chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 24.0
Sex: F
Vaccine: COVID19-2, FLUR4
Symptoms: Lymphadenopathy, Malaise, Oedema, Pain in extremity, Paraesthesia oral
Clinical narrative: Severe swelling of lymph node in left armpit, sore arm. This was accompanied by worsening COVID-like symptoms over the next 48 hours (tingling mouth/throat sensation, sore tongue, headache, fever, chills, fatigue, and worsening of symptoms associated with my current chronic gastrointestinal conditions). Increasingly prominent periorbital edema that is worse in the mornings (eyelids are so puffy that I do not feel they are fully open)... it's hard to tell but I think all of my lymph nodes are a bit puffy, or there is a noticeable amount of water retention all over my body.  I still do not feel back to normal but have not sought medical treatment.  Currently, my arm soreness has mostly dissipated, and my lymph node is still enlarged but slowly reducing in size every day. Currently struggling with the worsening edema around my eyes and neck, pounding headaches, and fatigue/low stamina/getting winded easily.
Age: 24.0
Sex: F
Vaccine: COVID19-2, FLUR4
Symptoms: Periorbital oedema, Periorbital swelling, Pharyngeal paraesthesia, Pyrexia
Clinical narrative: Severe swelling of lymph node in left armpit, sore arm. This was accompanied by worsening COVID-like symptoms over the next 48 hours (tingling mouth/throat sensation, sore tongue, headache, fever, chills, fatigue, and worsening of symptoms associated with my current chronic gastrointestinal conditions). Increasingly prominent periorbital edema that is worse in the mornings (eyelids are so puffy that I do not feel they are fully open)... it's hard to tell but I think all of my lymph nodes are a bit puffy, or there is a noticeable amount of water retention all over my body.  I still do not feel back to normal but have not sought medical treatment.  Currently, my arm soreness has mostly dissipated, and my lymph node is still enlarged but slowly reducing in size every day. Currently struggling with the worsening edema around my eyes and neck, pounding headaches, and fatigue/low stamina/getting winded easily.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Hypoaesthesia, Limb discomfort, Magnetic resonance imaging, Muscle spasms
Clinical narrative: Sharp pain in lower left calf, Over time have experienced on a daily basis tingling, burning, numbing, heavy, cramping, weakness, painful left and right legs.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Muscular weakness, Pain in extremity, Paraesthesia, Ultrasound Doppler, X-ray
Clinical narrative: Sharp pain in lower left calf, Over time have experienced on a daily basis tingling, burning, numbing, heavy, cramping, weakness, painful left and right legs.
Age: 42.0
Sex: F
Vaccine: FLUR4, HEP, MMR
Symptoms: Poor quality product administered, Product preparation issue
Clinical narrative: Patient was given MMR vaccine with expired diluent. The MMR vaccine itself was not expired, but the diluent was.
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: Error: Expired Product Administered-
Age: 64.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: Error: Expired Product Administered-
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Wrong product administered
Clinical narrative: Error: Wrong Vaccine/Product Administered-
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Adverse reaction, Arthralgia, Lymphadenopathy, Neck pain, Pain
Clinical narrative: patient had severe pain in the arm of the vaccine.  radiating into the neck and shoulder region.  no rash or redness or swelling were seen.  she did come into the pharmacy to ask how to treat the pain.  the vaccination was given at 11:10 am on 12-2-2022, she came back to the pharmacy the same day 12-2-22 around 3:30 pm to ask how to treat the symptoms.  supervising pharmacist called to check on patient 12-3-22, she stated the pain in getting better, however she is having known adverse reactions to the vaccine.  fever, body pains, and some lymph node swelling.  she has experienced the lymph node swelling with her previous shingrix vaccine.  she stated no other concerns.
Age: 65.0
Sex: F
Vaccine: VARZOS
Symptoms: Pain in extremity, Pyrexia
Clinical narrative: patient had severe pain in the arm of the vaccine.  radiating into the neck and shoulder region.  no rash or redness or swelling were seen.  she did come into the pharmacy to ask how to treat the pain.  the vaccination was given at 11:10 am on 12-2-2022, she came back to the pharmacy the same day 12-2-22 around 3:30 pm to ask how to treat the symptoms.  supervising pharmacist called to check on patient 12-3-22, she stated the pain in getting better, however she is having known adverse reactions to the vaccine.  fever, body pains, and some lymph node swelling.  she has experienced the lymph node swelling with her previous shingrix vaccine.  she stated no other concerns.
Age: 39.0
Sex: F
Vaccine: COVID19-2, FLU4, TDAP
Symptoms: Pain
Clinical narrative: the patient was complaining about the pain the following day after receiving the vaccines
Age: 60.0
Sex: F
Vaccine: COVID19-2
Symptoms: Erythema, Feeling hot, Injection site pain, Swelling face
Clinical narrative: Face swelling. "Red" super hot cheeks. No fever. Felt fine other than extremely red face and mildly swollen cheekbone area. Overall felt hot across whole body, no fever. Injection site was sore but tolerable.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Gait disturbance, Guillain-Barre syndrome, Hypoaesthesia, Lumbar puncture abnormal
Clinical narrative: On Jan 9 I had severe cramps in both legs and went to ER.  A spinal tap test was performed and resulted in the diagnosis of Guillain-Barre Syndrome.  Within days I was paralyzed from neck down and put on a respirator.  I was hospitalized a total of 94 days.  I was sent home 4/10/2021.  I still have trouble walking and have drop foot.  I have daily nerve pain, numbness in both legs knees down to feet, and easily fatigued.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle spasms, Neuralgia, Paralysis, Respiratory therapy
Clinical narrative: On Jan 9 I had severe cramps in both legs and went to ER.  A spinal tap test was performed and resulted in the diagnosis of Guillain-Barre Syndrome.  Within days I was paralyzed from neck down and put on a respirator.  I was hospitalized a total of 94 days.  I was sent home 4/10/2021.  I still have trouble walking and have drop foot.  I have daily nerve pain, numbness in both legs knees down to feet, and easily fatigued.
