chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Right ventricular enlargement, SARS-CoV-2 test positive, Stasis dermatitis, Systolic dysfunction, Troponin I increased
Clinical narrative: Patient is a 83 y.o. male patient of DO with history of CHF and COPD who presented with a 3-day complaint of SOB, subjective fever, dry cough and fatigue.  His wife was admitted to the hospital 2 days prior with COVID-19 infection.  Patient tested positive for COVID-19. CXR showed stable cardiomegaly with no acute pulmonary disease.  He was admitted for further evaluation and management of shortness of breath.   Acute on chronic systolic CHF Limited 2D echo on 11/20 Showed global hypokinesis of LV, EF of 34%.  RV is enlarged.   Noted elevated proBNP 2194 -> 1822 Exacerbation likely triggered by acute infection. He was diuresed and held due to hypotension. Appreciate cardiology input. Continue medical management as permitted by BP.   Elevated troponin Troponin I was 99-95-85. Likely type II MI event from acute systolic dysfunction. Troponin essentially flat. Denies chest pain. Continue to monitor.   Chronic A. Fib  HR is controlled. Continue Coreg. INR 2.3.   Pharmacy assisting with warfarin adjustments. Covid-19 Virus Infection COPD Date of onset of symptoms: 11/15 Symptoms present on admission: Cough and SOB Date of covid positive test: 11/18 Vaccination status: unvaccinated Imaging: CXR with no acute infiltrates. Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: Bronchodilators. Consultants following: ID Anticipated special isolation end date: 11/26 Worsening oxygenation requiring 2 L NC but now on room air 96% Pox. Appreciate ID input, on remdesivir, monitor renal function. Wean Solu-Medrol.   Acute respiratory failure Due to COVID-19. Improved. Continue bronchodilators. Add scheduled Albuterol MDI. Wean O2 as able to. Albuterol MDI scheduled.   Diabetes mellitus II Last HbA1c was 7.7 in May 2023. At home he was on Humulin 70/30, Lantus and Humalog. Discussed with endocrinology, insulin adjustments will be made.   AKI on CKD III Cr 2.26 -> 1.76. He is nonoliguric. Avoid nephrotoxins. Monitor Cr while on diuretics..   BLE stasis dermatitis No sign of acute infection. Continue to monitor.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Ventricular hypokinesia
Clinical narrative: Patient is a 83 y.o. male patient of DO with history of CHF and COPD who presented with a 3-day complaint of SOB, subjective fever, dry cough and fatigue.  His wife was admitted to the hospital 2 days prior with COVID-19 infection.  Patient tested positive for COVID-19. CXR showed stable cardiomegaly with no acute pulmonary disease.  He was admitted for further evaluation and management of shortness of breath.   Acute on chronic systolic CHF Limited 2D echo on 11/20 Showed global hypokinesis of LV, EF of 34%.  RV is enlarged.   Noted elevated proBNP 2194 -> 1822 Exacerbation likely triggered by acute infection. He was diuresed and held due to hypotension. Appreciate cardiology input. Continue medical management as permitted by BP.   Elevated troponin Troponin I was 99-95-85. Likely type II MI event from acute systolic dysfunction. Troponin essentially flat. Denies chest pain. Continue to monitor.   Chronic A. Fib  HR is controlled. Continue Coreg. INR 2.3.   Pharmacy assisting with warfarin adjustments. Covid-19 Virus Infection COPD Date of onset of symptoms: 11/15 Symptoms present on admission: Cough and SOB Date of covid positive test: 11/18 Vaccination status: unvaccinated Imaging: CXR with no acute infiltrates. Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: Bronchodilators. Consultants following: ID Anticipated special isolation end date: 11/26 Worsening oxygenation requiring 2 L NC but now on room air 96% Pox. Appreciate ID input, on remdesivir, monitor renal function. Wean Solu-Medrol.   Acute respiratory failure Due to COVID-19. Improved. Continue bronchodilators. Add scheduled Albuterol MDI. Wean O2 as able to. Albuterol MDI scheduled.   Diabetes mellitus II Last HbA1c was 7.7 in May 2023. At home he was on Humulin 70/30, Lantus and Humalog. Discussed with endocrinology, insulin adjustments will be made.   AKI on CKD III Cr 2.26 -> 1.76. He is nonoliguric. Avoid nephrotoxins. Monitor Cr while on diuretics..   BLE stasis dermatitis No sign of acute infection. Continue to monitor.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Atelectasis, Balance disorder, Barium swallow abnormal, Blood creatinine normal
Clinical narrative: Patient is a 80 y.o. female with a history of HFpEF, DVT on Eliquis, CKD3, OSA, TIA, DM2 5/18-5/25/23 for respirator failure, and mecanical falls. Patient represeted to hospital Observation 11/13/2023 for fall and found to be hypoxic.     1. Acute hypoxic respiratory failure: Found to have O2 sats of 85% at AL facility. Likely in setting of COVID 19. CT PE in ED without PE, showed atelectasis . Initially required 6L in ED, weaned to 1L O2 NC 11/16/23. discharge o2 eval completed prior to discharge and set up if needed. Treatment as below.  2. Covid: With recent exposure in past 7 days with son testing positive. Covid + on admission. Continued Remdesivir (last dose 11/17/23) and Decadron. As needed Duonebs, incentive spirometer. Wean oxygen as able. did not order steroids at discharge with her insulin needs. 3. Mechanical Fall: With history of previous falls. Reported walker rolled away, and patient lost balance and fell. No acute fracture noted on CT C/T/L spine. PT/OT consulted.  