chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 61.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Hypoaesthesia, Immediate post-injection reaction, Injected limb mobility decreased, Injection site pain
Clinical narrative: IM vaccine administered too high on Left arm causing immediate pain. By 9/22/23 evening approximately 10pm, pain was very intense and I took Ibuprofen. During the night I was awakened several times by intense pain in left upper arm/shoulder area. On the morning on 9/23/23 I was unable to actively move my Left arm at all, and passive movement caused excruciating pain in Left shoulder radiating down left arm and Left pinky and ring finger numbness. Palpable pain at left lateral shoulder, left deltoid, left deltoid insertion site, left elbow, with tingling and numbness in left pinky and ring fingers. During the day on 9/24/23 I took Ibuprofen, Tylenol, Valium 1 dose, Vicodin 1 dose with no decrease in pain at all. I was seen at Walk in Care on 9/25/23 and started short course of low dose Prednisone, completing on Prednisone on 9/26/23, as well as range of motion exercised. I felt some relief from pain by 9/26/23. Since completing short course of Prednisone, I have had a gradual increase in pain, tingling in Left pinky and ring fingers,  and decrease range of motion beginning 9/29/23 to present. Throughout the day, pain level ranges from 7 to 10 extreme. I continue to have pain in Left shoulder radiating to left deltoid incerion site and when radial nerve area is palpated, pain down to elbow with pinky and ring finger numbness.
Age: 61.0
Sex: F
Vaccine: FLU4
Symptoms: Pain, Pain in extremity, Paraesthesia, Product administered at inappropriate site, Sleep disorder
Clinical narrative: IM vaccine administered too high on Left arm causing immediate pain. By 9/22/23 evening approximately 10pm, pain was very intense and I took Ibuprofen. During the night I was awakened several times by intense pain in left upper arm/shoulder area. On the morning on 9/23/23 I was unable to actively move my Left arm at all, and passive movement caused excruciating pain in Left shoulder radiating down left arm and Left pinky and ring finger numbness. Palpable pain at left lateral shoulder, left deltoid, left deltoid insertion site, left elbow, with tingling and numbness in left pinky and ring fingers. During the day on 9/24/23 I took Ibuprofen, Tylenol, Valium 1 dose, Vicodin 1 dose with no decrease in pain at all. I was seen at Walk in Care on 9/25/23 and started short course of low dose Prednisone, completing on Prednisone on 9/26/23, as well as range of motion exercised. I felt some relief from pain by 9/26/23. Since completing short course of Prednisone, I have had a gradual increase in pain, tingling in Left pinky and ring fingers,  and decrease range of motion beginning 9/29/23 to present. Throughout the day, pain level ranges from 7 to 10 extreme. I continue to have pain in Left shoulder radiating to left deltoid incerion site and when radial nerve area is palpated, pain down to elbow with pinky and ring finger numbness.
Age: 17.0
Sex: F
Vaccine: FLUR4
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Patient is approximately 17years old and 10 months. Calculated year for age 18 years for the FlubloK age 18 and older.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: Patient was given the children comirnaty (5-11 year old) vaccine instead of the adult vaccine
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Wrong product administered
Clinical narrative: THE PATIENT EAS SUPPOSED TO GET FLU VACCINE BUT THE TECHNICIAN GAVE HER COVID VACCINE BY MISTAKE. THE PHARMACIST COUNSELED HER MOM THE GIRL WAS FINE. NEXT DAY THE PHARMACIST CALLED THE DAD TO FOLLOW UP . THE FATHER SAID THE GIRL WAS LITTLE TIRED BUT NOW SHE IS FINE.
Age: 40.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site warmth, Product administered at inappropriate site
Clinical narrative: Injection was administered under deltoid, mid upper left arm.  Patient started to experience   warmth, and redness around injection site  this next morning.    Patient has taken Ibuprofen and applying an ice pack to the area.  Borders around redness marked.
Age: 17.0
Sex: F
Vaccine: FLUR4
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Patient that received the vaccine is under 18 year old.. Patient is 17 years and 9 months old.   Patient did not have adverse event
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Decreased appetite, Fatigue, Heart rate irregular, Pain in extremity
Clinical narrative: Fever +100, sore arm, low/ high heart rate, exhaustion, lack of appetite
Age: 27.0
Sex: M
Vaccine: COVID19, FLUR4
Symptoms: Incorrect dose administered, No adverse event, Product administered to patient of inappropriate age, Wrong product administered
Clinical narrative: Patient came in for Flu vaccine and Covid-19 vaccine 10/05. During the process of retrieving the moderna from the fridge, the wrong moderna for pediatric use was chosen. The vaccine was not verified when drawing up that it was the adult dose of Spikevax. The patient was then administered the pedicatric Moderna. The patient was informed over the phone of the incident. He is reporting no side effects or adverse events at this time of this report.
Age: 70.0
Sex: M
Vaccine: FLU4, VARZOS
Symptoms: Chills, Crying
Clinical narrative: Unprovoked crying for about 20 minutes,followed by chills and shivering for about 1/2 hour.
Age: 1.33
Sex: M
Vaccine: DTAPIPVHIB, DTAPIPVHIB
Symptoms: No adverse event, Wrong product administered
Clinical narrative: Pentacel administered accidentally. Patient was ordered to receive DTAP, was due for DTAP.  No adverse outcomes. Patient has already had 3 doses of Dtap-Hib-IPV, most recent dose was 03/02/23. Patient has only had one dose of Hib-PRP-T and it was administered 06/07/23.
Age: 40.0
Sex: F
Vaccine: FLU4
Symptoms: Chest X-ray, Chest discomfort, Dyspnoea, Laboratory test, Nausea
Clinical narrative: 9AM- ACCORDING TO EMPLOYEE, SHE STARTED HAVING SYMPTOME OF SHORTNESS OF BREATH, WHEEZING, SORE THROAT, AND CHEST TIGHTNESS. THESE SYMPTOMS BECAME WORSE BY THE EVENING AND SHE WENT TO THE ER. THEY TREATED HER WITH ALBUTEROL AND SOLUMEDROL. THEY DID CHEST XRAY AND LABS. SHE WAS DISCHARGED HOME AND THEN RETURNED TO ER 10/03/23 WITH N/V.
