chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Chest pain, Computerised tomogram thorax normal, Condition aggravated
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Confusional state, Cough, Death, Diuretic therapy, Dyspnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram abnormal, Exposure to SARS-CoV-2, Fatigue
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Glycosylated haemoglobin normal, Hypoxia, Left ventricular failure, Loss of personal independence in daily activities, Lung opacity
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Oedema peripheral, Orthopnoea, Oxygen saturation decreased, Pleural effusion, Prohormone brain natriuretic peptide increased
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Renal impairment, Respiratory symptom, SARS-CoV-2 test positive, Sinus rhythm, Tachypnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Troponin increased, Ultrasound Doppler normal, Wheezing
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 57.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Extra dose administered
Clinical narrative: Patient received 2 flu shots. She had already received a flu shot at another location.  No issues at time patient left.
Age: 22.0
Sex: F
Vaccine: MMR
Symptoms: Chills, Erythema, Headache, Rash, Rash pruritic
Clinical narrative: Patient reported her "skin is on fire", she said it "feels like a really bad sunburn".  She reported a headache, vomiting, chills, redness on the back of her neck and bilateral legs as well as small red/ itchy bumps on her back and neck.
Age: 22.0
Sex: F
Vaccine: MMR
Symptoms: Skin burning sensation, Vomiting
Clinical narrative: Patient reported her "skin is on fire", she said it "feels like a really bad sunburn".  She reported a headache, vomiting, chills, redness on the back of her neck and bilateral legs as well as small red/ itchy bumps on her back and neck.
Age: 17.0
Sex: M
Vaccine: FLU4
Symptoms: Incorrect route of product administration
Clinical narrative: Medication given wrong route. Given intranasel. Person was given correct vaccine, correct route 10/27/22
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Abdominal discomfort, Diarrhoea, Nausea
Clinical narrative: severe diarrhea,gastric discomfort,mild nausea
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary normal, Asthenia, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/21/2022  PRESENTING PROBLEM: Hypoxia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE: The patient is a 89 y.o. male with PMHx of metastatic prostate cancer and HTN who presents today with malaise. Patient is accompanied by his wife and son at bedside. He has been vaccinated and boosted for COVID, last in 4/4/2022. He spent time with family over the weekend and two of them tested positive for COVID on 10/18. He took a home COVID test and was negative. He had a sore throat but otherwise felt fine. On the morning of presentation, he spiked a fever 102.5F and was feeling very weak, lethargic and became nauseated and dizzy with movement. He developed coughing but no shortness of breath. No diarrhea, myalgias, rashes or poor appetite. He took his regularly prescribed medications but nothing else. His wife initially called his PCP office to arrange for Paxlovid but was advised to call an ambulance. She called EMS and patient was brought to ED.   In the ED he was febrile, tachypneic with normal O2sats on room air but he became hypoxemic with activity 88 percent. Labs with normocytic anemia, normal WBC count and platelets, CMP with hypoalbuminemia. UA negative for infection, COVID-19 PCR positive. CXR with moderate left greater than right patchy airspace densities concerning for multifocal PNA and mild bilateral pleural effusions. He was given tylenol, ibuprofen and a liter of normal saline and was admitted for further evaluation.    He was continued on IV remdesivir.  He was started on Decadron due to episodes of hypoxia was sleeping.  CT angiogram thorax was negative for PE.  He felt improved enough to go home.  He was evaluated by pulmonary rehab and did not require supplemental oxygen.  He was range of home care.  He was enrolled in a transition to home program.  He was instructed to hold home prednisone until completion of Decadron then resume taking prednisone.  He should follow up with his PCP as an outpatient.  He was discharged home in stable condition on 10/21/2022.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Dizziness postural, Exposure to SARS-CoV-2, Hypoalbuminaemia, Hypoxia