4. Acute Metabolic Encephalopathy: Alert and oriented x3, but slower to respond. CT head in ED negative. Likely in setting of COVID and possible polypharmacy. Resolved. 5. Bradycardia: HR in 50s, intermittently dropping into 40s, decreased home coreg 11/16/23. Asymptomatic. Stopped propanolol and decreased coreg 11/17.23 6. Chronic HFpEF:  TTE 11/10/22 with EF 69%, grade I diastolic dysfunction euvolemic on admit. Discontinued hydrochlorothiazide given elderly age and fall history. Continued remainder of GDMT.  7. Hypernatremia: hydrochlorothiazide discontinued 11/14/23.  8. Hx CVA vs TIA: documented history of two "mini strokes" no residual deficits. Continued home statin  9. IDDM: Per hx, hgb A1c 5.9 on 10/5/23. Glucose levels exacerbated by steroid use. Discharged on home regime. 10. Immunoglobulin deficiency: per hx started on IVIG in 2018, currently on transfusions every 4 weeks. Follows with Dr (allergy/immunology).  11. Asthma: per hx. Not in acute exacerbation. Continued home Spriva, Symbicort, Singulair and albuterol  12. OSA: on bipap nightly, continued while inpatient.  13. HTN: continued home meds.  14. CKD stage 2: baseline creat 1-1.4. creat 1.1 on admit. Stable.  15. History of  DVT: per history. Continued Eliquis  16. History of C1 Fracture: In setting of previous falls. CT C spine without acute fracture on admission.  17. Chronic Pain with opiate dependence: Previously on Ultram. Continued Lyrica. Home tramadol dose decreased as inpatient and pain well controlled. 18. Dysphagia: noted during admission 4/2023. Found to have mild oropharyngeal dysphagia. s/p MBS. Ground, nectar thick liquids per SLP. Has since been advanced to graduated diet. 19. Osteopetrosis: on Prolia outpatient.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Bradycardia, COVID-19, Computerised tomogram head normal, Computerised tomogram spine normal, Computerised tomogram thorax abnormal
Clinical narrative: Patient is a 80 y.o. female with a history of HFpEF, DVT on Eliquis, CKD3, OSA, TIA, DM2 5/18-5/25/23 for respirator failure, and mecanical falls. Patient represeted to hospital Observation 11/13/2023 for fall and found to be hypoxic.     1. Acute hypoxic respiratory failure: Found to have O2 sats of 85% at AL facility. Likely in setting of COVID 19. CT PE in ED without PE, showed atelectasis . Initially required 6L in ED, weaned to 1L O2 NC 11/16/23. discharge o2 eval completed prior to discharge and set up if needed. Treatment as below.  2. Covid: With recent exposure in past 7 days with son testing positive. Covid + on admission. Continued Remdesivir (last dose 11/17/23) and Decadron. As needed Duonebs, incentive spirometer. Wean oxygen as able. did not order steroids at discharge with her insulin needs. 3. Mechanical Fall: With history of previous falls. Reported walker rolled away, and patient lost balance and fell. No acute fracture noted on CT C/T/L spine. PT/OT consulted.  4. Acute Metabolic Encephalopathy: Alert and oriented x3, but slower to respond. CT head in ED negative. Likely in setting of COVID and possible polypharmacy. Resolved. 5. Bradycardia: HR in 50s, intermittently dropping into 40s, decreased home coreg 11/16/23. Asymptomatic. Stopped propanolol and decreased coreg 11/17.23 6. Chronic HFpEF:  TTE 11/10/22 with EF 69%, grade I diastolic dysfunction euvolemic on admit. Discontinued hydrochlorothiazide given elderly age and fall history. Continued remainder of GDMT.  7. Hypernatremia: hydrochlorothiazide discontinued 11/14/23.  8. Hx CVA vs TIA: documented history of two "mini strokes" no residual deficits. Continued home statin  9. IDDM: Per hx, hgb A1c 5.9 on 10/5/23. Glucose levels exacerbated by steroid use. Discharged on home regime. 10. Immunoglobulin deficiency: per hx started on IVIG in 2018, currently on transfusions every 4 weeks. Follows with Dr (allergy/immunology).  11. Asthma: per hx. Not in acute exacerbation. Continued home Spriva, Symbicort, Singulair and albuterol  12. OSA: on bipap nightly, continued while inpatient.  13. HTN: continued home meds.  14. CKD stage 2: baseline creat 1-1.4. creat 1.1 on admit. Stable.  15. History of  DVT: per history. Continued Eliquis  16. History of C1 Fracture: In setting of previous falls. CT C spine without acute fracture on admission.  17. Chronic Pain with opiate dependence: Previously on Ultram. Continued Lyrica. Home tramadol dose decreased as inpatient and pain well controlled. 18. Dysphagia: noted during admission 4/2023. Found to have mild oropharyngeal dysphagia. s/p MBS. Ground, nectar thick liquids per SLP. Has since been advanced to graduated diet. 19. Osteopetrosis: on Prolia outpatient.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Diastolic dysfunction, Drug dependence, Dysphagia, Echocardiogram, Echocardiogram abnormal
