chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Head discomfort, Headache, Impaired work ability, Nausea, Pain
Clinical narrative: That first few minutes after nausea and headache. Got home and I started having warm, flushing feeling. Like you feel hot inside. I took my temperature. It was 99 and then 100. I started feeling like somebody beat me up. My body was over fatigued and feeling weak - sore everywhere. I went to bed as I was dizzy, too. I didn't want to eat anyways because I was nauseated. It was up to 102. I had fever, nausea, and that night my temperature was even higher and I couldn't get out of bed. I had headaches. I took 2 500 mg (1000 mg) of Tylenol. I took Pepcid. I tried to eat something. That headache was so severe and I took Benadryl. That continued on for the next week. I didn't want to keep taking Tylenol all the time. I took 1000 mg and then maybe Ibuprofen or 500 mg of Tylenol later that day and Benadryl that night. Going to the next week, I still had fever, headache, I had gurgling stomach. It felt like someone was working on something inside of my tummy. It wasn't gas. It felt like someone was touching different organs and it was making feel nauseated. I had dizziness if I didn't take Benadryl. Once I woke up, I'd have the headache, dizziness would be better and I'd try to eat but the nausea would still be there - I vomited once or two times. Body sore, really really tired. Chills lasted for more than a week - especially at night. Face was flushed from the first day of injection and it was flushed for about a week because I had a fever. I was so weak - couldn't do anything - like I had the flu but more severe symptoms. Would walk down our stairs and I would already be exhausted. Severe for first two weeks and then the nausea symptoms lessened but it's still on and off when I went back to work. The headache was just there and not going away - my head feels so heavy. Like something is puncturing me - sharp pain. I do have a very high tolerance of pain and so if I say it's hurting, it's really bad. I can tolerate more than other people. Severity of headache has been better since end of April - I was working and it was so hard. I'm a nurse and that's why I can't take off that long from work. The moment I didn't have the fever anymore, I went back to work even though I was suffering from the other symptoms still. . I missed two weeks of work. Because I'm part-time, it wasn't covered to have the time off.  The Tylenol  or alternating with Motrin would help lessen the pain a little but it was not getting rid of the pain so I just stopped taking it because I didn't want to damage my Kidneys. Headache, nausea and dizziness  is at this time  is about 80% gone. It's not as severe as those first month now by the first week of May.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Vomiting
Clinical narrative: That first few minutes after nausea and headache. Got home and I started having warm, flushing feeling. Like you feel hot inside. I took my temperature. It was 99 and then 100. I started feeling like somebody beat me up. My body was over fatigued and feeling weak - sore everywhere. I went to bed as I was dizzy, too. I didn't want to eat anyways because I was nauseated. It was up to 102. I had fever, nausea, and that night my temperature was even higher and I couldn't get out of bed. I had headaches. I took 2 500 mg (1000 mg) of Tylenol. I took Pepcid. I tried to eat something. That headache was so severe and I took Benadryl. That continued on for the next week. I didn't want to keep taking Tylenol all the time. I took 1000 mg and then maybe Ibuprofen or 500 mg of Tylenol later that day and Benadryl that night. Going to the next week, I still had fever, headache, I had gurgling stomach. It felt like someone was working on something inside of my tummy. It wasn't gas. It felt like someone was touching different organs and it was making feel nauseated. I had dizziness if I didn't take Benadryl. Once I woke up, I'd have the headache, dizziness would be better and I'd try to eat but the nausea would still be there - I vomited once or two times. Body sore, really really tired. Chills lasted for more than a week - especially at night. Face was flushed from the first day of injection and it was flushed for about a week because I had a fever. I was so weak - couldn't do anything - like I had the flu but more severe symptoms. Would walk down our stairs and I would already be exhausted. Severe for first two weeks and then the nausea symptoms lessened but it's still on and off when I went back to work. The headache was just there and not going away - my head feels so heavy. Like something is puncturing me - sharp pain. I do have a very high tolerance of pain and so if I say it's hurting, it's really bad. I can tolerate more than other people. Severity of headache has been better since end of April - I was working and it was so hard. I'm a nurse and that's why I can't take off that long from work. The moment I didn't have the fever anymore, I went back to work even though I was suffering from the other symptoms still. . I missed two weeks of work. Because I'm part-time, it wasn't covered to have the time off.  The Tylenol  or alternating with Motrin would help lessen the pain a little but it was not getting rid of the pain so I just stopped taking it because I didn't want to damage my Kidneys. Headache, nausea and dizziness  is at this time  is about 80% gone. It's not as severe as those first month now by the first week of May.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: patient experienced nausea and felt she may vomit after vaccination .  She hadn't had anything to eat or drink in at least past few hours.  once she had some apple juice and goldfish crackers she felt better .