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/21/2022  PRESENTING PROBLEM: Hypoxia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE: The patient is a 89 y.o. male with PMHx of metastatic prostate cancer and HTN who presents today with malaise. Patient is accompanied by his wife and son at bedside. He has been vaccinated and boosted for COVID, last in 4/4/2022. He spent time with family over the weekend and two of them tested positive for COVID on 10/18. He took a home COVID test and was negative. He had a sore throat but otherwise felt fine. On the morning of presentation, he spiked a fever 102.5F and was feeling very weak, lethargic and became nauseated and dizzy with movement. He developed coughing but no shortness of breath. No diarrhea, myalgias, rashes or poor appetite. He took his regularly prescribed medications but nothing else. His wife initially called his PCP office to arrange for Paxlovid but was advised to call an ambulance. She called EMS and patient was brought to ED.   In the ED he was febrile, tachypneic with normal O2sats on room air but he became hypoxemic with activity 88 percent. Labs with normocytic anemia, normal WBC count and platelets, CMP with hypoalbuminemia. UA negative for infection, COVID-19 PCR positive. CXR with moderate left greater than right patchy airspace densities concerning for multifocal PNA and mild bilateral pleural effusions. He was given tylenol, ibuprofen and a liter of normal saline and was admitted for further evaluation.    He was continued on IV remdesivir.  He was started on Decadron due to episodes of hypoxia was sleeping.  CT angiogram thorax was negative for PE.  He felt improved enough to go home.  He was evaluated by pulmonary rehab and did not require supplemental oxygen.  He was range of home care.  He was enrolled in a transition to home program.  He was instructed to hold home prednisone until completion of Decadron then resume taking prednisone.  He should follow up with his PCP as an outpatient.  He was discharged home in stable condition on 10/21/2022.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test abnormal, Lethargy, Lung disorder, Malaise, Metabolic function test abnormal
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/21/2022  PRESENTING PROBLEM: Hypoxia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE: The patient is a 89 y.o. male with PMHx of metastatic prostate cancer and HTN who presents today with malaise. Patient is accompanied by his wife and son at bedside. He has been vaccinated and boosted for COVID, last in 4/4/2022. He spent time with family over the weekend and two of them tested positive for COVID on 10/18. He took a home COVID test and was negative. He had a sore throat but otherwise felt fine. On the morning of presentation, he spiked a fever 102.5F and was feeling very weak, lethargic and became nauseated and dizzy with movement. He developed coughing but no shortness of breath. No diarrhea, myalgias, rashes or poor appetite. He took his regularly prescribed medications but nothing else. His wife initially called his PCP office to arrange for Paxlovid but was advised to call an ambulance. She called EMS and patient was brought to ED.   In the ED he was febrile, tachypneic with normal O2sats on room air but he became hypoxemic with activity 88 percent. Labs with normocytic anemia, normal WBC count and platelets, CMP with hypoalbuminemia. UA negative for infection, COVID-19 PCR positive. CXR with moderate left greater than right patchy airspace densities concerning for multifocal PNA and mild bilateral pleural effusions. He was given tylenol, ibuprofen and a liter of normal saline and was admitted for further evaluation.    He was continued on IV remdesivir.  He was started on Decadron due to episodes of hypoxia was sleeping.  CT angiogram thorax was negative for PE.  He felt improved enough to go home.  He was evaluated by pulmonary rehab and did not require supplemental oxygen.  He was range of home care.  He was enrolled in a transition to home program.  He was instructed to hold home prednisone until completion of Decadron then resume taking prednisone.  He should follow up with his PCP as an outpatient.  He was discharged home in stable condition on 10/21/2022.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Normocytic anaemia, Oropharyngeal pain, Platelet count normal, Pyrexia