Age: 40.0
Sex: F
Vaccine: FLU4
Symptoms: Oropharyngeal pain, Vomiting, Wheezing
Clinical narrative: 9AM- ACCORDING TO EMPLOYEE, SHE STARTED HAVING SYMPTOME OF SHORTNESS OF BREATH, WHEEZING, SORE THROAT, AND CHEST TIGHTNESS. THESE SYMPTOMS BECAME WORSE BY THE EVENING AND SHE WENT TO THE ER. THEY TREATED HER WITH ALBUTEROL AND SOLUMEDROL. THEY DID CHEST XRAY AND LABS. SHE WAS DISCHARGED HOME AND THEN RETURNED TO ER 10/03/23 WITH N/V.
Age: 61.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Nervousness, Rash
Clinical narrative: Patient scheduled to receive to vaccines at the pharmacy today (10/6/23) for Covid-19 Comirnaty and Flu vaccine. Patient had completed their form digitally prior to arriving to appointment today.  A second form was given to the patient to complete at time of arrival to their appointment. The patient had initially marked "Yes" to allergies and provided that they have an egg allergy on the digital form but did not include this on the recent written form completed today. The patient had marked "No" to allergies on the written form. Both copies of the forms were printed and taken to the vaccination room. At time of vaccination patient received Covid-19 Comirnaty vaccine and Fluarix Quadrivalent in their left deltoid. After administering both vaccines patient mentioned that they called someone(unknown) prior to appointment and that person had informed them that all of the new flu vaccines do not have egg in them. The patient was informed by the administering Pharmacist that this is not true and that the Fluarix vaccine should not be used with an egg allergy and that the patient should have received Flucelvax which is cell-based and suitable for patients with an egg allergy. Patient then mentioned that they have an egg allergy and that they tend to have a rash and shortness of breath when administered eggs.  Patient was then offered EMS service but patient declined. Patient then started to feel rashy and shaky. Patient informed that they are able to drive 1.9 miles to a nearby urgent care and would call later today to update the pharmacy manager on their status/health.
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Mobility decreased, Pain in extremity
Clinical narrative: patient stated extremely sore arm starting the night of 10/3/23, the day she received vaccination. Still hurting and difficult to lift arm 3 days later.
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, COVID-19, Chronic kidney disease, Condition aggravated, Cough
Clinical narrative: Patient is 78 years old with past medical history of COPD, CHF, atrial fibrillation, GERD, coronary artery disease, hyperlipidemia, obstructive sleep apnea, restless leg syndrome, diabetes mellitus type 2 presented to the hospital with a chief complaint of a dry cough associated with malaise and shortness of breath that has been worsening over the last 2 days.  Patient states that one of her family members had COVID but she was not in a recent contact with hand.  Patient was found to have COVID infection.  When seen, patient was resting in bed comfortably.  Otherwise patient has no fever, chills, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, difficulty urination, dysuria.  Patient has been generally weak over the last 2 days.   In the ED, patient was given a dose of azithromycin and Decadron.   Clinical Summary Patient tested positive for COVID 9/2 and required supplemental oxygen but was weaned to room air.  Patient did not start remdesivir but did have dexamethasone.  Patient was found to have a 2L NC PRN requirement at discharge.  Patient continues to have a cough but reports feeling well otherwise.  VS and labs have been stable otherwise.  Patient will be discharged home with instructions to follow up with PCP.   Discharge diagnosis COVID infection Cough Malaise Generalized weakness COPD CHF Atrial fibrillation Diabetes Hypothyroidism Hypertension Chronic kidney disease stage III Obstructive sleep apnea Restless leg syndrome History of fibromyalgia Coronary artery disease HFrEF Morbid obesity
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diabetes mellitus, Dyspnoea, Hypothyroidism, Malaise, SARS-CoV-2 test positive
Clinical narrative: Patient is 78 years old with past medical history of COPD, CHF, atrial fibrillation, GERD, coronary artery disease, hyperlipidemia, obstructive sleep apnea, restless leg syndrome, diabetes mellitus type 2 presented to the hospital with a chief complaint of a dry cough associated with malaise and shortness of breath that has been worsening over the last 2 days.  Patient states that one of her family members had COVID but she was not in a recent contact with hand.  Patient was found to have COVID infection.  When seen, patient was resting in bed comfortably.  Otherwise patient has no fever, chills, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, difficulty urination, dysuria.  Patient has been generally weak over the last 2 days.   In the ED, patient was given a dose of azithromycin and Decadron.   Clinical Summary Patient tested positive for COVID 9/2 and required supplemental oxygen but was weaned to room air.  Patient did not start remdesivir but did have dexamethasone.  Patient was found to have a 2L NC PRN requirement at discharge.  Patient continues to have a cough but reports feeling well otherwise.  VS and labs have been stable otherwise.  Patient will be discharged home with instructions to follow up with PCP.   Discharge diagnosis COVID infection Cough Malaise Generalized weakness COPD CHF Atrial fibrillation Diabetes Hypothyroidism Hypertension Chronic kidney disease stage III Obstructive sleep apnea Restless leg syndrome History of fibromyalgia Coronary artery disease HFrEF Morbid obesity
Age: 5.0
Sex: M
Vaccine: DTAPIPV
Symptoms: Pyrexia, Rash erythematous, Rash pruritic
Clinical narrative: Pt had low grade fever for two days following the vaccine. Pt started having small bumps like pimple all over body which appeared red in color and itchy after a week of the vaccine.
Age: 42.0
Sex: F
Vaccine: UNK
Symptoms: Brain fog, Exposure during pregnancy, Fatigue, Gastrointestinal disorder, Rash papular
Clinical narrative: Currently pregnant with November 23, 2023, due date. I usually do not experience side effects from the flu shot, but this time I am experiencing exhaustion, brain fog, intestinal disturbances, and a rash. The rash is itchy. Patches of raised rash bumps can be felt, but the rash is not such that it would be seen by others not looking for it.
Age: 42.0
Sex: F
Vaccine: UNK
Symptoms: Rash pruritic
Clinical narrative: Currently pregnant with November 23, 2023, due date. I usually do not experience side effects from the flu shot, but this time I am experiencing exhaustion, brain fog, intestinal disturbances, and a rash. The rash is itchy. Patches of raised rash bumps can be felt, but the rash is not such that it would be seen by others not looking for it.
