chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 57.0
Sex: F
Vaccine: UNK
Symptoms: Asthenia, Feeding disorder, Feeling cold, Malaise, Movement disorder
Clinical narrative: She received her Shingles and Pneumonia vaccine about 4 days ago; not feeling good at all; Has not been able to move; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; This spontaneous report has been received from the patient and refers to herself, a 57-year-old female patient.  The patient's pertinent medical history, concurrent conditions and concomitant therapies were not reported.  On an unknown date in September 2023, the patient was vaccinated with the first dose of zoster vaccine live (ZOSTAVAX) subcutaneous injection. On approximately 04-DEC-2023 (also reported as 'about 4 days ago' from 08-DEC-2023), the patient was vaccinated with the second dose of zoster vaccine live (ZOSTAVAX) and an unspecified dose of pneumococcal 23v polysaccharide vaccine (PNEUMOVAX23) injection (labelled drug-drug interaction). All vaccines were administered as prophylaxis (for all vaccines strength, dosage regimen, vaccination scheme, lot #, expiry date, anatomical site of administration and route of administration were not provided).  On an unknown date in December 2023, the patient was not feeling good at all (malaise), and had not been able to move for the past few days (movement disorder). She had also been experiencing mucus (secretion discharge), weakness (asthenia), chills and was unable to eat (feeding disorder). At the time of the reporting, the patient stated that she was feeling a little better and was able to move around and eat breakfast.  The outcome of the events movement disorder and feeding disorder was captured as recovered since the patient stated she was already able to move around and eat breakfast. The outcome for the other events was not provided.  The causal relationship between the events and the suspect vaccines was not established.
Age: 57.0
Sex: F
Vaccine: UNK
Symptoms: Secretion discharge
Clinical narrative: She received her Shingles and Pneumonia vaccine about 4 days ago; not feeling good at all; Has not been able to move; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; Consumer stated that she has been experiencing mucus, weakness, chills and is unable to eat; This spontaneous report has been received from the patient and refers to herself, a 57-year-old female patient.  The patient's pertinent medical history, concurrent conditions and concomitant therapies were not reported.  On an unknown date in September 2023, the patient was vaccinated with the first dose of zoster vaccine live (ZOSTAVAX) subcutaneous injection. On approximately 04-DEC-2023 (also reported as 'about 4 days ago' from 08-DEC-2023), the patient was vaccinated with the second dose of zoster vaccine live (ZOSTAVAX) and an unspecified dose of pneumococcal 23v polysaccharide vaccine (PNEUMOVAX23) injection (labelled drug-drug interaction). All vaccines were administered as prophylaxis (for all vaccines strength, dosage regimen, vaccination scheme, lot #, expiry date, anatomical site of administration and route of administration were not provided).  On an unknown date in December 2023, the patient was not feeling good at all (malaise), and had not been able to move for the past few days (movement disorder). She had also been experiencing mucus (secretion discharge), weakness (asthenia), chills and was unable to eat (feeding disorder). At the time of the reporting, the patient stated that she was feeling a little better and was able to move around and eat breakfast.  The outcome of the events movement disorder and feeding disorder was captured as recovered since the patient stated she was already able to move around and eat breakfast. The outcome for the other events was not provided.  The causal relationship between the events and the suspect vaccines was not established.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Gait disturbance, Tremor
Clinical narrative: Woke up with severe shivers, couldn?t make my body stop.  I was violently shaking and felt I was not stable to walk. Took a hot bath on the hottest setting and shivers didn?t stop. They continued for approx 30 minutes during a hot bath and after. I took 2 advil and turned up the heat, wrapped myself in layers of clothing, and laid under heavy blankets until the shivering stopped.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Diarrhoea, Dizziness, Fatigue, Nausea
Clinical narrative: Extreme fatigue lasting over 5 days so far. Extreme nausea, dizziness. Diarrhea ranging from severe to moderate also over 5 days. Treatment OTC Pepto Bismo. This was not a booster. It is my 5th COVID vaccine however I was informed this is NOT part of a series. This is a stand alone vaccine to fight current known strains.
Age: 71.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Asthenia, Gait disturbance, Hypersomnia, Hypoaesthesia, Pain in extremity
Clinical narrative: Next day, my arms were tingling, numb and very sore.  My body was so weak I could hardly walk from bed to a chair in living room.  I drank water all day, and ate just 2 english muffins for whole day.  I was off from work, but If I wasn't I would call in sick that day.  I never had two injections in my arms the same time.   I slept for most of day.  I will never take Covid AND a Flu shot at the same time again. I am 71 years old and my body can't handle it.
Age: 71.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Paraesthesia
Clinical narrative: Next day, my arms were tingling, numb and very sore.  My body was so weak I could hardly walk from bed to a chair in living room.  I drank water all day, and ate just 2 english muffins for whole day.  I was off from work, but If I wasn't I would call in sick that day.  I never had two injections in my arms the same time.   I slept for most of day.  I will never take Covid AND a Flu shot at the same time again. I am 71 years old and my body can't handle it.
Age: 38.0
Sex: F
Vaccine: TDAP
Symptoms: Pruritus
Clinical narrative: Patient received Boostrix on 1/5/23 12:50pm. Patient reported at 2:58pm that she was itching all over her body (no rash, not life threatening). Pharmacist administered Diphenhydramine 12.5mg/5 mL (10 mL) from immunization cart. Patient started feeling better at 3:11pm.