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/21/2022  PRESENTING PROBLEM: Hypoxia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE: The patient is a 89 y.o. male with PMHx of metastatic prostate cancer and HTN who presents today with malaise. Patient is accompanied by his wife and son at bedside. He has been vaccinated and boosted for COVID, last in 4/4/2022. He spent time with family over the weekend and two of them tested positive for COVID on 10/18. He took a home COVID test and was negative. He had a sore throat but otherwise felt fine. On the morning of presentation, he spiked a fever 102.5F and was feeling very weak, lethargic and became nauseated and dizzy with movement. He developed coughing but no shortness of breath. No diarrhea, myalgias, rashes or poor appetite. He took his regularly prescribed medications but nothing else. His wife initially called his PCP office to arrange for Paxlovid but was advised to call an ambulance. She called EMS and patient was brought to ED.   In the ED he was febrile, tachypneic with normal O2sats on room air but he became hypoxemic with activity 88 percent. Labs with normocytic anemia, normal WBC count and platelets, CMP with hypoalbuminemia. UA negative for infection, COVID-19 PCR positive. CXR with moderate left greater than right patchy airspace densities concerning for multifocal PNA and mild bilateral pleural effusions. He was given tylenol, ibuprofen and a liter of normal saline and was admitted for further evaluation.    He was continued on IV remdesivir.  He was started on Decadron due to episodes of hypoxia was sleeping.  CT angiogram thorax was negative for PE.  He felt improved enough to go home.  He was evaluated by pulmonary rehab and did not require supplemental oxygen.  He was range of home care.  He was enrolled in a transition to home program.  He was instructed to hold home prednisone until completion of Decadron then resume taking prednisone.  He should follow up with his PCP as an outpatient.  He was discharged home in stable condition on 10/21/2022.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Tachypnoea, Urine analysis normal, White blood cell count normal
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/21/2022  PRESENTING PROBLEM: Hypoxia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE: The patient is a 89 y.o. male with PMHx of metastatic prostate cancer and HTN who presents today with malaise. Patient is accompanied by his wife and son at bedside. He has been vaccinated and boosted for COVID, last in 4/4/2022. He spent time with family over the weekend and two of them tested positive for COVID on 10/18. He took a home COVID test and was negative. He had a sore throat but otherwise felt fine. On the morning of presentation, he spiked a fever 102.5F and was feeling very weak, lethargic and became nauseated and dizzy with movement. He developed coughing but no shortness of breath. No diarrhea, myalgias, rashes or poor appetite. He took his regularly prescribed medications but nothing else. His wife initially called his PCP office to arrange for Paxlovid but was advised to call an ambulance. She called EMS and patient was brought to ED.   In the ED he was febrile, tachypneic with normal O2sats on room air but he became hypoxemic with activity 88 percent. Labs with normocytic anemia, normal WBC count and platelets, CMP with hypoalbuminemia. UA negative for infection, COVID-19 PCR positive. CXR with moderate left greater than right patchy airspace densities concerning for multifocal PNA and mild bilateral pleural effusions. He was given tylenol, ibuprofen and a liter of normal saline and was admitted for further evaluation.    He was continued on IV remdesivir.  He was started on Decadron due to episodes of hypoxia was sleeping.  CT angiogram thorax was negative for PE.  He felt improved enough to go home.  He was evaluated by pulmonary rehab and did not require supplemental oxygen.  He was range of home care.  He was enrolled in a transition to home program.  He was instructed to hold home prednisone until completion of Decadron then resume taking prednisone.  He should follow up with his PCP as an outpatient.  He was discharged home in stable condition on 10/21/2022.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event
Clinical narrative: No adverse event, signs or symptoms of any issues. Only corresponding to email received.
Age: 36.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Patient received second dose early.  First dose administered on 8/23/22  and second dose administered on 9/13/22.  Patient notified of error at time of administration.
Age: 14.0
Sex: M
Vaccine: COVID19-2, FLU4, HPV9, TDAP
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient given Pfizer Bivalent booster when patient should have been given Pfizer monovalent/primary series dose.