Clinical narrative: Patient is a 80 y.o. female with a history of HFpEF, DVT on Eliquis, CKD3, OSA, TIA, DM2 5/18-5/25/23 for respirator failure, and mecanical falls. Patient represeted to hospital Observation 11/13/2023 for fall and found to be hypoxic.     1. Acute hypoxic respiratory failure: Found to have O2 sats of 85% at AL facility. Likely in setting of COVID 19. CT PE in ED without PE, showed atelectasis . Initially required 6L in ED, weaned to 1L O2 NC 11/16/23. discharge o2 eval completed prior to discharge and set up if needed. Treatment as below.  2. Covid: With recent exposure in past 7 days with son testing positive. Covid + on admission. Continued Remdesivir (last dose 11/17/23) and Decadron. As needed Duonebs, incentive spirometer. Wean oxygen as able. did not order steroids at discharge with her insulin needs. 3. Mechanical Fall: With history of previous falls. Reported walker rolled away, and patient lost balance and fell. No acute fracture noted on CT C/T/L spine. PT/OT consulted.  4. Acute Metabolic Encephalopathy: Alert and oriented x3, but slower to respond. CT head in ED negative. Likely in setting of COVID and possible polypharmacy. Resolved. 5. Bradycardia: HR in 50s, intermittently dropping into 40s, decreased home coreg 11/16/23. Asymptomatic. Stopped propanolol and decreased coreg 11/17.23 6. Chronic HFpEF:  TTE 11/10/22 with EF 69%, grade I diastolic dysfunction euvolemic on admit. Discontinued hydrochlorothiazide given elderly age and fall history. Continued remainder of GDMT.  7. Hypernatremia: hydrochlorothiazide discontinued 11/14/23.  8. Hx CVA vs TIA: documented history of two "mini strokes" no residual deficits. Continued home statin  9. IDDM: Per hx, hgb A1c 5.9 on 10/5/23. Glucose levels exacerbated by steroid use. Discharged on home regime. 10. Immunoglobulin deficiency: per hx started on IVIG in 2018, currently on transfusions every 4 weeks. Follows with Dr (allergy/immunology).  11. Asthma: per hx. Not in acute exacerbation. Continued home Spriva, Symbicort, Singulair and albuterol  12. OSA: on bipap nightly, continued while inpatient.  13. HTN: continued home meds.  14. CKD stage 2: baseline creat 1-1.4. creat 1.1 on admit. Stable.  15. History of  DVT: per history. Continued Eliquis  16. History of C1 Fracture: In setting of previous falls. CT C spine without acute fracture on admission.  17. Chronic Pain with opiate dependence: Previously on Ultram. Continued Lyrica. Home tramadol dose decreased as inpatient and pain well controlled. 18. Dysphagia: noted during admission 4/2023. Found to have mild oropharyngeal dysphagia. s/p MBS. Ground, nectar thick liquids per SLP. Has since been advanced to graduated diet. 19. Osteopetrosis: on Prolia outpatient.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Ejection fraction normal, Exposure to SARS-CoV-2, Fall, Glycosylated haemoglobin normal, Hypernatraemia
Clinical narrative: Patient is a 80 y.o. female with a history of HFpEF, DVT on Eliquis, CKD3, OSA, TIA, DM2 5/18-5/25/23 for respirator failure, and mecanical falls. Patient represeted to hospital Observation 11/13/2023 for fall and found to be hypoxic.     1. Acute hypoxic respiratory failure: Found to have O2 sats of 85% at AL facility. Likely in setting of COVID 19. CT PE in ED without PE, showed atelectasis . Initially required 6L in ED, weaned to 1L O2 NC 11/16/23. discharge o2 eval completed prior to discharge and set up if needed. Treatment as below.  2. Covid: With recent exposure in past 7 days with son testing positive. Covid + on admission. Continued Remdesivir (last dose 11/17/23) and Decadron. As needed Duonebs, incentive spirometer. Wean oxygen as able. did not order steroids at discharge with her insulin needs. 3. Mechanical Fall: With history of previous falls. Reported walker rolled away, and patient lost balance and fell. No acute fracture noted on CT C/T/L spine. PT/OT consulted.  4. Acute Metabolic Encephalopathy: Alert and oriented x3, but slower to respond. CT head in ED negative. Likely in setting of COVID and possible polypharmacy. Resolved. 5. Bradycardia: HR in 50s, intermittently dropping into 40s, decreased home coreg 11/16/23. Asymptomatic. Stopped propanolol and decreased coreg 11/17.23 6. Chronic HFpEF:  TTE 11/10/22 with EF 69%, grade I diastolic dysfunction euvolemic on admit. Discontinued hydrochlorothiazide given elderly age and fall history. Continued remainder of GDMT.  7. Hypernatremia: hydrochlorothiazide discontinued 11/14/23.  8. Hx CVA vs TIA: documented history of two "mini strokes" no residual deficits. Continued home statin  9. IDDM: Per hx, hgb A1c 5.9 on 10/5/23. Glucose levels exacerbated by steroid use. Discharged on home regime. 10. Immunoglobulin deficiency: per hx started on IVIG in 2018, currently on transfusions every 4 weeks. Follows with Dr (allergy/immunology).  11. Asthma: per hx. Not in acute exacerbation. Continued home Spriva, Symbicort, Singulair and albuterol  12. OSA: on bipap nightly, continued while inpatient.  13. HTN: continued home meds.  14. CKD stage 2: baseline creat 1-1.4. creat 1.1 on admit. Stable.  15. History of  DVT: per history. Continued Eliquis  16. History of C1 Fracture: In setting of previous falls. CT C spine without acute fracture on admission.  17. Chronic Pain with opiate dependence: Previously on Ultram. Continued Lyrica. Home tramadol dose decreased as inpatient and pain well controlled. 18. Dysphagia: noted during admission 4/2023. Found to have mild oropharyngeal dysphagia. s/p MBS. Ground, nectar thick liquids per SLP. Has since been advanced to graduated diet. 19. Osteopetrosis: on Prolia outpatient.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hyporesponsive to stimuli, Hypoxia, Metabolic encephalopathy, Osteoporosis, Pain