Age: 28.0
Sex: M
Vaccine: HEP
Symptoms: Extra dose administered
Clinical narrative: third dose or Heplisav B was administered of a 2 dose series
Age: 17.0
Sex: F
Vaccine: MNQ
Symptoms: Feeling abnormal, Loss of consciousness, Pallor, Peripheral coldness, Pulse abnormal
Clinical narrative: about 5 minutes after injection patient said she didn't feel right and was pale.  Her hands were cold and neck was warm.  I had technician call emergency services.  Patient then lots consciousness for a brief moment and mother and I tried to keep her talking.  I took her blood pressure (143/45) and O2 98%.  Her pulse was erratic and hard to read.  Fire department arrived and provided oxygen and retook her BP and O2.  EMTs arrived and transported patient to the hospital.
Age: 17.0
Sex: F
Vaccine: MNQ
Symptoms: Skin warm
Clinical narrative: about 5 minutes after injection patient said she didn't feel right and was pale.  Her hands were cold and neck was warm.  I had technician call emergency services.  Patient then lots consciousness for a brief moment and mother and I tried to keep her talking.  I took her blood pressure (143/45) and O2 98%.  Her pulse was erratic and hard to read.  Fire department arrived and provided oxygen and retook her BP and O2.  EMTs arrived and transported patient to the hospital.
Age: 75.0
Sex: F
Vaccine: FLUA4
Symptoms: Erythema, Headache, Inflammation, Muscular weakness, Pain
Clinical narrative: Faint, dry heaves, muscle weakness, headache and sore, red inflamed arm
Age: 75.0
Sex: F
Vaccine: FLUA4
Symptoms: Retching, Syncope
Clinical narrative: Faint, dry heaves, muscle weakness, headache and sore, red inflamed arm
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Inflammation, Injection site pain, Myalgia, Pain
Clinical narrative: Booster administered to patient on 11/30/2022 to left deltoid. Patient at the time mentioned pain at the injection site but left without reporting additional adverse reactions or allergic reactions. Reported on 12/03/2022 that pain and tenderness did radiate laterally to left pectoral muscle. Reports that he was monitoring the adverse effects and overall inflammation and pain was subsiding. Tenderness and some pain still persists at injection site and left pectoral muscle. States that he will continue monitoring and will alert medical authorities if the adverse effects worsens, continually persists or signs of infection show.
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Rash, Urticaria
Clinical narrative: patient received the vaccines ( shingles and flu) around 11: 20 am, After the pharmacist advised her to stay for 15 minutes for monitoring her (since she id doing shingles for first time , But she had the flu shoot in the past many times) , she left the pharmacy after these 15 minutes ,then she came back in an hour later stating that : she had broken in hives ,the pharmacist  checked her physically and notice she had a slight rash all over her body with no swelling or breathing problem  .The Pharmacist sat her down for monitoring ,checked her blood pressure which was 134/93 . And administer her Benadryl tablet from the emergency kit .the pharmacist monitor the pt for another 30 minutes  , when she said (and the pharmacist notice the rash got less) ,PT left the pharmacy and advised to visit the ER if the symptoms get worse.A phone call by the Pharmacist made and hour later to chek on the patient ,and she stated she is improving.
Age: 85.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Dizziness, Eye swelling, Pruritus, Skin exfoliation
Clinical narrative: RECEIVED FLU AND BIVALENT COVID VACCINE ON 11/23/2022 AND ON SATURDAY 11/26/2022 HE STATES HE STARTED TO ITCH ON HEAD AND ARMS AND OVER TIME GOT WORSE.  THIS MORNING ON 11/30/2022 THE SKIN ON HIS FACE LOOKS PEELED AND EYES ARE SWOLLEN LEFT EYE DID CLOSE UP PATIENT ALSO FEELS DIZZY. PATIENT GIVEN DECADRON 10MG  AND KENALOG 40 SHOT ADMINISTERED DURING THE VISIT.  BENADRYL 25MG BY MOUTH EVERY 6 HOURS FOR THE NEXT 2 DAYS.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Ringing in Ears, doesn't go away, can only be drowned out, Still affects me now(12/3/2022) but either a bit less or I've tuned it out somewhat.
Age: 84.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered
Clinical narrative: Patient came in to receive Pneumonia vaccine. Pharmacist accidently gave the Flu vaccine which the patient had already received 1.5 months back
Age: 61.0
Sex: F
Vaccine: COVID19-2, COVID19-2
Symptoms: Alopecia
Clinical narrative: Hair loss.  Patient is currently being treated with minoxidil 2.5mg po daily.
Age: 61.0
Sex: F
Vaccine: COVID19-2, COVID19-2
Symptoms: Alopecia, Blood iron, Blood test
Clinical narrative: Hair loss.  Patient is currently being treated with minoxidil 2.5mg po daily.