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging abnormal, Meningioma, Migraine, Visual impairment
Clinical narrative: I had a horrible migraine. After I described it to my Ophthalmologist, Dr. , he said he didn't believe it to be a typical migraine. I had vision disturbance in my right eye for about 2 weeks. After one week, I called my doctor. I'm not sure if it has cleared up or my brain has become used to it. I had a MRI and I followed up with a Neurosurgeon and he said I have a small brain tumor (meningioma), but it was not a part of the problem. I think that if the Janssen Vaccine hadn't been paused around the time I had my migraine, I wouldn't have been so alarmed and worried.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Adenovirus test, Alanine aminotransferase normal, Angiogram pulmonary abnormal, Aspartate aminotransferase normal, Blood alkaline phosphatase normal
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Blood bilirubin normal, Blood calcium, Blood chloride normal, Blood creatinine normal, Blood potassium normal
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium normal, Bordetella test negative, COVID-19, Carbon dioxide normal, Chest X-ray abnormal
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Chlamydia test negative, Cough, Dizziness, Dyspnoea
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Enterovirus test negative, Haematocrit decreased, Haemoglobin decreased, Headache, Hepatic steatosis
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza virus test negative, International normalised ratio normal
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Lung infiltration, Mycoplasma test negative, Platelet count normal, Protein total decreased, Respiratory syncytial virus test negative
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory viral panel, SARS-CoV-2 test positive, Scan with contrast, Troponin I normal, White blood cell count normal
Clinical narrative: 4/20/21 5:57 PM Patient contacted RN     4/20/21 6:24 PM Note   Developed cough, chest heaviness, and headache today.   Midsternal chest heaviness has been present all day.   Uses symbicort inhaler daily. Has not relieved Sx.   Denies trouble breathing.   Will go to ED for evaluation.   Reason for Disposition ? SEVERE or constant chest pain or pressure (Exception: mild central chest pain, present only when coughing)  Protocols used: CORONAVIRUS (COVID-19) DIAGNOSED OR SUSPECTED-A-AH ED Discharged 4/20/2021 (46 minutes)  Treatment team Providers Additional Orders and Documentation   Results    Meds    Orders    Flowsheets   Encounter Info: History, Allergies, Detailed Report, Vitals  Media From this encounter EKG-Encounter - Scan on 4/21/2021 5:06 AM  ED Discharged 4/25/2021 (1 hours) Last attending ? Treatment team COVID-19 Clinical impression Shortness of Breath Chief complaint ED Provider Notes (Resident) ? ? Emergency Medicine Cosigned by: DO at 4/25/2021  9:27 PM Expand AllCollapse All      ED PROVIDER NOTE        Patient:  MRN:    This note was partially completed using voice recognition technology, and was scanned for gross errors; however some errors may still exist.  Please contact the author with any questions or requests for clarification.    CC/HPI     Patient is a 50 y.o. female presenting to the ED with chief complaint of persistent cough and shortness of breath in the setting of Covid infection.   This is a patient with pertinent medical history of asthma.   Patient comes in for evaluation today mainly concerned that her asthma medications have not been helping with her breathing ever since being diagnosed with Covid. She was diagnosed about a week ago. She is not having some mild fevers as well as general achiness and fatigue. She is most concerned because she has been having persistent cough and some shortness of breath particularly over the past couple days. She is compliant with her daily Symbicort but has also been using her albuterol inhaler quite frequently. She reports she usually does not have to use her albuterol inhaler nearly as much. She also reports some lightheadedness which is mainly associated with position changes when she gets out of bed too quickly. Patient otherwise denies any previous history of blood clots; she has not had any recent calf swelling/tenderness. She feels that the shortness of breath has been progressively gotten worse over the course of the past week rather than all of a sudden getting worse. Denies any chest pain, even with deep inhalation.    ED to Hosp-Admission Discharged 4/27/2021 - 4/30/2021 (3 days)  MD Last attending ? Treatment team 2019 novel coronavirus?infected pneumonia (NCIP) Principal problem