Age: 69.0
Sex: F
Vaccine: HIBV
Symptoms: Expired product administered
Clinical narrative: Patient was given a vaccination that was expired.  Vaccine expired on 8/12/2023 - given on 10/6/2023
Age: 46.0
Sex: F
Vaccine: FLU4
Symptoms: Rash, Rash erythematous, Rash papular, Rash pruritic
Clinical narrative: From the left side of face to behind the left ear, down around the neck, and chest up to behind the right ear there is a red, raised and itchy rash.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Anxiety, Blood creatinine increased, Blood gases
Clinical narrative: Patient is a 44 y.o. female patient of CNP with history of HTN, IDDM2, Anxiety and depression, CKD3, morbid obesity, OSA   presented to Hospital with SOB, chills, cough, sore throat .   Acute COVID-19 Viral Infection  Acute Hypoxic Respiratory Failure P/w cough, sore throat, SOB. Pt is vaccinated x 2  Onset sx: 9/10/23, positive Covid test 9/11/23  Temp on arrival 99, HR 106, RR 24, BP 187/100 satting 95% on RA Initial CBC w 8.37, VBG 7.32/48  CT PE study: no PE, limited peripheral evaluation, no acute findings  No hypoxia on admission, placed on oxygen for comfort, hyperventilation due to panic attack Does not qualifies for remdesevir (due to elevated Cr) Start decadron as hypoxic, but could have hypoxia also due to untreated OSA as she is non-compliant with CPAP Continue supportive care with Albuterol q 4H, robitussin-DM, tylenol PRN Encourage IS use Contact precautions Heparin  for DVT ppx Patient improved and on RA, will discharge home on course of decadron, recommend outpatient sleep study once recovered for OSA     Hypertensive Urgency BP uncontrolled in ER, due to not taking home medications and anxiety Chlorthalidone and Losartan on hold from Nephrology since 9/2023  Resumed adalat, Metoprolol 100 mg BID  Labetalol PRN BP better controlled today    AKI on CKD3 Follows with nephrologist Dr  Initial creatinine in ER 1.8, last creatinine 9/5/23 1.9 Baseline appears to be 1.7-2 Given contrast in the ED for CT for PE Acute rise in Cr afterwards to 2.4, given 500ml of IV fluids Cr appears to be plateuing at 2.4 Avoid nephrotoxic meds, renally dose    Elevated Troponin without Delta Change Likely elevated in setting of illness, elevated BP and CKD3  Troponin 21> 21 EKG: tachycardia, no ischemia  No further work up  Anxiety/Hyperventilation  Depression , Bipolar  Had a panic attack in the ED Has hx of anxiety Hydroxyzine  PRN ordered Resume home meds Effexor and Seroquel    Hypothyroidism TSH was elevated 6.4 12 days ago , T4 normal No adjustment made to  Synthroid 200 mcg , unsure of compliance Follow up with PCP    IDDM2 with Hyperglycemia , poorly controlled with CKD3 Last A1C 10.6 6/6/23  Home meds: farxiga, metformin, Trulicity, no fill history on insulin per pharmacy  but she was on Lantus 60 units BID per PCP note, unsure of compliance Started on Lantus 40 units daily, Pre-prandial insulin at 5 units and increase Sliding scale sensitivity to normal   Morbid Obesity  OSA Body mass index is 48.55 kg/m².  Documented noncompliance with CPAP Life style modifications recommended   Chronic anemia Hgb 11.2 At baseline Resume iron  Monitor
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pH decreased, Blood pressure inadequately controlled, Blood pressure increased, Blood thyroid stimulating hormone normal, COVID-19
Clinical narrative: Patient is a 44 y.o. female patient of CNP with history of HTN, IDDM2, Anxiety and depression, CKD3, morbid obesity, OSA   presented to Hospital with SOB, chills, cough, sore throat .   Acute COVID-19 Viral Infection  Acute Hypoxic Respiratory Failure P/w cough, sore throat, SOB. Pt is vaccinated x 2  Onset sx: 9/10/23, positive Covid test 9/11/23  Temp on arrival 99, HR 106, RR 24, BP 187/100 satting 95% on RA Initial CBC w 8.37, VBG 7.32/48  CT PE study: no PE, limited peripheral evaluation, no acute findings  No hypoxia on admission, placed on oxygen for comfort, hyperventilation due to panic attack Does not qualifies for remdesevir (due to elevated Cr) Start decadron as hypoxic, but could have hypoxia also due to untreated OSA as she is non-compliant with CPAP Continue supportive care with Albuterol q 4H, robitussin-DM, tylenol PRN Encourage IS use Contact precautions Heparin  for DVT ppx Patient improved and on RA, will discharge home on course of decadron, recommend outpatient sleep study once recovered for OSA     Hypertensive Urgency BP uncontrolled in ER, due to not taking home medications and anxiety Chlorthalidone and Losartan on hold from Nephrology since 9/2023  Resumed adalat, Metoprolol 100 mg BID  Labetalol PRN BP better controlled today    AKI on CKD3 Follows with nephrologist Dr  Initial creatinine in ER 1.8, last creatinine 9/5/23 1.9 Baseline appears to be 1.7-2 Given contrast in the ED for CT for PE Acute rise in Cr afterwards to 2.4, given 500ml of IV fluids Cr appears to be plateuing at 2.4 Avoid nephrotoxic meds, renally dose    Elevated Troponin without Delta Change Likely elevated in setting of illness, elevated BP and CKD3  Troponin 21> 21 EKG: tachycardia, no ischemia  No further work up  Anxiety/Hyperventilation  Depression , Bipolar  Had a panic attack in the ED Has hx of anxiety Hydroxyzine  PRN ordered Resume home meds Effexor and Seroquel    Hypothyroidism TSH was elevated 6.4 12 days ago , T4 normal No adjustment made to  Synthroid 200 mcg , unsure of compliance Follow up with PCP    IDDM2 with Hyperglycemia , poorly controlled with CKD3 Last A1C 10.6 6/6/23  Home meds: farxiga, metformin, Trulicity, no fill history on insulin per pharmacy  but she was on Lantus 60 units BID per PCP note, unsure of compliance Started on Lantus 40 units daily, Pre-prandial insulin at 5 units and increase Sliding scale sensitivity to normal   Morbid Obesity  OSA Body mass index is 48.55 kg/m².  Documented noncompliance with CPAP Life style modifications recommended   Chronic anemia Hgb 11.2 At baseline Resume iron  Monitor
