chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Exposure to SARS-CoV-2, Malaise, Nasal congestion, Orthopnoea
Clinical narrative: Hospitalized 10/10/2021; COVID-19 positive 10/09/2021; fully vaccinated  ED visit on 10/9/2021 discharged home:  Patient seen in conjunction with the physician assistant.  I agree with his assessment plan.  Patient is vaccinated against COVID-19 but now has symptoms that started 24 hours ago that are concerning for infection.  She is COVID positive here.  Vitals are within normal limits, no indication for hospitalization.  She does have a history of atrial fibrillation and heart disease with cardiomyopathy.  Does qualify for monoclonal antibody infusion.  I did review the treatment with her and cleaning risks and benefits.  Verbal consent was obtained.  Antibody infusion ordered.  Will be monitored post infusion for the appropriate amount of time HISTORY OF PRESENT ILLNESS: 87-year-old female who is currently vaccinated for COVID-19 presents emergency department with cough nasal congestion and rhinorrhea which started yesterday afternoon.  Patient states she otherwise feels fine and has not had any fevers chills sweats chest pain chest pressure shortness of breath and is not coughing anything up.  Patient states she took Tylenol yesterday states she currently has no pain is 0/10 on the pain scale.  Patient states she also received her flu shot yesterday.  Patient denies any muscle aches and nausea vomiting diarrhea.  Patient states that on Wednesday she saw her grandson who had some mild upper respiratory symptoms and they just got him tested and he is currently positive for COVID-19. Assessment/Plan    DIAGNOSIS at time of disposition: 1. COVID-19 virus infection  2. Encounter for laboratory testing for COVID-19 virus     Discharge summary  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure with hypoxia COVID-19    HOSPITAL COURSE: 87 y/o female with history of atrial fib on xarelto, chronic HFpEF, hyperthyroid, Crohn's.  Positive COVID and received monoclonal antibody infusion on 10/09.  Returns with worsening shortness of breath, orthopnea.  She is fully vaccinated since March 2021.  Initially on 6L NC, and then requiring high flow and weaned back down to NC after lasix. She was diagnosed with a combination of heart failure and COVID-19 and admitted to the hospitalist service. She was started on decadron and remdesivir for COVID-19. Her oxygen was weaned to room air. Ambulatory pulse ox was stable and did not drop below 92%. Her stay was uncomplicated. She got her dose of remdesivir prior to discharge. She will finish her course of decadron outpatient. She was discharged home in stable and improved condition.      Active Issues Requiring Follow-up Issue: covid PNA Recommended follow-up provider/specialty: PCP What is needed: close outpatient follow up, continue follow up with GI   DISCHARGE DISPOSITION: Home without services
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: Hospitalized 10/10/2021; COVID-19 positive 10/09/2021; fully vaccinated  ED visit on 10/9/2021 discharged home:  Patient seen in conjunction with the physician assistant.  I agree with his assessment plan.  Patient is vaccinated against COVID-19 but now has symptoms that started 24 hours ago that are concerning for infection.  She is COVID positive here.  Vitals are within normal limits, no indication for hospitalization.  She does have a history of atrial fibrillation and heart disease with cardiomyopathy.  Does qualify for monoclonal antibody infusion.  I did review the treatment with her and cleaning risks and benefits.  Verbal consent was obtained.  Antibody infusion ordered.  Will be monitored post infusion for the appropriate amount of time HISTORY OF PRESENT ILLNESS: 87-year-old female who is currently vaccinated for COVID-19 presents emergency department with cough nasal congestion and rhinorrhea which started yesterday afternoon.  Patient states she otherwise feels fine and has not had any fevers chills sweats chest pain chest pressure shortness of breath and is not coughing anything up.  Patient states she took Tylenol yesterday states she currently has no pain is 0/10 on the pain scale.  Patient states she also received her flu shot yesterday.  Patient denies any muscle aches and nausea vomiting diarrhea.  Patient states that on Wednesday she saw her grandson who had some mild upper respiratory symptoms and they just got him tested and he is currently positive for COVID-19. Assessment/Plan    DIAGNOSIS at time of disposition: 1. COVID-19 virus infection  2. Encounter for laboratory testing for COVID-19 virus     Discharge summary  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute respiratory failure with hypoxia COVID-19    HOSPITAL COURSE: 87 y/o female with history of atrial fib on xarelto, chronic HFpEF, hyperthyroid, Crohn's.  Positive COVID and received monoclonal antibody infusion on 10/09.  Returns with worsening shortness of breath, orthopnea.  She is fully vaccinated since March 2021.  Initially on 6L NC, and then requiring high flow and weaned back down to NC after lasix. She was diagnosed with a combination of heart failure and COVID-19 and admitted to the hospitalist service. She was started on decadron and remdesivir for COVID-19. Her oxygen was weaned to room air. Ambulatory pulse ox was stable and did not drop below 92%. Her stay was uncomplicated. She got her dose of remdesivir prior to discharge. She will finish her course of decadron outpatient. She was discharged home in stable and improved condition.      Active Issues Requiring Follow-up Issue: covid PNA Recommended follow-up provider/specialty: PCP What is needed: close outpatient follow up, continue follow up with GI   DISCHARGE DISPOSITION: Home without services
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Ultrasound scan
Clinical narrative: - Developed DVT left calf; unknown if related to air plane flight with increased risk related to vaccination with history of thrombosis with thrombocytopenia syndrome (TTS) in patients. Understand it is predominately a concern with women, but just want to include this data point in case it is being seen in others. Received blood thinners at one dose for 20 days and then 69 days of a lower dosing.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Pain, Pyrexia, Taste disorder