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Fatigue, Headache, Loss of consciousness, Nausea, Pain
Clinical narrative: Fatigue, headache, body aches, nausea, vomiting, loss of consciousness/short seizure
Age: 61.0
Sex: F
Vaccine: VARZOS
Symptoms: Seizure, Vomiting
Clinical narrative: Fatigue, headache, body aches, nausea, vomiting, loss of consciousness/short seizure
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Paraesthesia
Clinical narrative: 30 minutes after receiving the vaccine (around 6:35), the patient had what she described as mild tingling/itching on her wrists and back, and her right ear turned slightly red. She had no difficulty breathing or swelling, no hives or wheals. I administered hydroxyzine 50mg by mouth per her choice at 6:40 following the protocol of 0.5 to 1mg/kg of body weight. I gave her the choice between that and benadryl. She requested that I not activate the advance emergency system. I continued to monitor for another 30 minutes, and she stated that she felt stable and the redness in her ear had subsided. I asked if she felt comfortable or safe going home, and if she knew what to look for in the case of symptoms escalating. She said yes and left. I followed up the morning of 1/6 at 9:00 AM. The patient states that she feels fine and she kept herself awake to monitor for continuing symptoms.
Age: 60.0
Sex: F
Vaccine: RSV
Symptoms: Paraesthesia oral, Swollen tongue
Clinical narrative: Patient described tongue as "feeling funny" about 5 minutes post-vaccination. She said her tongue was tingly and felt like it was getting larger. She explained the sensation did not radiate or affect the throat. After 20 minutes of sitting down, the patient said she felt back to normal.
Age: 14.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Discontinued product administered, No adverse event
Clinical narrative: The patient received a dose of the bivalent COVID vaccine on 9/14 as our clinic was unaware that the bivalent vaccine was no longer authorized to be given on that date. There was no adverse event. She had no side effects or any vaccine-related concern as a result of receiving the bivalent vaccine. She has since been vaccinated with the new COVID vaccine on 1/6/24.
Age: 95.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Aspiration, Asthenia, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient is a 95 y.o. female patient of MD with history of combined heart failure, HTN, CKD3, and COPD who presented to Hospital with confusion and weakness after recent admission at another hospital for COVID infection.  Required NRB on admission and was treated for COVID pneumonia as well as likely secondary bacterial pneumonia.  Course complicated by AKI on CKD3, dysphagia.  She was clinically improving and weaned to room air on 12/11, but became abruptly hypoxic in the evening on 12/11 due to a likely aspiration event and rapidly declined.  Given her do not resuscitate code status, she was transitioned to comfort care and died at 19:30 on 12/11/2023.   Discharge diagnoses:   Acute hypoxic respiratory failure COVID-19 infection Secondary bacterial pneumonia AKI on CKD3 Dysphagia Hemoptysis Generalized weakness  Acute metabolic encephalopathy Acute on chronic macrocytic anemia Chronic systolic and diastolic heart failure COPD with exacerbation Severe protein calorie malnutrition       Condition at Discharge: Expired
Age: 95.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chronic kidney disease, Confusional state, Death, Dysphagia, General physical health deterioration
Clinical narrative: Patient is a 95 y.o. female patient of MD with history of combined heart failure, HTN, CKD3, and COPD who presented to Hospital with confusion and weakness after recent admission at another hospital for COVID infection.  Required NRB on admission and was treated for COVID pneumonia as well as likely secondary bacterial pneumonia.  Course complicated by AKI on CKD3, dysphagia.  She was clinically improving and weaned to room air on 12/11, but became abruptly hypoxic in the evening on 12/11 due to a likely aspiration event and rapidly declined.  Given her do not resuscitate code status, she was transitioned to comfort care and died at 19:30 on 12/11/2023.   Discharge diagnoses:   Acute hypoxic respiratory failure COVID-19 infection Secondary bacterial pneumonia AKI on CKD3 Dysphagia Hemoptysis Generalized weakness  Acute metabolic encephalopathy Acute on chronic macrocytic anemia Chronic systolic and diastolic heart failure COPD with exacerbation Severe protein calorie malnutrition       Condition at Discharge: Expired
Age: 95.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypoxia, Pneumonia bacterial
Clinical narrative: Patient is a 95 y.o. female patient of MD with history of combined heart failure, HTN, CKD3, and COPD who presented to Hospital with confusion and weakness after recent admission at another hospital for COVID infection.  Required NRB on admission and was treated for COVID pneumonia as well as likely secondary bacterial pneumonia.  Course complicated by AKI on CKD3, dysphagia.  She was clinically improving and weaned to room air on 12/11, but became abruptly hypoxic in the evening on 12/11 due to a likely aspiration event and rapidly declined.  Given her do not resuscitate code status, she was transitioned to comfort care and died at 19:30 on 12/11/2023.   Discharge diagnoses:   Acute hypoxic respiratory failure COVID-19 infection Secondary bacterial pneumonia AKI on CKD3 Dysphagia Hemoptysis Generalized weakness  Acute metabolic encephalopathy Acute on chronic macrocytic anemia Chronic systolic and diastolic heart failure COPD with exacerbation Severe protein calorie malnutrition       Condition at Discharge: Expired
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Blood thyroid stimulating hormone increased, COVID-19, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Condition aggravated
