chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia, Hypovolaemia, Ischaemia, Livedo reticularis, Multiple organ dysfunction syndrome
Clinical narrative: Narrative: 70 year old MALE with a PMH significant for CLL and prior pulmonary embolism on chronic anticoagulation who now presents with complaints of a one week h/o increased SOB and generalized muscle weakness and numbness. In the ED he was noted to be in atrial fibrillation with a HR of 130-150. He was placed on a diltiazem gtt and is now admitted to the MICU for critical care monitoring and management. He presently denies chest pain, back or pleuritic pain, palpitations. and cough. He had a fever in the ED but denies chills presently. ASSESSMENT/PLAN: 1. Severe sepsis: Not in shock; Most likely due to pneumonia - Start ceftriaxone and azithromycin - Volume replete with crystalloid and colloid solutions 2. Pneumonia: CAP vs. Aspiration - As per #1 3. Pulmonary embolus: No sihns of pulmonary HTN or RV compromise presently - Continue anticoqagulation 4. Acute kidney injury: Most likely due to hypovolemia and sepsis - Volume replete - Start loop diuretics prn 6. Hyperkalemia - start calcium, HCO3, D50, IV regtular insulin, and Kayexylate - Start volume repletion as per #4 - Start loop diuretics prn 70 yo male with multiorgan failure including AKI. He presented to ER and was admitted with Afib/RVR and sepsis. He suffered a PEA arrest and required 3 pressors initially. He was was found to have Streptococcus on biofire. This morning he remains on epinephrine drip and levophed drip and has had no urine output and remains hyperkalemic. Temp ~103 Intubated, unresponsive, not on sedation Skin mottled, cool large ecchymoses on dependent areas of trunk No significant peripheral edema Patient is in multiorgan failure, has AKI undoubtedly in part secondary to ischemic ATN from sepsis and PEA arrest. He is now anuric. He is hyperkalemic with some peaking of T waves on EKG Discussed with ICU team, dialysis would be very high risk given hemodynamic instability, multiple pressor requirement. However, as discussed with team, will offer a trial given he is now anuric and hyperkalemic with EKG changes. However, would do so reluctantly given that dialysis may result in terminal event given current tenuous status and is very unlikely to change the outcome. Patient is not stable enough to transfer to another facility for CRRT as per ICU team.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Muscular weakness, Pneumonia, Pneumonia aspiration, Pneumonia streptococcal, Pulmonary embolism
Clinical narrative: Narrative: 70 year old MALE with a PMH significant for CLL and prior pulmonary embolism on chronic anticoagulation who now presents with complaints of a one week h/o increased SOB and generalized muscle weakness and numbness. In the ED he was noted to be in atrial fibrillation with a HR of 130-150. He was placed on a diltiazem gtt and is now admitted to the MICU for critical care monitoring and management. He presently denies chest pain, back or pleuritic pain, palpitations. and cough. He had a fever in the ED but denies chills presently. ASSESSMENT/PLAN: 1. Severe sepsis: Not in shock; Most likely due to pneumonia - Start ceftriaxone and azithromycin - Volume replete with crystalloid and colloid solutions 2. Pneumonia: CAP vs. Aspiration - As per #1 3. Pulmonary embolus: No sihns of pulmonary HTN or RV compromise presently - Continue anticoqagulation 4. Acute kidney injury: Most likely due to hypovolemia and sepsis - Volume replete - Start loop diuretics prn 6. Hyperkalemia - start calcium, HCO3, D50, IV regtular insulin, and Kayexylate - Start volume repletion as per #4 - Start loop diuretics prn 70 yo male with multiorgan failure including AKI. He presented to ER and was admitted with Afib/RVR and sepsis. He suffered a PEA arrest and required 3 pressors initially. He was was found to have Streptococcus on biofire. This morning he remains on epinephrine drip and levophed drip and has had no urine output and remains hyperkalemic. Temp ~103 Intubated, unresponsive, not on sedation Skin mottled, cool large ecchymoses on dependent areas of trunk No significant peripheral edema Patient is in multiorgan failure, has AKI undoubtedly in part secondary to ischemic ATN from sepsis and PEA arrest. He is now anuric. He is hyperkalemic with some peaking of T waves on EKG Discussed with ICU team, dialysis would be very high risk given hemodynamic instability, multiple pressor requirement. However, as discussed with team, will offer a trial given he is now anuric and hyperkalemic with EKG changes. However, would do so reluctantly given that dialysis may result in terminal event given current tenuous status and is very unlikely to change the outcome. Patient is not stable enough to transfer to another facility for CRRT as per ICU team.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Pulseless electrical activity, Pyrexia, SARS-CoV-2 test negative, Sepsis, Staphylococcus test positive