Age: 16.0
Sex: F
Vaccine: FLU4
Symptoms: Incorrect route of product administration
Clinical narrative: Vaccine was given incorrect route. Patient was brought back for correct vaccine and correct route on 10/26/2022
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Deafness, Dyspnoea, Pulmonary congestion
Clinical narrative: On 9/25/2022, I had a cough, chest congestion, and sinus congestion, runny nose, and some trouble breathing. On 9/25/2022, I took a COVID-19 home test and it was positive. I gave it 3 weeks to run its course. After 3 weeks I was not better. I continued to have the same symptoms. Around 10/12/2022, I went to see my doctor. I have a history of pneumonia. I did not have pneumonia yet, so the doctor prescribed an antibiotic and a steroid, prednisone. It's started to see improvement in about a week. As of today, 10/28/22 I still have congestion, lots of mucous, a little bit of hearing loss, but no loss of taste and smell.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Secretion discharge, Sinus congestion
Clinical narrative: On 9/25/2022, I had a cough, chest congestion, and sinus congestion, runny nose, and some trouble breathing. On 9/25/2022, I took a COVID-19 home test and it was positive. I gave it 3 weeks to run its course. After 3 weeks I was not better. I continued to have the same symptoms. Around 10/12/2022, I went to see my doctor. I have a history of pneumonia. I did not have pneumonia yet, so the doctor prescribed an antibiotic and a steroid, prednisone. It's started to see improvement in about a week. As of today, 10/28/22 I still have congestion, lots of mucous, a little bit of hearing loss, but no loss of taste and smell.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood bilirubin increased, Blood creatinine increased, Blood culture
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/25/2022   Clinical Narrative: Patient is a 86 y.o. female who presents today with weakness, malaise, poor oral intake. She has PMH of bladder cancer/urostomy, untreated right renal mass, coronary artery disease, hypertension, legal blindness, hypertension. She had Covid 5 weeks ago and feels she just had not gotten better since.    In the ED, she was hemodynamically stable, though EMS had given a liter of saline enroute for hypotension into the 90's. Urine was grossly infected. Labs revealed an AKI with creatinine 2.20, GFR 21, elevated bilirubin 1.7, leukocytosis 15,000, lactate 2.6,  13 bands. She was given Zosyn after blood/urine cultures obtained. CT abd/pelvis obtained, which showed mod-severe right hydroureternephrosis, and left renal mass. She requires admission for treatment of severe sepsis due to UTI and AKI.    Urine cultures grew Klebsiella pneumoniae and antibiotics were changed to Rocephin until discharge.  The obstruction of the right kidney was due to the mass, and per discussion with Urology there was not an ability to relieve this obstruction.  Doctor offered placement of a nephrostomy tube for drainage of the kidney but this was declined, and the patient a instead elected to have hospice referral, and to change to comfort care measures at home.  By discharge she was feeling much better without significant kidney pain.  Her vitals were stable and her renal function had normalized.   Medication changes at discharge are as follows: 1. Cefuroxime (Ceftin) 500 mg once daily for 14 days. This is an antibiotic to complete treatment of the kidney infection. 2. Discontinue taking atenolol (Tenormin) as it no longer appears needed for blood pressure control. 3. Discontinue aspirin as it can cause bleeding from the tumors in the kidney. 4. Discontinue atorvastatin (Lipitor) as you no longer need a cholesterol medication in the setting of cancer. 5. Discontinue ibuprofen as it also can cause bleeding and can cause worse kidney function. 6. Increased oxycodone 5 mg to up to 3 times daily if needed for pain control. 7. Discontinue iron supplement, as it can cause constipation especially if taking pain medications.   There was a hospice informational meeting the patient and her son prior to discharge. The patient is discharged under the care of her son as her her caregiver, with plans to follow and sign up with Hospice as an outpatient after returning home.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Blood lactic acid decreased, COVID-19, Computerised tomogram abdomen abnormal, Culture urine positive, Glomerular filtration rate decreased
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/25/2022   Clinical Narrative: Patient is a 86 y.o. female who presents today with weakness, malaise, poor oral intake. She has PMH of bladder cancer/urostomy, untreated right renal mass, coronary artery disease, hypertension, legal blindness, hypertension. She had Covid 5 weeks ago and feels she just had not gotten better since.    In the ED, she was hemodynamically stable, though EMS had given a liter of saline enroute for hypotension into the 90's. Urine was grossly infected. Labs revealed an AKI with creatinine 2.20, GFR 21, elevated bilirubin 1.7, leukocytosis 15,000, lactate 2.6,  13 bands. She was given Zosyn after blood/urine cultures obtained. CT abd/pelvis obtained, which showed mod-severe right hydroureternephrosis, and left renal mass. She requires admission for treatment of severe sepsis due to UTI and AKI.    