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Chronic kidney disease, Computerised tomogram thorax normal, Condition aggravated, Cough
Clinical narrative: Patient is a 44 y.o. female patient of CNP with history of HTN, IDDM2, Anxiety and depression, CKD3, morbid obesity, OSA   presented to Hospital with SOB, chills, cough, sore throat .   Acute COVID-19 Viral Infection  Acute Hypoxic Respiratory Failure P/w cough, sore throat, SOB. Pt is vaccinated x 2  Onset sx: 9/10/23, positive Covid test 9/11/23  Temp on arrival 99, HR 106, RR 24, BP 187/100 satting 95% on RA Initial CBC w 8.37, VBG 7.32/48  CT PE study: no PE, limited peripheral evaluation, no acute findings  No hypoxia on admission, placed on oxygen for comfort, hyperventilation due to panic attack Does not qualifies for remdesevir (due to elevated Cr) Start decadron as hypoxic, but could have hypoxia also due to untreated OSA as she is non-compliant with CPAP Continue supportive care with Albuterol q 4H, robitussin-DM, tylenol PRN Encourage IS use Contact precautions Heparin  for DVT ppx Patient improved and on RA, will discharge home on course of decadron, recommend outpatient sleep study once recovered for OSA     Hypertensive Urgency BP uncontrolled in ER, due to not taking home medications and anxiety Chlorthalidone and Losartan on hold from Nephrology since 9/2023  Resumed adalat, Metoprolol 100 mg BID  Labetalol PRN BP better controlled today    AKI on CKD3 Follows with nephrologist Dr  Initial creatinine in ER 1.8, last creatinine 9/5/23 1.9 Baseline appears to be 1.7-2 Given contrast in the ED for CT for PE Acute rise in Cr afterwards to 2.4, given 500ml of IV fluids Cr appears to be plateuing at 2.4 Avoid nephrotoxic meds, renally dose    Elevated Troponin without Delta Change Likely elevated in setting of illness, elevated BP and CKD3  Troponin 21> 21 EKG: tachycardia, no ischemia  No further work up  Anxiety/Hyperventilation  Depression , Bipolar  Had a panic attack in the ED Has hx of anxiety Hydroxyzine  PRN ordered Resume home meds Effexor and Seroquel    Hypothyroidism TSH was elevated 6.4 12 days ago , T4 normal No adjustment made to  Synthroid 200 mcg , unsure of compliance Follow up with PCP    IDDM2 with Hyperglycemia , poorly controlled with CKD3 Last A1C 10.6 6/6/23  Home meds: farxiga, metformin, Trulicity, no fill history on insulin per pharmacy  but she was on Lantus 60 units BID per PCP note, unsure of compliance Started on Lantus 40 units daily, Pre-prandial insulin at 5 units and increase Sliding scale sensitivity to normal   Morbid Obesity  OSA Body mass index is 48.55 kg/m².  Documented noncompliance with CPAP Life style modifications recommended   Chronic anemia Hgb 11.2 At baseline Resume iron  Monitor
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Diabetes mellitus inadequate control, Dyspnoea, Electrocardiogram abnormal, Full blood count, Glycosylated haemoglobin increased
Clinical narrative: Patient is a 44 y.o. female patient of CNP with history of HTN, IDDM2, Anxiety and depression, CKD3, morbid obesity, OSA   presented to Hospital with SOB, chills, cough, sore throat .   Acute COVID-19 Viral Infection  Acute Hypoxic Respiratory Failure P/w cough, sore throat, SOB. Pt is vaccinated x 2  Onset sx: 9/10/23, positive Covid test 9/11/23  Temp on arrival 99, HR 106, RR 24, BP 187/100 satting 95% on RA Initial CBC w 8.37, VBG 7.32/48  CT PE study: no PE, limited peripheral evaluation, no acute findings  No hypoxia on admission, placed on oxygen for comfort, hyperventilation due to panic attack Does not qualifies for remdesevir (due to elevated Cr) Start decadron as hypoxic, but could have hypoxia also due to untreated OSA as she is non-compliant with CPAP Continue supportive care with Albuterol q 4H, robitussin-DM, tylenol PRN Encourage IS use Contact precautions Heparin  for DVT ppx Patient improved and on RA, will discharge home on course of decadron, recommend outpatient sleep study once recovered for OSA     Hypertensive Urgency BP uncontrolled in ER, due to not taking home medications and anxiety Chlorthalidone and Losartan on hold from Nephrology since 9/2023  Resumed adalat, Metoprolol 100 mg BID  Labetalol PRN BP better controlled today    AKI on CKD3 Follows with nephrologist Dr  Initial creatinine in ER 1.8, last creatinine 9/5/23 1.9 Baseline appears to be 1.7-2 Given contrast in the ED for CT for PE Acute rise in Cr afterwards to 2.4, given 500ml of IV fluids Cr appears to be plateuing at 2.4 Avoid nephrotoxic meds, renally dose    Elevated Troponin without Delta Change Likely elevated in setting of illness, elevated BP and CKD3  Troponin 21> 21 EKG: tachycardia, no ischemia  No further work up  Anxiety/Hyperventilation  Depression , Bipolar  Had a panic attack in the ED Has hx of anxiety Hydroxyzine  PRN ordered Resume home meds Effexor and Seroquel    Hypothyroidism TSH was elevated 6.4 12 days ago , T4 normal No adjustment made to  Synthroid 200 mcg , unsure of compliance Follow up with PCP    IDDM2 with Hyperglycemia , poorly controlled with CKD3 Last A1C 10.6 6/6/23  Home meds: farxiga, metformin, Trulicity, no fill history on insulin per pharmacy  but she was on Lantus 60 units BID per PCP note, unsure of compliance Started on Lantus 40 units daily, Pre-prandial insulin at 5 units and increase Sliding scale sensitivity to normal   Morbid Obesity  OSA Body mass index is 48.55 kg/m².  Documented noncompliance with CPAP Life style modifications recommended   Chronic anemia Hgb 11.2 At baseline Resume iron  Monitor
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoglobin, Hyperglycaemia, Hypertensive urgency, Hyperventilation, Hypoxia