Clinical narrative: Covid-19 Virus Infection Date of onset of symptoms: 12/7/2023 Symptoms present on admission: Cough and dyspnea Date of covid positive test: 12/8/2023 Vaccination status: vaccinated Imaging: CT PE study with bilateral groundglass opacities Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: remdesivir Consultants following: ID consulted Anticipated special isolation end date: 12/17/2023 Ok to DC remdesivir on 12/11 Cleared for dc from ID perspective   Small cell carcinoma of the lung  (status post systemic chemotherapy, now on maintenance immunotherapy, follows with Dr.).   CT on admission with evidence of disease progression with increased size of hilar and left upper lobe mass. Oncology consulted given evidence of disease progression CT abdomen pelvis 12/9 showed progression of metastatic disease within the liver and multiple new enlarging hepatic lesions F/u with oncology outpatient   Uncontrolled hypothyroidism TSH has been steadily increasing since immunotherapy Felt to have immunotherapy related thyroid toxicity TSH 24.10 this morning, T4 0.8 Has been on levothyroxine 75 mcg; gave extra dose of 25 mg IV on 12/10 Started on levothyroxine 88 mcg on 12/11 Follow-up with PCP   Systolic Heart failure- not in exacerbation Hypertension Echo 9/2023- EF 47% September 2023 Continue home Lasix, Coreg, Aldactone   COPD Without acute exacerbation on admission Continue home inhalers   CAD status post CABG Aspirin and statin   GERD Continue PPI
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Disease progression, Dyspnoea, Hepatic lesion, Hyperthyroidism
Clinical narrative: Covid-19 Virus Infection Date of onset of symptoms: 12/7/2023 Symptoms present on admission: Cough and dyspnea Date of covid positive test: 12/8/2023 Vaccination status: vaccinated Imaging: CT PE study with bilateral groundglass opacities Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: remdesivir Consultants following: ID consulted Anticipated special isolation end date: 12/17/2023 Ok to DC remdesivir on 12/11 Cleared for dc from ID perspective   Small cell carcinoma of the lung  (status post systemic chemotherapy, now on maintenance immunotherapy, follows with Dr.).   CT on admission with evidence of disease progression with increased size of hilar and left upper lobe mass. Oncology consulted given evidence of disease progression CT abdomen pelvis 12/9 showed progression of metastatic disease within the liver and multiple new enlarging hepatic lesions F/u with oncology outpatient   Uncontrolled hypothyroidism TSH has been steadily increasing since immunotherapy Felt to have immunotherapy related thyroid toxicity TSH 24.10 this morning, T4 0.8 Has been on levothyroxine 75 mcg; gave extra dose of 25 mg IV on 12/10 Started on levothyroxine 88 mcg on 12/11 Follow-up with PCP   Systolic Heart failure- not in exacerbation Hypertension Echo 9/2023- EF 47% September 2023 Continue home Lasix, Coreg, Aldactone   COPD Without acute exacerbation on admission Continue home inhalers   CAD status post CABG Aspirin and statin   GERD Continue PPI
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Metastases to liver, Metastatic neoplasm, Pulmonary hilar enlargement, Pulmonary mass
Clinical narrative: Covid-19 Virus Infection Date of onset of symptoms: 12/7/2023 Symptoms present on admission: Cough and dyspnea Date of covid positive test: 12/8/2023 Vaccination status: vaccinated Imaging: CT PE study with bilateral groundglass opacities Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: remdesivir Consultants following: ID consulted Anticipated special isolation end date: 12/17/2023 Ok to DC remdesivir on 12/11 Cleared for dc from ID perspective   Small cell carcinoma of the lung  (status post systemic chemotherapy, now on maintenance immunotherapy, follows with Dr.).   CT on admission with evidence of disease progression with increased size of hilar and left upper lobe mass. Oncology consulted given evidence of disease progression CT abdomen pelvis 12/9 showed progression of metastatic disease within the liver and multiple new enlarging hepatic lesions F/u with oncology outpatient   Uncontrolled hypothyroidism TSH has been steadily increasing since immunotherapy Felt to have immunotherapy related thyroid toxicity TSH 24.10 this morning, T4 0.8 Has been on levothyroxine 75 mcg; gave extra dose of 25 mg IV on 12/10 Started on levothyroxine 88 mcg on 12/11 Follow-up with PCP   Systolic Heart failure- not in exacerbation Hypertension Echo 9/2023- EF 47% September 2023 Continue home Lasix, Coreg, Aldactone   COPD Without acute exacerbation on admission Continue home inhalers   CAD status post CABG Aspirin and statin   GERD Continue PPI
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Small cell lung cancer, Thyroxine
Clinical narrative: Covid-19 Virus Infection Date of onset of symptoms: 12/7/2023 Symptoms present on admission: Cough and dyspnea Date of covid positive test: 12/8/2023 Vaccination status: vaccinated Imaging: CT PE study with bilateral groundglass opacities Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: remdesivir Consultants following: ID consulted Anticipated special isolation end date: 12/17/2023 Ok to DC remdesivir on 12/11 Cleared for dc from ID perspective   Small cell carcinoma of the lung  (status post systemic chemotherapy, now on maintenance immunotherapy, follows with Dr.).   CT on admission with evidence of disease progression with increased size of hilar and left upper lobe mass. Oncology consulted given evidence of disease progression CT abdomen pelvis 12/9 showed progression of metastatic disease within the liver and multiple new enlarging hepatic lesions F/u with oncology outpatient   Uncontrolled hypothyroidism TSH has been steadily increasing since immunotherapy Felt to have immunotherapy related thyroid toxicity TSH 24.10 this morning, T4 0.8 Has been on levothyroxine 75 mcg; gave extra dose of 25 mg IV on 12/10 Started on levothyroxine 88 mcg on 12/11 Follow-up with PCP   Systolic Heart failure- not in exacerbation Hypertension Echo 9/2023- EF 47% September 2023 Continue home Lasix, Coreg, Aldactone   COPD Without acute exacerbation on admission Continue home inhalers   CAD status post CABG Aspirin and statin   GERD Continue PPI