Clinical narrative: Chills, fever, aches, taste
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Body temperature increased
Clinical narrative: Temp 103.6
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Erectile dysfunction, Gingival bleeding, Penis disorder, Tenderness, Testicular atrophy
Clinical narrative: Erectile dysfunction: Major decrease in nighttime or morning erections. Major increase in inability to gain an erection upon physical contact. Shrinkage of the testes and recess of the penis much more prevalent. Began soon after the inoculation and have persisted to present.  Major increase of tenderness of gums (very little before shot) and consistent gum bleeding whenever brushing teeth began soon after inoculation and 1 time event of small blood clots coming out of gums 5 month after shot. No change was made in brushing habits, tooth brush type or diet in the transition from not having these symptom to having it other than receiving the vaccine.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Thrombosis
Clinical narrative: Erectile dysfunction: Major decrease in nighttime or morning erections. Major increase in inability to gain an erection upon physical contact. Shrinkage of the testes and recess of the penis much more prevalent. Began soon after the inoculation and have persisted to present.  Major increase of tenderness of gums (very little before shot) and consistent gum bleeding whenever brushing teeth began soon after inoculation and 1 time event of small blood clots coming out of gums 5 month after shot. No change was made in brushing habits, tooth brush type or diet in the transition from not having these symptom to having it other than receiving the vaccine.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Exposure during pregnancy, Headache, Oropharyngeal pain, Pain
Clinical narrative: I am 23 weeks pregnant due date 2/14/2022. I had my second shot yesterday and wonk up with severe arm pain, body aches, chills, fever 100.3, headache, and sore throat.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Pyrexia
Clinical narrative: I am 23 weeks pregnant due date 2/14/2022. I had my second shot yesterday and wonk up with severe arm pain, body aches, chills, fever 100.3, headache, and sore throat.
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood test, Chest X-ray, Computerised tomogram head, Epistaxis, Headache
Clinical narrative: High bp  Severe headache  Nose bleeds  Started with in 20 minutes of vaccine.  High bp and headaches continue since vax.  daily issue
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypertension
Clinical narrative: High bp  Severe headache  Nose bleeds  Started with in 20 minutes of vaccine.  High bp and headaches continue since vax.  daily issue
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Activated partial thromboplastin time, Basophil count increased, Blood creatinine normal, Blood pressure increased, C-reactive protein normal
Clinical narrative: High bp  Severe headache  Nose bleeds  Started with in 20 minutes of vaccine.  High bp and headaches continue since vax.  daily issue
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Epistaxis, Full blood count abnormal, Headache, Lymphocyte count decreased, Lymphocyte percentage decreased
Clinical narrative: High bp  Severe headache  Nose bleeds  Started with in 20 minutes of vaccine.  High bp and headaches continue since vax.  daily issue
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Metabolic function test, Prothrombin level normal
Clinical narrative: High bp  Severe headache  Nose bleeds  Started with in 20 minutes of vaccine.  High bp and headaches continue since vax.  daily issue
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood test, Chest X-ray, Computerised tomogram head, Epistaxis, Headache
Clinical narrative: Headache Elevated Blood pressure Nose bleeds
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypertension
Clinical narrative: Headache Elevated Blood pressure Nose bleeds
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Activated partial thromboplastin time, Basophil count increased, Blood creatinine normal, Blood pressure increased, C-reactive protein normal
Clinical narrative: Headache Elevated Blood pressure Nose bleeds
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Epistaxis, Full blood count abnormal, Headache, Lymphocyte count decreased, Lymphocyte percentage decreased
Clinical narrative: Headache Elevated Blood pressure Nose bleeds
Age: 55.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Metabolic function test, Prothrombin level normal
Clinical narrative: Headache Elevated Blood pressure Nose bleeds
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, Body temperature increased, COVID-19, Chest X-ray normal, Condition aggravated
Clinical narrative: Hospitalized 10/8/2021; COVID-19 positive 10/8/2021; fully vaccinated  Discharge Summary(Physician) ? ? General Medicine BRIEF OVERVIEW: Admission Date: 10/8/2021 Discharge Date: Oct 13, 2021     DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Weakness [R53.1] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is an 82-year-old male with a past medical history of cardiomyopathy, systolic CHF, aortic stenosis status post bioprosthetic aortic valve, dementia, CKD, hypertension and prostate cancer who presented secondary to a chief complaint of weakness.  The patient developed a cough 3 days prior to admission which was nonproductive.  He became weak during this time.  Blood home the night prior to admission he slid out of his chair and required family to assist him to the floor.  He did not lose consciousness.  To decreased oral intake.  He fell again and EMS was called.  In the emergency department, he had a temperature of 39.0°.  CMP and complete blood count were unremarkable.  Procalcitonin was 0.1.  UA was positive for ketones and protein.  No signs of infection.  COVID PCR was positive.  Chest x-ray was negative for acute process.  Tylenol was given in the emergency department as well as a 500 mL bolus.  The patient was admitted for COVID infection with generalized weakness.  He was seen by PT/OT who recommended subacute rehab, but family opted for home with home care.  The patient did not require oxygen.  He was afebrile.  He was discharged home on 10/13/2021 with home care.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cough, Fall, Full blood count normal, Hypophagia, Metabolic function test