Clinical narrative: Narrative: 70 year old MALE with a PMH significant for CLL and prior pulmonary embolism on chronic anticoagulation who now presents with complaints of a one week h/o increased SOB and generalized muscle weakness and numbness. In the ED he was noted to be in atrial fibrillation with a HR of 130-150. He was placed on a diltiazem gtt and is now admitted to the MICU for critical care monitoring and management. He presently denies chest pain, back or pleuritic pain, palpitations. and cough. He had a fever in the ED but denies chills presently. ASSESSMENT/PLAN: 1. Severe sepsis: Not in shock; Most likely due to pneumonia - Start ceftriaxone and azithromycin - Volume replete with crystalloid and colloid solutions 2. Pneumonia: CAP vs. Aspiration - As per #1 3. Pulmonary embolus: No sihns of pulmonary HTN or RV compromise presently - Continue anticoqagulation 4. Acute kidney injury: Most likely due to hypovolemia and sepsis - Volume replete - Start loop diuretics prn 6. Hyperkalemia - start calcium, HCO3, D50, IV regtular insulin, and Kayexylate - Start volume repletion as per #4 - Start loop diuretics prn 70 yo male with multiorgan failure including AKI. He presented to ER and was admitted with Afib/RVR and sepsis. He suffered a PEA arrest and required 3 pressors initially. He was was found to have Streptococcus on biofire. This morning he remains on epinephrine drip and levophed drip and has had no urine output and remains hyperkalemic. Temp ~103 Intubated, unresponsive, not on sedation Skin mottled, cool large ecchymoses on dependent areas of trunk No significant peripheral edema Patient is in multiorgan failure, has AKI undoubtedly in part secondary to ischemic ATN from sepsis and PEA arrest. He is now anuric. He is hyperkalemic with some peaking of T waves on EKG Discussed with ICU team, dialysis would be very high risk given hemodynamic instability, multiple pressor requirement. However, as discussed with team, will offer a trial given he is now anuric and hyperkalemic with EKG changes. However, would do so reluctantly given that dialysis may result in terminal event given current tenuous status and is very unlikely to change the outcome. Patient is not stable enough to transfer to another facility for CRRT as per ICU team.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Streptococcal infection, Unresponsive to stimuli, Urine output decreased
Clinical narrative: Narrative: 70 year old MALE with a PMH significant for CLL and prior pulmonary embolism on chronic anticoagulation who now presents with complaints of a one week h/o increased SOB and generalized muscle weakness and numbness. In the ED he was noted to be in atrial fibrillation with a HR of 130-150. He was placed on a diltiazem gtt and is now admitted to the MICU for critical care monitoring and management. He presently denies chest pain, back or pleuritic pain, palpitations. and cough. He had a fever in the ED but denies chills presently. ASSESSMENT/PLAN: 1. Severe sepsis: Not in shock; Most likely due to pneumonia - Start ceftriaxone and azithromycin - Volume replete with crystalloid and colloid solutions 2. Pneumonia: CAP vs. Aspiration - As per #1 3. Pulmonary embolus: No sihns of pulmonary HTN or RV compromise presently - Continue anticoqagulation 4. Acute kidney injury: Most likely due to hypovolemia and sepsis - Volume replete - Start loop diuretics prn 6. Hyperkalemia - start calcium, HCO3, D50, IV regtular insulin, and Kayexylate - Start volume repletion as per #4 - Start loop diuretics prn 70 yo male with multiorgan failure including AKI. He presented to ER and was admitted with Afib/RVR and sepsis. He suffered a PEA arrest and required 3 pressors initially. He was was found to have Streptococcus on biofire. This morning he remains on epinephrine drip and levophed drip and has had no urine output and remains hyperkalemic. Temp ~103 Intubated, unresponsive, not on sedation Skin mottled, cool large ecchymoses on dependent areas of trunk No significant peripheral edema Patient is in multiorgan failure, has AKI undoubtedly in part secondary to ischemic ATN from sepsis and PEA arrest. He is now anuric. He is hyperkalemic with some peaking of T waves on EKG Discussed with ICU team, dialysis would be very high risk given hemodynamic instability, multiple pressor requirement. However, as discussed with team, will offer a trial given he is now anuric and hyperkalemic with EKG changes. However, would do so reluctantly given that dialysis may result in terminal event given current tenuous status and is very unlikely to change the outcome. Patient is not stable enough to transfer to another facility for CRRT as per ICU team.
Age: 96.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acquired diaphragmatic eventration, Aortic dilatation, Atelectasis, Atypical pneumonia, Bacterial test positive
Clinical narrative: Narrative: 96M with past medical history of DM, HTN, HLD, protein C deficiency with recurrent DVTs on coumadin, and history of squamous cell carcinoma s/p lobectomy presents to Emergency Department on 8/20/2021 with chief complaint of SOB x 2 days ago while he was at his long term care facility. He reported occasional cough that is not productive. He denied chest pain, fever, chills, sweats. He was COVID negative on 8/20/21. He stated that the day prior to admission, he began to feel worse with body aches and fatigue. Denied any recent sick contacts and was afebrile. Pt stated that he is on 3L of O2 as his home oxygen, however, he feels as though he was still getting SOB without exertion. He was admitted to the hospital. On 8/27, patient developed shortness of breath and a rapid response was called, patient was up to on 5L of O2 and was given an extra dose of Lasix 40mg IV. Additionally a bladder scan was performed and showed 500ml, and 350ml of puss filled urine was extracted. Urinalysis was performed and showed cloudy in appearance with many bacteria, and WBC clumps. Later in the morning around 0900, patient had a second rapid response called due to difficulty in arousing patient. His hospital roommate was coughing as well, so COVID test done in this patient and was positive despite being vaccinated with Moderna COVID vaccine on 1/15/2021 and 2/12/2021. Despite IV antibiotics, antifungals and intensive COVID therapies, the patient ultimately passed away 3 days later on 8/30 due to COVID pneumonia.