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, Blood glucose increased
Clinical narrative: Patient is a 70 y.o. female patient of, MD with history of COPD, GERD, type 2 diabetes, depression, tobacco abuse. Presented to Hospital with 1 week of multiple complaints including body aches, shortness of breath, dry nonproductive cough. Recent hospitalization for sepsis with pneumonia and pyelonephritis with obstructing nephrolithiasis. Problem based management in the hospital is as follows:   Acute hypoxic and hypercapnic respiratory failure, improved Covid-19 Virus Infection Hx of COPD, not in exacerbation  Date of onset of symptoms: 11/29/2023 Symptoms present on admission: Yes, Shortness of Breath, cough, body aches Date of covid positive test: 12/5/2023 Vaccination status: vaccinated Imaging: CT PA without any obvious consolidation, does show emphysematous changes Oxygen requirements on admission: 4L via NC Current oxygen requirements: 2L via NC Medical therapy: remdesivir and steroids, remdesivir completed, discharged on Decadron taper Consultants following: ID consulted Anticipated special isolation end date: 12/15/2023 Dulera, as needed albuterol inhaler   Recent Pyelonephritis with obstructing nephrolithiasis Acute complicated UTI S/p stenting, appears in place on recent imaging. UA with large leuk esterase, WBC 70, rare WBC clumps and nitrite negative Urine culture contaminated Initiated on ceftriaxone 12/6 per ID recs.  De-escalated to oral Omnicef 12/11 per ID recs Recommend maintaining outpatient follow-up with urology.   Constipation Continued bowel regimen   Elevated LFTs Alk phos 244, AST 56, ALT 56 Mild elevations, imaging unrevealing for acute pathology. Current outpatient   Type 2 diabetes with peripheral neuropathy Home insulin regimen: 25 units Levemir nightly Carbohydrate consistent diet BG elevated to 250s 16 units twice daily long-acting insulin inpatient for better BG control while on steroids Sliding scale insulin Continued gabapentin   Depression Continued Cymbalta   GERD Continued Protonix   Tobacco abuse Typically 1 pack/day smoker, has not been using 2/2 recent illnesses Recommend continued cessation from tobacco NRT provided   After 5 days of hospital stay, patient was doing well so she was discharged in stable condition. Advised to f/u with PCP and Urology. All questions and concerns were addressed before discharge.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Cough, Culture urine, Dyspnoea
Clinical narrative: Patient is a 70 y.o. female patient of, MD with history of COPD, GERD, type 2 diabetes, depression, tobacco abuse. Presented to Hospital with 1 week of multiple complaints including body aches, shortness of breath, dry nonproductive cough. Recent hospitalization for sepsis with pneumonia and pyelonephritis with obstructing nephrolithiasis. Problem based management in the hospital is as follows:   Acute hypoxic and hypercapnic respiratory failure, improved Covid-19 Virus Infection Hx of COPD, not in exacerbation  Date of onset of symptoms: 11/29/2023 Symptoms present on admission: Yes, Shortness of Breath, cough, body aches Date of covid positive test: 12/5/2023 Vaccination status: vaccinated Imaging: CT PA without any obvious consolidation, does show emphysematous changes Oxygen requirements on admission: 4L via NC Current oxygen requirements: 2L via NC Medical therapy: remdesivir and steroids, remdesivir completed, discharged on Decadron taper Consultants following: ID consulted Anticipated special isolation end date: 12/15/2023 Dulera, as needed albuterol inhaler   Recent Pyelonephritis with obstructing nephrolithiasis Acute complicated UTI S/p stenting, appears in place on recent imaging. UA with large leuk esterase, WBC 70, rare WBC clumps and nitrite negative Urine culture contaminated Initiated on ceftriaxone 12/6 per ID recs.  De-escalated to oral Omnicef 12/11 per ID recs Recommend maintaining outpatient follow-up with urology.   Constipation Continued bowel regimen   Elevated LFTs Alk phos 244, AST 56, ALT 56 Mild elevations, imaging unrevealing for acute pathology. Current outpatient   Type 2 diabetes with peripheral neuropathy Home insulin regimen: 25 units Levemir nightly Carbohydrate consistent diet BG elevated to 250s 16 units twice daily long-acting insulin inpatient for better BG control while on steroids Sliding scale insulin Continued gabapentin   Depression Continued Cymbalta   GERD Continued Protonix   Tobacco abuse Typically 1 pack/day smoker, has not been using 2/2 recent illnesses Recommend continued cessation from tobacco NRT provided   After 5 days of hospital stay, patient was doing well so she was discharged in stable condition. Advised to f/u with PCP and Urology. All questions and concerns were addressed before discharge.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Emphysema, Illness, Imaging procedure, Insulin therapy, Liver function test increased