Age: 4.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Expired product administered, Incorrect dose administered, Product storage error
Clinical narrative: Inadvertent administration of 0.2 ml of  12 + Moderna vaccine  that was in room temp for more than 12 hours to a recipient who was to receive Moderna vaccine for 6 mos to 5 years (0.25 ml).  The bottle for her age, which was thawing,  was mixed up with the expired adult vaccine when drawn up by myself.   So she received approximately 40 mcg of essentially expired vaccine instead of the 25 mcg of unexpired vaccine she should have received.  Parents were notified immediately after error was realized and before leaving the clinic yesterday afternoon.  I called her mother, this afternoon 12/3/2022, who stated pt had not experienced any untoward signs or symptoms. Pt also spoke with me and was happy and energetic.  I will follow up daily with the family.  Also needing to know how to proceed with finishing her vaccination for COVID.  Not sure if should negate this vaccine as suspect not effective as out of temp range for more than 12 hours.  Previously, the vial had had only one needle puncture for another patient.
Age: 6.0
Sex: F
Vaccine: COVID19-2
Symptoms: Headache, Interchange of vaccine products, Lethargy, Loss of personal independence in daily activities, Pyrexia
Clinical narrative: 15.5 hours post-injection, woke up with low-grade fever and headache. 21.5 hours post-injection, sent home from school with 101 fever and severe headache. 26 hours post-injection, 102 fever, repetitive vomiting, lethargic. 38 hours post-injection, all symptoms completely resolved. The entire adverse event lasted less than 24 hours, leading us to believe this was a vaccine reaction and not an illness. Patient has a twin sister who received the same vaccination at the same time from the same lot, but exhibited only an insignificant and brief low-grade fever. Patient's previous COVID-19 immunizations were without adverse effects, BUT were Pfizer rather than Moderna.
Age: 6.0
Sex: F
Vaccine: COVID19-2
Symptoms: Vomiting
Clinical narrative: 15.5 hours post-injection, woke up with low-grade fever and headache. 21.5 hours post-injection, sent home from school with 101 fever and severe headache. 26 hours post-injection, 102 fever, repetitive vomiting, lethargic. 38 hours post-injection, all symptoms completely resolved. The entire adverse event lasted less than 24 hours, leading us to believe this was a vaccine reaction and not an illness. Patient has a twin sister who received the same vaccination at the same time from the same lot, but exhibited only an insignificant and brief low-grade fever. Patient's previous COVID-19 immunizations were without adverse effects, BUT were Pfizer rather than Moderna.
Sex: U
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Pfizer COVID19 Bivalent given as first dose of primary series.
Age: 54.0
Sex: F
Vaccine: FLUC4
Symptoms: Injection site swelling, Injection site warmth, Throat irritation
Clinical narrative: PATIENT RETURNED TO PHARMACY 30 MINUTES POST VACCINATION WITH RAISED, WARM INJECTION SITE.  SHE ALSO REPORTED SCRATCHY THROAT.  WE ADMINISTERED 25MG DIPHENHYDRAMINE AND APPLIED COLD COMPRESS TO SITE.  PATIENT WAS OBSERVED FOR ANOTHER 20 MINUTES AND SYMPTOMS HAD IMPROVED.  FOLLOW UP 4 HOURS LATER WITH PATIENT OVER THE PHONE.  PATIENT STATES ALL SYMPTOMS HAVE RESOLVED AND NO FURTHER ISSUES APPEARED
Age: 31.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dizziness, Immediate post-injection reaction
Clinical narrative: 2:05 pm. 5-10 minutes after receiving bivalent booster patient complaints of having slight dizziness. Wheeled patient to med bay monitored vital signs. orange juice offered.   2:17 Vital Signs stable and patient was able to sit without any further complains of dizziness release from vaccination site.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of personal independence in daily activities, Mechanical urticaria
Clinical narrative: Very bad Dermatographia. Drastically effecting day to day activities. took two months to stop,  visited dermatologist and allergist. No one could help and due to breast feeding I could not take medication for it.
Age: 3.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Incorrect dose administered, Product preparation issue, Pyrexia
Clinical narrative: On 12-2-22 patient received 0.2ml of covid 19 pfizer toddler age 3-4 without diluent of 2.2 ml  this was his seccond dose  Parent said did run   a high fever at around 2:30am the morning of 12-3-22 and motrin/tylenol did bring fever down. As of the early morning of 12-3-22 patient was doing better per father. Pediatrician was contacted on 12-2-22 and did call parents and posion control and decided to just watch for adverse effects and report any to them if occur. Following up with Pfizer on 12-5-22
Age: 3.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Body height, Body temperature, Decreased appetite, Eye discharge, Irritability
Clinical narrative: On 12-2-22 patient received 0.2ml of covid 19 pfizer toddler age 3-4 without diluent of 2.2 ml  this was his seccond dose  Parent said did run   a high fever at around 2:30am the morning of 12-3-22 and motrin/tylenol did bring fever down. As of the early morning of 12-3-22 patient was doing better per father. Pediatrician was contacted on 12-2-22 and did call parents and posion control and decided to just watch for adverse effects and report any to them if occur. Following up with Pfizer on 12-5-22
Age: 3.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lethargy, Overdose, Product preparation error, Pyrexia, Sleep terror
Clinical narrative: On 12-2-22 patient received 0.2ml of covid 19 pfizer toddler age 3-4 without diluent of 2.2 ml  this was his seccond dose  Parent said did run   a high fever at around 2:30am the morning of 12-3-22 and motrin/tylenol did bring fever down. As of the early morning of 12-3-22 patient was doing better per father. Pediatrician was contacted on 12-2-22 and did call parents and posion control and decided to just watch for adverse effects and report any to them if occur. Following up with Pfizer on 12-5-22
Age: 3.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Weight
Clinical narrative: On 12-2-22 patient received 0.2ml of covid 19 pfizer toddler age 3-4 without diluent of 2.2 ml  this was his seccond dose  Parent said did run   a high fever at around 2:30am the morning of 12-3-22 and motrin/tylenol did bring fever down. As of the early morning of 12-3-22 patient was doing better per father. Pediatrician was contacted on 12-2-22 and did call parents and posion control and decided to just watch for adverse effects and report any to them if occur. Following up with Pfizer on 12-5-22
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: N/A - LOT# WAS DISCOVERED TO BE EXPIRED AFTER VACCINE ADMINISTRATION.