Age: 96.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Bladder scan, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Cough
Clinical narrative: Narrative: 96M with past medical history of DM, HTN, HLD, protein C deficiency with recurrent DVTs on coumadin, and history of squamous cell carcinoma s/p lobectomy presents to Emergency Department on 8/20/2021 with chief complaint of SOB x 2 days ago while he was at his long term care facility. He reported occasional cough that is not productive. He denied chest pain, fever, chills, sweats. He was COVID negative on 8/20/21. He stated that the day prior to admission, he began to feel worse with body aches and fatigue. Denied any recent sick contacts and was afebrile. Pt stated that he is on 3L of O2 as his home oxygen, however, he feels as though he was still getting SOB without exertion. He was admitted to the hospital. On 8/27, patient developed shortness of breath and a rapid response was called, patient was up to on 5L of O2 and was given an extra dose of Lasix 40mg IV. Additionally a bladder scan was performed and showed 500ml, and 350ml of puss filled urine was extracted. Urinalysis was performed and showed cloudy in appearance with many bacteria, and WBC clumps. Later in the morning around 0900, patient had a second rapid response called due to difficulty in arousing patient. His hospital roommate was coughing as well, so COVID test done in this patient and was positive despite being vaccinated with Moderna COVID vaccine on 1/15/2021 and 2/12/2021. Despite IV antibiotics, antifungals and intensive COVID therapies, the patient ultimately passed away 3 days later on 8/30 due to COVID pneumonia.
Age: 96.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Death, Depressed level of consciousness, Dyspnoea, Fatigue, Lung infiltration
Clinical narrative: Narrative: 96M with past medical history of DM, HTN, HLD, protein C deficiency with recurrent DVTs on coumadin, and history of squamous cell carcinoma s/p lobectomy presents to Emergency Department on 8/20/2021 with chief complaint of SOB x 2 days ago while he was at his long term care facility. He reported occasional cough that is not productive. He denied chest pain, fever, chills, sweats. He was COVID negative on 8/20/21. He stated that the day prior to admission, he began to feel worse with body aches and fatigue. Denied any recent sick contacts and was afebrile. Pt stated that he is on 3L of O2 as his home oxygen, however, he feels as though he was still getting SOB without exertion. He was admitted to the hospital. On 8/27, patient developed shortness of breath and a rapid response was called, patient was up to on 5L of O2 and was given an extra dose of Lasix 40mg IV. Additionally a bladder scan was performed and showed 500ml, and 350ml of puss filled urine was extracted. Urinalysis was performed and showed cloudy in appearance with many bacteria, and WBC clumps. Later in the morning around 0900, patient had a second rapid response called due to difficulty in arousing patient. His hospital roommate was coughing as well, so COVID test done in this patient and was positive despite being vaccinated with Moderna COVID vaccine on 1/15/2021 and 2/12/2021. Despite IV antibiotics, antifungals and intensive COVID therapies, the patient ultimately passed away 3 days later on 8/30 due to COVID pneumonia.
Age: 96.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Pain, Pleural effusion, Pyuria, SARS-CoV-2 test positive
Clinical narrative: Narrative: 96M with past medical history of DM, HTN, HLD, protein C deficiency with recurrent DVTs on coumadin, and history of squamous cell carcinoma s/p lobectomy presents to Emergency Department on 8/20/2021 with chief complaint of SOB x 2 days ago while he was at his long term care facility. He reported occasional cough that is not productive. He denied chest pain, fever, chills, sweats. He was COVID negative on 8/20/21. He stated that the day prior to admission, he began to feel worse with body aches and fatigue. Denied any recent sick contacts and was afebrile. Pt stated that he is on 3L of O2 as his home oxygen, however, he feels as though he was still getting SOB without exertion. He was admitted to the hospital. On 8/27, patient developed shortness of breath and a rapid response was called, patient was up to on 5L of O2 and was given an extra dose of Lasix 40mg IV. Additionally a bladder scan was performed and showed 500ml, and 350ml of puss filled urine was extracted. Urinalysis was performed and showed cloudy in appearance with many bacteria, and WBC clumps. Later in the morning around 0900, patient had a second rapid response called due to difficulty in arousing patient. His hospital roommate was coughing as well, so COVID test done in this patient and was positive despite being vaccinated with Moderna COVID vaccine on 1/15/2021 and 2/12/2021. Despite IV antibiotics, antifungals and intensive COVID therapies, the patient ultimately passed away 3 days later on 8/30 due to COVID pneumonia.
Age: 96.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Total lung capacity decreased, Urine abnormality, Urine analysis abnormal, White blood cells urine positive
Clinical narrative: Narrative: 96M with past medical history of DM, HTN, HLD, protein C deficiency with recurrent DVTs on coumadin, and history of squamous cell carcinoma s/p lobectomy presents to Emergency Department on 8/20/2021 with chief complaint of SOB x 2 days ago while he was at his long term care facility. He reported occasional cough that is not productive. He denied chest pain, fever, chills, sweats. He was COVID negative on 8/20/21. He stated that the day prior to admission, he began to feel worse with body aches and fatigue. Denied any recent sick contacts and was afebrile. Pt stated that he is on 3L of O2 as his home oxygen, however, he feels as though he was still getting SOB without exertion. He was admitted to the hospital. On 8/27, patient developed shortness of breath and a rapid response was called, patient was up to on 5L of O2 and was given an extra dose of Lasix 40mg IV. Additionally a bladder scan was performed and showed 500ml, and 350ml of puss filled urine was extracted. Urinalysis was performed and showed cloudy in appearance with many bacteria, and WBC clumps. Later in the morning around 0900, patient had a second rapid response called due to difficulty in arousing patient. His hospital roommate was coughing as well, so COVID test done in this patient and was positive despite being vaccinated with Moderna COVID vaccine on 1/15/2021 and 2/12/2021. Despite IV antibiotics, antifungals and intensive COVID therapies, the patient ultimately passed away 3 days later on 8/30 due to COVID pneumonia.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Anaemia, Atrial fibrillation, Death, Hyperlipidaemia, Malnutrition