Clinical narrative: Patient is a 70 y.o. female patient of, MD with history of COPD, GERD, type 2 diabetes, depression, tobacco abuse. Presented to Hospital with 1 week of multiple complaints including body aches, shortness of breath, dry nonproductive cough. Recent hospitalization for sepsis with pneumonia and pyelonephritis with obstructing nephrolithiasis. Problem based management in the hospital is as follows:   Acute hypoxic and hypercapnic respiratory failure, improved Covid-19 Virus Infection Hx of COPD, not in exacerbation  Date of onset of symptoms: 11/29/2023 Symptoms present on admission: Yes, Shortness of Breath, cough, body aches Date of covid positive test: 12/5/2023 Vaccination status: vaccinated Imaging: CT PA without any obvious consolidation, does show emphysematous changes Oxygen requirements on admission: 4L via NC Current oxygen requirements: 2L via NC Medical therapy: remdesivir and steroids, remdesivir completed, discharged on Decadron taper Consultants following: ID consulted Anticipated special isolation end date: 12/15/2023 Dulera, as needed albuterol inhaler   Recent Pyelonephritis with obstructing nephrolithiasis Acute complicated UTI S/p stenting, appears in place on recent imaging. UA with large leuk esterase, WBC 70, rare WBC clumps and nitrite negative Urine culture contaminated Initiated on ceftriaxone 12/6 per ID recs.  De-escalated to oral Omnicef 12/11 per ID recs Recommend maintaining outpatient follow-up with urology.   Constipation Continued bowel regimen   Elevated LFTs Alk phos 244, AST 56, ALT 56 Mild elevations, imaging unrevealing for acute pathology. Current outpatient   Type 2 diabetes with peripheral neuropathy Home insulin regimen: 25 units Levemir nightly Carbohydrate consistent diet BG elevated to 250s 16 units twice daily long-acting insulin inpatient for better BG control while on steroids Sliding scale insulin Continued gabapentin   Depression Continued Cymbalta   GERD Continued Protonix   Tobacco abuse Typically 1 pack/day smoker, has not been using 2/2 recent illnesses Recommend continued cessation from tobacco NRT provided   After 5 days of hospital stay, patient was doing well so she was discharged in stable condition. Advised to f/u with PCP and Urology. All questions and concerns were addressed before discharge.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Nephrolithiasis, Nitrite urine absent, Pain, Pneumonia, Pyelonephritis
Clinical narrative: Patient is a 70 y.o. female patient of, MD with history of COPD, GERD, type 2 diabetes, depression, tobacco abuse. Presented to Hospital with 1 week of multiple complaints including body aches, shortness of breath, dry nonproductive cough. Recent hospitalization for sepsis with pneumonia and pyelonephritis with obstructing nephrolithiasis. Problem based management in the hospital is as follows:   Acute hypoxic and hypercapnic respiratory failure, improved Covid-19 Virus Infection Hx of COPD, not in exacerbation  Date of onset of symptoms: 11/29/2023 Symptoms present on admission: Yes, Shortness of Breath, cough, body aches Date of covid positive test: 12/5/2023 Vaccination status: vaccinated Imaging: CT PA without any obvious consolidation, does show emphysematous changes Oxygen requirements on admission: 4L via NC Current oxygen requirements: 2L via NC Medical therapy: remdesivir and steroids, remdesivir completed, discharged on Decadron taper Consultants following: ID consulted Anticipated special isolation end date: 12/15/2023 Dulera, as needed albuterol inhaler   Recent Pyelonephritis with obstructing nephrolithiasis Acute complicated UTI S/p stenting, appears in place on recent imaging. UA with large leuk esterase, WBC 70, rare WBC clumps and nitrite negative Urine culture contaminated Initiated on ceftriaxone 12/6 per ID recs.  De-escalated to oral Omnicef 12/11 per ID recs Recommend maintaining outpatient follow-up with urology.   Constipation Continued bowel regimen   Elevated LFTs Alk phos 244, AST 56, ALT 56 Mild elevations, imaging unrevealing for acute pathology. Current outpatient   Type 2 diabetes with peripheral neuropathy Home insulin regimen: 25 units Levemir nightly Carbohydrate consistent diet BG elevated to 250s 16 units twice daily long-acting insulin inpatient for better BG control while on steroids Sliding scale insulin Continued gabapentin   Depression Continued Cymbalta   GERD Continued Protonix   Tobacco abuse Typically 1 pack/day smoker, has not been using 2/2 recent illnesses Recommend continued cessation from tobacco NRT provided   After 5 days of hospital stay, patient was doing well so she was discharged in stable condition. Advised to f/u with PCP and Urology. All questions and concerns were addressed before discharge.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Sepsis, Stent placement, Urinary tract infection
Clinical narrative: Patient is a 70 y.o. female patient of, MD with history of COPD, GERD, type 2 diabetes, depression, tobacco abuse. Presented to Hospital with 1 week of multiple complaints including body aches, shortness of breath, dry nonproductive cough. Recent hospitalization for sepsis with pneumonia and pyelonephritis with obstructing nephrolithiasis. Problem based management in the hospital is as follows:   Acute hypoxic and hypercapnic respiratory failure, improved Covid-19 Virus Infection Hx of COPD, not in exacerbation  Date of onset of symptoms: 11/29/2023 Symptoms present on admission: Yes, Shortness of Breath, cough, body aches Date of covid positive test: 12/5/2023 Vaccination status: vaccinated Imaging: CT PA without any obvious consolidation, does show emphysematous changes Oxygen requirements on admission: 4L via NC Current oxygen requirements: 2L via NC Medical therapy: remdesivir and steroids, remdesivir completed, discharged on Decadron taper Consultants following: ID consulted Anticipated special isolation end date: 12/15/2023 Dulera, as needed albuterol inhaler   Recent Pyelonephritis with obstructing nephrolithiasis Acute complicated UTI S/p stenting, appears in place on recent imaging. UA with large leuk esterase, WBC 70, rare WBC clumps and nitrite negative Urine culture contaminated Initiated on ceftriaxone 12/6 per ID recs.  De-escalated to oral Omnicef 12/11 per ID recs Recommend maintaining outpatient follow-up with urology.   Constipation Continued bowel regimen   Elevated LFTs Alk phos 244, AST 56, ALT 56 Mild elevations, imaging unrevealing for acute pathology. Current outpatient   Type 2 diabetes with peripheral neuropathy Home insulin regimen: 25 units Levemir nightly Carbohydrate consistent diet BG elevated to 250s 16 units twice daily long-acting insulin inpatient for better BG control while on steroids Sliding scale insulin Continued gabapentin   Depression Continued Cymbalta   GERD Continued Protonix   Tobacco abuse Typically 1 pack/day smoker, has not been using 2/2 recent illnesses Recommend continued cessation from tobacco NRT provided   After 5 days of hospital stay, patient was doing well so she was discharged in stable condition. Advised to f/u with PCP and Urology. All questions and concerns were addressed before discharge.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract obstruction, White blood cells urine abnormal, White blood cells urine positive