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urticaria
Clinical narrative: Patient  stated that 2 days after receiving the vaccine (11/28), she noticed hives starting to form on her front of neck, chest, legs, and arms that have significantly decreased to 2 small hives on her arm.
Age: 77.0
Sex: M
Vaccine: COVID19-2
Symptoms: Rash, Rash macular
Clinical narrative: Patient stated that 4 days after obtaining his vaccine, he was sitting on bench putting socks on when he noticed a rash on his left knee that over 2 days spread down the length of his leg in "splotches".
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal X-ray, Acute respiratory failure, Asthenia, Bronchitis, COVID-19
Clinical narrative: Severe muscle deconditioning Patient is a very pleasant 84 y.o. male patient of MD with history of alcohol abuse, CAD, COPD, depression, DM2 and HTN, mild dementia presented to Hospital with c/o shortness of breath on 11/7/2022.  The patient was experiencing acute hypoxemic respiratory failure from multiple etiologies including acute exacerbation of COPD, acute bronchitis, and COVID-19 positive pneumonia.  Patient was seen in consultation by infectious disease and the patient did receive remdesivir and IV dexamethasone and has improved significantly however due to his prolonged hospitalization the patient is significantly debilitated with severe muscle deconditioning and after a comprehensive evaluation by both physical and occupational therapies the patient has been deemed to be an appropriate candidate for aggressive rehabilitation here at transitional care unit.  This morning on physical exam the patient is examined at bedside he is awake alert and oriented x3 and denies any new complaints and specifically denies any chest pain or worsening shortness of breath, nausea or vomiting, diarrhea or constipation, dizziness or headache.  He will begin his aggressive rehabilitation plan of care soon as possible.   11/22/22:  Has delirium and he has history of confusion due to previous alcohol use is underlying mood disorder versus encephalopathy from alcohol withdrawal versus dementia due to alcoholism versus early dementia    Acute hypoxemic respiratory failure  Due to multiple etiologies including acute exacerbation of COPD, acute bronchitis and COVID-19 pneumonia.  Patient was treated aggressively with remdesivir and IV dexamethasone and now remains on supplemental oxygen at 3 L/min per nasal cannula but denies any worsening shortness of breath.  We will continue with nebulized bronchodilators and attempt to wean supplemental oxygen as tolerated. 11/22/22: He has COVID-19 he recovered from it but he has confusion x-ray is pending labs are unremarkable but the white count is borderline he will be treated with supportive care and antibiotic if needed    Hypertension Blood pressures are currently well controlled on atenolol 50 mg daily.   COPD (chronic obstructive pulmonary disease)  We will continue with nebulized bronchodilators and aggressive pulmonary hygiene. 11/22/22: He has COVID-19 he recovered from it but he has  abnormal x-ray  he will be treated with  antibiotic   Diabetes mellitus We will restart metformin and continue with sliding scale insulin as needed.  Most recent hemoglobin A1c was 7.0. 11/22/22: He has type 2 diabetes currently on metformin blood sugar has been good    Gastroesophageal reflux disease without esophagitis We will continue with Protonix 40 mg daily and as needed Maalox plus.   Alcoholism  Patient currently not exhibiting any signs of withdrawal will be encouraged abstinence upon discharge.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea, Glycosylated haemoglobin increased
Clinical narrative: Severe muscle deconditioning Patient is a very pleasant 84 y.o. male patient of MD with history of alcohol abuse, CAD, COPD, depression, DM2 and HTN, mild dementia presented to Hospital with c/o shortness of breath on 11/7/2022.  The patient was experiencing acute hypoxemic respiratory failure from multiple etiologies including acute exacerbation of COPD, acute bronchitis, and COVID-19 positive pneumonia.  Patient was seen in consultation by infectious disease and the patient did receive remdesivir and IV dexamethasone and has improved significantly however due to his prolonged hospitalization the patient is significantly debilitated with severe muscle deconditioning and after a comprehensive evaluation by both physical and occupational therapies the patient has been deemed to be an appropriate candidate for aggressive rehabilitation here at transitional care unit.  This morning on physical exam the patient is examined at bedside he is awake alert and oriented x3 and denies any new complaints and specifically denies any chest pain or worsening shortness of breath, nausea or vomiting, diarrhea or constipation, dizziness or headache.  He will begin his aggressive rehabilitation plan of care soon as possible.   11/22/22:  Has delirium and he has history of confusion due to previous alcohol use is underlying mood disorder versus encephalopathy from alcohol withdrawal versus dementia due to alcoholism versus early dementia    Acute hypoxemic respiratory failure  Due to multiple etiologies including acute exacerbation of COPD, acute bronchitis and COVID-19 pneumonia.  Patient was treated aggressively with remdesivir and IV dexamethasone and now remains on supplemental oxygen at 3 L/min per nasal cannula but denies any worsening shortness of breath.  We will continue with nebulized bronchodilators and attempt to wean supplemental oxygen as tolerated. 11/22/22: He has COVID-19 he recovered from it but he has confusion x-ray is pending labs are unremarkable but the white count is borderline he will be treated with supportive care and antibiotic if needed    Hypertension Blood pressures are currently well controlled on atenolol 50 mg daily.   