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chills, Cough, Diarrhoea, Dyspnoea
Clinical narrative: Numbness in left hand. Left arm heavy and sore.Fever. Chills. Cough. Heart palpable. Shortness of breath. Stomach cramps. Nausea. Diarrhea. Pain behind eyes. Burning itchy skin. Uterine bleeding.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Eye pain, Hypoaesthesia, Limb discomfort, Nausea, Pain in extremity
Clinical narrative: Numbness in left hand. Left arm heavy and sore.Fever. Chills. Cough. Heart palpable. Shortness of breath. Stomach cramps. Nausea. Diarrhea. Pain behind eyes. Burning itchy skin. Uterine bleeding.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Palpitations, Pruritus, Pyrexia, Skin burning sensation, Uterine haemorrhage
Clinical narrative: Numbness in left hand. Left arm heavy and sore.Fever. Chills. Cough. Heart palpable. Shortness of breath. Stomach cramps. Nausea. Diarrhea. Pain behind eyes. Burning itchy skin. Uterine bleeding.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea
Clinical narrative: It was like an adrenaline rush at first, light headed and felt like i was going to pass out- 04/2/2021 Shortness of breathe last for 2 weeks. Given a Steroid Shot- 04/16/2021 Given an Inhaler 04/16/2021
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Atrial fibrillation, Cardiac stress test, Echocardiogram, Electrocardiogram, Hypotension
Clinical narrative: Hypotension with development of intermittent  atrial fibrulation
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Gait disturbance, Mobility decreased, Pain in extremity, Polymyalgia rheumatica
Clinical narrative: Starting day after vaccine:  pain shoulders, arms, legs;.  After couple weeks, tried ibuprofen, then etodolac.  Finally, doctor diagnosed possibly polymyalgia rheumaticas symptioms and prescribed 10 days of prednisone 20 mg.  Prednisone relieved pain and returned to normal range of movement.  But last pill yesterday, so must  see if pain returns.  Problem has continued from March 12 to today.   Pain was extreme: very difficult to walk stairs, get out of bed, etc.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Dizziness, Dyspnoea, Flushing, Tremor
Clinical narrative: PATIENT FELT DIZZY AND FLUSHED WHICH PROCEEDED TO VOMITTING, DIFFICULTY BREATHING AND CHILLS AND SHAKING THE PATIENT WAS MONITORED WHILE PARAMEDICS ARRIVED.  PATIENT VITALS WERE NORMAL AND PATIENT WAS MONITORED BY PARAMEDICS AND PHARMACY STAFF FOR ABOUT HALF AN HOUR. PATIENT REFUSED FURTHER TREATMENT AND WENT HOME ON THEIR OWN AND WAS INSTRUCTED TO FOLLOW UP WITH THEIR DOCTOR, AN URGENT CARE CENTER OR CALL PARAMEDICS IF FURTHER CARE IS NEEDED OR THEIR STATUS CHANGES.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: PATIENT FELT DIZZY AND FLUSHED WHICH PROCEEDED TO VOMITTING, DIFFICULTY BREATHING AND CHILLS AND SHAKING THE PATIENT WAS MONITORED WHILE PARAMEDICS ARRIVED.  PATIENT VITALS WERE NORMAL AND PATIENT WAS MONITORED BY PARAMEDICS AND PHARMACY STAFF FOR ABOUT HALF AN HOUR. PATIENT REFUSED FURTHER TREATMENT AND WENT HOME ON THEIR OWN AND WAS INSTRUCTED TO FOLLOW UP WITH THEIR DOCTOR, AN URGENT CARE CENTER OR CALL PARAMEDICS IF FURTHER CARE IS NEEDED OR THEIR STATUS CHANGES.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal distension, Breast tenderness, Emotional distress, Headache, Heavy menstrual bleeding