Clinical narrative: Patient is a 80 y.o. female with a history of HFpEF, DVT on Eliquis, CKD3, OSA, TIA, DM2 5/18-5/25/23 for respirator failure, and mecanical falls. Patient represeted to hospital Observation 11/13/2023 for fall and found to be hypoxic.     1. Acute hypoxic respiratory failure: Found to have O2 sats of 85% at AL facility. Likely in setting of COVID 19. CT PE in ED without PE, showed atelectasis . Initially required 6L in ED, weaned to 1L O2 NC 11/16/23. discharge o2 eval completed prior to discharge and set up if needed. Treatment as below.  2. Covid: With recent exposure in past 7 days with son testing positive. Covid + on admission. Continued Remdesivir (last dose 11/17/23) and Decadron. As needed Duonebs, incentive spirometer. Wean oxygen as able. did not order steroids at discharge with her insulin needs. 3. Mechanical Fall: With history of previous falls. Reported walker rolled away, and patient lost balance and fell. No acute fracture noted on CT C/T/L spine. PT/OT consulted.  4. Acute Metabolic Encephalopathy: Alert and oriented x3, but slower to respond. CT head in ED negative. Likely in setting of COVID and possible polypharmacy. Resolved. 5. Bradycardia: HR in 50s, intermittently dropping into 40s, decreased home coreg 11/16/23. Asymptomatic. Stopped propanolol and decreased coreg 11/17.23 6. Chronic HFpEF:  TTE 11/10/22 with EF 69%, grade I diastolic dysfunction euvolemic on admit. Discontinued hydrochlorothiazide given elderly age and fall history. Continued remainder of GDMT.  7. Hypernatremia: hydrochlorothiazide discontinued 11/14/23.  8. Hx CVA vs TIA: documented history of two "mini strokes" no residual deficits. Continued home statin  9. IDDM: Per hx, hgb A1c 5.9 on 10/5/23. Glucose levels exacerbated by steroid use. Discharged on home regime. 10. Immunoglobulin deficiency: per hx started on IVIG in 2018, currently on transfusions every 4 weeks. Follows with Dr (allergy/immunology).  11. Asthma: per hx. Not in acute exacerbation. Continued home Spriva, Symbicort, Singulair and albuterol  12. OSA: on bipap nightly, continued while inpatient.  13. HTN: continued home meds.  14. CKD stage 2: baseline creat 1-1.4. creat 1.1 on admit. Stable.  15. History of  DVT: per history. Continued Eliquis  16. History of C1 Fracture: In setting of previous falls. CT C spine without acute fracture on admission.  17. Chronic Pain with opiate dependence: Previously on Ultram. Continued Lyrica. Home tramadol dose decreased as inpatient and pain well controlled. 18. Dysphagia: noted during admission 4/2023. Found to have mild oropharyngeal dysphagia. s/p MBS. Ground, nectar thick liquids per SLP. Has since been advanced to graduated diet. 19. Osteopetrosis: on Prolia outpatient.
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Walking aid user
Clinical narrative: Patient is a 80 y.o. female with a history of HFpEF, DVT on Eliquis, CKD3, OSA, TIA, DM2 5/18-5/25/23 for respirator failure, and mecanical falls. Patient represeted to hospital Observation 11/13/2023 for fall and found to be hypoxic.     1. Acute hypoxic respiratory failure: Found to have O2 sats of 85% at AL facility. Likely in setting of COVID 19. CT PE in ED without PE, showed atelectasis . Initially required 6L in ED, weaned to 1L O2 NC 11/16/23. discharge o2 eval completed prior to discharge and set up if needed. Treatment as below.  2. Covid: With recent exposure in past 7 days with son testing positive. Covid + on admission. Continued Remdesivir (last dose 11/17/23) and Decadron. As needed Duonebs, incentive spirometer. Wean oxygen as able. did not order steroids at discharge with her insulin needs. 3. Mechanical Fall: With history of previous falls. Reported walker rolled away, and patient lost balance and fell. No acute fracture noted on CT C/T/L spine. PT/OT consulted.  4. Acute Metabolic Encephalopathy: Alert and oriented x3, but slower to respond. CT head in ED negative. Likely in setting of COVID and possible polypharmacy. Resolved. 5. Bradycardia: HR in 50s, intermittently dropping into 40s, decreased home coreg 11/16/23. Asymptomatic. Stopped propanolol and decreased coreg 11/17.23 6. Chronic HFpEF:  TTE 11/10/22 with EF 69%, grade I diastolic dysfunction euvolemic on admit. Discontinued hydrochlorothiazide given elderly age and fall history. Continued remainder of GDMT.  7. Hypernatremia: hydrochlorothiazide discontinued 11/14/23.  8. Hx CVA vs TIA: documented history of two "mini strokes" no residual deficits. Continued home statin  9. IDDM: Per hx, hgb A1c 5.9 on 10/5/23. Glucose levels exacerbated by steroid use. Discharged on home regime. 10. Immunoglobulin deficiency: per hx started on IVIG in 2018, currently on transfusions every 4 weeks. Follows with Dr (allergy/immunology).  11. Asthma: per hx. Not in acute exacerbation. Continued home Spriva, Symbicort, Singulair and albuterol  12. OSA: on bipap nightly, continued while inpatient.  13. HTN: continued home meds.  14. CKD stage 2: baseline creat 1-1.4. creat 1.1 on admit. Stable.  15. History of  DVT: per history. Continued Eliquis  16. History of C1 Fracture: In setting of previous falls. CT C spine without acute fracture on admission.  17. Chronic Pain with opiate dependence: Previously on Ultram. Continued Lyrica. Home tramadol dose decreased as inpatient and pain well controlled. 18. Dysphagia: noted during admission 4/2023. Found to have mild oropharyngeal dysphagia. s/p MBS. Ground, nectar thick liquids per SLP. Has since been advanced to graduated diet. 19. Osteopetrosis: on Prolia outpatient.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: Patient received a invalid dose due to improper to dose preparation using diluent from Merck manufacturer resulting in a lower that authorized dosage administered.