Clinical narrative: Patient is a 70 y.o. female patient of, MD with history of COPD, GERD, type 2 diabetes, depression, tobacco abuse. Presented to Hospital with 1 week of multiple complaints including body aches, shortness of breath, dry nonproductive cough. Recent hospitalization for sepsis with pneumonia and pyelonephritis with obstructing nephrolithiasis. Problem based management in the hospital is as follows:   Acute hypoxic and hypercapnic respiratory failure, improved Covid-19 Virus Infection Hx of COPD, not in exacerbation  Date of onset of symptoms: 11/29/2023 Symptoms present on admission: Yes, Shortness of Breath, cough, body aches Date of covid positive test: 12/5/2023 Vaccination status: vaccinated Imaging: CT PA without any obvious consolidation, does show emphysematous changes Oxygen requirements on admission: 4L via NC Current oxygen requirements: 2L via NC Medical therapy: remdesivir and steroids, remdesivir completed, discharged on Decadron taper Consultants following: ID consulted Anticipated special isolation end date: 12/15/2023 Dulera, as needed albuterol inhaler   Recent Pyelonephritis with obstructing nephrolithiasis Acute complicated UTI S/p stenting, appears in place on recent imaging. UA with large leuk esterase, WBC 70, rare WBC clumps and nitrite negative Urine culture contaminated Initiated on ceftriaxone 12/6 per ID recs.  De-escalated to oral Omnicef 12/11 per ID recs Recommend maintaining outpatient follow-up with urology.   Constipation Continued bowel regimen   Elevated LFTs Alk phos 244, AST 56, ALT 56 Mild elevations, imaging unrevealing for acute pathology. Current outpatient   Type 2 diabetes with peripheral neuropathy Home insulin regimen: 25 units Levemir nightly Carbohydrate consistent diet BG elevated to 250s 16 units twice daily long-acting insulin inpatient for better BG control while on steroids Sliding scale insulin Continued gabapentin   Depression Continued Cymbalta   GERD Continued Protonix   Tobacco abuse Typically 1 pack/day smoker, has not been using 2/2 recent illnesses Recommend continued cessation from tobacco NRT provided   After 5 days of hospital stay, patient was doing well so she was discharged in stable condition. Advised to f/u with PCP and Urology. All questions and concerns were addressed before discharge.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy skin, Rash, Rash erythematous, Rash pruritic
Clinical narrative: Pimple like red bumps that are extremely itchy. I have had this now for over several weeks. Started on torso, then arms. then side then back then legs. it subsided then it has come back with a vengeance.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, Cachexia, Chronic obstructive pulmonary disease, Computerised tomogram thorax normal
Clinical narrative: Patient is a 70 y.o. female patient of CNP with history of sever copd on home oxygen 3l NC, htn, RLS, GERD presented to Hospital with sob .   COPD exacerbation Acute on top of chronic hypoxemic respiratory failure on home oxygen 3 L NC Covid-19 Virus Infection Possible pneumonia Date of onset of symptoms: 11/15/23 Symptoms present on admission: sob and cough Date of covid positive test: 12/7 Vaccination status: unvaccinated Imaging: CT pending Oxygen requirements on admission: 3l NC Current oxygen requirements: 3L NC Medical therapy: remdesivir and steroids Consultants following: ID Anticipated special isolation end date: 12/13/23   Continue respiratory monitoring, keep SpO2 88 to 92% Continue remdesivir and steroids ID is following CT pulmonary arteries negative for PE or any acute pulmonary process DuoNeb as needed Continue Spiriva PT OT Continue ceftriaxone  Pulmonary was consulted recommending, add Symbicort Will discharge the patient on p.o. Augmentin for another 5 days.   Hypokalemia Replete as needed     Hypertension Continue Hyzaar and amlodipine   Hyperlipidemia On atorvastatin   Cachexia Consult dietitian
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Dyspnoea, Hypokalaemia, Respiratory failure
Clinical narrative: Patient is a 70 y.o. female patient of CNP with history of sever copd on home oxygen 3l NC, htn, RLS, GERD presented to Hospital with sob .   COPD exacerbation Acute on top of chronic hypoxemic respiratory failure on home oxygen 3 L NC Covid-19 Virus Infection Possible pneumonia Date of onset of symptoms: 11/15/23 Symptoms present on admission: sob and cough Date of covid positive test: 12/7 Vaccination status: unvaccinated Imaging: CT pending Oxygen requirements on admission: 3l NC Current oxygen requirements: 3L NC Medical therapy: remdesivir and steroids Consultants following: ID Anticipated special isolation end date: 12/13/23   Continue respiratory monitoring, keep SpO2 88 to 92% Continue remdesivir and steroids ID is following CT pulmonary arteries negative for PE or any acute pulmonary process DuoNeb as needed Continue Spiriva PT OT Continue ceftriaxone  Pulmonary was consulted recommending, add Symbicort Will discharge the patient on p.o. Augmentin for another 5 days.   Hypokalemia Replete as needed     Hypertension Continue Hyzaar and amlodipine   Hyperlipidemia On atorvastatin   Cachexia Consult dietitian