Clinical narrative: Narrative: 87yo male with h/o prostate cancer and new pulmonary nodules, AFib, malnutrition, anemia & HLD died on 9/3/2021. Pt had received covid vaccines on 2/8/21 & 2/18/21. This death is likely not related to the vaccinations due to comorbidities, age, and length of time from vaccine administration.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary mass
Clinical narrative: Narrative: 87yo male with h/o prostate cancer and new pulmonary nodules, AFib, malnutrition, anemia & HLD died on 9/3/2021. Pt had received covid vaccines on 2/8/21 & 2/18/21. This death is likely not related to the vaccinations due to comorbidities, age, and length of time from vaccine administration.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Deep vein thrombosis, Haematocrit increased, Haemoglobin increased, Phlebotomy
Clinical narrative: Narrative: Patient with no family h/o VTE and no prior history of VTE developed massive proximal DVT an bilateral PE 2.5 months after Moderna #2 vaccine. Only other risk factor identified was elevated hgb/hct that he had been recently followed by hematology for (with recent phlebotomies). Hematologist states pt will need anticoagulation for life after this VTE event
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Alanine aminotransferase normal, Aspartate aminotransferase increased, Asthenia, Blood alkaline phosphatase increased, Blood creatinine increased
Clinical narrative: Narrative: 62 yo male with past medical history including EtOH/HCV hepatitis with liver transplant in Dec 2020, HTN, GERD reported to the Emergency Department for COVID symptoms on 9/7/2021. Reported chills, fatigue, nasal congestion, sore throat, cough, body aches, diarrhea for 10 days. For hepatitis C, he completed Mavyret therapy in April and is currently taking Tacrolimus 3mg AM and 2mg PM as well as mycophenolate 500mg BID. He states compliance to both meds, has not missed any doses. -Date of positive COVID-19 test: 9/7/21, despite being fully vaccinated with Pfizer's COVID vaccine on 1/29/2021 and 2/22/2021 -Date of symptom onset (estimated based on chart review): approx 8/29-8/30 -High risk factors identified: immunosuppressant therapy, BMI >/= 25 - Recommendation: Patient is considered at high risk for progression to severe disease and/or hospitalization based on risk factor(s) identified above. He was offered MAB infusion by ED provider and accepted. The agent and dose are documented elsewhere in this report. 5 days later he reported to the Emergency Department again, stating that he felt worse with increased weakness and dyspnea with significantly decreased oral intake. Overall, he did not have difficulty breathing. In the ED, he was afebrile, HR 60s, BP elevated to 176/112, and satting >98% on RA. Labs revealed WBC 5.3, Hg 13.3, Plts 102, K 3.6, Mg 1.6, Cr 1.32, trops and BNP neg, AST 39, ALT 11, Alk Phos 131. CXR showed patchy bilateral airspace opacities more notable in the lower lobes. He was admitted to treat empirically for community acquired pneumonia given that he's immunocompromised, and monitor on continuous pulse ox for consideration of remdesivir/dexamethasone. Patient did not require oxygen during his brief stay and did not require remdesivir or dexamethsone. He was discharged in stable condition on 9/14/2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood magnesium normal, Blood potassium normal, Blood pressure increased, Brain natriuretic peptide normal, COVID-19
Clinical narrative: Narrative: 62 yo male with past medical history including EtOH/HCV hepatitis with liver transplant in Dec 2020, HTN, GERD reported to the Emergency Department for COVID symptoms on 9/7/2021. Reported chills, fatigue, nasal congestion, sore throat, cough, body aches, diarrhea for 10 days. For hepatitis C, he completed Mavyret therapy in April and is currently taking Tacrolimus 3mg AM and 2mg PM as well as mycophenolate 500mg BID. He states compliance to both meds, has not missed any doses. -Date of positive COVID-19 test: 9/7/21, despite being fully vaccinated with Pfizer's COVID vaccine on 1/29/2021 and 2/22/2021 -Date of symptom onset (estimated based on chart review): approx 8/29-8/30 -High risk factors identified: immunosuppressant therapy, BMI >/= 25 - Recommendation: Patient is considered at high risk for progression to severe disease and/or hospitalization based on risk factor(s) identified above. He was offered MAB infusion by ED provider and accepted. The agent and dose are documented elsewhere in this report. 5 days later he reported to the Emergency Department again, stating that he felt worse with increased weakness and dyspnea with significantly decreased oral intake. Overall, he did not have difficulty breathing. In the ED, he was afebrile, HR 60s, BP elevated to 176/112, and satting >98% on RA. Labs revealed WBC 5.3, Hg 13.3, Plts 102, K 3.6, Mg 1.6, Cr 1.32, trops and BNP neg, AST 39, ALT 11, Alk Phos 131. CXR showed patchy bilateral airspace opacities more notable in the lower lobes. He was admitted to treat empirically for community acquired pneumonia given that he's immunocompromised, and monitor on continuous pulse ox for consideration of remdesivir/dexamethasone. Patient did not require oxygen during his brief stay and did not require remdesivir or dexamethsone. He was discharged in stable condition on 9/14/2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray abnormal, Chills, Condition aggravated, Cough, Diarrhoea
Clinical narrative: Narrative: 62 yo male with past medical history including EtOH/HCV hepatitis with liver transplant in Dec 2020, HTN, GERD reported to the Emergency Department for COVID symptoms on 9/7/2021. Reported chills, fatigue, nasal congestion, sore throat, cough, body aches, diarrhea for 10 days. For hepatitis C, he completed Mavyret therapy in April and is currently taking Tacrolimus 3mg AM and 2mg PM as well as mycophenolate 500mg BID. He states compliance to both meds, has not missed any doses. -Date of positive COVID-19 test: 9/7/21, despite being fully vaccinated with Pfizer's COVID vaccine on 1/29/2021 and 2/22/2021 -Date of symptom onset (estimated based on chart review): approx 8/29-8/30 -High risk factors identified: immunosuppressant therapy, BMI >/= 25 - Recommendation: Patient is considered at high risk for progression to severe disease and/or hospitalization based on risk factor(s) identified above. He was offered MAB infusion by ED provider and accepted. The agent and dose are documented elsewhere in this report. 5 days later he reported to the Emergency Department again, stating that he felt worse with increased weakness and dyspnea with significantly decreased oral intake. Overall, he did not have difficulty breathing. In the ED, he was afebrile, HR 60s, BP elevated to 176/112, and satting >98% on RA. Labs revealed WBC 5.3, Hg 13.3, Plts 102, K 3.6, Mg 1.6, Cr 1.32, trops and BNP neg, AST 39, ALT 11, Alk Phos 131. CXR showed patchy bilateral airspace opacities more notable in the lower lobes. He was admitted to treat empirically for community acquired pneumonia given that he's immunocompromised, and monitor on continuous pulse ox for consideration of remdesivir/dexamethasone. Patient did not require oxygen during his brief stay and did not require remdesivir or dexamethsone. He was discharged in stable condition on 9/14/2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Fatigue, Haemoglobin decreased, Hepatitis C, Hypophagia