Age: 1.58
Sex: F
Vaccine: HEPA
Symptoms: Circumstance or information capable of leading to medication error, Underdose
Clinical narrative: Patient moved her leg and did not receive full dose
Age: 60.0
Sex: M
Vaccine: TD
Symptoms: Back pain, Chills, Influenza like illness, Myalgia, Nausea
Clinical narrative: Donor stated having severe muscle pain all down the right arm following his last tetanus shot. The pain then moved from his right arm to the entire back. Donor also reported nausea, heavy mucous, chills and severe flu like symptoms without fever.  Donor stated his symptoms started the day after his shot and lasted approximately four days with severe symptoms and 4 days with symptoms tapering off. Donor reported his symptoms approximately 10 days after symptoms had been resolved.
Age: 60.0
Sex: M
Vaccine: TD
Symptoms: Secretion discharge
Clinical narrative: Donor stated having severe muscle pain all down the right arm following his last tetanus shot. The pain then moved from his right arm to the entire back. Donor also reported nausea, heavy mucous, chills and severe flu like symptoms without fever.  Donor stated his symptoms started the day after his shot and lasted approximately four days with severe symptoms and 4 days with symptoms tapering off. Donor reported his symptoms approximately 10 days after symptoms had been resolved.
Age: 82.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site erythema, Injection site pain, Pain, Sleep disorder
Clinical narrative: Has lingering pink dot on skin at site of injection and entire deltoid muscle is "achy" and throbbing at night, interrupting sleep
Age: 15.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness
Clinical narrative: Patient had a vasovagal response and almost passed out.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Angiogram pulmonary abnormal, Blood creatinine increased, Blood culture negative
Clinical narrative: Patient is a 66 y.o. female patient of No, Physician with history renal transplant on immunosuppression, GERD, hypertension who presents now to hospital with fever and shortness of breath. Patient found to have acute respiratory failure from COVID-19.    Covid-19 Pneumonia only, no sepsis Date of onset of symptoms: New symptoms 11/19/23 Symptoms present on admission: Shortness of breath, fever Date of covid positive test: 11/12 Vaccination status: vaccinated Imaging: CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Oxygen requirements on admission: 2 L Current oxygen requirements: Room air Medical therapy: remdesivir, steroids, rocephin, and zithromax Consultants following: pulm Anticipated special isolation end date: 11/30   AKI, improved Cr 1.31 on 11/27; baseline Cr normal Given history or renal transplant, will consult nephrology IVF ordered Cr 1.07 on 11/28  Follow up with nephrology as outpatient  Monitor renal function    GERD  Continue home protonix   Hypertension Continue home amlodipine Monitor BP   S/p renal transplantation Continue home CellCept Prograf Renal function near baseline, monitor while on Remdesivir Aspirin use Takes aspirin to "thin blood while on dialysis" Continue for now, unclear if needs to be continued   Acute respiratory failure with hypoxia, resolved  Likely due to COVID-19 PNA On room air at baseline, requiring 2L on admission CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Azithro/Rocephin started MRSA probe negative Blood cx (11/24) NGTD Urine antigens negative Procalcitonin 65 Weaned to room air (11/25), but pt still feels short of breath with exertion    Hyponatremia, resolved Na 129 on admission Secondary to poor intake, diarrhea Resolved with gentle IVF   Hypokalemia, resolved Hyperkalemia Suspect due to poor oral intake and diarrhea K 3.4 (11/23) on admission Replaced and resolved Now with hyperkalemia, K 5.3 (11/26) Low K diet Lokelma x 1 K 5.1
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium decreased, Blood potassium increased, Blood sodium decreased, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient is a 66 y.o. female patient of No, Physician with history renal transplant on immunosuppression, GERD, hypertension who presents now to hospital with fever and shortness of breath. Patient found to have acute respiratory failure from COVID-19.    Covid-19 Pneumonia only, no sepsis Date of onset of symptoms: New symptoms 11/19/23 Symptoms present on admission: Shortness of breath, fever Date of covid positive test: 11/12 Vaccination status: vaccinated Imaging: CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Oxygen requirements on admission: 2 L Current oxygen requirements: Room air Medical therapy: remdesivir, steroids, rocephin, and zithromax Consultants following: pulm Anticipated special isolation end date: 11/30   AKI, improved Cr 1.31 on 11/27; baseline Cr normal Given history or renal transplant, will consult nephrology IVF ordered Cr 1.07 on 11/28  Follow up with nephrology as outpatient  Monitor renal function    GERD  Continue home protonix   Hypertension Continue home amlodipine Monitor BP   S/p renal transplantation Continue home CellCept Prograf Renal function near baseline, monitor while on Remdesivir Aspirin use Takes aspirin to "thin blood while on dialysis" Continue for now, unclear if needs to be continued   Acute respiratory failure with hypoxia, resolved  Likely due to COVID-19 PNA On room air at baseline, requiring 2L on admission CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Azithro/Rocephin started MRSA probe negative Blood cx (11/24) NGTD Urine antigens negative Procalcitonin 65 Weaned to room air (11/25), but pt still feels short of breath with exertion    Hyponatremia, resolved Na 129 on admission Secondary to poor intake, diarrhea Resolved with gentle IVF   Hypokalemia, resolved Hyperkalemia Suspect due to poor oral intake and diarrhea K 3.4 (11/23) on admission Replaced and resolved Now with hyperkalemia, K 5.3 (11/26) Low K diet Lokelma x 1 K 5.1