Clinical narrative: Hospitalized 10/8/2021; COVID-19 positive 10/8/2021; fully vaccinated  Discharge Summary(Physician) ? ? General Medicine BRIEF OVERVIEW: Admission Date: 10/8/2021 Discharge Date: Oct 13, 2021     DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Weakness [R53.1] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is an 82-year-old male with a past medical history of cardiomyopathy, systolic CHF, aortic stenosis status post bioprosthetic aortic valve, dementia, CKD, hypertension and prostate cancer who presented secondary to a chief complaint of weakness.  The patient developed a cough 3 days prior to admission which was nonproductive.  He became weak during this time.  Blood home the night prior to admission he slid out of his chair and required family to assist him to the floor.  He did not lose consciousness.  To decreased oral intake.  He fell again and EMS was called.  In the emergency department, he had a temperature of 39.0°.  CMP and complete blood count were unremarkable.  Procalcitonin was 0.1.  UA was positive for ketones and protein.  No signs of infection.  COVID PCR was positive.  Chest x-ray was negative for acute process.  Tylenol was given in the emergency department as well as a 500 mL bolus.  The patient was admitted for COVID infection with generalized weakness.  He was seen by PT/OT who recommended subacute rehab, but family opted for home with home care.  The patient did not require oxygen.  He was afebrile.  He was discharged home on 10/13/2021 with home care.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Procalcitonin, Protein urine present, SARS-CoV-2 test positive, Urine analysis abnormal, Urine ketone body present
Clinical narrative: Hospitalized 10/8/2021; COVID-19 positive 10/8/2021; fully vaccinated  Discharge Summary(Physician) ? ? General Medicine BRIEF OVERVIEW: Admission Date: 10/8/2021 Discharge Date: Oct 13, 2021     DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Weakness [R53.1] COVID-19 virus infection [U07.1] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is an 82-year-old male with a past medical history of cardiomyopathy, systolic CHF, aortic stenosis status post bioprosthetic aortic valve, dementia, CKD, hypertension and prostate cancer who presented secondary to a chief complaint of weakness.  The patient developed a cough 3 days prior to admission which was nonproductive.  He became weak during this time.  Blood home the night prior to admission he slid out of his chair and required family to assist him to the floor.  He did not lose consciousness.  To decreased oral intake.  He fell again and EMS was called.  In the emergency department, he had a temperature of 39.0°.  CMP and complete blood count were unremarkable.  Procalcitonin was 0.1.  UA was positive for ketones and protein.  No signs of infection.  COVID PCR was positive.  Chest x-ray was negative for acute process.  Tylenol was given in the emergency department as well as a 500 mL bolus.  The patient was admitted for COVID infection with generalized weakness.  He was seen by PT/OT who recommended subacute rehab, but family opted for home with home care.  The patient did not require oxygen.  He was afebrile.  He was discharged home on 10/13/2021 with home care.
Age: 23.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Rash, Testicular pain, Testicular swelling
Clinical narrative: Testicular pain, testicular swelling, rash
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Herpes zoster, Influenza like illness, Pyrexia, Rash
Clinical narrative: "Flu like symptoms" the day after third dose of  vaccine, including low-grade fever, lasting 1 day. Rash  on day 3 post-vaccine, diagnosed 2 days later as shingles. Currently on anti-viral medication as shingles is running its course.
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Diarrhoea
Clinical narrative: Intense diarrhea for 48 hours after 2nd does.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Nausea, Pain
Clinical narrative: Fever, fatigue, nausea, body aches, head ache, chills.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Fever, fatigue, nausea, body aches, head ache, chills.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Inflammation, Tenderness
Clinical narrative: Left testicle inflammation.   Hurt to the touch for 3 days after vaccine.  No trouble with any excretory function, void normal.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: COVID positive - date of vaccination approximate.  Patient noted Pfizer vaccine in January.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Breath sounds abnormal, COVID-19, COVID-19 pneumonia, Chest X-ray normal, Chronic obstructive pulmonary disease
Clinical narrative: Hospitalized 10/12/2021; COVID-19 positive 10/12/2021; fully vaccinated  Assessment/Plan    DIAGNOSIS at time of disposition: 1. Hypoxia  2. COVID-19  Current Discharge Medication List ED Disposition   Hospitalized MEDICAL DECISION MAKING Patient is a 69-year-old who presents to the emergency department today complaining of shortness of breath, chronic cough, and primarily fever.  Exam, patient is somewhat tachypneic.  He has some coarse breath sounds bilaterally.  He is hypoxic requiring supplemental oxygen. Patient did note that his wife was recently diagnosed with COVID-19.  This is high in differential.  Also, other etiologies of sepsis or on the differential.  Given this, I will obtain IV access, chest x-ray, complete blood count, CMP, blood cultures and lactic acid. Patient did require titration of oxygen level from secondary to hypoxia at 2 L. Chest x-ray came back overall reassuring.  Patient's COVID-19 test did come back positive.  I did order Decadron for this patient. Given hypoxia, patient will require admission.  I did discuss case with patient and hospitalist who are agreeable with this plan of care.  