Urine cultures grew Klebsiella pneumoniae and antibiotics were changed to Rocephin until discharge.  The obstruction of the right kidney was due to the mass, and per discussion with Urology there was not an ability to relieve this obstruction.  Doctor offered placement of a nephrostomy tube for drainage of the kidney but this was declined, and the patient a instead elected to have hospice referral, and to change to comfort care measures at home.  By discharge she was feeling much better without significant kidney pain.  Her vitals were stable and her renal function had normalized.   Medication changes at discharge are as follows: 1. Cefuroxime (Ceftin) 500 mg once daily for 14 days. This is an antibiotic to complete treatment of the kidney infection. 2. Discontinue taking atenolol (Tenormin) as it no longer appears needed for blood pressure control. 3. Discontinue aspirin as it can cause bleeding from the tumors in the kidney. 4. Discontinue atorvastatin (Lipitor) as you no longer need a cholesterol medication in the setting of cancer. 5. Discontinue ibuprofen as it also can cause bleeding and can cause worse kidney function. 6. Increased oxycodone 5 mg to up to 3 times daily if needed for pain control. 7. Discontinue iron supplement, as it can cause constipation especially if taking pain medications.   There was a hospice informational meeting the patient and her son prior to discharge. The patient is discharged under the care of her son as her her caregiver, with plans to follow and sign up with Hospice as an outpatient after returning home.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Hydronephrosis, Hydroureter, Hypophagia, Hypotension, Klebsiella test positive
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/25/2022   Clinical Narrative: Patient is a 86 y.o. female who presents today with weakness, malaise, poor oral intake. She has PMH of bladder cancer/urostomy, untreated right renal mass, coronary artery disease, hypertension, legal blindness, hypertension. She had Covid 5 weeks ago and feels she just had not gotten better since.    In the ED, she was hemodynamically stable, though EMS had given a liter of saline enroute for hypotension into the 90's. Urine was grossly infected. Labs revealed an AKI with creatinine 2.20, GFR 21, elevated bilirubin 1.7, leukocytosis 15,000, lactate 2.6,  13 bands. She was given Zosyn after blood/urine cultures obtained. CT abd/pelvis obtained, which showed mod-severe right hydroureternephrosis, and left renal mass. She requires admission for treatment of severe sepsis due to UTI and AKI.    Urine cultures grew Klebsiella pneumoniae and antibiotics were changed to Rocephin until discharge.  The obstruction of the right kidney was due to the mass, and per discussion with Urology there was not an ability to relieve this obstruction.  Doctor offered placement of a nephrostomy tube for drainage of the kidney but this was declined, and the patient a instead elected to have hospice referral, and to change to comfort care measures at home.  By discharge she was feeling much better without significant kidney pain.  Her vitals were stable and her renal function had normalized.   Medication changes at discharge are as follows: 1. Cefuroxime (Ceftin) 500 mg once daily for 14 days. This is an antibiotic to complete treatment of the kidney infection. 2. Discontinue taking atenolol (Tenormin) as it no longer appears needed for blood pressure control. 3. Discontinue aspirin as it can cause bleeding from the tumors in the kidney. 4. Discontinue atorvastatin (Lipitor) as you no longer need a cholesterol medication in the setting of cancer. 5. Discontinue ibuprofen as it also can cause bleeding and can cause worse kidney function. 6. Increased oxycodone 5 mg to up to 3 times daily if needed for pain control. 7. Discontinue iron supplement, as it can cause constipation especially if taking pain medications.   There was a hospice informational meeting the patient and her son prior to discharge. The patient is discharged under the care of her son as her her caregiver, with plans to follow and sign up with Hospice as an outpatient after returning home.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Leukocytosis, Malaise, Renal impairment, Renal mass, Sepsis
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/25/2022   Clinical Narrative: Patient is a 86 y.o. female who presents today with weakness, malaise, poor oral intake. She has PMH of bladder cancer/urostomy, untreated right renal mass, coronary artery disease, hypertension, legal blindness, hypertension. She had Covid 5 weeks ago and feels she just had not gotten better since.    In the ED, she was hemodynamically stable, though EMS had given a liter of saline enroute for hypotension into the 90's. Urine was grossly infected. Labs revealed an AKI with creatinine 2.20, GFR 21, elevated bilirubin 1.7, leukocytosis 15,000, lactate 2.6,  13 bands. She was given Zosyn after blood/urine cultures obtained. CT abd/pelvis obtained, which showed mod-severe right hydroureternephrosis, and left renal mass. She requires admission for treatment of severe sepsis due to UTI and AKI.    Urine cultures grew Klebsiella pneumoniae and antibiotics were changed to Rocephin until discharge.  