chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Condition aggravated, Eating disorder, Echocardiogram abnormal, Ejection fraction decreased, Hiatus hernia
Clinical narrative: Patient is a 83 y.o. male patient of MD with history of chronic respiratory failure on home 2-3 L, Afib on Eliquis, HFpEF, CAD, HTN, HLD presented to Medical Center with seizure like activity and hypoxia, admitted for COVID PNA    Acute on Chronic Respiratory Failure with Hypoxia Presented with AMS and Hypoxia Secondary to COVID-19, Pleural effusions, PNA On 2L O2 at baseline, recently on HHFNC when sent to Select and was initially improved, on BIPAP on admission, now weaned to HHFNC>>3L NC CTPA (10/21) showed significant worsening of bilateral pleural fluid effusions, Large on R, mod on left  with adjacent B/L LL consolidations and extensive patchy infiltrates in RUL and LLL Currently on 2 to 3 L nasal cannula Stable to discharge per pulmonary   Covid-19 Virus Infection Date of onset of symptoms: 10/21 Symptoms present on admission: Hypoxia, AMS Date of covid positive test: 10/21 Vaccination status: vaccinated Imaging: CTPA with bilateral patchy opacities Oxygen requirements on admission: BIPAP Current oxygen requirements: HHFNC Medical therapy: completed remdesivir, continue steroids x 10 days, Completed 7 days of Cefepime Consultants following: Pulm  Anticipated special isolation end date: 11/1/23   HAP Pseudomonas Pneumonia Afebrile, Leukocytosis to 11.62k CTPA with B/L LL consolidations and extensive patchy infiltrates in RUL and LLL MRSA probe negative Sputum cx positive for Pseudomonas Vanco and Cefepime started on admission, Vanco discontinued as MRSA probe negative Completed Cefepime x 7 day course   Episode of unresponsiveness Concern for seizure like activity per Select Hospital Likely due to hypoxia due to COVID-19, PNA No CT head ordered on admission Neurology consulted, low suspicion for seizure Hold off on AED at this time Can obtain MRI brain and spot EEG if further episodes of unresponsiveness occur outside of setting of hypoxia or if seizure like activity is notes No further episodes   Hiatal hernia Difficulty eating due to hiatal hernia Chopped/soft diet per pt preference Boost TID   COPD Exacerbation due to PNA and COVID-19 Continue home AirDuo Diginhaler Continue home Duonebs Already on steroids due to COVID Chronic HFpEF HTN Echo (9/2023) with EF 50-55% Continue home  Coreg and lasix   Afib  Continue home Sotalol, Coreg and Eliquis    CAD HLD S/p previous PCI Continue home ASA and Lipitor    GOC Palliative care consulted Continue DNR CCA, okay with intubation
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hypoxia, Leukocytosis, Lung consolidation, Lung infiltration, Lung opacity
Clinical narrative: Patient is a 83 y.o. male patient of MD with history of chronic respiratory failure on home 2-3 L, Afib on Eliquis, HFpEF, CAD, HTN, HLD presented to Medical Center with seizure like activity and hypoxia, admitted for COVID PNA    Acute on Chronic Respiratory Failure with Hypoxia Presented with AMS and Hypoxia Secondary to COVID-19, Pleural effusions, PNA On 2L O2 at baseline, recently on HHFNC when sent to Select and was initially improved, on BIPAP on admission, now weaned to HHFNC>>3L NC CTPA (10/21) showed significant worsening of bilateral pleural fluid effusions, Large on R, mod on left  with adjacent B/L LL consolidations and extensive patchy infiltrates in RUL and LLL Currently on 2 to 3 L nasal cannula Stable to discharge per pulmonary   Covid-19 Virus Infection Date of onset of symptoms: 10/21 Symptoms present on admission: Hypoxia, AMS Date of covid positive test: 10/21 Vaccination status: vaccinated Imaging: CTPA with bilateral patchy opacities Oxygen requirements on admission: BIPAP Current oxygen requirements: HHFNC Medical therapy: completed remdesivir, continue steroids x 10 days, Completed 7 days of Cefepime Consultants following: Pulm  Anticipated special isolation end date: 11/1/23   HAP Pseudomonas Pneumonia Afebrile, Leukocytosis to 11.62k CTPA with B/L LL consolidations and extensive patchy infiltrates in RUL and LLL MRSA probe negative Sputum cx positive for Pseudomonas Vanco and Cefepime started on admission, Vanco discontinued as MRSA probe negative Completed Cefepime x 7 day course   Episode of unresponsiveness Concern for seizure like activity per Select Hospital Likely due to hypoxia due to COVID-19, PNA No CT head ordered on admission Neurology consulted, low suspicion for seizure Hold off on AED at this time Can obtain MRI brain and spot EEG if further episodes of unresponsiveness occur outside of setting of hypoxia or if seizure like activity is notes No further episodes   Hiatal hernia Difficulty eating due to hiatal hernia Chopped/soft diet per pt preference Boost TID   COPD Exacerbation due to PNA and COVID-19 Continue home AirDuo Diginhaler Continue home Duonebs Already on steroids due to COVID Chronic HFpEF HTN Echo (9/2023) with EF 50-55% Continue home  Coreg and lasix   Afib  Continue home Sotalol, Coreg and Eliquis    CAD HLD S/p previous PCI Continue home ASA and Lipitor    GOC Palliative care consulted Continue DNR CCA, okay with intubation