Patient has no further questions or concerns at this time. 10/13/2021 notes: ASSESSMENT / PLAN: Acute hypoxic respiratory failure COVID-19 pneumonia COPD exacerbation - continue steroids, decadron 6mg daily, remdesivir - pneumonia by clinical exam, rales, COVID-19, infiltrates often do not appear on CXR and can be seen with CT, no indication for CT here currently - scheduled breathing treatments - symbicort - needs COPD education, did not realize he had COPD or why he was on symbicort, never picked up his nebulizer machine - monitor oxygen closely given high risk of decompensation. 10/14/2021 note: ASSESSMENT / PLAN: Principal Problem:  Respiratory failure (HCC)  Acute hypoxic respiratory failure COVID-19 pneumonia COPD exacerbation -Symptom onset 10/10. Currently requiring 4L via NC - pneumonia by clinical exam, rales, COVID-19, infiltrates often do not appear on CXR and can be seen with CT, no indication for CT here currently -Decadron 6mg x10 days -Remdesivir - Albuterol INH q4hr - Dulera BID, Spiriva daily - needs COPD education, did not realize he had COPD or why he was on symbicort, never picked up his nebulizer machine. Will consult Pulm Rehab once closer to discharge - Continuous pulse ox - Daily labs  Transaminitis, improving -Likely related to COVID -CMP daily, especially while on remdesivir  Disposition: stable on 4L via NC. Continue steroids, remdesivir, and supportive care. Continue to wean O2. If able to wean further, can consider discharge in next 24-48hr with home O2
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram, Condition aggravated, Cough, Dyspnoea, Exposure to SARS-CoV-2
Clinical narrative: Hospitalized 10/12/2021; COVID-19 positive 10/12/2021; fully vaccinated  Assessment/Plan    DIAGNOSIS at time of disposition: 1. Hypoxia  2. COVID-19  Current Discharge Medication List ED Disposition   Hospitalized MEDICAL DECISION MAKING Patient is a 69-year-old who presents to the emergency department today complaining of shortness of breath, chronic cough, and primarily fever.  Exam, patient is somewhat tachypneic.  He has some coarse breath sounds bilaterally.  He is hypoxic requiring supplemental oxygen. Patient did note that his wife was recently diagnosed with COVID-19.  This is high in differential.  Also, other etiologies of sepsis or on the differential.  Given this, I will obtain IV access, chest x-ray, complete blood count, CMP, blood cultures and lactic acid. Patient did require titration of oxygen level from secondary to hypoxia at 2 L. Chest x-ray came back overall reassuring.  Patient's COVID-19 test did come back positive.  I did order Decadron for this patient. Given hypoxia, patient will require admission.  I did discuss case with patient and hospitalist who are agreeable with this plan of care.  Patient has no further questions or concerns at this time. 10/13/2021 notes: ASSESSMENT / PLAN: Acute hypoxic respiratory failure COVID-19 pneumonia COPD exacerbation - continue steroids, decadron 6mg daily, remdesivir - pneumonia by clinical exam, rales, COVID-19, infiltrates often do not appear on CXR and can be seen with CT, no indication for CT here currently - scheduled breathing treatments - symbicort - needs COPD education, did not realize he had COPD or why he was on symbicort, never picked up his nebulizer machine - monitor oxygen closely given high risk of decompensation. 10/14/2021 note: ASSESSMENT / PLAN: Principal Problem:  Respiratory failure (HCC)  Acute hypoxic respiratory failure COVID-19 pneumonia COPD exacerbation -Symptom onset 10/10. Currently requiring 4L via NC - pneumonia by clinical exam, rales, COVID-19, infiltrates often do not appear on CXR and can be seen with CT, no indication for CT here currently -Decadron 6mg x10 days -Remdesivir - Albuterol INH q4hr - Dulera BID, Spiriva daily - needs COPD education, did not realize he had COPD or why he was on symbicort, never picked up his nebulizer machine. Will consult Pulm Rehab once closer to discharge - Continuous pulse ox - Daily labs  Transaminitis, improving -Likely related to COVID -CMP daily, especially while on remdesivir  Disposition: stable on 4L via NC. Continue steroids, remdesivir, and supportive care. Continue to wean O2. If able to wean further, can consider discharge in next 24-48hr with home O2
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypoxia, Pyrexia, Respiratory failure, SARS-CoV-2 test positive, Tachypnoea
Clinical narrative: Hospitalized 10/12/2021; COVID-19 positive 10/12/2021; fully vaccinated  Assessment/Plan    DIAGNOSIS at time of disposition: 1. Hypoxia  2. COVID-19  Current Discharge Medication List ED Disposition   Hospitalized MEDICAL DECISION MAKING Patient is a 69-year-old who presents to the emergency department today complaining of shortness of breath, chronic cough, and primarily fever.  Exam, patient is somewhat tachypneic.  He has some coarse breath sounds bilaterally.  He is hypoxic requiring supplemental oxygen. Patient did note that his wife was recently diagnosed with COVID-19.  This is high in differential.  Also, other etiologies of sepsis or on the differential.  Given this, I will obtain IV access, chest x-ray, complete blood count, CMP, blood cultures and lactic acid. Patient did require titration of oxygen level from secondary to hypoxia at 2 L. Chest x-ray came back overall reassuring.  Patient's COVID-19 test did come back positive.  I did order Decadron for this patient. Given hypoxia, patient will require admission.  I did discuss case with patient and hospitalist who are agreeable with this plan of care.  Patient has no further questions or concerns at this time. 10/13/2021 notes: ASSESSMENT / PLAN: Acute hypoxic respiratory failure COVID-19 pneumonia COPD exacerbation - continue steroids, decadron 6mg daily, remdesivir - pneumonia by clinical exam, rales, COVID-19, infiltrates often do not appear on CXR and can be seen with CT, no indication for CT here currently - scheduled breathing treatments - symbicort - needs COPD education, did not realize he had COPD or why he was on symbicort, never picked up his nebulizer machine - monitor oxygen closely given high risk of decompensation. 10/14/2021 note: ASSESSMENT / PLAN: Principal Problem:  Respiratory failure (HCC)  Acute hypoxic respiratory failure COVID-19 pneumonia COPD exacerbation -Symptom onset 10/10. Currently requiring 4L via NC - pneumonia by clinical exam, rales, COVID-19, infiltrates often do not appear on CXR and can be seen with CT, no indication for CT here currently -Decadron 6mg x10 days -Remdesivir - Albuterol INH q4hr - Dulera BID, Spiriva daily - needs COPD education, did not realize he had COPD or why he was on symbicort, never picked up his nebulizer machine. Will consult Pulm Rehab once closer to discharge - Continuous pulse ox - Daily labs  Transaminitis, improving -Likely related to COVID -CMP daily, especially while on remdesivir  Disposition: stable on 4L via NC. Continue steroids, remdesivir, and supportive care. Continue to wean O2. If able to wean further, can consider discharge in next 24-48hr with home O2
