chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent Booster
Age: 54.0
Sex: F
Vaccine: UNK
Symptoms: Blood urine
Clinical narrative: Blood tinged urine  No treatment at this time. Scheduled appt with PCP
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Colonoscopy abnormal, Diverticulitis, Endoscopy abnormal, Gastritis, Inflammation
Clinical narrative: I was constantly going to the bathroom and having rectal bleeding. I called my doctor and they referred me to a GI specialist and had 2 colonoscopy and endoscopy and was diagnosed with Ulcerative Proctitis. I went back to my doctor, and they put me on Humira because I had inflammation and rectal bleeding. So, now I have been seeing a GI doctor, and seeing a Rheumatologist. I seem to be getting better now, but I was really concerned at first. I thought I was dying.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Proctitis ulcerative, Rectal haemorrhage
Clinical narrative: I was constantly going to the bathroom and having rectal bleeding. I called my doctor and they referred me to a GI specialist and had 2 colonoscopy and endoscopy and was diagnosed with Ulcerative Proctitis. I went back to my doctor, and they put me on Humira because I had inflammation and rectal bleeding. So, now I have been seeing a GI doctor, and seeing a Rheumatologist. I seem to be getting better now, but I was really concerned at first. I thought I was dying.
Age: 60.0
Sex: F
Vaccine: COVID19-2
Symptoms: Insomnia
Clinical narrative: Ongoing insomnia
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Received previous booster monovalent vaccine instead of the new bivalent booster, no adverse reaction noted the first 15 min of observation.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent booster
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient received Monovalent instead of Bivalent booster
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Anaemia, Anticoagulant therapy, Bloody discharge, COVID-19
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Chronic left ventricular failure, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Condition aggravated, Dyspnoea, Endotracheal intubation, Extubation, Gastrointestinal haemorrhage
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Gastrointestinal tube insertion, Gastrointestinal tube removal, Haemoglobin decreased, Hypercapnia, Injury
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Intensive care, Mechanical ventilation, Oedema, Oxygen saturation decreased, Pleural effusion
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Polyuria, Positive airway pressure therapy, Product use issue, Pulmonary congestion, Pulmonary oedema
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Treatment failure, Treatment noncompliance, Ulcer
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Blood gases abnormal, Blood pH decreased, COVID-19, Cardiac failure acute
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cardiac failure congestive, Chronic obstructive pulmonary disease, Condition aggravated, Confusional state, Endotracheal intubation
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Extubation, Intensive care, Mental status changes, PCO2 increased, Positive airway pressure therapy
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pulmonary mass, Respiratory failure, SARS-CoV-2 test positive, Somnolence, Splenectomy
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Treatment noncompliance
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Anaemia, Blood bicarbonate increased, Blood gases, Blood pH decreased
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, Cardiac failure, Cardiac failure acute, Cardiac failure congestive
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Echocardiogram, Ejection fraction normal, Endotracheal intubation, Fatigue, Fraction of inspired oxygen
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hypertension, Influenza virus test negative, Intensive care, Laboratory test, Left ventricular failure
Clinical narrative: Discharge Provider: DO Primary Care Provider at Discharge:  MD Admission Date: 10/4/2022 Discharge Date: 10/14/2022  HOSPITAL COURSE: Patient is a 78 y.o. female who presented to hospital with acute on chronic hypoxic and hypercapnic respiratory failure secondary to COPD exacerbation in the setting of acute Covid-19 infection.   COPD Exacerbation: Arrived by EMS following 3 days of increasing shortness of breath after running out of inhaler. Was found by EMS to have oxygen saturations 77% on her home oxygen. Was noted to be hypoxic and hypercapnic in ED. Attempts to improve respirations with BiPAP were unsuccessful so patient was intubated.  CXR with findings of cardiomegaly and vascular congestion. Was started on IV steroids, DuoNebs, Symbicort. Patient remained on vent for 24hrs and was successfully extubated 10/5/2022 and transferred out of ICU. Oxygen was weaned down to baseline 3.5L. Experienced a couple of night time desaturations and CO2 retention due to not wearing BiPAP when sleeping. Overnight pulse ox done 10/9: Maintains sats with mask on but drops when seal broken. Breathing slowly improved throughout admission. Steroid were weaned, will continue taper at discharge.    Covid-19 Infection: Tested positive 10/4/2022 on admission. Likely infection that triggered COPD exacerbation and respiratory failure. Was started on Remdesivir and completed 5 day course 10/4-10/8.  Was placed on steroids per COPD exacerbation. Finished 10 days of respiratory isolation prior to discharge.   GI bleed/Anemia: While intubated patient experienced bloody secretions from OG tube. Differential at that time included ulcer with concomitant use of lovenox vs trauma during ETT/OG placement. This resovled after ETT/OG were removed. Patient has chronic anemia with Hb 11 on admission. Decreased slightly during stay, but remained stable around 9.5.   Acute Exacerbation Chronic Diastolic CHF: CXR with mild pulmonary edema and small-moderate bilateral pleural effusions. Also had some mild pitting edema lower extremities. Was started on IV lasix 40mg BID, and subsequently increased to 60mg BID. Appeared to diurese well, with decrease in pitting edema. Was transitioned back to home PO 40mg Lasix BID which she tolerated well.    OSA: Infrequent use of home CPAP. Patient was instructed to use BiPAP while here in hospital as she was experiencing significant CO2 retention and decreased saturations over night. Patient should continue to utilize BiPAP at night/during naps on discharge.