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient is a 70 y.o. female patient of CNP with history of sever copd on home oxygen 3l NC, htn, RLS, GERD presented to Hospital with sob .   COPD exacerbation Acute on top of chronic hypoxemic respiratory failure on home oxygen 3 L NC Covid-19 Virus Infection Possible pneumonia Date of onset of symptoms: 11/15/23 Symptoms present on admission: sob and cough Date of covid positive test: 12/7 Vaccination status: unvaccinated Imaging: CT pending Oxygen requirements on admission: 3l NC Current oxygen requirements: 3L NC Medical therapy: remdesivir and steroids Consultants following: ID Anticipated special isolation end date: 12/13/23   Continue respiratory monitoring, keep SpO2 88 to 92% Continue remdesivir and steroids ID is following CT pulmonary arteries negative for PE or any acute pulmonary process DuoNeb as needed Continue Spiriva PT OT Continue ceftriaxone  Pulmonary was consulted recommending, add Symbicort Will discharge the patient on p.o. Augmentin for another 5 days.   Hypokalemia Replete as needed     Hypertension Continue Hyzaar and amlodipine   Hyperlipidemia On atorvastatin   Cachexia Consult dietitian
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Brain natriuretic peptide increased, COVID-19, Cardiac failure congestive, Chest X-ray abnormal
Clinical narrative: Patient is a 68 y.o. male patient of DO with history of nonischemic cardiomyopathy, LBBB, CKD, COPD, PAF, hyperlipidemia presented to Medical Center with shortness of breath, chest pain.   Acute systolic CHF exacerbation Elevated troponin with flat trend, likely type II non-STEMI/demand ischemia secondary to CHF Dyspnea on exertion for the last week. Intermittent episodes of midsternal chest discomfort for the last 2 days. In setting of nonischemic cardiomyopathy status post biventricular ICD placement (05/2020).   Echocardiogram from 06/2023 with an EF of 45%. EKG AV paced.  CXR showing pulmonary congestion. Hemodynamically stable. BNP elevated (6900).  Started on IV Lasix on admission, Started on IV Lasix on admission, switched to p.o. on 12/6 Continue home regimen (BB, Entresto).  Consult cardiology team.  Recommendations noted   Covid-19 Virus Infection Date of onset of symptoms: 12/03/23 Symptoms present on admission: Myalgias, chills, cough; preceded by dyspnea on exertion for the last week Date of covid positive test: 12/04/23 Vaccination status: vaccinated Imaging: CXR showing left perihilar and right basilar interstitial infiltrate as well as vascular congestion.  CT chest showing mild GGO on the left upper lobe CRP 33 on 12/6 Oxygen requirements on admission: None Anticipated special isolation end date: 12/10/23 Discussed with ID team via secure chat regarding Paxlovid therapy.  Per their recommendations to initiate remdesivir x 3 days as Paxlovid has notable interactions with patient's home meds.  Monitor daily CMP while on remdesivir   PAF: Rate controlled on admission. Continue home regimen (beta-blocker, oral anticoagulation). Monitor in telemetry bed.   CKD: Stage III Creatinine of 1.95; GFR 37 (baseline GFR in the mid 40s). Monitor renal function and electrolytes closely.   DM type II: Hemoglobin A1c level 5.9. Sliding scale insulin as well as diabetic diet.   Anemia (please specify type if known) POA Thrombocytopenia Likely from CKD.  Monitor
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Chest pain, Chills, Condition aggravated, Cough
Clinical narrative: Patient is a 68 y.o. male patient of DO with history of nonischemic cardiomyopathy, LBBB, CKD, COPD, PAF, hyperlipidemia presented to Medical Center with shortness of breath, chest pain.   Acute systolic CHF exacerbation Elevated troponin with flat trend, likely type II non-STEMI/demand ischemia secondary to CHF Dyspnea on exertion for the last week. Intermittent episodes of midsternal chest discomfort for the last 2 days. In setting of nonischemic cardiomyopathy status post biventricular ICD placement (05/2020).   Echocardiogram from 06/2023 with an EF of 45%. EKG AV paced.  CXR showing pulmonary congestion. Hemodynamically stable. BNP elevated (6900).  Started on IV Lasix on admission, Started on IV Lasix on admission, switched to p.o. on 12/6 Continue home regimen (BB, Entresto).  Consult cardiology team.  Recommendations noted   Covid-19 Virus Infection Date of onset of symptoms: 12/03/23 Symptoms present on admission: Myalgias, chills, cough; preceded by dyspnea on exertion for the last week Date of covid positive test: 12/04/23 Vaccination status: vaccinated Imaging: CXR showing left perihilar and right basilar interstitial infiltrate as well as vascular congestion.  CT chest showing mild GGO on the left upper lobe CRP 33 on 12/6 Oxygen requirements on admission: None Anticipated special isolation end date: 12/10/23 Discussed with ID team via secure chat regarding Paxlovid therapy.  Per their recommendations to initiate remdesivir x 3 days as Paxlovid has notable interactions with patient's home meds.  Monitor daily CMP while on remdesivir   PAF: Rate controlled on admission. Continue home regimen (beta-blocker, oral anticoagulation). Monitor in telemetry bed.   CKD: Stage III Creatinine of 1.95; GFR 37 (baseline GFR in the mid 40s). Monitor renal function and electrolytes closely.   DM type II: Hemoglobin A1c level 5.9. Sliding scale insulin as well as diabetic diet.   Anemia (please specify type if known) POA Thrombocytopenia Likely from CKD.  Monitor
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram
Clinical narrative: Patient is a 68 y.o. male patient of DO with history of nonischemic cardiomyopathy, LBBB, CKD, COPD, PAF, hyperlipidemia presented to Medical Center with shortness of breath, chest pain.   Acute systolic CHF exacerbation Elevated troponin with flat trend, likely type II non-STEMI/demand ischemia secondary to CHF Dyspnea on exertion for the last week. Intermittent episodes of midsternal chest discomfort for the last 2 days. In setting of nonischemic cardiomyopathy status post biventricular ICD placement (05/2020).   Echocardiogram from 06/2023 with an EF of 45%. EKG AV paced.  CXR showing pulmonary congestion. Hemodynamically stable. BNP elevated (6900).  Started on IV Lasix on admission, Started on IV Lasix on admission, switched to p.o. on 12/6 Continue home regimen (BB, Entresto).  Consult cardiology team.  Recommendations noted   Covid-19 Virus Infection Date of onset of symptoms: 12/03/23 Symptoms present on admission: Myalgias, chills, cough; preceded by dyspnea on exertion for the last week Date of covid positive test: 12/04/23 Vaccination status: vaccinated Imaging: CXR showing left perihilar and right basilar interstitial infiltrate as well as vascular congestion.  CT chest showing mild GGO on the left upper lobe CRP 33 on 12/6 Oxygen requirements on admission: None Anticipated special isolation end date: 12/10/23 Discussed with ID team via secure chat regarding Paxlovid therapy.  Per their recommendations to initiate remdesivir x 3 days as Paxlovid has notable interactions with patient's home meds.  Monitor daily CMP while on remdesivir   PAF: Rate controlled on admission. Continue home regimen (beta-blocker, oral anticoagulation). Monitor in telemetry bed.   CKD: Stage III Creatinine of 1.95; GFR 37 (baseline GFR in the mid 40s). Monitor renal function and electrolytes closely.   DM type II: Hemoglobin A1c level 5.9. Sliding scale insulin as well as diabetic diet.   Anemia (please specify type if known) POA Thrombocytopenia Likely from CKD.  Monitor
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Left ventricular failure, Myalgia, Myocardial ischaemia, Pulmonary congestion, SARS-CoV-2 test positive
Clinical narrative: Patient is a 68 y.o. male patient of DO with history of nonischemic cardiomyopathy, LBBB, CKD, COPD, PAF, hyperlipidemia presented to Medical Center with shortness of breath, chest pain.   Acute systolic CHF exacerbation Elevated troponin with flat trend, likely type II non-STEMI/demand ischemia secondary to CHF Dyspnea on exertion for the last week. Intermittent episodes of midsternal chest discomfort for the last 2 days. In setting of nonischemic cardiomyopathy status post biventricular ICD placement (05/2020).   Echocardiogram from 06/2023 with an EF of 45%. EKG AV paced.  CXR showing pulmonary congestion. Hemodynamically stable. BNP elevated (6900).  Started on IV Lasix on admission, Started on IV Lasix on admission, switched to p.o. on 12/6 Continue home regimen (BB, Entresto).  Consult cardiology team.  Recommendations noted   Covid-19 Virus Infection Date of onset of symptoms: 12/03/23 Symptoms present on admission: Myalgias, chills, cough; preceded by dyspnea on exertion for the last week Date of covid positive test: 12/04/23 Vaccination status: vaccinated Imaging: CXR showing left perihilar and right basilar interstitial infiltrate as well as vascular congestion.  CT chest showing mild GGO on the left upper lobe CRP 33 on 12/6 Oxygen requirements on admission: None Anticipated special isolation end date: 12/10/23 Discussed with ID team via secure chat regarding Paxlovid therapy.  Per their recommendations to initiate remdesivir x 3 days as Paxlovid has notable interactions with patient's home meds.  Monitor daily CMP while on remdesivir   PAF: Rate controlled on admission. Continue home regimen (beta-blocker, oral anticoagulation). Monitor in telemetry bed.   CKD: Stage III Creatinine of 1.95; GFR 37 (baseline GFR in the mid 40s). Monitor renal function and electrolytes closely.   DM type II: Hemoglobin A1c level 5.9. Sliding scale insulin as well as diabetic diet.   Anemia (please specify type if known) POA Thrombocytopenia Likely from CKD.  Monitor
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin increased
Clinical narrative: Patient is a 68 y.o. male patient of DO with history of nonischemic cardiomyopathy, LBBB, CKD, COPD, PAF, hyperlipidemia presented to Medical Center with shortness of breath, chest pain.   Acute systolic CHF exacerbation Elevated troponin with flat trend, likely type II non-STEMI/demand ischemia secondary to CHF Dyspnea on exertion for the last week. Intermittent episodes of midsternal chest discomfort for the last 2 days. In setting of nonischemic cardiomyopathy status post biventricular ICD placement (05/2020).   Echocardiogram from 06/2023 with an EF of 45%. EKG AV paced.  CXR showing pulmonary congestion. Hemodynamically stable. BNP elevated (6900).  Started on IV Lasix on admission, Started on IV Lasix on admission, switched to p.o. on 12/6 Continue home regimen (BB, Entresto).  Consult cardiology team.  Recommendations noted   Covid-19 Virus Infection Date of onset of symptoms: 12/03/23 Symptoms present on admission: Myalgias, chills, cough; preceded by dyspnea on exertion for the last week Date of covid positive test: 12/04/23 Vaccination status: vaccinated Imaging: CXR showing left perihilar and right basilar interstitial infiltrate as well as vascular congestion.  CT chest showing mild GGO on the left upper lobe CRP 33 on 12/6 Oxygen requirements on admission: None Anticipated special isolation end date: 12/10/23 Discussed with ID team via secure chat regarding Paxlovid therapy.  Per their recommendations to initiate remdesivir x 3 days as Paxlovid has notable interactions with patient's home meds.  Monitor daily CMP while on remdesivir   PAF: Rate controlled on admission. Continue home regimen (beta-blocker, oral anticoagulation). Monitor in telemetry bed.   CKD: Stage III Creatinine of 1.95; GFR 37 (baseline GFR in the mid 40s). Monitor renal function and electrolytes closely.   DM type II: Hemoglobin A1c level 5.9. Sliding scale insulin as well as diabetic diet.   Anemia (please specify type if known) POA Thrombocytopenia Likely from CKD.  Monitor