Clinical narrative: Menstrual period delayed by 8 days. Heavy PMS symptoms including breast tenderness, irritability, headache, cramping and bloating lasting for 10 days accompanied by a heavier than usual menstrual period but lasting a shorter amount of time than typically experienced previously (typical period is about 5-6 days long, this period was only 4 days in duration).  Worth noting the reason I was hyper aware that my period was late is 1) it has never been late in my entire life and I am 41 years old. 2) I use an app to track my cycle and it kept alerting me that it was late. I am on birth control and knew that I was not pregnant, however, it caused distress because I didn't know what was wrong with me and no one wants to have severe PMS for 10 days with no relief in sight.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Irritability, Menstruation delayed, Muscle spasms, Polymenorrhoea, Pregnancy test negative
Clinical narrative: Menstrual period delayed by 8 days. Heavy PMS symptoms including breast tenderness, irritability, headache, cramping and bloating lasting for 10 days accompanied by a heavier than usual menstrual period but lasting a shorter amount of time than typically experienced previously (typical period is about 5-6 days long, this period was only 4 days in duration).  Worth noting the reason I was hyper aware that my period was late is 1) it has never been late in my entire life and I am 41 years old. 2) I use an app to track my cycle and it kept alerting me that it was late. I am on birth control and knew that I was not pregnant, however, it caused distress because I didn't know what was wrong with me and no one wants to have severe PMS for 10 days with no relief in sight.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Premenstrual syndrome
Clinical narrative: Menstrual period delayed by 8 days. Heavy PMS symptoms including breast tenderness, irritability, headache, cramping and bloating lasting for 10 days accompanied by a heavier than usual menstrual period but lasting a shorter amount of time than typically experienced previously (typical period is about 5-6 days long, this period was only 4 days in duration).  Worth noting the reason I was hyper aware that my period was late is 1) it has never been late in my entire life and I am 41 years old. 2) I use an app to track my cycle and it kept alerting me that it was late. I am on birth control and knew that I was not pregnant, however, it caused distress because I didn't know what was wrong with me and no one wants to have severe PMS for 10 days with no relief in sight.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Pyrexia
Clinical narrative: Head ache, feverish
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood creatine phosphokinase, Blood creatine phosphokinase MB increased, Borrelia test, C-reactive protein increased, Cardiac telemetry normal
Clinical narrative: Patient developed chest pain and difficulty breathing when lying down; symptoms started at 7pm on 5/21/2021.  Seen in the emergency room at Hospital  for chest pain, found to have elevated troponin level of 11.6 ng/mL (normal <0.05).  CT chest negative for pulmonary embolism.  Patient transferred to Medical Center.  Initial high sensitivity Troponin-T level 1224 ng/L (normal <15), BNP 805 pg/mL (nl <300).  EKG with diffuse ST segment changes.  Echocardiogram (5/23 AM) with normal systolic and diastolic function, LVEF 58%; no pericardial effusion, no pathologic valve regurgitation.  Patient admitted to telemetry monitoring bed (no arrhythmias noted during hospitalization). Patient treated initially with Ibuprofen 400 mg PO q6 hours and famotidine 20 mg PO q12 hours for presumed myopericarditis.  Workup sent for viral causes of myocarditis: Respiratory viral panel negative.  Infectious Myocarditis workup sent: CMV, Cocksakievirus A and B antibody, CMV IgG/IgM, Echovirus antibody, Infectious Mononucleosis Screen, Lyme C6 AB IgG/IgM, Mycoplasma IgG/IgM, Parvo IgG/IgM, Varicella IgG/IgM.   Follow-up echocardiogram on 5/23 (PM) and 5/24 (AM) demonstrated no change in LV systolic or diastolic function.   Cardiac enzymes, including high-sensitivity troponin T, CK and CKMB, were trended. Cardiac MRI was performed - preliminary results show evidence of myocarditis Lab Trends (earliest to most recent, as of 1 pm on 5/25/2021):  High sensitivity Troponin T: 1224, 732, 664, 1058, 1332, 1141  CKMB: 65.6, 41.6, 19.3, 11.4, 6.3, 3.2  Pro-NT-BNP: 803,493, 392, 293  CRP: 58.2, 32.8, 28.6, 14.9.   At the time of sumission of this report, the patient remains in the hospital. Further results will be communicated to VAERS.