Clinical narrative: Patient is a 44 y.o. female patient of CNP with history of HTN, IDDM2, Anxiety and depression, CKD3, morbid obesity, OSA   presented to Hospital with SOB, chills, cough, sore throat .   Acute COVID-19 Viral Infection  Acute Hypoxic Respiratory Failure P/w cough, sore throat, SOB. Pt is vaccinated x 2  Onset sx: 9/10/23, positive Covid test 9/11/23  Temp on arrival 99, HR 106, RR 24, BP 187/100 satting 95% on RA Initial CBC w 8.37, VBG 7.32/48  CT PE study: no PE, limited peripheral evaluation, no acute findings  No hypoxia on admission, placed on oxygen for comfort, hyperventilation due to panic attack Does not qualifies for remdesevir (due to elevated Cr) Start decadron as hypoxic, but could have hypoxia also due to untreated OSA as she is non-compliant with CPAP Continue supportive care with Albuterol q 4H, robitussin-DM, tylenol PRN Encourage IS use Contact precautions Heparin  for DVT ppx Patient improved and on RA, will discharge home on course of decadron, recommend outpatient sleep study once recovered for OSA     Hypertensive Urgency BP uncontrolled in ER, due to not taking home medications and anxiety Chlorthalidone and Losartan on hold from Nephrology since 9/2023  Resumed adalat, Metoprolol 100 mg BID  Labetalol PRN BP better controlled today    AKI on CKD3 Follows with nephrologist Dr  Initial creatinine in ER 1.8, last creatinine 9/5/23 1.9 Baseline appears to be 1.7-2 Given contrast in the ED for CT for PE Acute rise in Cr afterwards to 2.4, given 500ml of IV fluids Cr appears to be plateuing at 2.4 Avoid nephrotoxic meds, renally dose    Elevated Troponin without Delta Change Likely elevated in setting of illness, elevated BP and CKD3  Troponin 21> 21 EKG: tachycardia, no ischemia  No further work up  Anxiety/Hyperventilation  Depression , Bipolar  Had a panic attack in the ED Has hx of anxiety Hydroxyzine  PRN ordered Resume home meds Effexor and Seroquel    Hypothyroidism TSH was elevated 6.4 12 days ago , T4 normal No adjustment made to  Synthroid 200 mcg , unsure of compliance Follow up with PCP    IDDM2 with Hyperglycemia , poorly controlled with CKD3 Last A1C 10.6 6/6/23  Home meds: farxiga, metformin, Trulicity, no fill history on insulin per pharmacy  but she was on Lantus 60 units BID per PCP note, unsure of compliance Started on Lantus 40 units daily, Pre-prandial insulin at 5 units and increase Sliding scale sensitivity to normal   Morbid Obesity  OSA Body mass index is 48.55 kg/m².  Documented noncompliance with CPAP Life style modifications recommended   Chronic anemia Hgb 11.2 At baseline Resume iron  Monitor
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Illness, Insulin-requiring type 2 diabetes mellitus, Oropharyngeal pain, Panic attack, SARS-CoV-2 test positive
Clinical narrative: Patient is a 44 y.o. female patient of CNP with history of HTN, IDDM2, Anxiety and depression, CKD3, morbid obesity, OSA   presented to Hospital with SOB, chills, cough, sore throat .   Acute COVID-19 Viral Infection  Acute Hypoxic Respiratory Failure P/w cough, sore throat, SOB. Pt is vaccinated x 2  Onset sx: 9/10/23, positive Covid test 9/11/23  Temp on arrival 99, HR 106, RR 24, BP 187/100 satting 95% on RA Initial CBC w 8.37, VBG 7.32/48  CT PE study: no PE, limited peripheral evaluation, no acute findings  No hypoxia on admission, placed on oxygen for comfort, hyperventilation due to panic attack Does not qualifies for remdesevir (due to elevated Cr) Start decadron as hypoxic, but could have hypoxia also due to untreated OSA as she is non-compliant with CPAP Continue supportive care with Albuterol q 4H, robitussin-DM, tylenol PRN Encourage IS use Contact precautions Heparin  for DVT ppx Patient improved and on RA, will discharge home on course of decadron, recommend outpatient sleep study once recovered for OSA     Hypertensive Urgency BP uncontrolled in ER, due to not taking home medications and anxiety Chlorthalidone and Losartan on hold from Nephrology since 9/2023  Resumed adalat, Metoprolol 100 mg BID  Labetalol PRN BP better controlled today    AKI on CKD3 Follows with nephrologist Dr  Initial creatinine in ER 1.8, last creatinine 9/5/23 1.9 Baseline appears to be 1.7-2 Given contrast in the ED for CT for PE Acute rise in Cr afterwards to 2.4, given 500ml of IV fluids Cr appears to be plateuing at 2.4 Avoid nephrotoxic meds, renally dose    Elevated Troponin without Delta Change Likely elevated in setting of illness, elevated BP and CKD3  Troponin 21> 21 EKG: tachycardia, no ischemia  No further work up  Anxiety/Hyperventilation  Depression , Bipolar  Had a panic attack in the ED Has hx of anxiety Hydroxyzine  PRN ordered Resume home meds Effexor and Seroquel    Hypothyroidism TSH was elevated 6.4 12 days ago , T4 normal No adjustment made to  Synthroid 200 mcg , unsure of compliance Follow up with PCP    IDDM2 with Hyperglycemia , poorly controlled with CKD3 Last A1C 10.6 6/6/23  Home meds: farxiga, metformin, Trulicity, no fill history on insulin per pharmacy  but she was on Lantus 60 units BID per PCP note, unsure of compliance Started on Lantus 40 units daily, Pre-prandial insulin at 5 units and increase Sliding scale sensitivity to normal   Morbid Obesity  OSA Body mass index is 48.55 kg/m².  Documented noncompliance with CPAP Life style modifications recommended   Chronic anemia Hgb 11.2 At baseline Resume iron  Monitor
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Scan with contrast normal, Tachycardia, Thyroxine normal, Treatment noncompliance, Troponin increased