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Mental status changes, Pleural effusion, Pneumonia, Pneumonia pseudomonal, Positive airway pressure therapy
Clinical narrative: Patient is a 83 y.o. male patient of MD with history of chronic respiratory failure on home 2-3 L, Afib on Eliquis, HFpEF, CAD, HTN, HLD presented to Medical Center with seizure like activity and hypoxia, admitted for COVID PNA    Acute on Chronic Respiratory Failure with Hypoxia Presented with AMS and Hypoxia Secondary to COVID-19, Pleural effusions, PNA On 2L O2 at baseline, recently on HHFNC when sent to Select and was initially improved, on BIPAP on admission, now weaned to HHFNC>>3L NC CTPA (10/21) showed significant worsening of bilateral pleural fluid effusions, Large on R, mod on left  with adjacent B/L LL consolidations and extensive patchy infiltrates in RUL and LLL Currently on 2 to 3 L nasal cannula Stable to discharge per pulmonary   Covid-19 Virus Infection Date of onset of symptoms: 10/21 Symptoms present on admission: Hypoxia, AMS Date of covid positive test: 10/21 Vaccination status: vaccinated Imaging: CTPA with bilateral patchy opacities Oxygen requirements on admission: BIPAP Current oxygen requirements: HHFNC Medical therapy: completed remdesivir, continue steroids x 10 days, Completed 7 days of Cefepime Consultants following: Pulm  Anticipated special isolation end date: 11/1/23   HAP Pseudomonas Pneumonia Afebrile, Leukocytosis to 11.62k CTPA with B/L LL consolidations and extensive patchy infiltrates in RUL and LLL MRSA probe negative Sputum cx positive for Pseudomonas Vanco and Cefepime started on admission, Vanco discontinued as MRSA probe negative Completed Cefepime x 7 day course   Episode of unresponsiveness Concern for seizure like activity per Select Hospital Likely due to hypoxia due to COVID-19, PNA No CT head ordered on admission Neurology consulted, low suspicion for seizure Hold off on AED at this time Can obtain MRI brain and spot EEG if further episodes of unresponsiveness occur outside of setting of hypoxia or if seizure like activity is notes No further episodes   Hiatal hernia Difficulty eating due to hiatal hernia Chopped/soft diet per pt preference Boost TID   COPD Exacerbation due to PNA and COVID-19 Continue home AirDuo Diginhaler Continue home Duonebs Already on steroids due to COVID Chronic HFpEF HTN Echo (9/2023) with EF 50-55% Continue home  Coreg and lasix   Afib  Continue home Sotalol, Coreg and Eliquis    CAD HLD S/p previous PCI Continue home ASA and Lipitor    GOC Palliative care consulted Continue DNR CCA, okay with intubation
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pseudomonas test positive, SARS-CoV-2 test positive, Seizure like phenomena, Staphylococcus test negative, Unresponsive to stimuli
Clinical narrative: Patient is a 83 y.o. male patient of MD with history of chronic respiratory failure on home 2-3 L, Afib on Eliquis, HFpEF, CAD, HTN, HLD presented to Medical Center with seizure like activity and hypoxia, admitted for COVID PNA    Acute on Chronic Respiratory Failure with Hypoxia Presented with AMS and Hypoxia Secondary to COVID-19, Pleural effusions, PNA On 2L O2 at baseline, recently on HHFNC when sent to Select and was initially improved, on BIPAP on admission, now weaned to HHFNC>>3L NC CTPA (10/21) showed significant worsening of bilateral pleural fluid effusions, Large on R, mod on left  with adjacent B/L LL consolidations and extensive patchy infiltrates in RUL and LLL Currently on 2 to 3 L nasal cannula Stable to discharge per pulmonary   Covid-19 Virus Infection Date of onset of symptoms: 10/21 Symptoms present on admission: Hypoxia, AMS Date of covid positive test: 10/21 Vaccination status: vaccinated Imaging: CTPA with bilateral patchy opacities Oxygen requirements on admission: BIPAP Current oxygen requirements: HHFNC Medical therapy: completed remdesivir, continue steroids x 10 days, Completed 7 days of Cefepime Consultants following: Pulm  Anticipated special isolation end date: 11/1/23   HAP Pseudomonas Pneumonia Afebrile, Leukocytosis to 11.62k CTPA with B/L LL consolidations and extensive patchy infiltrates in RUL and LLL MRSA probe negative Sputum cx positive for Pseudomonas Vanco and Cefepime started on admission, Vanco discontinued as MRSA probe negative Completed Cefepime x 7 day course   Episode of unresponsiveness Concern for seizure like activity per Select Hospital Likely due to hypoxia due to COVID-19, PNA No CT head ordered on admission Neurology consulted, low suspicion for seizure Hold off on AED at this time Can obtain MRI brain and spot EEG if further episodes of unresponsiveness occur outside of setting of hypoxia or if seizure like activity is notes No further episodes   Hiatal hernia Difficulty eating due to hiatal hernia Chopped/soft diet per pt preference Boost TID   COPD Exacerbation due to PNA and COVID-19 Continue home AirDuo Diginhaler Continue home Duonebs Already on steroids due to COVID Chronic HFpEF HTN Echo (9/2023) with EF 50-55% Continue home  Coreg and lasix   Afib  Continue home Sotalol, Coreg and Eliquis    CAD HLD S/p previous PCI Continue home ASA and Lipitor    GOC Palliative care consulted Continue DNR CCA, okay with intubation