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dyspnoea, Dyspnoea exertional, Hyperkalaemia, Hypokalaemia
Clinical narrative: Patient is a 66 y.o. female patient of No, Physician with history renal transplant on immunosuppression, GERD, hypertension who presents now to hospital with fever and shortness of breath. Patient found to have acute respiratory failure from COVID-19.    Covid-19 Pneumonia only, no sepsis Date of onset of symptoms: New symptoms 11/19/23 Symptoms present on admission: Shortness of breath, fever Date of covid positive test: 11/12 Vaccination status: vaccinated Imaging: CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Oxygen requirements on admission: 2 L Current oxygen requirements: Room air Medical therapy: remdesivir, steroids, rocephin, and zithromax Consultants following: pulm Anticipated special isolation end date: 11/30   AKI, improved Cr 1.31 on 11/27; baseline Cr normal Given history or renal transplant, will consult nephrology IVF ordered Cr 1.07 on 11/28  Follow up with nephrology as outpatient  Monitor renal function    GERD  Continue home protonix   Hypertension Continue home amlodipine Monitor BP   S/p renal transplantation Continue home CellCept Prograf Renal function near baseline, monitor while on Remdesivir Aspirin use Takes aspirin to "thin blood while on dialysis" Continue for now, unclear if needs to be continued   Acute respiratory failure with hypoxia, resolved  Likely due to COVID-19 PNA On room air at baseline, requiring 2L on admission CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Azithro/Rocephin started MRSA probe negative Blood cx (11/24) NGTD Urine antigens negative Procalcitonin 65 Weaned to room air (11/25), but pt still feels short of breath with exertion    Hyponatremia, resolved Na 129 on admission Secondary to poor intake, diarrhea Resolved with gentle IVF   Hypokalemia, resolved Hyperkalemia Suspect due to poor oral intake and diarrhea K 3.4 (11/23) on admission Replaced and resolved Now with hyperkalemia, K 5.3 (11/26) Low K diet Lokelma x 1 K 5.1
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Hyponatraemia, Hypophagia, Hypoxia, Lung consolidation, Medical diet
Clinical narrative: Patient is a 66 y.o. female patient of No, Physician with history renal transplant on immunosuppression, GERD, hypertension who presents now to hospital with fever and shortness of breath. Patient found to have acute respiratory failure from COVID-19.    Covid-19 Pneumonia only, no sepsis Date of onset of symptoms: New symptoms 11/19/23 Symptoms present on admission: Shortness of breath, fever Date of covid positive test: 11/12 Vaccination status: vaccinated Imaging: CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Oxygen requirements on admission: 2 L Current oxygen requirements: Room air Medical therapy: remdesivir, steroids, rocephin, and zithromax Consultants following: pulm Anticipated special isolation end date: 11/30   AKI, improved Cr 1.31 on 11/27; baseline Cr normal Given history or renal transplant, will consult nephrology IVF ordered Cr 1.07 on 11/28  Follow up with nephrology as outpatient  Monitor renal function    GERD  Continue home protonix   Hypertension Continue home amlodipine Monitor BP   S/p renal transplantation Continue home CellCept Prograf Renal function near baseline, monitor while on Remdesivir Aspirin use Takes aspirin to "thin blood while on dialysis" Continue for now, unclear if needs to be continued   Acute respiratory failure with hypoxia, resolved  Likely due to COVID-19 PNA On room air at baseline, requiring 2L on admission CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Azithro/Rocephin started MRSA probe negative Blood cx (11/24) NGTD Urine antigens negative Procalcitonin 65 Weaned to room air (11/25), but pt still feels short of breath with exertion    Hyponatremia, resolved Na 129 on admission Secondary to poor intake, diarrhea Resolved with gentle IVF   Hypokalemia, resolved Hyperkalemia Suspect due to poor oral intake and diarrhea K 3.4 (11/23) on admission Replaced and resolved Now with hyperkalemia, K 5.3 (11/26) Low K diet Lokelma x 1 K 5.1
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Procalcitonin, Pyrexia, Renal function test, SARS-CoV-2 test positive, Staphylococcus test negative
Clinical narrative: Patient is a 66 y.o. female patient of No, Physician with history renal transplant on immunosuppression, GERD, hypertension who presents now to hospital with fever and shortness of breath. Patient found to have acute respiratory failure from COVID-19.    Covid-19 Pneumonia only, no sepsis Date of onset of symptoms: New symptoms 11/19/23 Symptoms present on admission: Shortness of breath, fever Date of covid positive test: 11/12 Vaccination status: vaccinated Imaging: CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Oxygen requirements on admission: 2 L Current oxygen requirements: Room air Medical therapy: remdesivir, steroids, rocephin, and zithromax Consultants following: pulm Anticipated special isolation end date: 11/30   AKI, improved Cr 1.31 on 11/27; baseline Cr normal Given history or renal transplant, will consult nephrology IVF ordered Cr 1.07 on 11/28  Follow up with nephrology as outpatient  Monitor renal function    GERD  Continue home protonix   Hypertension Continue home amlodipine Monitor BP   S/p renal transplantation Continue home CellCept Prograf Renal function near baseline, monitor while on Remdesivir Aspirin use Takes aspirin to "thin blood while on dialysis" Continue for now, unclear if needs to be continued   Acute respiratory failure with hypoxia, resolved  Likely due to COVID-19 PNA On room air at baseline, requiring 2L on admission CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Azithro/Rocephin started MRSA probe negative Blood cx (11/24) NGTD Urine antigens negative Procalcitonin 65 Weaned to room air (11/25), but pt still feels short of breath with exertion    Hyponatremia, resolved Na 129 on admission Secondary to poor intake, diarrhea Resolved with gentle IVF   Hypokalemia, resolved Hyperkalemia Suspect due to poor oral intake and diarrhea K 3.4 (11/23) on admission Replaced and resolved Now with hyperkalemia, K 5.3 (11/26) Low K diet Lokelma x 1 K 5.1