COPD (chronic obstructive pulmonary disease)  We will continue with nebulized bronchodilators and aggressive pulmonary hygiene. 11/22/22: He has COVID-19 he recovered from it but he has  abnormal x-ray  he will be treated with  antibiotic   Diabetes mellitus We will restart metformin and continue with sliding scale insulin as needed.  Most recent hemoglobin A1c was 7.0. 11/22/22: He has type 2 diabetes currently on metformin blood sugar has been good    Gastroesophageal reflux disease without esophagitis We will continue with Protonix 40 mg daily and as needed Maalox plus.   Alcoholism  Patient currently not exhibiting any signs of withdrawal will be encouraged abstinence upon discharge.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test normal, Muscle disorder, SARS-CoV-2 test positive, White blood cell count abnormal, X-ray
Clinical narrative: Severe muscle deconditioning Patient is a very pleasant 84 y.o. male patient of MD with history of alcohol abuse, CAD, COPD, depression, DM2 and HTN, mild dementia presented to Hospital with c/o shortness of breath on 11/7/2022.  The patient was experiencing acute hypoxemic respiratory failure from multiple etiologies including acute exacerbation of COPD, acute bronchitis, and COVID-19 positive pneumonia.  Patient was seen in consultation by infectious disease and the patient did receive remdesivir and IV dexamethasone and has improved significantly however due to his prolonged hospitalization the patient is significantly debilitated with severe muscle deconditioning and after a comprehensive evaluation by both physical and occupational therapies the patient has been deemed to be an appropriate candidate for aggressive rehabilitation here at transitional care unit.  This morning on physical exam the patient is examined at bedside he is awake alert and oriented x3 and denies any new complaints and specifically denies any chest pain or worsening shortness of breath, nausea or vomiting, diarrhea or constipation, dizziness or headache.  He will begin his aggressive rehabilitation plan of care soon as possible.   11/22/22:  Has delirium and he has history of confusion due to previous alcohol use is underlying mood disorder versus encephalopathy from alcohol withdrawal versus dementia due to alcoholism versus early dementia    Acute hypoxemic respiratory failure  Due to multiple etiologies including acute exacerbation of COPD, acute bronchitis and COVID-19 pneumonia.  Patient was treated aggressively with remdesivir and IV dexamethasone and now remains on supplemental oxygen at 3 L/min per nasal cannula but denies any worsening shortness of breath.  We will continue with nebulized bronchodilators and attempt to wean supplemental oxygen as tolerated. 11/22/22: He has COVID-19 he recovered from it but he has confusion x-ray is pending labs are unremarkable but the white count is borderline he will be treated with supportive care and antibiotic if needed    Hypertension Blood pressures are currently well controlled on atenolol 50 mg daily.   COPD (chronic obstructive pulmonary disease)  We will continue with nebulized bronchodilators and aggressive pulmonary hygiene. 11/22/22: He has COVID-19 he recovered from it but he has  abnormal x-ray  he will be treated with  antibiotic   Diabetes mellitus We will restart metformin and continue with sliding scale insulin as needed.  Most recent hemoglobin A1c was 7.0. 11/22/22: He has type 2 diabetes currently on metformin blood sugar has been good    Gastroesophageal reflux disease without esophagitis We will continue with Protonix 40 mg daily and as needed Maalox plus.   Alcoholism  Patient currently not exhibiting any signs of withdrawal will be encouraged abstinence upon discharge.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anticoagulant therapy, Blood pressure increased, COVID-19, Chest X-ray
Clinical narrative: Patient is a 83 y.o. male patient Local MD with history of GAD, HD, HTN and afib presented to local Medical Center with stroke like symptoms .   Covid-19 Virus Infection Date of onset of symptoms: Unsure Symptoms present on admission: Confusion, maybe some mild dyspnea Date of covid positive test: 11/24/22 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: RA Current oxygen requirements: 2L Medical therapy: steroids-- plan for 10 day course Consultants following: None Anticipated special isolation end date: 12/4/2022 Patient high risk for readmission   Acute Hypoxemic Respiratory Failure Etiology: covid Baseline O2 requirements: none Current O2 requirements: 2L Continue pulmonary hygiene Wean O2 to baseline oxygen requirements as able Continue treatment of underlying etiologies as outlined Plan for home O2 on DC- 2L   Acute Metabolic Encephalopathy Cognitive Impairment Fall Patient with no formal diagnosis of dementia, wife reports patient with recent memory impairment Patient with inpatient fall overnight Confusion likely related to covid-19 Delirium precautions Fall precautions Haldol prn Home xanax resumedPermanent Atrial Fibrillation Follows with Dr. at local Hospital Initial rate control with cardizem gtt Anticoagulated with xarelto Home coreg switched to metoprolol Cardio cs'd Weaned off cardizem gtt as able; HR controlled Stable for DC per cardio   Stroke-Like Symptoms Patient presented from outside hospital for neurology evaluation and MRI Symptoms include- confusion, dysarthria, right sided grip weakness Patient has not taking home xarelto for one week-- resumed CT head 11/25 with no acute intracranial abnormality visualized.  MRI stroke 11/26 without acute abnormality HA1C 7.7 LDL 18 PT/OT/ST ordered Stroke ruled out Cleared per neurology for DC   Essential HTN Home losartan, coreg, imdur continued on admission Amlodipine held-- restarted 11/27 due to elevated BP IV hydralazine prn   DM2 HA1C 7.7 11/2022 Uncertain if new onset Consider metformin versus lifestyle modifications, outpatient PCP follow-up SSI, accuchecks ordered   GAD Patient takes scheduled Xanax at home and will continue for now, though would not recommend this medication for his age Patient would benefit from geriatrics evaluation as an outpatient   Hypokalemia Treatment per electrolyte replacement protocol Replace, recheck