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Swelling, Tenderness
Clinical narrative: Pain, tenderness and swelling under arm and breast area.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Lymph node pain, Lymphadenopathy
Clinical narrative: Enlarged, panful lymph node under right arm.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Bone pain, Dyspnoea, Nasal congestion, Pyrexia
Clinical narrative: Stuffy nose, Fever, bone ache, shortness of breath
Age: 34.0
Sex: F
Vaccine: FLU4
Symptoms: Feeling hot, Limb discomfort, Musculoskeletal stiffness, Neck pain, Pain in extremity
Clinical narrative: Left Arm became heavy, warm, painful from fingers to neck. Neck very painful and stiff. Lasted approx 18hrs.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Balance disorder, Loss of personal independence in daily activities, Magnetic resonance imaging head normal, Vertigo
Clinical narrative: The afternoon of receiving the first Pfizer COVID-19 vaccine, expereinced severe vertigo episode. Disequilibrium persisted resulting in order for an MRI. MRI did not reveal mass effect or acute infarct. Referall to ENT for further investigation pending.   Ongoing disequilibrium from the first event affected requirements of daily living and balance at level that significantly impaired safety and functioning.
Age: 24.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chills, Dizziness, Fatigue, Hyperhidrosis, Pain
Clinical narrative: Fever(101 degrees), Sever body aches, chills, sweats, dizziness, restless & tiredness
Age: 24.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Restlessness, SARS-CoV-2 test negative
Clinical narrative: Fever(101 degrees), Sever body aches, chills, sweats, dizziness, restless & tiredness
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Myocarditis
Clinical narrative: Myocarditis
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Fatigue, Feeling abnormal, Insomnia, Laboratory test
Clinical narrative: After receiving 2nd shot of Pfizer vaccine (approx. 3-4 days), began waking with swollen hands.  Also, was unable to sleep/rest and felt that body was in overdrive - this subsided after 3-4 weeks.  Swollen hands continued, then becoming sore in morning, then sore all day, then became quite painful by mid July. July 16th Dr. at loval medical facility rx'd a round of Prednisone for 20 days. July 18th developed Vertigo and still have, which is becoming debilitating. Aug. 4th another doctor rx'd Valtaren for pain, which did not work.  Then rx'd Celebrex and was taking that until Sept. 21st.  Currently on another round of Prednisone. Aug. 12th pain also in feet. *Also have overall feeling of sickness and fatigue, and brain fog.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Malaise, Pain in extremity, Peripheral swelling, Vertigo
Clinical narrative: After receiving 2nd shot of Pfizer vaccine (approx. 3-4 days), began waking with swollen hands.  Also, was unable to sleep/rest and felt that body was in overdrive - this subsided after 3-4 weeks.  Swollen hands continued, then becoming sore in morning, then sore all day, then became quite painful by mid July. July 16th Dr. at loval medical facility rx'd a round of Prednisone for 20 days. July 18th developed Vertigo and still have, which is becoming debilitating. Aug. 4th another doctor rx'd Valtaren for pain, which did not work.  Then rx'd Celebrex and was taking that until Sept. 21st.  Currently on another round of Prednisone. Aug. 12th pain also in feet. *Also have overall feeling of sickness and fatigue, and brain fog.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Cerebral disorder, Fatigue, Feeling abnormal, Inflammation
Clinical narrative: After receiving 2nd shot of Pfizer vaccine (approx. 3-4 days), began waking with swollen hands.  Also, was unable to sleep/rest and felt that body was in overdrive - this subsided after 3-4 weeks.  Swollen hands continued, then becoming sore in morning, then sore all day, then became quite painful by mid July. July 16th Dr. at loval medical facility rx'd a round of Prednisone for 20 days. July 18th developed Vertigo and still have, which is becoming debilitating. Aug. 4th another doctor rx'd Valtaren for pain, which did not work.  Then rx'd Celebrex and was taking that until Sept. 21st.  Currently on another round of Prednisone. Aug. 12th pain also in feet. *Also have overall feeling of sickness and fatigue, and brain fog.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Insomnia, Pain in extremity, Paraesthesia, Peripheral swelling, Vertigo
Clinical narrative: After receiving 2nd shot of Pfizer vaccine (approx. 3-4 days), began waking with swollen hands.  Also, was unable to sleep/rest and felt that body was in overdrive - this subsided after 3-4 weeks.  Swollen hands continued, then becoming sore in morning, then sore all day, then became quite painful by mid July. July 16th Dr. at loval medical facility rx'd a round of Prednisone for 20 days. July 18th developed Vertigo and still have, which is becoming debilitating. Aug. 4th another doctor rx'd Valtaren for pain, which did not work.  Then rx'd Celebrex and was taking that until Sept. 21st.  Currently on another round of Prednisone. Aug. 12th pain also in feet. *Also have overall feeling of sickness and fatigue, and brain fog.