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Urine antigen test
Clinical narrative: Patient is a 66 y.o. female patient of No, Physician with history renal transplant on immunosuppression, GERD, hypertension who presents now to hospital with fever and shortness of breath. Patient found to have acute respiratory failure from COVID-19.    Covid-19 Pneumonia only, no sepsis Date of onset of symptoms: New symptoms 11/19/23 Symptoms present on admission: Shortness of breath, fever Date of covid positive test: 11/12 Vaccination status: vaccinated Imaging: CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Oxygen requirements on admission: 2 L Current oxygen requirements: Room air Medical therapy: remdesivir, steroids, rocephin, and zithromax Consultants following: pulm Anticipated special isolation end date: 11/30   AKI, improved Cr 1.31 on 11/27; baseline Cr normal Given history or renal transplant, will consult nephrology IVF ordered Cr 1.07 on 11/28  Follow up with nephrology as outpatient  Monitor renal function    GERD  Continue home protonix   Hypertension Continue home amlodipine Monitor BP   S/p renal transplantation Continue home CellCept Prograf Renal function near baseline, monitor while on Remdesivir Aspirin use Takes aspirin to "thin blood while on dialysis" Continue for now, unclear if needs to be continued   Acute respiratory failure with hypoxia, resolved  Likely due to COVID-19 PNA On room air at baseline, requiring 2L on admission CTPA (11/23) with patchy areas of peripheral consolidation bilaterally Azithro/Rocephin started MRSA probe negative Blood cx (11/24) NGTD Urine antigens negative Procalcitonin 65 Weaned to room air (11/25), but pt still feels short of breath with exertion    Hyponatremia, resolved Na 129 on admission Secondary to poor intake, diarrhea Resolved with gentle IVF   Hypokalemia, resolved Hyperkalemia Suspect due to poor oral intake and diarrhea K 3.4 (11/23) on admission Replaced and resolved Now with hyperkalemia, K 5.3 (11/26) Low K diet Lokelma x 1 K 5.1
Age: 64.0
Sex: M
Vaccine: RSV
Symptoms: Facial pain, Swelling face, Tenderness
Clinical narrative: The patient reported that a few hours after receiving the vaccine, he began to have facial pain, tenderness, and swelling. It occurred only on one side of the face, in the area below the eye. It persisted through the evening, so the patient was seen in an urgent care facility. He was instructed to use OTC pain relievers and to follow up with his primary care physician.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary normal, Blood culture negative, Blood glucose increased, COVID-19
Clinical narrative: Patient is a 66 y.o. female patient of CNP with history of PE, CoPD, Aflutter, hypotension, CAD s/p CABG, Depression, DM II, HTN, Hypothyroidism, esophageal CA, Parkinson's presented to Medical Center with SOB and hypotension  .   Acute hypoxemic respiratory failure d/t viral sepsis 2/2 Covid-19 Virus - resolving Required 5L; baseline on RA however been almost bed-bound recently Uncertain if solely d/t COVID at this time; has HFrEF and chronic hypotension POA with tachycardia, resp failure, WBC 14k(given steroids)  Date of covid positive test: 11/17, vaccinated. Anticipated isolation until 11/27  CTPA unremarkable, BCx NGTD, abx held   Now back to RA, completed course of remdesevir and decadron   Chronic hypotension Recurrent orthostatic syncope Symptoms x few weeks PTA In the setting of RT and Parkinson's  Midodrine resumed; BP stable so far   Esophageal CA dX 7/23 On RT and Chemo final Rad therapy 11/21 per onc   CAD Chronic HFrEF Elevated Trop Remote h/o CABG TTE 11/6 showed EF 30%(was 45% in 7/23) Seen by cardio that time; no invasive procedures given ongoing co morbidities and RT No ACS suspected at this time Cont home ASA, BB(with holding parameters), Statin May need palliative care referral outpatient Her low BP with midodrine recently started precluded Lasix, aldactone, entresto DM II; uncontrolled BG 326; no DKA A1C 12.3 Home PO meds held Cont home Lantus and AC Lispro here SSI added   PSVT Aflutter Currently in NSR Cont home Amio, BB, and Eliquis   Parkinson's Cont Sinemet, aricept TID but takes only daily Resumed prescribed dose   GOC discussion Seen by Palliative recently D/w pt and husband; full code still at this time
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Chemotherapy, Condition aggravated, Dyspnoea, Echocardiogram, Echocardiogram abnormal
Clinical narrative: Patient is a 66 y.o. female patient of CNP with history of PE, CoPD, Aflutter, hypotension, CAD s/p CABG, Depression, DM II, HTN, Hypothyroidism, esophageal CA, Parkinson's presented to Medical Center with SOB and hypotension  .   Acute hypoxemic respiratory failure d/t viral sepsis 2/2 Covid-19 Virus - resolving Required 5L; baseline on RA however been almost bed-bound recently Uncertain if solely d/t COVID at this time; has HFrEF and chronic hypotension POA with tachycardia, resp failure, WBC 14k(given steroids)  Date of covid positive test: 11/17, vaccinated. Anticipated isolation until 11/27  CTPA unremarkable, BCx NGTD, abx held   Now back to RA, completed course of remdesevir and decadron   Chronic hypotension Recurrent orthostatic syncope Symptoms x few weeks PTA In the setting of RT and Parkinson's  Midodrine resumed; BP stable so far   Esophageal CA dX 7/23 On RT and Chemo final Rad therapy 11/21 per onc   CAD Chronic HFrEF Elevated Trop Remote h/o CABG TTE 11/6 showed EF 30%(was 45% in 7/23) Seen by cardio that time; no invasive procedures given ongoing co morbidities and RT No ACS suspected at this time Cont home ASA, BB(with holding parameters), Statin May need palliative care referral outpatient Her low BP with midodrine recently started precluded Lasix, aldactone, entresto DM II; uncontrolled BG 326; no DKA A1C 12.3 Home PO meds held Cont home Lantus and AC Lispro here SSI added   PSVT Aflutter Currently in NSR Cont home Amio, BB, and Eliquis   Parkinson's Cont Sinemet, aricept TID but takes only daily Resumed prescribed dose   GOC discussion Seen by Palliative recently D/w pt and husband; full code still at this time