Clinical narrative: Patient is a 44 y.o. female patient of CNP with history of HTN, IDDM2, Anxiety and depression, CKD3, morbid obesity, OSA   presented to Hospital with SOB, chills, cough, sore throat .   Acute COVID-19 Viral Infection  Acute Hypoxic Respiratory Failure P/w cough, sore throat, SOB. Pt is vaccinated x 2  Onset sx: 9/10/23, positive Covid test 9/11/23  Temp on arrival 99, HR 106, RR 24, BP 187/100 satting 95% on RA Initial CBC w 8.37, VBG 7.32/48  CT PE study: no PE, limited peripheral evaluation, no acute findings  No hypoxia on admission, placed on oxygen for comfort, hyperventilation due to panic attack Does not qualifies for remdesevir (due to elevated Cr) Start decadron as hypoxic, but could have hypoxia also due to untreated OSA as she is non-compliant with CPAP Continue supportive care with Albuterol q 4H, robitussin-DM, tylenol PRN Encourage IS use Contact precautions Heparin  for DVT ppx Patient improved and on RA, will discharge home on course of decadron, recommend outpatient sleep study once recovered for OSA     Hypertensive Urgency BP uncontrolled in ER, due to not taking home medications and anxiety Chlorthalidone and Losartan on hold from Nephrology since 9/2023  Resumed adalat, Metoprolol 100 mg BID  Labetalol PRN BP better controlled today    AKI on CKD3 Follows with nephrologist Dr  Initial creatinine in ER 1.8, last creatinine 9/5/23 1.9 Baseline appears to be 1.7-2 Given contrast in the ED for CT for PE Acute rise in Cr afterwards to 2.4, given 500ml of IV fluids Cr appears to be plateuing at 2.4 Avoid nephrotoxic meds, renally dose    Elevated Troponin without Delta Change Likely elevated in setting of illness, elevated BP and CKD3  Troponin 21> 21 EKG: tachycardia, no ischemia  No further work up  Anxiety/Hyperventilation  Depression , Bipolar  Had a panic attack in the ED Has hx of anxiety Hydroxyzine  PRN ordered Resume home meds Effexor and Seroquel    Hypothyroidism TSH was elevated 6.4 12 days ago , T4 normal No adjustment made to  Synthroid 200 mcg , unsure of compliance Follow up with PCP    IDDM2 with Hyperglycemia , poorly controlled with CKD3 Last A1C 10.6 6/6/23  Home meds: farxiga, metformin, Trulicity, no fill history on insulin per pharmacy  but she was on Lantus 60 units BID per PCP note, unsure of compliance Started on Lantus 40 units daily, Pre-prandial insulin at 5 units and increase Sliding scale sensitivity to normal   Morbid Obesity  OSA Body mass index is 48.55 kg/m².  Documented noncompliance with CPAP Life style modifications recommended   Chronic anemia Hgb 11.2 At baseline Resume iron  Monitor
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: rash
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Blood culture negative, COVID-19 pneumonia
Clinical narrative: Patient is a 78 y.o. male patient of PA-C with history of  diabetes mellitus, HTN, hypothyroidism, sleep apnea presented to Hospital with  shortness of breath and fatigue, has been on ventilator for respiratory failure, status postcardiac arrest on 9/11   Acute Hypoxemic Respiratory Failure Multifocal Pneumonia Secondary to COVID 19 Sepsis Status post cardiac arrest Shock Critical care managing, was on a ventilator support and multiple IV pressor support Remains on multiple pressor support Blood cultures no growth =.  Urine antigen negative Sputum cultures pending Discussed with critical care team-possible plan for withdrawal of care later today and transition to comfort Eventually patient was transition to withdrawal of care and comfort and per chart was pronounced dead at 1937 on 9/13   AKI Worsening with poor urine output Nephrology following-high risk for RRT   Acute VTE Lower extremity Dopplers positive for DVT On heparin drip   Diabetes Mellitis type 2 Continue sliding scale    Hypothyroidism Continue Synthroid   Hypertension Meds on hold    Elevated liver enzymes  Probably Shock liver Continue to monitor
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Cardiac arrest, Death, Deep vein thrombosis, Dependence on respirator, Dyspnoea
Clinical narrative: Patient is a 78 y.o. male patient of PA-C with history of  diabetes mellitus, HTN, hypothyroidism, sleep apnea presented to Hospital with  shortness of breath and fatigue, has been on ventilator for respiratory failure, status postcardiac arrest on 9/11   Acute Hypoxemic Respiratory Failure Multifocal Pneumonia Secondary to COVID 19 Sepsis Status post cardiac arrest Shock Critical care managing, was on a ventilator support and multiple IV pressor support Remains on multiple pressor support Blood cultures no growth =.  Urine antigen negative Sputum cultures pending Discussed with critical care team-possible plan for withdrawal of care later today and transition to comfort Eventually patient was transition to withdrawal of care and comfort and per chart was pronounced dead at 1937 on 9/13   AKI Worsening with poor urine output Nephrology following-high risk for RRT   Acute VTE Lower extremity Dopplers positive for DVT On heparin drip   Diabetes Mellitis type 2 Continue sliding scale    Hypothyroidism Continue Synthroid   Hypertension Meds on hold    Elevated liver enzymes  Probably Shock liver Continue to monitor
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fatigue, Hepatic enzyme increased, Hypertension, Hypothyroidism, Intensive care
Clinical narrative: Patient is a 78 y.o. male patient of PA-C with history of  diabetes mellitus, HTN, hypothyroidism, sleep apnea presented to Hospital with  shortness of breath and fatigue, has been on ventilator for respiratory failure, status postcardiac arrest on 9/11   Acute Hypoxemic Respiratory Failure Multifocal Pneumonia Secondary to COVID 19 Sepsis Status post cardiac arrest Shock Critical care managing, was on a ventilator support and multiple IV pressor support Remains on multiple pressor support Blood cultures no growth =.  Urine antigen negative Sputum cultures pending Discussed with critical care team-possible plan for withdrawal of care later today and transition to comfort Eventually patient was transition to withdrawal of care and comfort and per chart was pronounced dead at 1937 on 9/13   AKI Worsening with poor urine output Nephrology following-high risk for RRT   Acute VTE Lower extremity Dopplers positive for DVT On heparin drip   Diabetes Mellitis type 2 Continue sliding scale    Hypothyroidism Continue Synthroid   Hypertension Meds on hold    Elevated liver enzymes  Probably Shock liver Continue to monitor