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: White blood cell count increased
Clinical narrative: Patient is a 83 y.o. male patient of MD with history of chronic respiratory failure on home 2-3 L, Afib on Eliquis, HFpEF, CAD, HTN, HLD presented to Medical Center with seizure like activity and hypoxia, admitted for COVID PNA    Acute on Chronic Respiratory Failure with Hypoxia Presented with AMS and Hypoxia Secondary to COVID-19, Pleural effusions, PNA On 2L O2 at baseline, recently on HHFNC when sent to Select and was initially improved, on BIPAP on admission, now weaned to HHFNC>>3L NC CTPA (10/21) showed significant worsening of bilateral pleural fluid effusions, Large on R, mod on left  with adjacent B/L LL consolidations and extensive patchy infiltrates in RUL and LLL Currently on 2 to 3 L nasal cannula Stable to discharge per pulmonary   Covid-19 Virus Infection Date of onset of symptoms: 10/21 Symptoms present on admission: Hypoxia, AMS Date of covid positive test: 10/21 Vaccination status: vaccinated Imaging: CTPA with bilateral patchy opacities Oxygen requirements on admission: BIPAP Current oxygen requirements: HHFNC Medical therapy: completed remdesivir, continue steroids x 10 days, Completed 7 days of Cefepime Consultants following: Pulm  Anticipated special isolation end date: 11/1/23   HAP Pseudomonas Pneumonia Afebrile, Leukocytosis to 11.62k CTPA with B/L LL consolidations and extensive patchy infiltrates in RUL and LLL MRSA probe negative Sputum cx positive for Pseudomonas Vanco and Cefepime started on admission, Vanco discontinued as MRSA probe negative Completed Cefepime x 7 day course   Episode of unresponsiveness Concern for seizure like activity per Select Hospital Likely due to hypoxia due to COVID-19, PNA No CT head ordered on admission Neurology consulted, low suspicion for seizure Hold off on AED at this time Can obtain MRI brain and spot EEG if further episodes of unresponsiveness occur outside of setting of hypoxia or if seizure like activity is notes No further episodes   Hiatal hernia Difficulty eating due to hiatal hernia Chopped/soft diet per pt preference Boost TID   COPD Exacerbation due to PNA and COVID-19 Continue home AirDuo Diginhaler Continue home Duonebs Already on steroids due to COVID Chronic HFpEF HTN Echo (9/2023) with EF 50-55% Continue home  Coreg and lasix   Afib  Continue home Sotalol, Coreg and Eliquis    CAD HLD S/p previous PCI Continue home ASA and Lipitor    GOC Palliative care consulted Continue DNR CCA, okay with intubation
Age: 98.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray, Condition aggravated
Clinical narrative: Patient is a 99 y.o. male patient of, DO with history of COPD on home oxygen, type 2 diabetes, coronary disease, history of right upper lobe lobectomy presented to Hospital with shortness of breath and COVID-positive.   Acute on chronic respiratory failure Shortness of breath with multifocal pneumonia Mostly COVID Pneumonia  Started on  Rocephin and Zithromax Breathing treatment Pain management Supportive care ID team is following      Covid-19 Virus Infection Date of onset of symptoms: 10/17/2023 Symptoms present on admission: Yes Date of covid positive test: 10/19/2023 Vaccination status:  Imaging: Chest x-ray Oxygen requirements on admission: Yes Current oxygen requirements: 3 L Medical therapy: steroids, rocephin, and zithromax, and Remdesvir Consultants following:  ID  Anticipated special isolation end date: 10/28/2023   Type 2 diabetes uncontrolled Last A1c 8.4 Continue metformin  add sliding scale   Anxiety Continue Zoloft   Hypertension Continue amlodipine   Insomnia Continue melatonin
Age: 98.0
Sex: M
Vaccine: COVID19-2
Symptoms: Diabetes mellitus inadequate control, Dyspnoea, Glycosylated haemoglobin increased, Malaise, Pneumonia
Clinical narrative: Patient is a 99 y.o. male patient of, DO with history of COPD on home oxygen, type 2 diabetes, coronary disease, history of right upper lobe lobectomy presented to Hospital with shortness of breath and COVID-positive.   Acute on chronic respiratory failure Shortness of breath with multifocal pneumonia Mostly COVID Pneumonia  Started on  Rocephin and Zithromax Breathing treatment Pain management Supportive care ID team is following      Covid-19 Virus Infection Date of onset of symptoms: 10/17/2023 Symptoms present on admission: Yes Date of covid positive test: 10/19/2023 Vaccination status:  Imaging: Chest x-ray Oxygen requirements on admission: Yes Current oxygen requirements: 3 L Medical therapy: steroids, rocephin, and zithromax, and Remdesvir Consultants following:  ID  Anticipated special isolation end date: 10/28/2023   Type 2 diabetes uncontrolled Last A1c 8.4 Continue metformin  add sliding scale   Anxiety Continue Zoloft   Hypertension Continue amlodipine   Insomnia Continue melatonin