The obstruction of the right kidney was due to the mass, and per discussion with Urology there was not an ability to relieve this obstruction.  Doctor offered placement of a nephrostomy tube for drainage of the kidney but this was declined, and the patient a instead elected to have hospice referral, and to change to comfort care measures at home.  By discharge she was feeling much better without significant kidney pain.  Her vitals were stable and her renal function had normalized.   Medication changes at discharge are as follows: 1. Cefuroxime (Ceftin) 500 mg once daily for 14 days. This is an antibiotic to complete treatment of the kidney infection. 2. Discontinue taking atenolol (Tenormin) as it no longer appears needed for blood pressure control. 3. Discontinue aspirin as it can cause bleeding from the tumors in the kidney. 4. Discontinue atorvastatin (Lipitor) as you no longer need a cholesterol medication in the setting of cancer. 5. Discontinue ibuprofen as it also can cause bleeding and can cause worse kidney function. 6. Increased oxycodone 5 mg to up to 3 times daily if needed for pain control. 7. Discontinue iron supplement, as it can cause constipation especially if taking pain medications.   There was a hospice informational meeting the patient and her son prior to discharge. The patient is discharged under the care of her son as her her caregiver, with plans to follow and sign up with Hospice as an outpatient after returning home.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection, White blood cell count increased
Clinical narrative: Admission Date: 10/19/2022 Discharge Date: 10/25/2022   Clinical Narrative: Patient is a 86 y.o. female who presents today with weakness, malaise, poor oral intake. She has PMH of bladder cancer/urostomy, untreated right renal mass, coronary artery disease, hypertension, legal blindness, hypertension. She had Covid 5 weeks ago and feels she just had not gotten better since.    In the ED, she was hemodynamically stable, though EMS had given a liter of saline enroute for hypotension into the 90's. Urine was grossly infected. Labs revealed an AKI with creatinine 2.20, GFR 21, elevated bilirubin 1.7, leukocytosis 15,000, lactate 2.6,  13 bands. She was given Zosyn after blood/urine cultures obtained. CT abd/pelvis obtained, which showed mod-severe right hydroureternephrosis, and left renal mass. She requires admission for treatment of severe sepsis due to UTI and AKI.    Urine cultures grew Klebsiella pneumoniae and antibiotics were changed to Rocephin until discharge.  The obstruction of the right kidney was due to the mass, and per discussion with Urology there was not an ability to relieve this obstruction.  Doctor offered placement of a nephrostomy tube for drainage of the kidney but this was declined, and the patient a instead elected to have hospice referral, and to change to comfort care measures at home.  By discharge she was feeling much better without significant kidney pain.  Her vitals were stable and her renal function had normalized.   Medication changes at discharge are as follows: 1. Cefuroxime (Ceftin) 500 mg once daily for 14 days. This is an antibiotic to complete treatment of the kidney infection. 2. Discontinue taking atenolol (Tenormin) as it no longer appears needed for blood pressure control. 3. Discontinue aspirin as it can cause bleeding from the tumors in the kidney. 4. Discontinue atorvastatin (Lipitor) as you no longer need a cholesterol medication in the setting of cancer. 5. Discontinue ibuprofen as it also can cause bleeding and can cause worse kidney function. 6. Increased oxycodone 5 mg to up to 3 times daily if needed for pain control. 7. Discontinue iron supplement, as it can cause constipation especially if taking pain medications.   There was a hospice informational meeting the patient and her son prior to discharge. The patient is discharged under the care of her son as her her caregiver, with plans to follow and sign up with Hospice as an outpatient after returning home.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Disturbance in attention, Fatigue, Night sweats
Clinical narrative: I was feeling really tired and couldn't focus on anything. I had developed a cough and night sweats, so I tested myself for COVID-19 and tested positive on August 31, 2022 and was prescribed PAXLOVID. My symptoms went away after about a week and I had tested negative but then I started getting a cough around September 13,2022 and tested positive for COVID-19 again. I felt worse the second time around and had to call my doctor for more meds. I still have to use a inhaler because I start wheezing.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Wheezing
Clinical narrative: I was feeling really tired and couldn't focus on anything. I had developed a cough and night sweats, so I tested myself for COVID-19 and tested positive on August 31, 2022 and was prescribed PAXLOVID. My symptoms went away after about a week and I had tested negative but then I started getting a cough around September 13,2022 and tested positive for COVID-19 again. I felt worse the second time around and had to call my doctor for more meds. I still have to use a inhaler because I start wheezing.