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Visual impairment
Clinical narrative: After receiving 2nd shot of Pfizer vaccine (approx. 3-4 days), began waking with swollen hands.  Also, was unable to sleep/rest and felt that body was in overdrive - this subsided after 3-4 weeks.  Swollen hands continued, then becoming sore in morning, then sore all day, then became quite painful by mid July. July 16th Dr. at loval medical facility rx'd a round of Prednisone for 20 days. July 18th developed Vertigo and still have, which is becoming debilitating. Aug. 4th another doctor rx'd Valtaren for pain, which did not work.  Then rx'd Celebrex and was taking that until Sept. 21st.  Currently on another round of Prednisone. Aug. 12th pain also in feet. *Also have overall feeling of sickness and fatigue, and brain fog.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Seizure
Clinical narrative: Seizure that lasted about 3-5 minutes , has history of Epilepsy  with last seizure about 8 months ago
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal exploration, Abdominal pain, Acidosis, Acute abdomen, Enterocutaneous fistula
Clinical narrative: Patient developed sudden onset of abdominal pain 3 days after her second shot, which progressed and on 5/28 she presented to hospital with acidosis and acute surgical abdomen.  She was found to have bowel ischemia and taken multiple times for exploration and resection - 5/29, 5/31, 6/2, 6/5, 6/7, and 6/9.  She had a prolonged course in the ICU and hospital and was discharged to home on 7/14.  However, patient developed short gut syndrome and enterocutaneous fistula, now TPN dependent.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Intensive care, Intestinal ischaemia, Intestinal resection, Parenteral nutrition, Short-bowel syndrome
Clinical narrative: Patient developed sudden onset of abdominal pain 3 days after her second shot, which progressed and on 5/28 she presented to hospital with acidosis and acute surgical abdomen.  She was found to have bowel ischemia and taken multiple times for exploration and resection - 5/29, 5/31, 6/2, 6/5, 6/7, and 6/9.  She had a prolonged course in the ICU and hospital and was discharged to home on 7/14.  However, patient developed short gut syndrome and enterocutaneous fistula, now TPN dependent.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Moderna 8/27 and 9/24. Positive on 10/4
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Fibrin D dimer increased, Heart rate increased, Hypoaesthesia, Lethargy
Clinical narrative: About 12 hours after second dose, I started having tachycardia in the 130s. Woke out of my sleep with the rate this high and could not get it down. Normal resting heart rate is in the high 80s. Also had numbness and tingling of my limbs. This was on top of the typical expected lethargy and body aches from the vaccine. It was enough to scare me and make me go to the ED after midnight. In the ED they had to give me medications to force my heart rate down. They also drew labs and found my d-dimer to be high, but nothing found on xray or ct for it.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Paraesthesia, Sleep disorder, Tachycardia, X-ray
Clinical narrative: About 12 hours after second dose, I started having tachycardia in the 130s. Woke out of my sleep with the rate this high and could not get it down. Normal resting heart rate is in the high 80s. Also had numbness and tingling of my limbs. This was on top of the typical expected lethargy and body aches from the vaccine. It was enough to scare me and make me go to the ED after midnight. In the ED they had to give me medications to force my heart rate down. They also drew labs and found my d-dimer to be high, but nothing found on xray or ct for it.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Amniotic cavity infection, Caesarean section, Delivery, Exposure during pregnancy, Intensive care
Clinical narrative: On 8/25 patient (26 weeks pregnant) developed sudden premature rupture of membrane.  Patient was admitted to hospital and underwent emergent C section on 9/6, delivering a baby at 28 weeks.  Patient had at least 2 prior pregnancy and delivery and she said her baby was always term.  She developed chorioamnionitis and septic shock, requiring ICU admission.  Patient was discharged to home on 9/11.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Premature baby, Premature rupture of membranes, Septic shock
Clinical narrative: On 8/25 patient (26 weeks pregnant) developed sudden premature rupture of membrane.  Patient was admitted to hospital and underwent emergent C section on 9/6, delivering a baby at 28 weeks.  Patient had at least 2 prior pregnancy and delivery and she said her baby was always term.  She developed chorioamnionitis and septic shock, requiring ICU admission.  Patient was discharged to home on 9/11.