Age: 98.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Type 2 diabetes mellitus
Clinical narrative: Patient is a 99 y.o. male patient of, DO with history of COPD on home oxygen, type 2 diabetes, coronary disease, history of right upper lobe lobectomy presented to Hospital with shortness of breath and COVID-positive.   Acute on chronic respiratory failure Shortness of breath with multifocal pneumonia Mostly COVID Pneumonia  Started on  Rocephin and Zithromax Breathing treatment Pain management Supportive care ID team is following      Covid-19 Virus Infection Date of onset of symptoms: 10/17/2023 Symptoms present on admission: Yes Date of covid positive test: 10/19/2023 Vaccination status:  Imaging: Chest x-ray Oxygen requirements on admission: Yes Current oxygen requirements: 3 L Medical therapy: steroids, rocephin, and zithromax, and Remdesvir Consultants following:  ID  Anticipated special isolation end date: 10/28/2023   Type 2 diabetes uncontrolled Last A1c 8.4 Continue metformin  add sliding scale   Anxiety Continue Zoloft   Hypertension Continue amlodipine   Insomnia Continue melatonin
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Asthenia, Brain radiation necrosis, COVID-19
Clinical narrative: Patient is a 81 y.o. female patient of MD with history of PE, NHL, breast cancer, NSCLC with bone mets, GERD, RLS, who presented to Hospital with shortness of breath and weakness with close contacts who were COVID positive, COVID confirmed to be positive.   Covid-19 Virus Infection Acute hypox res failure 2/2 above-resolved Date of onset of symptoms: 10/10/2023 Symptoms present on admission: SOB, cough Date of covid positive test: 10/23/2023 Vaccination status: vaccinated Imaging: CTA with bilateral ground glass opacities.  No PE. Oxygen requirements on admission: 2Lpm by NC Oxygen requirements on discharge: Room air, no oxygen required per home O2 testing Medical therapy: Completed 4 doses of remdesivir We will discharge on p.o. dexamethasone to complete a total of 10 days Consultants following: ID Anticipated special isolation end date: 10/28/2023   Mild hypokalemia-resolved   GERD Pantoprazole   PE, remote CTA showed no PE Continue home Xarelto   Central diabetes insipidus  DDAVP held while inpatient, continue to hold until 3 days after completing dexamethasone   Current use of immunotherapy with Keytruda for metastatic non-small cell lung cancer Vasogenic edema in the brain-likely radiation necrosis Follow up with oncology as outpatient Obtain MRI -some decrease in vasogenic edema, unable to assess masses due to lack on contrast
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Dyspnoea, Exposure to SARS-CoV-2, Hypokalaemia, Intracranial mass
Clinical narrative: Patient is a 81 y.o. female patient of MD with history of PE, NHL, breast cancer, NSCLC with bone mets, GERD, RLS, who presented to Hospital with shortness of breath and weakness with close contacts who were COVID positive, COVID confirmed to be positive.   Covid-19 Virus Infection Acute hypox res failure 2/2 above-resolved Date of onset of symptoms: 10/10/2023 Symptoms present on admission: SOB, cough Date of covid positive test: 10/23/2023 Vaccination status: vaccinated Imaging: CTA with bilateral ground glass opacities.  No PE. Oxygen requirements on admission: 2Lpm by NC Oxygen requirements on discharge: Room air, no oxygen required per home O2 testing Medical therapy: Completed 4 doses of remdesivir We will discharge on p.o. dexamethasone to complete a total of 10 days Consultants following: ID Anticipated special isolation end date: 10/28/2023   Mild hypokalemia-resolved   GERD Pantoprazole   PE, remote CTA showed no PE Continue home Xarelto   Central diabetes insipidus  DDAVP held while inpatient, continue to hold until 3 days after completing dexamethasone   Current use of immunotherapy with Keytruda for metastatic non-small cell lung cancer Vasogenic edema in the brain-likely radiation necrosis Follow up with oncology as outpatient Obtain MRI -some decrease in vasogenic edema, unable to assess masses due to lack on contrast
Age: 80.0
Sex: F
Vaccine: COVID19-2
Symptoms: Lung opacity, SARS-CoV-2 test positive, Vasogenic cerebral oedema