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest pain, Computerised tomogram thorax normal, Coxsackie virus test, Cytomegalovirus test, Dyspnoea
Clinical narrative: Patient developed chest pain and difficulty breathing when lying down; symptoms started at 7pm on 5/21/2021.  Seen in the emergency room at Hospital  for chest pain, found to have elevated troponin level of 11.6 ng/mL (normal <0.05).  CT chest negative for pulmonary embolism.  Patient transferred to Medical Center.  Initial high sensitivity Troponin-T level 1224 ng/L (normal <15), BNP 805 pg/mL (nl <300).  EKG with diffuse ST segment changes.  Echocardiogram (5/23 AM) with normal systolic and diastolic function, LVEF 58%; no pericardial effusion, no pathologic valve regurgitation.  Patient admitted to telemetry monitoring bed (no arrhythmias noted during hospitalization). Patient treated initially with Ibuprofen 400 mg PO q6 hours and famotidine 20 mg PO q12 hours for presumed myopericarditis.  Workup sent for viral causes of myocarditis: Respiratory viral panel negative.  Infectious Myocarditis workup sent: CMV, Cocksakievirus A and B antibody, CMV IgG/IgM, Echovirus antibody, Infectious Mononucleosis Screen, Lyme C6 AB IgG/IgM, Mycoplasma IgG/IgM, Parvo IgG/IgM, Varicella IgG/IgM.   Follow-up echocardiogram on 5/23 (PM) and 5/24 (AM) demonstrated no change in LV systolic or diastolic function.   Cardiac enzymes, including high-sensitivity troponin T, CK and CKMB, were trended. Cardiac MRI was performed - preliminary results show evidence of myocarditis Lab Trends (earliest to most recent, as of 1 pm on 5/25/2021):  High sensitivity Troponin T: 1224, 732, 664, 1058, 1332, 1141  CKMB: 65.6, 41.6, 19.3, 11.4, 6.3, 3.2  Pro-NT-BNP: 803,493, 392, 293  CRP: 58.2, 32.8, 28.6, 14.9.   At the time of sumission of this report, the patient remains in the hospital. Further results will be communicated to VAERS.
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Echocardiogram, Echovirus test, Ejection fraction, Electrocardiogram ST segment abnormal, Magnetic resonance imaging heart
Clinical narrative: Patient developed chest pain and difficulty breathing when lying down; symptoms started at 7pm on 5/21/2021.  Seen in the emergency room at Hospital  for chest pain, found to have elevated troponin level of 11.6 ng/mL (normal <0.05).  CT chest negative for pulmonary embolism.  Patient transferred to Medical Center.  Initial high sensitivity Troponin-T level 1224 ng/L (normal <15), BNP 805 pg/mL (nl <300).  EKG with diffuse ST segment changes.  Echocardiogram (5/23 AM) with normal systolic and diastolic function, LVEF 58%; no pericardial effusion, no pathologic valve regurgitation.  Patient admitted to telemetry monitoring bed (no arrhythmias noted during hospitalization). Patient treated initially with Ibuprofen 400 mg PO q6 hours and famotidine 20 mg PO q12 hours for presumed myopericarditis.  Workup sent for viral causes of myocarditis: Respiratory viral panel negative.  Infectious Myocarditis workup sent: CMV, Cocksakievirus A and B antibody, CMV IgG/IgM, Echovirus antibody, Infectious Mononucleosis Screen, Lyme C6 AB IgG/IgM, Mycoplasma IgG/IgM, Parvo IgG/IgM, Varicella IgG/IgM.   Follow-up echocardiogram on 5/23 (PM) and 5/24 (AM) demonstrated no change in LV systolic or diastolic function.   Cardiac enzymes, including high-sensitivity troponin T, CK and CKMB, were trended. Cardiac MRI was performed - preliminary results show evidence of myocarditis Lab Trends (earliest to most recent, as of 1 pm on 5/25/2021):  High sensitivity Troponin T: 1224, 732, 664, 1058, 1332, 1141  CKMB: 65.6, 41.6, 19.3, 11.4, 6.3, 3.2  Pro-NT-BNP: 803,493, 392, 293  CRP: 58.2, 32.8, 28.6, 14.9.   At the time of sumission of this report, the patient remains in the hospital. Further results will be communicated to VAERS.