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Ejection fraction decreased, Glycosylated haemoglobin increased, Hypotension, Left ventricular failure, Oesophageal carcinoma
Clinical narrative: Patient is a 66 y.o. female patient of CNP with history of PE, CoPD, Aflutter, hypotension, CAD s/p CABG, Depression, DM II, HTN, Hypothyroidism, esophageal CA, Parkinson's presented to Medical Center with SOB and hypotension  .   Acute hypoxemic respiratory failure d/t viral sepsis 2/2 Covid-19 Virus - resolving Required 5L; baseline on RA however been almost bed-bound recently Uncertain if solely d/t COVID at this time; has HFrEF and chronic hypotension POA with tachycardia, resp failure, WBC 14k(given steroids)  Date of covid positive test: 11/17, vaccinated. Anticipated isolation until 11/27  CTPA unremarkable, BCx NGTD, abx held   Now back to RA, completed course of remdesevir and decadron   Chronic hypotension Recurrent orthostatic syncope Symptoms x few weeks PTA In the setting of RT and Parkinson's  Midodrine resumed; BP stable so far   Esophageal CA dX 7/23 On RT and Chemo final Rad therapy 11/21 per onc   CAD Chronic HFrEF Elevated Trop Remote h/o CABG TTE 11/6 showed EF 30%(was 45% in 7/23) Seen by cardio that time; no invasive procedures given ongoing co morbidities and RT No ACS suspected at this time Cont home ASA, BB(with holding parameters), Statin May need palliative care referral outpatient Her low BP with midodrine recently started precluded Lasix, aldactone, entresto DM II; uncontrolled BG 326; no DKA A1C 12.3 Home PO meds held Cont home Lantus and AC Lispro here SSI added   PSVT Aflutter Currently in NSR Cont home Amio, BB, and Eliquis   Parkinson's Cont Sinemet, aricept TID but takes only daily Resumed prescribed dose   GOC discussion Seen by Palliative recently D/w pt and husband; full code still at this time
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Radiotherapy, SARS-CoV-2 test positive, Sinus rhythm, Syncope, Tachycardia
Clinical narrative: Patient is a 66 y.o. female patient of CNP with history of PE, CoPD, Aflutter, hypotension, CAD s/p CABG, Depression, DM II, HTN, Hypothyroidism, esophageal CA, Parkinson's presented to Medical Center with SOB and hypotension  .   Acute hypoxemic respiratory failure d/t viral sepsis 2/2 Covid-19 Virus - resolving Required 5L; baseline on RA however been almost bed-bound recently Uncertain if solely d/t COVID at this time; has HFrEF and chronic hypotension POA with tachycardia, resp failure, WBC 14k(given steroids)  Date of covid positive test: 11/17, vaccinated. Anticipated isolation until 11/27  CTPA unremarkable, BCx NGTD, abx held   Now back to RA, completed course of remdesevir and decadron   Chronic hypotension Recurrent orthostatic syncope Symptoms x few weeks PTA In the setting of RT and Parkinson's  Midodrine resumed; BP stable so far   Esophageal CA dX 7/23 On RT and Chemo final Rad therapy 11/21 per onc   CAD Chronic HFrEF Elevated Trop Remote h/o CABG TTE 11/6 showed EF 30%(was 45% in 7/23) Seen by cardio that time; no invasive procedures given ongoing co morbidities and RT No ACS suspected at this time Cont home ASA, BB(with holding parameters), Statin May need palliative care referral outpatient Her low BP with midodrine recently started precluded Lasix, aldactone, entresto DM II; uncontrolled BG 326; no DKA A1C 12.3 Home PO meds held Cont home Lantus and AC Lispro here SSI added   PSVT Aflutter Currently in NSR Cont home Amio, BB, and Eliquis   Parkinson's Cont Sinemet, aricept TID but takes only daily Resumed prescribed dose   GOC discussion Seen by Palliative recently D/w pt and husband; full code still at this time
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Viral sepsis, White blood cell count increased
Clinical narrative: Patient is a 66 y.o. female patient of CNP with history of PE, CoPD, Aflutter, hypotension, CAD s/p CABG, Depression, DM II, HTN, Hypothyroidism, esophageal CA, Parkinson's presented to Medical Center with SOB and hypotension  .   Acute hypoxemic respiratory failure d/t viral sepsis 2/2 Covid-19 Virus - resolving Required 5L; baseline on RA however been almost bed-bound recently Uncertain if solely d/t COVID at this time; has HFrEF and chronic hypotension POA with tachycardia, resp failure, WBC 14k(given steroids)  Date of covid positive test: 11/17, vaccinated. Anticipated isolation until 11/27  CTPA unremarkable, BCx NGTD, abx held   Now back to RA, completed course of remdesevir and decadron   Chronic hypotension Recurrent orthostatic syncope Symptoms x few weeks PTA In the setting of RT and Parkinson's  Midodrine resumed; BP stable so far   Esophageal CA dX 7/23 On RT and Chemo final Rad therapy 11/21 per onc   CAD Chronic HFrEF Elevated Trop Remote h/o CABG TTE 11/6 showed EF 30%(was 45% in 7/23) Seen by cardio that time; no invasive procedures given ongoing co morbidities and RT No ACS suspected at this time Cont home ASA, BB(with holding parameters), Statin May need palliative care referral outpatient Her low BP with midodrine recently started precluded Lasix, aldactone, entresto DM II; uncontrolled BG 326; no DKA A1C 12.3 Home PO meds held Cont home Lantus and AC Lispro here SSI added   PSVT Aflutter Currently in NSR Cont home Amio, BB, and Eliquis   Parkinson's Cont Sinemet, aricept TID but takes only daily Resumed prescribed dose   GOC discussion Seen by Palliative recently D/w pt and husband; full code still at this time
Age: 52.0
Sex: F
Vaccine: VARZOS, VARZOS
Symptoms: Unevaluable event
Clinical narrative: Vaccine Refridgerated