Clinical narrative: Patient is a 81 y.o. female patient of MD with history of PE, NHL, breast cancer, NSCLC with bone mets, GERD, RLS, who presented to Hospital with shortness of breath and weakness with close contacts who were COVID positive, COVID confirmed to be positive.   Covid-19 Virus Infection Acute hypox res failure 2/2 above-resolved Date of onset of symptoms: 10/10/2023 Symptoms present on admission: SOB, cough Date of covid positive test: 10/23/2023 Vaccination status: vaccinated Imaging: CTA with bilateral ground glass opacities.  No PE. Oxygen requirements on admission: 2Lpm by NC Oxygen requirements on discharge: Room air, no oxygen required per home O2 testing Medical therapy: Completed 4 doses of remdesivir We will discharge on p.o. dexamethasone to complete a total of 10 days Consultants following: ID Anticipated special isolation end date: 10/28/2023   Mild hypokalemia-resolved   GERD Pantoprazole   PE, remote CTA showed no PE Continue home Xarelto   Central diabetes insipidus  DDAVP held while inpatient, continue to hold until 3 days after completing dexamethasone   Current use of immunotherapy with Keytruda for metastatic non-small cell lung cancer Vasogenic edema in the brain-likely radiation necrosis Follow up with oncology as outpatient Obtain MRI -some decrease in vasogenic edema, unable to assess masses due to lack on contrast
Age: 80.0
Sex: F
Vaccine: RSV
Symptoms: Erythema, Pain, Pruritus
Clinical narrative: patient complains of itching and redness after soreness.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Depression, Menstrual disorder, Premenstrual dysphoric disorder, Tinnitus
Clinical narrative: Tinnitus in both ears since vaccine; severe increase in menstrual cycle symptoms and PMDD in cycle following the vaccine only, with main complaints being intense depression and anxiety.
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Atrioventricular block first degree, COVID-19 pneumonia, Cardiomegaly
Clinical narrative: Patient is a 87 y.o. male patient of DO with history of aortic stenosis s/p TAVR 2017, CAD, prior CVA, GERD, HTN, HLD, and SSS s/p pacemaker presented to Hospital with chest pain.   Acute hypoxic respiratory failure - resolved COVID-19 Viral pneumonia P/w 1 day history of cough, SOB with exertion and chest tightness Afebrile on arrival, HR 91, RR 16, BP 132/61, satting >94% on RA Initial CBC w leukocytosis to 14.05. BMP unremarkable  CXR: cardiomegaly, no acute process  Per ED, hypoxic with ambulation Started on decadron Currently stable on RA D-dimer was checked on admission, and mildly elevated CTPA w/o PE, No focal consolidation, pleural effusion or pneumothorax. Solid pulmonary nodule in the right lower lobe measuring 4 mm Ambulate as able and check O2 level while ambulation Albuterol, robitussin-DM, tylenol PRN Encourage IS use PT/OT/SW   Essential HTN HLD SSS s/p pacemaker 2017 Aortic stenosis s/p TAVR 2017 Normotensive on admission, no complaints Initial troponin 21, repeat 23 EKG (my read): 1st degree AV block, V-paced  2D echo in 8/2022 w LVEF 56%, grade 1 diastolic dysfunction, TAVR functioning well  Continue home metoprolol, statin, and plavix Monitor on telemetry
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest X-ray abnormal, Chest discomfort, Chest pain, Cough, Dyspnoea
Clinical narrative: Patient is a 87 y.o. male patient of DO with history of aortic stenosis s/p TAVR 2017, CAD, prior CVA, GERD, HTN, HLD, and SSS s/p pacemaker presented to Hospital with chest pain.   Acute hypoxic respiratory failure - resolved COVID-19 Viral pneumonia P/w 1 day history of cough, SOB with exertion and chest tightness Afebrile on arrival, HR 91, RR 16, BP 132/61, satting >94% on RA Initial CBC w leukocytosis to 14.05. BMP unremarkable  CXR: cardiomegaly, no acute process  Per ED, hypoxic with ambulation Started on decadron Currently stable on RA D-dimer was checked on admission, and mildly elevated CTPA w/o PE, No focal consolidation, pleural effusion or pneumothorax. Solid pulmonary nodule in the right lower lobe measuring 4 mm Ambulate as able and check O2 level while ambulation Albuterol, robitussin-DM, tylenol PRN Encourage IS use PT/OT/SW   Essential HTN HLD SSS s/p pacemaker 2017 Aortic stenosis s/p TAVR 2017 Normotensive on admission, no complaints Initial troponin 21, repeat 23 EKG (my read): 1st degree AV block, V-paced  2D echo in 8/2022 w LVEF 56%, grade 1 diastolic dysfunction, TAVR functioning well  Continue home metoprolol, statin, and plavix Monitor on telemetry
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea exertional, Electrocardiogram abnormal, Fibrin D dimer increased, Leukocytosis, Metabolic function test normal