Clinical narrative: Narrative: 62 yo male with past medical history including EtOH/HCV hepatitis with liver transplant in Dec 2020, HTN, GERD reported to the Emergency Department for COVID symptoms on 9/7/2021. Reported chills, fatigue, nasal congestion, sore throat, cough, body aches, diarrhea for 10 days. For hepatitis C, he completed Mavyret therapy in April and is currently taking Tacrolimus 3mg AM and 2mg PM as well as mycophenolate 500mg BID. He states compliance to both meds, has not missed any doses. -Date of positive COVID-19 test: 9/7/21, despite being fully vaccinated with Pfizer's COVID vaccine on 1/29/2021 and 2/22/2021 -Date of symptom onset (estimated based on chart review): approx 8/29-8/30 -High risk factors identified: immunosuppressant therapy, BMI >/= 25 - Recommendation: Patient is considered at high risk for progression to severe disease and/or hospitalization based on risk factor(s) identified above. He was offered MAB infusion by ED provider and accepted. The agent and dose are documented elsewhere in this report. 5 days later he reported to the Emergency Department again, stating that he felt worse with increased weakness and dyspnea with significantly decreased oral intake. Overall, he did not have difficulty breathing. In the ED, he was afebrile, HR 60s, BP elevated to 176/112, and satting >98% on RA. Labs revealed WBC 5.3, Hg 13.3, Plts 102, K 3.6, Mg 1.6, Cr 1.32, trops and BNP neg, AST 39, ALT 11, Alk Phos 131. CXR showed patchy bilateral airspace opacities more notable in the lower lobes. He was admitted to treat empirically for community acquired pneumonia given that he's immunocompromised, and monitor on continuous pulse ox for consideration of remdesivir/dexamethasone. Patient did not require oxygen during his brief stay and did not require remdesivir or dexamethsone. He was discharged in stable condition on 9/14/2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Malaise, Nasal congestion, Oropharyngeal pain, Pain
Clinical narrative: Narrative: 62 yo male with past medical history including EtOH/HCV hepatitis with liver transplant in Dec 2020, HTN, GERD reported to the Emergency Department for COVID symptoms on 9/7/2021. Reported chills, fatigue, nasal congestion, sore throat, cough, body aches, diarrhea for 10 days. For hepatitis C, he completed Mavyret therapy in April and is currently taking Tacrolimus 3mg AM and 2mg PM as well as mycophenolate 500mg BID. He states compliance to both meds, has not missed any doses. -Date of positive COVID-19 test: 9/7/21, despite being fully vaccinated with Pfizer's COVID vaccine on 1/29/2021 and 2/22/2021 -Date of symptom onset (estimated based on chart review): approx 8/29-8/30 -High risk factors identified: immunosuppressant therapy, BMI >/= 25 - Recommendation: Patient is considered at high risk for progression to severe disease and/or hospitalization based on risk factor(s) identified above. He was offered MAB infusion by ED provider and accepted. The agent and dose are documented elsewhere in this report. 5 days later he reported to the Emergency Department again, stating that he felt worse with increased weakness and dyspnea with significantly decreased oral intake. Overall, he did not have difficulty breathing. In the ED, he was afebrile, HR 60s, BP elevated to 176/112, and satting >98% on RA. Labs revealed WBC 5.3, Hg 13.3, Plts 102, K 3.6, Mg 1.6, Cr 1.32, trops and BNP neg, AST 39, ALT 11, Alk Phos 131. CXR showed patchy bilateral airspace opacities more notable in the lower lobes. He was admitted to treat empirically for community acquired pneumonia given that he's immunocompromised, and monitor on continuous pulse ox for consideration of remdesivir/dexamethasone. Patient did not require oxygen during his brief stay and did not require remdesivir or dexamethsone. He was discharged in stable condition on 9/14/2021.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Platelet count decreased, Pneumonia, SARS-CoV-2 test positive, Troponin normal, White blood cell count normal
Clinical narrative: Narrative: 62 yo male with past medical history including EtOH/HCV hepatitis with liver transplant in Dec 2020, HTN, GERD reported to the Emergency Department for COVID symptoms on 9/7/2021. Reported chills, fatigue, nasal congestion, sore throat, cough, body aches, diarrhea for 10 days. For hepatitis C, he completed Mavyret therapy in April and is currently taking Tacrolimus 3mg AM and 2mg PM as well as mycophenolate 500mg BID. He states compliance to both meds, has not missed any doses. -Date of positive COVID-19 test: 9/7/21, despite being fully vaccinated with Pfizer's COVID vaccine on 1/29/2021 and 2/22/2021 -Date of symptom onset (estimated based on chart review): approx 8/29-8/30 -High risk factors identified: immunosuppressant therapy, BMI >/= 25 - Recommendation: Patient is considered at high risk for progression to severe disease and/or hospitalization based on risk factor(s) identified above. He was offered MAB infusion by ED provider and accepted. The agent and dose are documented elsewhere in this report. 5 days later he reported to the Emergency Department again, stating that he felt worse with increased weakness and dyspnea with significantly decreased oral intake. Overall, he did not have difficulty breathing. In the ED, he was afebrile, HR 60s, BP elevated to 176/112, and satting >98% on RA. Labs revealed WBC 5.3, Hg 13.3, Plts 102, K 3.6, Mg 1.6, Cr 1.32, trops and BNP neg, AST 39, ALT 11, Alk Phos 131. CXR showed patchy bilateral airspace opacities more notable in the lower lobes. He was admitted to treat empirically for community acquired pneumonia given that he's immunocompromised, and monitor on continuous pulse ox for consideration of remdesivir/dexamethasone. Patient did not require oxygen during his brief stay and did not require remdesivir or dexamethsone. He was discharged in stable condition on 9/14/2021.