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Syncope
Clinical narrative: He has a history of feeling dizzy after vaccination He felt dizzy 5 to 10 minutes after the Covid Pfizer vaccination at around 0610. He has a tendency of feeling dizzy after vaccination. He then passed out and fell on his arm. He recovered few seconds after falling down. He does not remember that he passed out.  His vital signs are within normal. He was observed for 1 hour and follow-up in the clinic the next day
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Respiratory distress
Clinical narrative: Severe, ongoing respiratory distress Numbness in right face
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site swelling, Lymph node pain, Lymphadenopathy
Clinical narrative: Lymph nodes under arm and under jawline swelling and sore..Injection site swelling 2? around site of injection going on 4 days tried taking ibuprofen but doesn?t seem to help much.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac disorder, Electrocardiogram, Myocardial infarction
Clinical narrative: according to my cardiologist I had a heart attack showing on my May 27, 2021 EKG. She states there is a heart attack showing on my September 28,2021 EKG as well. I am 57 years old and have never been told I had any reason to be concerned about heart disease. My thought is did the J&J vaccine cause the heart attack? I had the vaccine in March/April and the heart attack shows on the May EKG so I feel the timing is indicative of the vaccine being the potential cause.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Swelling face, Urticaria
Clinical narrative: Facial swelling and hives that continued for 2-3 days requiring 2 visits to emergency department and benadryl for symptomatic care.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Headache
Clinical narrative: Within 30 days my blood pressure rose to 184/90. I was unaware that my blood pressure had risen, as i only had a constant headache and because I donate blood, I have my blood pressure checked every 60 days or so. I sought treatment from my physician and was placed on Losartan.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Breast inflammation, Breast pain, Chest pain, Dyspnoea
Clinical narrative: Lymph nodes under left arm left breast inflammation/ sore, chest pain, abdominal cramping, nausea, headache,  right leg cramping, difficulty breathing
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram, Headache, Lymphadenopathy, Muscle spasms, Nausea
Clinical narrative: Lymph nodes under left arm left breast inflammation/ sore, chest pain, abdominal cramping, nausea, headache,  right leg cramping, difficulty breathing
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Pain, Pyrexia
Clinical narrative: F ever 101. 2 Aches Chills
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure, Dialysis, Dyspnoea, Endotracheal intubation, Intensive care
Clinical narrative: Shortly after receiving the vaccine patient developed BLE swelling and SOB.  Patient was then diagnosed with pericarditis.  She underwent pericardiectomy on 6/4/2021.  Subsequently she developed heart failure and renal failure and was admitted to ICU.  She was intubated and required dialysis.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Pericardial excision, Pericarditis, Peripheral swelling, Renal failure
Clinical narrative: Shortly after receiving the vaccine patient developed BLE swelling and SOB.  Patient was then diagnosed with pericarditis.  She underwent pericardiectomy on 6/4/2021.  Subsequently she developed heart failure and renal failure and was admitted to ICU.  She was intubated and required dialysis.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Lip swelling
Clinical narrative: Swelling of the lips
Age: 62.0
Sex: M
Vaccine: FLU4, VARZOS
Symptoms: Chills, Fatigue, Headache, Myalgia
Clinical narrative: Chills, fatigue, muscle aches, headache
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration
Clinical narrative: Area red and hard.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Dry mouth, Pruritus, Sleep disorder, Swollen tongue
Clinical narrative: Per employee: Woke at 2am with thick tongue, dry mouth, itchy palm.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Death, Dyspnoea
Clinical narrative: Notified that individual developed shortness of breath and died on 10/9/21.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Delivery, Exposure during pregnancy, Haemorrhage, Haemostasis, Packed red blood cell transfusion
Clinical narrative: Patient received her booster on 9/11/2021 towards the end of her pregnancy, one month prior to delivery.  Five days after a vaginal delivery, patient suddenly developed life-threatening hemorrhage.  She required 5u PRBC, 4u FFP, 1 cryoprecipitate.  She underwent an emergent D&C, had a Bakri balloon placed, and bilateral uterine artery embolization.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Transfusion, Uterine artery embolisation, Uterine dilation and curettage
Clinical narrative: Patient received her booster on 9/11/2021 towards the end of her pregnancy, one month prior to delivery.  Five days after a vaginal delivery, patient suddenly developed life-threatening hemorrhage.  She required 5u PRBC, 4u FFP, 1 cryoprecipitate.  She underwent an emergent D&C, had a Bakri balloon placed, and bilateral uterine artery embolization.
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site lymphadenopathy
Clinical narrative: lymphadenopathy ipsilateral of injection site
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Burning sensation, Decreased appetite, Dyspnoea, Headache
Clinical narrative: Terrible pain in left ankle, moved up to upper thigh and knee causing burning, tingling and stiffness to entire thigh, headache, loss of appetite, and difficulty breathing.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test, Musculoskeletal stiffness, Pain in extremity, Paraesthesia
Clinical narrative: Terrible pain in left ankle, moved up to upper thigh and knee causing burning, tingling and stiffness to entire thigh, headache, loss of appetite, and difficulty breathing.