Clinical narrative: Patient is a 87 y.o. male patient of DO with history of aortic stenosis s/p TAVR 2017, CAD, prior CVA, GERD, HTN, HLD, and SSS s/p pacemaker presented to Hospital with chest pain.   Acute hypoxic respiratory failure - resolved COVID-19 Viral pneumonia P/w 1 day history of cough, SOB with exertion and chest tightness Afebrile on arrival, HR 91, RR 16, BP 132/61, satting >94% on RA Initial CBC w leukocytosis to 14.05. BMP unremarkable  CXR: cardiomegaly, no acute process  Per ED, hypoxic with ambulation Started on decadron Currently stable on RA D-dimer was checked on admission, and mildly elevated CTPA w/o PE, No focal consolidation, pleural effusion or pneumothorax. Solid pulmonary nodule in the right lower lobe measuring 4 mm Ambulate as able and check O2 level while ambulation Albuterol, robitussin-DM, tylenol PRN Encourage IS use PT/OT/SW   Essential HTN HLD SSS s/p pacemaker 2017 Aortic stenosis s/p TAVR 2017 Normotensive on admission, no complaints Initial troponin 21, repeat 23 EKG (my read): 1st degree AV block, V-paced  2D echo in 8/2022 w LVEF 56%, grade 1 diastolic dysfunction, TAVR functioning well  Continue home metoprolol, statin, and plavix Monitor on telemetry
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pneumonia viral, Pulmonary mass, Troponin increased, White blood cell count increased
Clinical narrative: Patient is a 87 y.o. male patient of DO with history of aortic stenosis s/p TAVR 2017, CAD, prior CVA, GERD, HTN, HLD, and SSS s/p pacemaker presented to Hospital with chest pain.   Acute hypoxic respiratory failure - resolved COVID-19 Viral pneumonia P/w 1 day history of cough, SOB with exertion and chest tightness Afebrile on arrival, HR 91, RR 16, BP 132/61, satting >94% on RA Initial CBC w leukocytosis to 14.05. BMP unremarkable  CXR: cardiomegaly, no acute process  Per ED, hypoxic with ambulation Started on decadron Currently stable on RA D-dimer was checked on admission, and mildly elevated CTPA w/o PE, No focal consolidation, pleural effusion or pneumothorax. Solid pulmonary nodule in the right lower lobe measuring 4 mm Ambulate as able and check O2 level while ambulation Albuterol, robitussin-DM, tylenol PRN Encourage IS use PT/OT/SW   Essential HTN HLD SSS s/p pacemaker 2017 Aortic stenosis s/p TAVR 2017 Normotensive on admission, no complaints Initial troponin 21, repeat 23 EKG (my read): 1st degree AV block, V-paced  2D echo in 8/2022 w LVEF 56%, grade 1 diastolic dysfunction, TAVR functioning well  Continue home metoprolol, statin, and plavix Monitor on telemetry
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Cough, Decreased appetite, Depression, Haemoptysis
Clinical narrative: Arm Pain, with pain up my neck, Fever, chills, body aches , Ill for 5 days and beyond, wicked Sore throat (felt like I'd a hedge hog in my throat) one week out from vaccines, yellow phlegm and blood coughing up, Laryngitis, coughing, headache, post nasal drip and incessant tickle, prevented sleep. FATIGUE Diminished Appetite, Irritable, depression.  12-26 still experiencing cough on laying down, managing with antihistamine. Also have experience change in my voice which is slowly recovering.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Irritability, Laryngitis, Malaise, Neck pain
Clinical narrative: Arm Pain, with pain up my neck, Fever, chills, body aches , Ill for 5 days and beyond, wicked Sore throat (felt like I'd a hedge hog in my throat) one week out from vaccines, yellow phlegm and blood coughing up, Laryngitis, coughing, headache, post nasal drip and incessant tickle, prevented sleep. FATIGUE Diminished Appetite, Irritable, depression.  12-26 still experiencing cough on laying down, managing with antihistamine. Also have experience change in my voice which is slowly recovering.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, SARS-CoV-2 test negative
Clinical narrative: Arm Pain, with pain up my neck, Fever, chills, body aches , Ill for 5 days and beyond, wicked Sore throat (felt like I'd a hedge hog in my throat) one week out from vaccines, yellow phlegm and blood coughing up, Laryngitis, coughing, headache, post nasal drip and incessant tickle, prevented sleep. FATIGUE Diminished Appetite, Irritable, depression.  12-26 still experiencing cough on laying down, managing with antihistamine. Also have experience change in my voice which is slowly recovering.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Sleep disorder, Sputum discoloured, Upper-airway cough syndrome
Clinical narrative: Arm Pain, with pain up my neck, Fever, chills, body aches , Ill for 5 days and beyond, wicked Sore throat (felt like I'd a hedge hog in my throat) one week out from vaccines, yellow phlegm and blood coughing up, Laryngitis, coughing, headache, post nasal drip and incessant tickle, prevented sleep. FATIGUE Diminished Appetite, Irritable, depression.  12-26 still experiencing cough on laying down, managing with antihistamine. Also have experience change in my voice which is slowly recovering.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal X-ray, Asthenia, COVID-19, Cerebral calcification, Chest X-ray abnormal