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Cognitive disorder, Computerised tomogram head normal, Condition aggravated, Confusional state, Delirium
Clinical narrative: Patient is a 83 y.o. male patient Local MD with history of GAD, HD, HTN and afib presented to local Medical Center with stroke like symptoms .   Covid-19 Virus Infection Date of onset of symptoms: Unsure Symptoms present on admission: Confusion, maybe some mild dyspnea Date of covid positive test: 11/24/22 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: RA Current oxygen requirements: 2L Medical therapy: steroids-- plan for 10 day course Consultants following: None Anticipated special isolation end date: 12/4/2022 Patient high risk for readmission   Acute Hypoxemic Respiratory Failure Etiology: covid Baseline O2 requirements: none Current O2 requirements: 2L Continue pulmonary hygiene Wean O2 to baseline oxygen requirements as able Continue treatment of underlying etiologies as outlined Plan for home O2 on DC- 2L   Acute Metabolic Encephalopathy Cognitive Impairment Fall Patient with no formal diagnosis of dementia, wife reports patient with recent memory impairment Patient with inpatient fall overnight Confusion likely related to covid-19 Delirium precautions Fall precautions Haldol prn Home xanax resumedPermanent Atrial Fibrillation Follows with Dr. at local Hospital Initial rate control with cardizem gtt Anticoagulated with xarelto Home coreg switched to metoprolol Cardio cs'd Weaned off cardizem gtt as able; HR controlled Stable for DC per cardio   Stroke-Like Symptoms Patient presented from outside hospital for neurology evaluation and MRI Symptoms include- confusion, dysarthria, right sided grip weakness Patient has not taking home xarelto for one week-- resumed CT head 11/25 with no acute intracranial abnormality visualized.  MRI stroke 11/26 without acute abnormality HA1C 7.7 LDL 18 PT/OT/ST ordered Stroke ruled out Cleared per neurology for DC   Essential HTN Home losartan, coreg, imdur continued on admission Amlodipine held-- restarted 11/27 due to elevated BP IV hydralazine prn   DM2 HA1C 7.7 11/2022 Uncertain if new onset Consider metformin versus lifestyle modifications, outpatient PCP follow-up SSI, accuchecks ordered   GAD Patient takes scheduled Xanax at home and will continue for now, though would not recommend this medication for his age Patient would benefit from geriatrics evaluation as an outpatient   Hypokalemia Treatment per electrolyte replacement protocol Replace, recheck
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Dysarthria, Electrolyte substitution therapy, Fall, Glycosylated haemoglobin increased, Grip strength decreased
Clinical narrative: Patient is a 83 y.o. male patient Local MD with history of GAD, HD, HTN and afib presented to local Medical Center with stroke like symptoms .   Covid-19 Virus Infection Date of onset of symptoms: Unsure Symptoms present on admission: Confusion, maybe some mild dyspnea Date of covid positive test: 11/24/22 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: RA Current oxygen requirements: 2L Medical therapy: steroids-- plan for 10 day course Consultants following: None Anticipated special isolation end date: 12/4/2022 Patient high risk for readmission   Acute Hypoxemic Respiratory Failure Etiology: covid Baseline O2 requirements: none Current O2 requirements: 2L Continue pulmonary hygiene Wean O2 to baseline oxygen requirements as able Continue treatment of underlying etiologies as outlined Plan for home O2 on DC- 2L   Acute Metabolic Encephalopathy Cognitive Impairment Fall Patient with no formal diagnosis of dementia, wife reports patient with recent memory impairment Patient with inpatient fall overnight Confusion likely related to covid-19 Delirium precautions Fall precautions Haldol prn Home xanax resumedPermanent Atrial Fibrillation Follows with Dr. at local Hospital Initial rate control with cardizem gtt Anticoagulated with xarelto Home coreg switched to metoprolol Cardio cs'd Weaned off cardizem gtt as able; HR controlled Stable for DC per cardio   Stroke-Like Symptoms Patient presented from outside hospital for neurology evaluation and MRI Symptoms include- confusion, dysarthria, right sided grip weakness Patient has not taking home xarelto for one week-- resumed CT head 11/25 with no acute intracranial abnormality visualized.  MRI stroke 11/26 without acute abnormality HA1C 7.7 LDL 18 PT/OT/ST ordered Stroke ruled out Cleared per neurology for DC   Essential HTN Home losartan, coreg, imdur continued on admission Amlodipine held-- restarted 11/27 due to elevated BP IV hydralazine prn   DM2 HA1C 7.7 11/2022 Uncertain if new onset Consider metformin versus lifestyle modifications, outpatient PCP follow-up SSI, accuchecks ordered   GAD Patient takes scheduled Xanax at home and will continue for now, though would not recommend this medication for his age Patient would benefit from geriatrics evaluation as an outpatient   Hypokalemia Treatment per electrolyte replacement protocol Replace, recheck
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Hypokalaemia, Low density lipoprotein normal, Magnetic resonance imaging normal, Memory impairment, Metabolic encephalopathy