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Mononucleosis heterophile test, Mycoplasma test, Myocarditis, N-terminal prohormone brain natriuretic peptide increased, Parvovirus B19 test negative
Clinical narrative: Patient developed chest pain and difficulty breathing when lying down; symptoms started at 7pm on 5/21/2021.  Seen in the emergency room at Hospital  for chest pain, found to have elevated troponin level of 11.6 ng/mL (normal <0.05).  CT chest negative for pulmonary embolism.  Patient transferred to Medical Center.  Initial high sensitivity Troponin-T level 1224 ng/L (normal <15), BNP 805 pg/mL (nl <300).  EKG with diffuse ST segment changes.  Echocardiogram (5/23 AM) with normal systolic and diastolic function, LVEF 58%; no pericardial effusion, no pathologic valve regurgitation.  Patient admitted to telemetry monitoring bed (no arrhythmias noted during hospitalization). Patient treated initially with Ibuprofen 400 mg PO q6 hours and famotidine 20 mg PO q12 hours for presumed myopericarditis.  Workup sent for viral causes of myocarditis: Respiratory viral panel negative.  Infectious Myocarditis workup sent: CMV, Cocksakievirus A and B antibody, CMV IgG/IgM, Echovirus antibody, Infectious Mononucleosis Screen, Lyme C6 AB IgG/IgM, Mycoplasma IgG/IgM, Parvo IgG/IgM, Varicella IgG/IgM.   Follow-up echocardiogram on 5/23 (PM) and 5/24 (AM) demonstrated no change in LV systolic or diastolic function.   Cardiac enzymes, including high-sensitivity troponin T, CK and CKMB, were trended. Cardiac MRI was performed - preliminary results show evidence of myocarditis Lab Trends (earliest to most recent, as of 1 pm on 5/25/2021):  High sensitivity Troponin T: 1224, 732, 664, 1058, 1332, 1141  CKMB: 65.6, 41.6, 19.3, 11.4, 6.3, 3.2  Pro-NT-BNP: 803,493, 392, 293  CRP: 58.2, 32.8, 28.6, 14.9.   At the time of sumission of this report, the patient remains in the hospital. Further results will be communicated to VAERS.
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Respiratory viral panel, Troponin T increased, Troponin increased, Varicella virus test
Clinical narrative: Patient developed chest pain and difficulty breathing when lying down; symptoms started at 7pm on 5/21/2021.  Seen in the emergency room at Hospital  for chest pain, found to have elevated troponin level of 11.6 ng/mL (normal <0.05).  CT chest negative for pulmonary embolism.  Patient transferred to Medical Center.  Initial high sensitivity Troponin-T level 1224 ng/L (normal <15), BNP 805 pg/mL (nl <300).  EKG with diffuse ST segment changes.  Echocardiogram (5/23 AM) with normal systolic and diastolic function, LVEF 58%; no pericardial effusion, no pathologic valve regurgitation.  Patient admitted to telemetry monitoring bed (no arrhythmias noted during hospitalization). Patient treated initially with Ibuprofen 400 mg PO q6 hours and famotidine 20 mg PO q12 hours for presumed myopericarditis.  Workup sent for viral causes of myocarditis: Respiratory viral panel negative.  Infectious Myocarditis workup sent: CMV, Cocksakievirus A and B antibody, CMV IgG/IgM, Echovirus antibody, Infectious Mononucleosis Screen, Lyme C6 AB IgG/IgM, Mycoplasma IgG/IgM, Parvo IgG/IgM, Varicella IgG/IgM.   Follow-up echocardiogram on 5/23 (PM) and 5/24 (AM) demonstrated no change in LV systolic or diastolic function.   Cardiac enzymes, including high-sensitivity troponin T, CK and CKMB, were trended. Cardiac MRI was performed - preliminary results show evidence of myocarditis Lab Trends (earliest to most recent, as of 1 pm on 5/25/2021):  High sensitivity Troponin T: 1224, 732, 664, 1058, 1332, 1141  CKMB: 65.6, 41.6, 19.3, 11.4, 6.3, 3.2  Pro-NT-BNP: 803,493, 392, 293  CRP: 58.2, 32.8, 28.6, 14.9.   At the time of sumission of this report, the patient remains in the hospital. Further results will be communicated to VAERS.