Clinical narrative: Patient is a 73 y.o. female patient of No, Physician with history of MS who presented to Hospital with weakness and confusion.   Acute metabolic encephalopathy, resolved Generalized weakness Abnormal CT head One day of  generalized weakness, inability to get up, confusion, likely in the setting of COVID with underlying multiple sclerosis and underlying cognitive dysfunction CT head on admission with calcifications in the basal ganglia, pineal gland and likely mineralization involving the right cerebellum, less likely hemorrhage No evidence of UTI Neurology consulted, MRI no acute changes.  No furhter work-up recommended Therapy and SW consulted, planning for SNF Currently close to baseline but patient is normally oriented to time as she is currently oriented to person, place and year Check abdominal x-ray for stool burden, schedule melatonin nightly for optimize sleep-wake cycle   Multiple sclerosis Diagnosed in 2008, and follow with neurologist but does not follow with anyone since moving down to city On Rebif MWF, no recent flare Given severe weakness with underlying MS, Neurology consulted MRI as above Outpatient follow up in MS clinic  Resumed Rebif as both Neuro and ID cleared for it- patient's family to bring in supply   COVID-19 virus infection Date of onset of symptoms: 10/26 Symptoms present on admission: weakness, confusion, mild cough Date of covid positive test: 10/27 Vaccination status: vaccinated with initial series, no boosters Imaging: CXR with pulmonary venous hypertension/pulmonary vascular congestion with some cephalization present Oxygen requirements on admission: room air Current oxygen requirements: room air Medical therapy: Paxlovid Consultants following: ID for Paxlovid therapy (complete course on discharge) Anticipated special isolation end date: ten days from positive test   Tachycardia, resolved Occurred overnight into 10/31, unclear etiology EKG personally reviewed and showed regular rate, L axis deviation, TWI in aVR consistent with previous EKG Give IVF and monitor   Neurogenic bladder On oxybutynin at home Continue here as Detrol   Hypertension Patient with elevated blood pressure, no history of and not on medications No other etiology for elevated blood pressure  Start low dose amlodipine, increase to 5 mg daily - BP improved   Constipation Noted on Ab xray Continue daily miralax and colace, use prn senna
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Cognitive disorder, Computerised tomogram head abnormal, Condition aggravated, Confusional state, Constipation
Clinical narrative: Patient is a 73 y.o. female patient of No, Physician with history of MS who presented to Hospital with weakness and confusion.   Acute metabolic encephalopathy, resolved Generalized weakness Abnormal CT head One day of  generalized weakness, inability to get up, confusion, likely in the setting of COVID with underlying multiple sclerosis and underlying cognitive dysfunction CT head on admission with calcifications in the basal ganglia, pineal gland and likely mineralization involving the right cerebellum, less likely hemorrhage No evidence of UTI Neurology consulted, MRI no acute changes.  No furhter work-up recommended Therapy and SW consulted, planning for SNF Currently close to baseline but patient is normally oriented to time as she is currently oriented to person, place and year Check abdominal x-ray for stool burden, schedule melatonin nightly for optimize sleep-wake cycle   Multiple sclerosis Diagnosed in 2008, and follow with neurologist but does not follow with anyone since moving down to city On Rebif MWF, no recent flare Given severe weakness with underlying MS, Neurology consulted MRI as above Outpatient follow up in MS clinic  Resumed Rebif as both Neuro and ID cleared for it- patient's family to bring in supply   COVID-19 virus infection Date of onset of symptoms: 10/26 Symptoms present on admission: weakness, confusion, mild cough Date of covid positive test: 10/27 Vaccination status: vaccinated with initial series, no boosters Imaging: CXR with pulmonary venous hypertension/pulmonary vascular congestion with some cephalization present Oxygen requirements on admission: room air Current oxygen requirements: room air Medical therapy: Paxlovid Consultants following: ID for Paxlovid therapy (complete course on discharge) Anticipated special isolation end date: ten days from positive test   Tachycardia, resolved Occurred overnight into 10/31, unclear etiology EKG personally reviewed and showed regular rate, L axis deviation, TWI in aVR consistent with previous EKG Give IVF and monitor   Neurogenic bladder On oxybutynin at home Continue here as Detrol   Hypertension Patient with elevated blood pressure, no history of and not on medications No other etiology for elevated blood pressure  Start low dose amlodipine, increase to 5 mg daily - BP improved   Constipation Noted on Ab xray Continue daily miralax and colace, use prn senna
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Electrocardiogram T wave inversion, Electrocardiogram abnormal, Endocrine disorder, Hypertension