Age: 62.0
Sex: F
Vaccine: FLUC4
Symptoms: Injection site pain, Lymph node pain, Malaise, Oedema peripheral, Skin swelling
Clinical narrative: She got her flu vaccine, the injection was uneventful, in and out pretty standard.  Later that day she felt soreness at the injection site.  The next day she was pretty run down, really didn't think mush of that.  When taking a shower she noticed what she thought was tenderness on top of her arm at the injection site she noticed her armpit was very puffy, very tender to touch in the nodes, and it's now starting going down the nodes closer to her chest and up into the throat and back of the neck on the right side only.   Her arm between the elbow and shoulder is puffy and edematous, but the armpit actually sticks out on that side.  She went to her PCP on 10/13/21 and saw the PA as her PCP was out of town and she agreed that it was weird, not running a temp and she was put on Ibuprofen 600 mg b.i.d., as well as Cephalexin 500 mg t.i.d. for 7 days in the case is was a cellulitis and to use warm compresses on that and she is doing all of the above as instructed.   This does not seem to be working and she is going to call her doctor on Monday to see if she can be seen by the PCP herself.  It is very tender and cannot settle down to sleep and it wakes her up at night and keeps her from sleeping.    She was told to watch things over the weekend and if not better to call back and be seen next week.  Was advised that if she got worse as she is traveling to go to an UC or ER.    She did have her COVID vaccines on 1/4/21 and 2/1/21 and had chills, fever and was down for 3 days with the first one.  The 2nd one she was not as sick with that one.
Age: 62.0
Sex: F
Vaccine: FLUC4
Symptoms: Sleep disorder, Tenderness, Thyroid function test
Clinical narrative: She got her flu vaccine, the injection was uneventful, in and out pretty standard.  Later that day she felt soreness at the injection site.  The next day she was pretty run down, really didn't think mush of that.  When taking a shower she noticed what she thought was tenderness on top of her arm at the injection site she noticed her armpit was very puffy, very tender to touch in the nodes, and it's now starting going down the nodes closer to her chest and up into the throat and back of the neck on the right side only.   Her arm between the elbow and shoulder is puffy and edematous, but the armpit actually sticks out on that side.  She went to her PCP on 10/13/21 and saw the PA as her PCP was out of town and she agreed that it was weird, not running a temp and she was put on Ibuprofen 600 mg b.i.d., as well as Cephalexin 500 mg t.i.d. for 7 days in the case is was a cellulitis and to use warm compresses on that and she is doing all of the above as instructed.   This does not seem to be working and she is going to call her doctor on Monday to see if she can be seen by the PCP herself.  It is very tender and cannot settle down to sleep and it wakes her up at night and keeps her from sleeping.    She was told to watch things over the weekend and if not better to call back and be seen next week.  Was advised that if she got worse as she is traveling to go to an UC or ER.    She did have her COVID vaccines on 1/4/21 and 2/1/21 and had chills, fever and was down for 3 days with the first one.  The 2nd one she was not as sick with that one.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Balance disorder, Chills, Fatigue, Headache, Injection site erythema
Clinical narrative: No side effects with first vaccination in August 2021. The second vaccination was received at 8 am, Oct. 12, 2021. No symptoms until 6 pm that evening, began with a dull headache, some stiffness and by 8 p.m. shivers, fever, headache worsened, muscle ache that created an imbalance, tiredness but not able to actually sleep and pain, redness and swelling at the injection site.  Oct. 13, 2021, rested with ibuprofen, slept well, and felt like 110% Oct. 14th.  The vaccine kicked my immune system into high gear but worth it long term.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site pain, Injection site swelling, Insomnia, Musculoskeletal stiffness, Myalgia
Clinical narrative: No side effects with first vaccination in August 2021. The second vaccination was received at 8 am, Oct. 12, 2021. No symptoms until 6 pm that evening, began with a dull headache, some stiffness and by 8 p.m. shivers, fever, headache worsened, muscle ache that created an imbalance, tiredness but not able to actually sleep and pain, redness and swelling at the injection site.  Oct. 13, 2021, rested with ibuprofen, slept well, and felt like 110% Oct. 14th.  The vaccine kicked my immune system into high gear but worth it long term.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Pyrexia
Clinical narrative: No side effects with first vaccination in August 2021. The second vaccination was received at 8 am, Oct. 12, 2021. No symptoms until 6 pm that evening, began with a dull headache, some stiffness and by 8 p.m. shivers, fever, headache worsened, muscle ache that created an imbalance, tiredness but not able to actually sleep and pain, redness and swelling at the injection site.  Oct. 13, 2021, rested with ibuprofen, slept well, and felt like 110% Oct. 14th.  The vaccine kicked my immune system into high gear but worth it long term.
Age: 61.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Atrial fibrillation, Electrocardiogram abnormal, Hyperthyroidism, Laboratory test, Palpitations
Clinical narrative: I began experiencing heart palpitations, extreme intolerance to heat, racing heartrate within days of getting the first vaccine.  I attributed these symptoms to stress at first, as I was moving between states at the time.  The symptoms continued to worsen over time, and I ended up in the hospital with A-fib due to Hyperthyroidism.
Age: 61.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Stress, Temperature intolerance, Thyroxine free increased
Clinical narrative: I began experiencing heart palpitations, extreme intolerance to heat, racing heartrate within days of getting the first vaccine.  I attributed these symptoms to stress at first, as I was moving between states at the time.  The symptoms continued to worsen over time, and I ended up in the hospital with A-fib due to Hyperthyroidism.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Nausea, Tremor
Clinical narrative: started at 3:43 PM. body shake, chills, bad headache and a bit nauseous.