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Respiratory failure, Sepsis, Shock, Type 2 diabetes mellitus, Urine antigen test
Clinical narrative: Patient is a 78 y.o. male patient of PA-C with history of  diabetes mellitus, HTN, hypothyroidism, sleep apnea presented to Hospital with  shortness of breath and fatigue, has been on ventilator for respiratory failure, status postcardiac arrest on 9/11   Acute Hypoxemic Respiratory Failure Multifocal Pneumonia Secondary to COVID 19 Sepsis Status post cardiac arrest Shock Critical care managing, was on a ventilator support and multiple IV pressor support Remains on multiple pressor support Blood cultures no growth =.  Urine antigen negative Sputum cultures pending Discussed with critical care team-possible plan for withdrawal of care later today and transition to comfort Eventually patient was transition to withdrawal of care and comfort and per chart was pronounced dead at 1937 on 9/13   AKI Worsening with poor urine output Nephrology following-high risk for RRT   Acute VTE Lower extremity Dopplers positive for DVT On heparin drip   Diabetes Mellitis type 2 Continue sliding scale    Hypothyroidism Continue Synthroid   Hypertension Meds on hold    Elevated liver enzymes  Probably Shock liver Continue to monitor
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Urine output decreased
Clinical narrative: Patient is a 78 y.o. male patient of PA-C with history of  diabetes mellitus, HTN, hypothyroidism, sleep apnea presented to Hospital with  shortness of breath and fatigue, has been on ventilator for respiratory failure, status postcardiac arrest on 9/11   Acute Hypoxemic Respiratory Failure Multifocal Pneumonia Secondary to COVID 19 Sepsis Status post cardiac arrest Shock Critical care managing, was on a ventilator support and multiple IV pressor support Remains on multiple pressor support Blood cultures no growth =.  Urine antigen negative Sputum cultures pending Discussed with critical care team-possible plan for withdrawal of care later today and transition to comfort Eventually patient was transition to withdrawal of care and comfort and per chart was pronounced dead at 1937 on 9/13   AKI Worsening with poor urine output Nephrology following-high risk for RRT   Acute VTE Lower extremity Dopplers positive for DVT On heparin drip   Diabetes Mellitis type 2 Continue sliding scale    Hypothyroidism Continue Synthroid   Hypertension Meds on hold    Elevated liver enzymes  Probably Shock liver Continue to monitor
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Autonomic nervous system imbalance, Blood culture negative
Clinical narrative: Patient is an 80 year old  female with a history of Myasthenia Gravis, Parkinson's disease, recurrent UTIs with admission for Sepsis secondary to  ESBL E. coli in March 2023, who presented from her SNF  to hospital 9/1/23 with weakness, fatigue, nausea and emesis. On presentation, SBP less than 90 mmHg. Tested positive for COVID-19. CXR and CT Abdomen/Pelvis  nonacute.    1. Myasthenia Gravis: concern for mild exacerbation with primary symptom generalized weakness. No dysphagia or respiratory symptoms. Likely due to COVID-19 infection. Follows with Neuro (Dr.). On Imuran, Prednisone 20 mg and Vyvgart infusions. IVIG started 9/1/23 x 5 . Held Imuran, continued Prednisone. Vyvgart will need to be delayed due to IVIG. Monitored VC/NIF Q4H while hospitalized, stable. Neurology  followed.  2. COVID-19 infection: 1 week of symptoms, nausea/vomiting  and fatigue. On 2L in ED for O2 sat of 91%, weaned to room air with sats mid 90s. s/p Decadron IV and Remdesivir in ED, no further need for Decadron or Remdesivir given lack of hypoxia, LFT elevation and onset of symptoms more than 5 days prior to admission. Admit CXR nonacute. Monitored with continuous pulse Ox while hospitalized. Pulmonary hygiene. 3. Leukocytosis: WBC 18, denied infectious symptoms. Could be reactive from above. Urinalysis  benign. Blood culture  9/1/23 NGTD. Monitored CBC and fever curve while hospitalized. Trend down slowly. 4. Elevated Liver Enzymes: AST 281, ALT 50 on admit. Admit CT Abdomen/Pelvis  nonacute. Resolved with supportive care. 5. Hypotension: SBP less than 90 on admit, lactate normal. Resolved with IVF bolus. BP higher as well, likely autonomic dysfunction. Avoid wide fluctuations in BP. BP stable at the time of discharge.  6. Parkinson's Disease: per history; continued Sinemet.  7. Overactive Bladder: home Myrbetriq was stopped as outpatient.  8. Obesity: BMI 34. Lifestyle modifications.  9. Lower Extremity Wound: present on admission. Wound care. ET RN followed.  10. Code status: Full code, discussed on admit.  11. VTE  Prophylaxis: Lovenox.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Blood lactic acid normal, COVID-19, Chest X-ray normal, Computerised tomogram abdomen normal, Escherichia infection