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acquired diaphragmatic eventration, Atelectasis, Bradycardia, COVID-19, Chest X-ray abnormal
Clinical narrative: Narrative: 83 yo M with COPD on 2-3L home O2, HFrEF (EF 35-40% Jan 2018), Atrial Fibrillation on apixaban presenting with increased O2 requirement and hypotension in the setting of COVID. He was diagnosed with COVID on 9/11 to another hospital in town despite being fully vaccinated with Pfizer's COVID vaccine on 2/5/2021 and 2/26/2021. He was not admitted at that time. Since then he had been staying with one of his daughters (daughter he lives with is also sick with COVID) and has decreased PO intake. He was slightly more SOB than is usual for him, remained on 2.5-3L O2. Used BiPap at night and continued since he has been sick. He received monoclonal antibody infusion 9/16/2021 and at that appointment he was noted to be bradycardic with HR in 40s and hypotensive to 70s/40s so came for further evaluation. He was admitted. Hypotension thought to be due to hypovolemia secondary to PO intake in setting of recent COVID infection. Improved with fluid resuscitation. He was discharged on 9/19/2021.
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea, Hypophagia, Hypotension
Clinical narrative: Narrative: 83 yo M with COPD on 2-3L home O2, HFrEF (EF 35-40% Jan 2018), Atrial Fibrillation on apixaban presenting with increased O2 requirement and hypotension in the setting of COVID. He was diagnosed with COVID on 9/11 to another hospital in town despite being fully vaccinated with Pfizer's COVID vaccine on 2/5/2021 and 2/26/2021. He was not admitted at that time. Since then he had been staying with one of his daughters (daughter he lives with is also sick with COVID) and has decreased PO intake. He was slightly more SOB than is usual for him, remained on 2.5-3L O2. Used BiPap at night and continued since he has been sick. He received monoclonal antibody infusion 9/16/2021 and at that appointment he was noted to be bradycardic with HR in 40s and hypotensive to 70s/40s so came for further evaluation. He was admitted. Hypotension thought to be due to hypovolemia secondary to PO intake in setting of recent COVID infection. Improved with fluid resuscitation. He was discharged on 9/19/2021.
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypovolaemia, Malaise, Pleural fibrosis, Positive airway pressure therapy, SARS-CoV-2 test positive
Clinical narrative: Narrative: 83 yo M with COPD on 2-3L home O2, HFrEF (EF 35-40% Jan 2018), Atrial Fibrillation on apixaban presenting with increased O2 requirement and hypotension in the setting of COVID. He was diagnosed with COVID on 9/11 to another hospital in town despite being fully vaccinated with Pfizer's COVID vaccine on 2/5/2021 and 2/26/2021. He was not admitted at that time. Since then he had been staying with one of his daughters (daughter he lives with is also sick with COVID) and has decreased PO intake. He was slightly more SOB than is usual for him, remained on 2.5-3L O2. Used BiPap at night and continued since he has been sick. He received monoclonal antibody infusion 9/16/2021 and at that appointment he was noted to be bradycardic with HR in 40s and hypotensive to 70s/40s so came for further evaluation. He was admitted. Hypotension thought to be due to hypovolemia secondary to PO intake in setting of recent COVID infection. Improved with fluid resuscitation. He was discharged on 9/19/2021.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Narrative: Breakthrough COVID infection requiring hospitalization
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Central venous catheterisation, Chest X-ray abnormal, Choking sensation
Clinical narrative: Narrative: Admission Date: AUG 29,2021 Discharge Date: AUG 30,2021 Admit Diagnosis: Covid + 72 yo M w a PMH T2DM, HTN, COPD (not on home O2), CKD on hemodialysis (MWF), CAD, hx substance abuse, prostate cancer (Dx 2017), hep C (treated), who presented with worsening cold-like symptoms of 1 week duration. Patient says that for the past 7 days he has been having worsening fatigue, congestion, mild SOB, and productive cough. He also says that he has been feeling like he's choking . During this time he did not have any subjective fevers, night sweats or chills. Patient also denied any headaches, dizziness, chest pain, nausea, vomiting, bloody bowel movements, hemoptysis, or hematemesis for the past 7 days. When presented to the emergency department, patient was hemodynamically stable, T 98.6, P 75, RR 20, BP 107/66. Covid test was performed which came back positive. Patient previously received two doses of the Pfizer Covid vaccine (2/5/2021 and 2/26/2021). CXR with minimally changed radiographic findings, apart from the new right sided tunneled catheter. Patient was admitted to the Medicine Service for further management. #COVID+ pneumonia/pneumonitis: Patient with covid-like symptoms of 1-week duration. Fatigue, cough, congestion, mild SOB. Has not required supplemental O2 - therefore, dexamaethasone and remdisivir held. Gave Regeneron (8/30) given high risk PMH (COPD, ESRD) and positive test <10 days ago. Discharged on 8/30 in stable condition.