Clinical narrative: Patient is a 83 y.o. male patient Local MD with history of GAD, HD, HTN and afib presented to local Medical Center with stroke like symptoms .   Covid-19 Virus Infection Date of onset of symptoms: Unsure Symptoms present on admission: Confusion, maybe some mild dyspnea Date of covid positive test: 11/24/22 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: RA Current oxygen requirements: 2L Medical therapy: steroids-- plan for 10 day course Consultants following: None Anticipated special isolation end date: 12/4/2022 Patient high risk for readmission   Acute Hypoxemic Respiratory Failure Etiology: covid Baseline O2 requirements: none Current O2 requirements: 2L Continue pulmonary hygiene Wean O2 to baseline oxygen requirements as able Continue treatment of underlying etiologies as outlined Plan for home O2 on DC- 2L   Acute Metabolic Encephalopathy Cognitive Impairment Fall Patient with no formal diagnosis of dementia, wife reports patient with recent memory impairment Patient with inpatient fall overnight Confusion likely related to covid-19 Delirium precautions Fall precautions Haldol prn Home xanax resumedPermanent Atrial Fibrillation Follows with Dr. at local Hospital Initial rate control with cardizem gtt Anticoagulated with xarelto Home coreg switched to metoprolol Cardio cs'd Weaned off cardizem gtt as able; HR controlled Stable for DC per cardio   Stroke-Like Symptoms Patient presented from outside hospital for neurology evaluation and MRI Symptoms include- confusion, dysarthria, right sided grip weakness Patient has not taking home xarelto for one week-- resumed CT head 11/25 with no acute intracranial abnormality visualized.  MRI stroke 11/26 without acute abnormality HA1C 7.7 LDL 18 PT/OT/ST ordered Stroke ruled out Cleared per neurology for DC   Essential HTN Home losartan, coreg, imdur continued on admission Amlodipine held-- restarted 11/27 due to elevated BP IV hydralazine prn   DM2 HA1C 7.7 11/2022 Uncertain if new onset Consider metformin versus lifestyle modifications, outpatient PCP follow-up SSI, accuchecks ordered   GAD Patient takes scheduled Xanax at home and will continue for now, though would not recommend this medication for his age Patient would benefit from geriatrics evaluation as an outpatient   Hypokalemia Treatment per electrolyte replacement protocol Replace, recheck
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Neurological symptom, SARS-CoV-2 test positive, Type 2 diabetes mellitus
Clinical narrative: Patient is a 83 y.o. male patient Local MD with history of GAD, HD, HTN and afib presented to local Medical Center with stroke like symptoms .   Covid-19 Virus Infection Date of onset of symptoms: Unsure Symptoms present on admission: Confusion, maybe some mild dyspnea Date of covid positive test: 11/24/22 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: RA Current oxygen requirements: 2L Medical therapy: steroids-- plan for 10 day course Consultants following: None Anticipated special isolation end date: 12/4/2022 Patient high risk for readmission   Acute Hypoxemic Respiratory Failure Etiology: covid Baseline O2 requirements: none Current O2 requirements: 2L Continue pulmonary hygiene Wean O2 to baseline oxygen requirements as able Continue treatment of underlying etiologies as outlined Plan for home O2 on DC- 2L   Acute Metabolic Encephalopathy Cognitive Impairment Fall Patient with no formal diagnosis of dementia, wife reports patient with recent memory impairment Patient with inpatient fall overnight Confusion likely related to covid-19 Delirium precautions Fall precautions Haldol prn Home xanax resumedPermanent Atrial Fibrillation Follows with Dr. at local Hospital Initial rate control with cardizem gtt Anticoagulated with xarelto Home coreg switched to metoprolol Cardio cs'd Weaned off cardizem gtt as able; HR controlled Stable for DC per cardio   Stroke-Like Symptoms Patient presented from outside hospital for neurology evaluation and MRI Symptoms include- confusion, dysarthria, right sided grip weakness Patient has not taking home xarelto for one week-- resumed CT head 11/25 with no acute intracranial abnormality visualized.  MRI stroke 11/26 without acute abnormality HA1C 7.7 LDL 18 PT/OT/ST ordered Stroke ruled out Cleared per neurology for DC   Essential HTN Home losartan, coreg, imdur continued on admission Amlodipine held-- restarted 11/27 due to elevated BP IV hydralazine prn   DM2 HA1C 7.7 11/2022 Uncertain if new onset Consider metformin versus lifestyle modifications, outpatient PCP follow-up SSI, accuchecks ordered   GAD Patient takes scheduled Xanax at home and will continue for now, though would not recommend this medication for his age Patient would benefit from geriatrics evaluation as an outpatient   Hypokalemia Treatment per electrolyte replacement protocol Replace, recheck
Age: 43.0
Sex: F
Vaccine: FLUA4
Symptoms: Needle issue, Product leakage
Clinical narrative: I gave vaccine and needle malfunctioned and some of the vaccine leaked. I did not administer the full syringe. Once this happened I withdrew the needle.  I re-administered a full dose.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal dreams, Fatigue, Hallucination, Immediate post-injection reaction, Insomnia
Clinical narrative: I am a healthy 41 year old woman, mother of three children, citizen, with no history of medical conditions. On January 15th, 2022, I received the Moderna booster vaccine (this was my third vaccination, I had previously received two Pfizer vaccinations in the summer of 2021). Immediately following the vaccination, I experienced, for the first time in my life, severe insomnia, sleep paralysis, hallucinations, and very vivid dreams. I have been battling these symptoms since January of this year. I have consistently, every night with no exception, multiple vivid dreams (in which I am sometimes fully aware I am lying in my bed while dreaming). I also consistently wake up every morning unrefreshed and tired, and experience excessive daytime sleepiness throughout the day. In summary, I haven't had a proper restorative night's sleep since receiving the Moderna vaccine.  The muscles around my left eye have begun to twitch recently (past 4 weeks) and partially squeeze my eye closed throughout the day. Needless to say, I am extremely suspicious that the Moderna vaccine caused this, since nothing else can explain this sudden onset of symptoms. I have never had any issues with my sleep before. I am very healthy, and have a wonderful life otherwise.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Muscle twitching, Poor quality sleep, Sleep paralysis, Somnolence
