a video visit with the nurse from the local hospital. They prescribed a six-day course of prednisone and a ten-day course of doxycycline. Yesterday, I sent a message to the nurse practitioner informing them that I don't feel any different from before and I'm actually having sinus headaches as well. I have not heard back from them yet.
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Anticoagulant therapy, Atelectasis, Atrial fibrillation, Blood creatinine increased
Clinical narrative: Clinical Summary Patient is a 79 y.o. male with a history of HTN, HLD, OSA, chronic pain syndrome, hypothyroidism, CKD 2, TIA who presented to hospital 11/26/2022 with shortness of breath. Labs in ED showed lactic acid 2.1, troponin 36, WBC 15.2, Cr 1.5. CXR showed bilateral basilar atelectasis. Patient was found to be in hypoxic respiratory failure and sepsis as well Afib w/ RVR. COVID-19 was positive.   1. Acute respiratory failure: w/ hypoxia. Secondary to COVID-19, superimposed bacterial pneumonia. Imaging as below. Required BiPAP initially in ED than transitioned to NRB. Improved to 11L oxymizer. Continued supplemental O2 as needed, weaned as tolerated. Incentive spirometry ordered, IV lasix for dry strategy (redosed 11/30). Was able to wean to 2L NC on 11/30. Qualified for home O2, cont to wean as outpatient.  2. Sepsis: met criteria on admission with tachycardia, leukocytosis, tachypnea, lactic acidosis. Suspected pulmonary source. S/p 30 cc/kg IVF. Abx as below. Blood cultures so far NGTD. Completed course for CAP.  3. COVID-19 pneumonia: symptom onset 5 days prior to admission. Vaccinated with booster. Positive test 11/26/22. Continued dexamethasone, remdesevir. Supportive care. Trended inflammatory markers- improved. Complete decadron course.  4. Superimposed bacterial pneumonia: On admission, WBC 15.2, procal 1.28. CT chest suggesting multifocal pneumonia. Atypical antigens negative. Continued rocephin. Stopped azithromycin. Completed course for Cap.  5. Atrial fibrillation w/ RVR: new diagnosis. In ED, HR noted 166. EKG showed Afib w/ RVR. Weaned off diltiazem GTT. Continued heparin GTT, transition to DOAC once more clinically stable. Continued PO metoprolol. Cardiology followed. Transition to eliquis on 11/30.  Follow up afib clinic.  6. Elevated troponins: Trops 9, 22, 36. EKG with no acute ischemic changes. No chest pain noted. ECHO 11/27/22 showed LVEF 62%, no WMA, pulmonary HTN. Suspected demand ischemia related to above, low suspicion for ACS. Continued metoprolol. Cardiology followed. 7. Lactic acidosis: secondary to sepsis. Lactic acid 2.1, 2.4, 2.6. S/p IVF. Resolved. 8. CKD 2: baseline Cr 1.1-1.3. Cr on admission 1.5. Monitored. 9. HTN: continued home amlodipine. Held home losartan with higher than baseline Cr. Restart as able. Monitored. 10. HLD: continued home statin. 11. Hypothyroidism: continued home levothyroxine 12. Chronic pain syndrome: Continued home suboxone. NARx reviewed 13. H/o TIA: per hx. Continued home statin
Age: 79.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood culture negative, Blood lactic acid, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: Clinical Summary Patient is a 79 y.o. male with a history of HTN, HLD, OSA, chronic pain syndrome, hypothyroidism, CKD 2, TIA who presented to hospital 11/26/2022 with shortness of breath. Labs in ED showed lactic acid 2.1, troponin 36, WBC 15.2, Cr 1.5. CXR showed bilateral basilar atelectasis. Patient was found to be in hypoxic respiratory failure and sepsis as well Afib w/ RVR. COVID-19 was positive.   1. Acute respiratory failure: w/ hypoxia. Secondary to COVID-19, superimposed bacterial pneumonia. Imaging as below. Required BiPAP initially in ED than transitioned to NRB. Improved to 11L oxymizer. Continued supplemental O2 as needed, weaned as tolerated. Incentive spirometry ordered, IV lasix for dry strategy (redosed 11/30). Was able to wean to 2L NC on 11/30. Qualified for home O2, cont to wean as outpatient.  2. Sepsis: met criteria on admission with tachycardia, leukocytosis, tachypnea, lactic acidosis. Suspected pulmonary source. S/p 30 cc/kg IVF. Abx as below. Blood cultures so far NGTD. Completed course for CAP.  3. COVID-19 pneumonia: symptom onset 5 days prior to admission. Vaccinated with booster. Positive test 11/26/22. Continued dexamethasone, remdesevir. Supportive care. Trended inflammatory markers- improved. Complete decadron course.  4. Superimposed bacterial pneumonia: On admission, WBC 15.2, procal 1.28. CT chest suggesting multifocal pneumonia. Atypical antigens negative. Continued rocephin. Stopped azithromycin. Completed course for Cap.  5. Atrial fibrillation w/ RVR: new diagnosis. In ED, HR noted 166. EKG showed Afib w/ RVR. Weaned off diltiazem GTT. Continued heparin GTT, transition to DOAC once more clinically stable. Continued PO metoprolol. Cardiology followed. Transition to eliquis on 11/30.  Follow up afib clinic.  6. Elevated troponins: Trops 9, 22, 36. EKG with no acute ischemic changes. No chest pain noted. ECHO 11/27/22 showed LVEF 62%, no WMA, pulmonary HTN. Suspected demand ischemia related to above, low suspicion for ACS. Continued metoprolol. Cardiology followed. 7. Lactic acidosis: secondary to sepsis. Lactic acid 2.1, 2.4, 2.6. S/p IVF. Resolved. 8. CKD 2: baseline Cr 1.1-1.3. Cr on admission 1.5. Monitored. 9. HTN: continued home amlodipine. Held home losartan with higher than baseline Cr. Restart as able. Monitored. 10. HLD: continued home statin. 11. Hypothyroidism: continued home levothyroxine 12. Chronic pain syndrome: Continued home suboxone. NARx reviewed 13. H/o TIA: per hx. Continued home statin