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cough, Dyspnoea, Fatigue, Malaise, Nasopharyngitis
Clinical narrative: Narrative: Admission Date: AUG 29,2021 Discharge Date: AUG 30,2021 Admit Diagnosis: Covid + 72 yo M w a PMH T2DM, HTN, COPD (not on home O2), CKD on hemodialysis (MWF), CAD, hx substance abuse, prostate cancer (Dx 2017), hep C (treated), who presented with worsening cold-like symptoms of 1 week duration. Patient says that for the past 7 days he has been having worsening fatigue, congestion, mild SOB, and productive cough. He also says that he has been feeling like he's choking . During this time he did not have any subjective fevers, night sweats or chills. Patient also denied any headaches, dizziness, chest pain, nausea, vomiting, bloody bowel movements, hemoptysis, or hematemesis for the past 7 days. When presented to the emergency department, patient was hemodynamically stable, T 98.6, P 75, RR 20, BP 107/66. Covid test was performed which came back positive. Patient previously received two doses of the Pfizer Covid vaccine (2/5/2021 and 2/26/2021). CXR with minimally changed radiographic findings, apart from the new right sided tunneled catheter. Patient was admitted to the Medicine Service for further management. #COVID+ pneumonia/pneumonitis: Patient with covid-like symptoms of 1-week duration. Fatigue, cough, congestion, mild SOB. Has not required supplemental O2 - therefore, dexamaethasone and remdisivir held. Gave Regeneron (8/30) given high risk PMH (COPD, ESRD) and positive test <10 days ago. Discharged on 8/30 in stable condition.
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Productive cough, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Narrative: Admission Date: AUG 29,2021 Discharge Date: AUG 30,2021 Admit Diagnosis: Covid + 72 yo M w a PMH T2DM, HTN, COPD (not on home O2), CKD on hemodialysis (MWF), CAD, hx substance abuse, prostate cancer (Dx 2017), hep C (treated), who presented with worsening cold-like symptoms of 1 week duration. Patient says that for the past 7 days he has been having worsening fatigue, congestion, mild SOB, and productive cough. He also says that he has been feeling like he's choking . During this time he did not have any subjective fevers, night sweats or chills. Patient also denied any headaches, dizziness, chest pain, nausea, vomiting, bloody bowel movements, hemoptysis, or hematemesis for the past 7 days. When presented to the emergency department, patient was hemodynamically stable, T 98.6, P 75, RR 20, BP 107/66. Covid test was performed which came back positive. Patient previously received two doses of the Pfizer Covid vaccine (2/5/2021 and 2/26/2021). CXR with minimally changed radiographic findings, apart from the new right sided tunneled catheter. Patient was admitted to the Medicine Service for further management. #COVID+ pneumonia/pneumonitis: Patient with covid-like symptoms of 1-week duration. Fatigue, cough, congestion, mild SOB. Has not required supplemental O2 - therefore, dexamaethasone and remdisivir held. Gave Regeneron (8/30) given high risk PMH (COPD, ESRD) and positive test <10 days ago. Discharged on 8/30 in stable condition.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arteriosclerosis, Asthenia, Back pain, COVID-19, COVID-19 pneumonia
Clinical narrative: Narrative: Admission date: AUG 24,2021 Discharge date: SEP 3,2021. Admission diagnosis: COVID pneumonia 81 y/o M with past medical history of ESRD (hemodialysis 3x per week), CAD (s/p PCI 2011 to RCA), HTN, HLD, presenting to the ED after a fall with back pain. Patient was seen at hemodialysis center yesterday and tested positive for COVID. He is vaccinated with Pfizer vaccine on 3/15/2021 and 4/5/2021 and was not experiencing any symptoms including SOB or diarrhea. He had a mechanical fall yesterday. He was down for about 2-3 hours when a worker found him. Patient states he continued to try and get up, but was too weak. He has been drinking very little as he was told he should no be drinking any more than 32 ounces of liquid per day to decrease swelling. Patient continued to have back pain today, and therefor EMS was called to bring him to the Emergency Dept. Upon admission, COVID therapy was initially held given his asymptomatic state, but he later developed new O2 requirement and fever up to 101.7 on 8/25. Given CXR with R mid/lower lobe opacities consistent with pneumonia, ceftriaxone and azithromycin were started. Dexamethasone was also started 8/25. Due to persistent oxygen requirements, remdesivir was started. Oxygen requirements down to room air on 8/26. Fevers resolved.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray abnormal, Fall, Fluid intake reduced, Lung infiltration, Lung opacity