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood test, Chest pain, Dyspnoea, Echocardiogram, Magnetic resonance imaging
Clinical narrative: Patient developed chest pain and difficulty breathing when lying down; symptoms started at 7pm on 5/21/2021.  Seen in the emergency room at Hospital  for chest pain, found to have elevated troponin level of 11.6 ng/mL (normal <0.05).  CT chest negative for pulmonary embolism.  Patient transferred to Medical Center.  Initial high sensitivity Troponin-T level 1224 ng/L (normal <15), BNP 805 pg/mL (nl <300).  EKG with diffuse ST segment changes.  Echocardiogram (5/23 AM) with normal systolic and diastolic function, LVEF 58%; no pericardial effusion, no pathologic valve regurgitation.  Patient admitted to telemetry monitoring bed (no arrhythmias noted during hospitalization). Patient treated initially with Ibuprofen 400 mg PO q6 hours and famotidine 20 mg PO q12 hours for presumed myopericarditis.  Workup sent for viral causes of myocarditis: Respiratory viral panel negative.  Infectious Myocarditis workup sent: CMV, Cocksakievirus A and B antibody, CMV IgG/IgM, Echovirus antibody, Infectious Mononucleosis Screen, Lyme C6 AB IgG/IgM, Mycoplasma IgG/IgM, Parvo IgG/IgM, Varicella IgG/IgM.   Follow-up echocardiogram on 5/23 (PM) and 5/24 (AM) demonstrated no change in LV systolic or diastolic function.   Cardiac enzymes, including high-sensitivity troponin T, CK and CKMB, were trended. Cardiac MRI was performed - preliminary results show evidence of myocarditis Lab Trends (earliest to most recent, as of 1 pm on 5/25/2021):  High sensitivity Troponin T: 1224, 732, 664, 1058, 1332, 1141  CKMB: 65.6, 41.6, 19.3, 11.4, 6.3, 3.2  Pro-NT-BNP: 803,493, 392, 293  CRP: 58.2, 32.8, 28.6, 14.9.   At the time of sumission of this report, the patient remains in the hospital. Further results will be communicated to VAERS.
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Troponin increased
Clinical narrative: Patient developed chest pain and difficulty breathing when lying down; symptoms started at 7pm on 5/21/2021.  Seen in the emergency room at Hospital  for chest pain, found to have elevated troponin level of 11.6 ng/mL (normal <0.05).  CT chest negative for pulmonary embolism.  Patient transferred to Medical Center.  Initial high sensitivity Troponin-T level 1224 ng/L (normal <15), BNP 805 pg/mL (nl <300).  EKG with diffuse ST segment changes.  Echocardiogram (5/23 AM) with normal systolic and diastolic function, LVEF 58%; no pericardial effusion, no pathologic valve regurgitation.  Patient admitted to telemetry monitoring bed (no arrhythmias noted during hospitalization). Patient treated initially with Ibuprofen 400 mg PO q6 hours and famotidine 20 mg PO q12 hours for presumed myopericarditis.  Workup sent for viral causes of myocarditis: Respiratory viral panel negative.  Infectious Myocarditis workup sent: CMV, Cocksakievirus A and B antibody, CMV IgG/IgM, Echovirus antibody, Infectious Mononucleosis Screen, Lyme C6 AB IgG/IgM, Mycoplasma IgG/IgM, Parvo IgG/IgM, Varicella IgG/IgM.   Follow-up echocardiogram on 5/23 (PM) and 5/24 (AM) demonstrated no change in LV systolic or diastolic function.   Cardiac enzymes, including high-sensitivity troponin T, CK and CKMB, were trended. Cardiac MRI was performed - preliminary results show evidence of myocarditis Lab Trends (earliest to most recent, as of 1 pm on 5/25/2021):  High sensitivity Troponin T: 1224, 732, 664, 1058, 1332, 1141  CKMB: 65.6, 41.6, 19.3, 11.4, 6.3, 3.2  Pro-NT-BNP: 803,493, 392, 293  CRP: 58.2, 32.8, 28.6, 14.9.   At the time of sumission of this report, the patient remains in the hospital. Further results will be communicated to VAERS.