Clinical narrative: Patient is an 80 year old  female with a history of Myasthenia Gravis, Parkinson's disease, recurrent UTIs with admission for Sepsis secondary to  ESBL E. coli in March 2023, who presented from her SNF  to hospital 9/1/23 with weakness, fatigue, nausea and emesis. On presentation, SBP less than 90 mmHg. Tested positive for COVID-19. CXR and CT Abdomen/Pelvis  nonacute.    1. Myasthenia Gravis: concern for mild exacerbation with primary symptom generalized weakness. No dysphagia or respiratory symptoms. Likely due to COVID-19 infection. Follows with Neuro (Dr.). On Imuran, Prednisone 20 mg and Vyvgart infusions. IVIG started 9/1/23 x 5 . Held Imuran, continued Prednisone. Vyvgart will need to be delayed due to IVIG. Monitored VC/NIF Q4H while hospitalized, stable. Neurology  followed.  2. COVID-19 infection: 1 week of symptoms, nausea/vomiting  and fatigue. On 2L in ED for O2 sat of 91%, weaned to room air with sats mid 90s. s/p Decadron IV and Remdesivir in ED, no further need for Decadron or Remdesivir given lack of hypoxia, LFT elevation and onset of symptoms more than 5 days prior to admission. Admit CXR nonacute. Monitored with continuous pulse Ox while hospitalized. Pulmonary hygiene. 3. Leukocytosis: WBC 18, denied infectious symptoms. Could be reactive from above. Urinalysis  benign. Blood culture  9/1/23 NGTD. Monitored CBC and fever curve while hospitalized. Trend down slowly. 4. Elevated Liver Enzymes: AST 281, ALT 50 on admit. Admit CT Abdomen/Pelvis  nonacute. Resolved with supportive care. 5. Hypotension: SBP less than 90 on admit, lactate normal. Resolved with IVF bolus. BP higher as well, likely autonomic dysfunction. Avoid wide fluctuations in BP. BP stable at the time of discharge.  6. Parkinson's Disease: per history; continued Sinemet.  7. Overactive Bladder: home Myrbetriq was stopped as outpatient.  8. Obesity: BMI 34. Lifestyle modifications.  9. Lower Extremity Wound: present on admission. Wound care. ET RN followed.  10. Code status: Full code, discussed on admit.  11. VTE  Prophylaxis: Lovenox.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Full blood count, Hepatic enzyme increased, Hypertension, Hypotension
Clinical narrative: Patient is an 80 year old  female with a history of Myasthenia Gravis, Parkinson's disease, recurrent UTIs with admission for Sepsis secondary to  ESBL E. coli in March 2023, who presented from her SNF  to hospital 9/1/23 with weakness, fatigue, nausea and emesis. On presentation, SBP less than 90 mmHg. Tested positive for COVID-19. CXR and CT Abdomen/Pelvis  nonacute.    1. Myasthenia Gravis: concern for mild exacerbation with primary symptom generalized weakness. No dysphagia or respiratory symptoms. Likely due to COVID-19 infection. Follows with Neuro (Dr.). On Imuran, Prednisone 20 mg and Vyvgart infusions. IVIG started 9/1/23 x 5 . Held Imuran, continued Prednisone. Vyvgart will need to be delayed due to IVIG. Monitored VC/NIF Q4H while hospitalized, stable. Neurology  followed.  2. COVID-19 infection: 1 week of symptoms, nausea/vomiting  and fatigue. On 2L in ED for O2 sat of 91%, weaned to room air with sats mid 90s. s/p Decadron IV and Remdesivir in ED, no further need for Decadron or Remdesivir given lack of hypoxia, LFT elevation and onset of symptoms more than 5 days prior to admission. Admit CXR nonacute. Monitored with continuous pulse Ox while hospitalized. Pulmonary hygiene. 3. Leukocytosis: WBC 18, denied infectious symptoms. Could be reactive from above. Urinalysis  benign. Blood culture  9/1/23 NGTD. Monitored CBC and fever curve while hospitalized. Trend down slowly. 4. Elevated Liver Enzymes: AST 281, ALT 50 on admit. Admit CT Abdomen/Pelvis  nonacute. Resolved with supportive care. 5. Hypotension: SBP less than 90 on admit, lactate normal. Resolved with IVF bolus. BP higher as well, likely autonomic dysfunction. Avoid wide fluctuations in BP. BP stable at the time of discharge.  6. Parkinson's Disease: per history; continued Sinemet.  7. Overactive Bladder: home Myrbetriq was stopped as outpatient.  8. Obesity: BMI 34. Lifestyle modifications.  9. Lower Extremity Wound: present on admission. Wound care. ET RN followed.  10. Code status: Full code, discussed on admit.  11. VTE  Prophylaxis: Lovenox.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Immunoglobulin therapy, Leukocytosis, Limb injury, Liver function test increased, Nausea
Clinical narrative: Patient is an 80 year old  female with a history of Myasthenia Gravis, Parkinson's disease, recurrent UTIs with admission for Sepsis secondary to  ESBL E. coli in March 2023, who presented from her SNF  to hospital 9/1/23 with weakness, fatigue, nausea and emesis. On presentation, SBP less than 90 mmHg. Tested positive for COVID-19. CXR and CT Abdomen/Pelvis  nonacute.    1. Myasthenia Gravis: concern for mild exacerbation with primary symptom generalized weakness. No dysphagia or respiratory symptoms. Likely due to COVID-19 infection. Follows with Neuro (Dr.). On Imuran, Prednisone 20 mg and Vyvgart infusions. IVIG started 9/1/23 x 5 . Held Imuran, continued Prednisone. Vyvgart will need to be delayed due to IVIG. Monitored VC/NIF Q4H while hospitalized, stable. Neurology  followed.  2. COVID-19 infection: 1 week of symptoms, nausea/vomiting  and fatigue. On 2L in ED for O2 sat of 91%, weaned to room air with sats mid 90s. s/p Decadron IV and Remdesivir in ED, no further need for Decadron or Remdesivir given lack of hypoxia, LFT elevation and onset of symptoms more than 5 days prior to admission. Admit CXR nonacute. Monitored with continuous pulse Ox while hospitalized. Pulmonary hygiene. 3. Leukocytosis: WBC 18, denied infectious symptoms. Could be reactive from above. Urinalysis  benign. Blood culture  9/1/23 NGTD. Monitored CBC and fever curve while hospitalized. Trend down slowly. 4. Elevated Liver Enzymes: AST 281, ALT 50 on admit. Admit CT Abdomen/Pelvis  nonacute. Resolved with supportive care. 5. Hypotension: SBP less than 90 on admit, lactate normal. Resolved with IVF bolus. BP higher as well, likely autonomic dysfunction. Avoid wide fluctuations in BP. BP stable at the time of discharge.  6. Parkinson's Disease: per history; continued Sinemet.  7. Overactive Bladder: home Myrbetriq was stopped as outpatient.  8. Obesity: BMI 34. Lifestyle modifications.  9. Lower Extremity Wound: present on admission. Wound care. ET RN followed.  10. Code status: Full code, discussed on admit.  11. VTE  Prophylaxis: Lovenox.