Clinical narrative: Narrative: Admission date: AUG 24,2021 Discharge date: SEP 3,2021. Admission diagnosis: COVID pneumonia 81 y/o M with past medical history of ESRD (hemodialysis 3x per week), CAD (s/p PCI 2011 to RCA), HTN, HLD, presenting to the ED after a fall with back pain. Patient was seen at hemodialysis center yesterday and tested positive for COVID. He is vaccinated with Pfizer vaccine on 3/15/2021 and 4/5/2021 and was not experiencing any symptoms including SOB or diarrhea. He had a mechanical fall yesterday. He was down for about 2-3 hours when a worker found him. Patient states he continued to try and get up, but was too weak. He has been drinking very little as he was told he should no be drinking any more than 32 ounces of liquid per day to decrease swelling. Patient continued to have back pain today, and therefor EMS was called to bring him to the Emergency Dept. Upon admission, COVID therapy was initially held given his asymptomatic state, but he later developed new O2 requirement and fever up to 101.7 on 8/25. Given CXR with R mid/lower lobe opacities consistent with pneumonia, ceftriaxone and azithromycin were started. Dexamethasone was also started 8/25. Due to persistent oxygen requirements, remdesivir was started. Oxygen requirements down to room air on 8/26. Fevers resolved.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Osteoarthritis, Pyrexia, SARS-CoV-2 test positive, Swelling
Clinical narrative: Narrative: Admission date: AUG 24,2021 Discharge date: SEP 3,2021. Admission diagnosis: COVID pneumonia 81 y/o M with past medical history of ESRD (hemodialysis 3x per week), CAD (s/p PCI 2011 to RCA), HTN, HLD, presenting to the ED after a fall with back pain. Patient was seen at hemodialysis center yesterday and tested positive for COVID. He is vaccinated with Pfizer vaccine on 3/15/2021 and 4/5/2021 and was not experiencing any symptoms including SOB or diarrhea. He had a mechanical fall yesterday. He was down for about 2-3 hours when a worker found him. Patient states he continued to try and get up, but was too weak. He has been drinking very little as he was told he should no be drinking any more than 32 ounces of liquid per day to decrease swelling. Patient continued to have back pain today, and therefor EMS was called to bring him to the Emergency Dept. Upon admission, COVID therapy was initially held given his asymptomatic state, but he later developed new O2 requirement and fever up to 101.7 on 8/25. Given CXR with R mid/lower lobe opacities consistent with pneumonia, ceftriaxone and azithromycin were started. Dexamethasone was also started 8/25. Due to persistent oxygen requirements, remdesivir was started. Oxygen requirements down to room air on 8/26. Fevers resolved.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Fall, Thrombocytopenia
Clinical narrative: Narrative: PATIENT PRESENTED TO NON-FACILITY HOSPITAL: Chief complaint: fall, Covid-19, thrombocytopenia
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood fibrinogen increased, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia
Clinical narrative: Narrative: COVID infection following COVID vaccine series 12/29/2020 , Pfizer, dose #1 01/19/2021 Pfizer, dose #2 08/23 COVID swab, result: detected 08/21 pt cc: cough, dyspnea, fatigue exposure: unknown 08/23 pt admit to medicine cc: General fatigue and shortness of breath dx: Acute hypoxic respiratory failure LOS: 5 days 08/23 CTA PE impression: Negative study for acute pulmonary embolism. Multifocal pneumonia, with the largest opacity in the RIGHT lower lobe. Recommend PA and lateral chest radiographs in 6-8 weeks after appropriate treatment to document resolution. 08/23 CXR impression: No acute pulmonary finding. 08/25 FIBRINOGEN result: 491 08/25DDIMER result: 0.99 08/25 ESR result: 41 08/26 FIBRINOGEN result: 378 08/26 DDIMER result: 0.6 08/26 ESR result: 30 08/27 FIBRINOGEN result: 326 08/27 DDIMER result: 1.56 08/27 ESR result: 21 09/05 pt traveled and was readmitted to a non-Facility hospital LOS: unknown 09/09 COVID-19 ANTIGEN(BINAX) result: not detected 09/09 ESR result: 7 09/09 CTA PE impression: No pulmonary embolus. Since prior CT dated 8/23/2021, some worsening of multifocal airspace and groundglass opacities, consistent with known viral pneumonia, again most pronounced in the right lower lobe. 09/09 BNP result: 106.3 09/09 procalcitonin result: <0.05 09/09 pt admit to cc: General fatigue and shortness of breath dx: COVID Pneumonia LOS: 1 day 09/10 FIBRINOGEN result: 250 09/10 DDIMER result: 1.41 09/10 ESR result: 10
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Fatigue
Clinical narrative: Narrative: COVID infection following COVID vaccine series 12/29/2020 , Pfizer, dose #1 01/19/2021 Pfizer, dose #2 08/23 COVID swab, result: detected 08/21 pt cc: cough, dyspnea, fatigue exposure: unknown 08/23 pt admit to medicine cc: General fatigue and shortness of breath dx: Acute hypoxic respiratory failure LOS: 5 days 08/23 CTA PE impression: Negative study for acute pulmonary embolism. Multifocal pneumonia, with the largest opacity in the RIGHT lower lobe. Recommend PA and lateral chest radiographs in 6-8 weeks after appropriate treatment to document resolution. 08/23 CXR impression: No acute pulmonary finding. 08/25 FIBRINOGEN result: 491 08/25DDIMER result: 0.99 08/25 ESR result: 41 08/26 FIBRINOGEN result: 378 08/26 DDIMER result: 0.6 08/26 ESR result: 30 08/27 FIBRINOGEN result: 326 08/27 DDIMER result: 1.56 08/27 ESR result: 21 09/05 pt traveled and was readmitted to a non-Facility hospital LOS: unknown 09/09 COVID-19 ANTIGEN(BINAX) result: not detected 09/09 ESR result: 7 09/09 CTA PE impression: No pulmonary embolus. Since prior CT dated 8/23/2021, some worsening of multifocal airspace and groundglass opacities, consistent with known viral pneumonia, again most pronounced in the right lower lobe. 09/09 BNP result: 106.3 09/09 procalcitonin result: <0.05 09/09 pt admit to cc: General fatigue and shortness of breath dx: COVID Pneumonia LOS: 1 day 09/10 FIBRINOGEN result: 250 09/10 DDIMER result: 1.41 09/10 ESR result: 10