Clinical narrative: I am a healthy 41 year old woman, mother of three children, citizen, with no history of medical conditions. On January 15th, 2022, I received the Moderna booster vaccine (this was my third vaccination, I had previously received two Pfizer vaccinations in the summer of 2021). Immediately following the vaccination, I experienced, for the first time in my life, severe insomnia, sleep paralysis, hallucinations, and very vivid dreams. I have been battling these symptoms since January of this year. I have consistently, every night with no exception, multiple vivid dreams (in which I am sometimes fully aware I am lying in my bed while dreaming). I also consistently wake up every morning unrefreshed and tired, and experience excessive daytime sleepiness throughout the day. In summary, I haven't had a proper restorative night's sleep since receiving the Moderna vaccine.  The muscles around my left eye have begun to twitch recently (past 4 weeks) and partially squeeze my eye closed throughout the day. Needless to say, I am extremely suspicious that the Moderna vaccine caused this, since nothing else can explain this sudden onset of symptoms. I have never had any issues with my sleep before. I am very healthy, and have a wonderful life otherwise.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood glucose increased, COVID-19, Chest X-ray normal, Computerised tomogram abdomen abnormal
Clinical narrative: Clinical Summary Patient is a 43 y.o. male with a history of CKD on PD, T1DM who presented to the HCF 11/24/2022 with fever, nausea and emesis.  Found to have COVID-19      1. Acute Covid-19 Virus Infection/Sepsis?POA: Home test + 11/24/2022.  Positive at HCF 11/25/2022.  Vaccinated.  No booster.  Chest x-ray does not show any acute changes.  Febrile, leukocytosis.  Procalcitonin elevated.  No Decadron or abx as per infectious disease.  S/p Paxlovid .  ID followed 2. Acute Hypoxic Respiratory Failure: Likely due to COVID.  Does not use oxygen at home.   Weaned to room air. 3. Elevated troponin: 365?316.  No chest pain.  Likely demand ischemia due to hypoxia and ESRD.   4. Hypertensive urgency: Improved.  Continued home meds.  5. ESRD: on PD, last dialysis 11/23/2022 with reported clear dialysate. Follows with Dr. (Nephrologist).  Nephrology followed 6. IDDM1: A1c 5.3?11/25/2022.  Basal home insulin was decreased initially due to hypoglycemia.  Blood sugars were then elevated due to patient's refusal to take sliding scale as advised.  Resume home dose at discharge.  Patient to follow blood sugar closely at home and use SSI as needed along with basal.  7. History of Right Foot OM: S/p right 5th ray amputation on 8/30/2019. S/p right foot debridement with partial 5th metatarsal resection and right foot application of skin substitute graft on 10/3/2019. XR Right Foot showed concerns of osteomyelitis.  No need for MRI as per infectious disease.  Follow-up with podiatry as outpatient.  Initially patient said that he has appointment for BKA, then asked for referrals?provided. 8. Abnormal CT Finding: Admit CT revealed few punctate bilateral nonobstructing renal stones, bulging annulus at L4-5 flattening anterior thecal sac. Follow up as outpatient with PCP.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: End stage renal disease, Glycosylated haemoglobin normal, Hypertensive urgency, Hypoglycaemia, Intervertebral disc protrusion
Clinical narrative: Clinical Summary Patient is a 43 y.o. male with a history of CKD on PD, T1DM who presented to the HCF 11/24/2022 with fever, nausea and emesis.  Found to have COVID-19      1. Acute Covid-19 Virus Infection/Sepsis?POA: Home test + 11/24/2022.  Positive at HCF 11/25/2022.  Vaccinated.  No booster.  Chest x-ray does not show any acute changes.  Febrile, leukocytosis.  Procalcitonin elevated.  No Decadron or abx as per infectious disease.  S/p Paxlovid .  ID followed 2. Acute Hypoxic Respiratory Failure: Likely due to COVID.  Does not use oxygen at home.   Weaned to room air. 3. Elevated troponin: 365?316.  No chest pain.  Likely demand ischemia due to hypoxia and ESRD.   4. Hypertensive urgency: Improved.  Continued home meds.  5. ESRD: on PD, last dialysis 11/23/2022 with reported clear dialysate. Follows with Dr. (Nephrologist).  Nephrology followed 6. IDDM1: A1c 5.3?11/25/2022.  Basal home insulin was decreased initially due to hypoglycemia.  Blood sugars were then elevated due to patient's refusal to take sliding scale as advised.  Resume home dose at discharge.  Patient to follow blood sugar closely at home and use SSI as needed along with basal.  7. History of Right Foot OM: S/p right 5th ray amputation on 8/30/2019. S/p right foot debridement with partial 5th metatarsal resection and right foot application of skin substitute graft on 10/3/2019. XR Right Foot showed concerns of osteomyelitis.  No need for MRI as per infectious disease.  Follow-up with podiatry as outpatient.  Initially patient said that he has appointment for BKA, then asked for referrals?provided. 8. Abnormal CT Finding: Admit CT revealed few punctate bilateral nonobstructing renal stones, bulging annulus at L4-5 flattening anterior thecal sac. Follow up as outpatient with PCP.