Clinical narrative: Patient is a 73 y.o. female patient of No, Physician with history of MS who presented to Hospital with weakness and confusion.   Acute metabolic encephalopathy, resolved Generalized weakness Abnormal CT head One day of  generalized weakness, inability to get up, confusion, likely in the setting of COVID with underlying multiple sclerosis and underlying cognitive dysfunction CT head on admission with calcifications in the basal ganglia, pineal gland and likely mineralization involving the right cerebellum, less likely hemorrhage No evidence of UTI Neurology consulted, MRI no acute changes.  No furhter work-up recommended Therapy and SW consulted, planning for SNF Currently close to baseline but patient is normally oriented to time as she is currently oriented to person, place and year Check abdominal x-ray for stool burden, schedule melatonin nightly for optimize sleep-wake cycle   Multiple sclerosis Diagnosed in 2008, and follow with neurologist but does not follow with anyone since moving down to city On Rebif MWF, no recent flare Given severe weakness with underlying MS, Neurology consulted MRI as above Outpatient follow up in MS clinic  Resumed Rebif as both Neuro and ID cleared for it- patient's family to bring in supply   COVID-19 virus infection Date of onset of symptoms: 10/26 Symptoms present on admission: weakness, confusion, mild cough Date of covid positive test: 10/27 Vaccination status: vaccinated with initial series, no boosters Imaging: CXR with pulmonary venous hypertension/pulmonary vascular congestion with some cephalization present Oxygen requirements on admission: room air Current oxygen requirements: room air Medical therapy: Paxlovid Consultants following: ID for Paxlovid therapy (complete course on discharge) Anticipated special isolation end date: ten days from positive test   Tachycardia, resolved Occurred overnight into 10/31, unclear etiology EKG personally reviewed and showed regular rate, L axis deviation, TWI in aVR consistent with previous EKG Give IVF and monitor   Neurogenic bladder On oxybutynin at home Continue here as Detrol   Hypertension Patient with elevated blood pressure, no history of and not on medications No other etiology for elevated blood pressure  Start low dose amlodipine, increase to 5 mg daily - BP improved   Constipation Noted on Ab xray Continue daily miralax and colace, use prn senna
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging normal, Metabolic encephalopathy, Mobility decreased, Multiple sclerosis, Nervous system disorder
Clinical narrative: Patient is a 73 y.o. female patient of No, Physician with history of MS who presented to Hospital with weakness and confusion.   Acute metabolic encephalopathy, resolved Generalized weakness Abnormal CT head One day of  generalized weakness, inability to get up, confusion, likely in the setting of COVID with underlying multiple sclerosis and underlying cognitive dysfunction CT head on admission with calcifications in the basal ganglia, pineal gland and likely mineralization involving the right cerebellum, less likely hemorrhage No evidence of UTI Neurology consulted, MRI no acute changes.  No furhter work-up recommended Therapy and SW consulted, planning for SNF Currently close to baseline but patient is normally oriented to time as she is currently oriented to person, place and year Check abdominal x-ray for stool burden, schedule melatonin nightly for optimize sleep-wake cycle   Multiple sclerosis Diagnosed in 2008, and follow with neurologist but does not follow with anyone since moving down to city On Rebif MWF, no recent flare Given severe weakness with underlying MS, Neurology consulted MRI as above Outpatient follow up in MS clinic  Resumed Rebif as both Neuro and ID cleared for it- patient's family to bring in supply   COVID-19 virus infection Date of onset of symptoms: 10/26 Symptoms present on admission: weakness, confusion, mild cough Date of covid positive test: 10/27 Vaccination status: vaccinated with initial series, no boosters Imaging: CXR with pulmonary venous hypertension/pulmonary vascular congestion with some cephalization present Oxygen requirements on admission: room air Current oxygen requirements: room air Medical therapy: Paxlovid Consultants following: ID for Paxlovid therapy (complete course on discharge) Anticipated special isolation end date: ten days from positive test   Tachycardia, resolved Occurred overnight into 10/31, unclear etiology EKG personally reviewed and showed regular rate, L axis deviation, TWI in aVR consistent with previous EKG Give IVF and monitor   Neurogenic bladder On oxybutynin at home Continue here as Detrol   Hypertension Patient with elevated blood pressure, no history of and not on medications No other etiology for elevated blood pressure  Start low dose amlodipine, increase to 5 mg daily - BP improved   Constipation Noted on Ab xray Continue daily miralax and colace, use prn senna
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Neurogenic bladder, Pulmonary congestion, Pulmonary venous hypertension, SARS-CoV-2 test positive, Tachycardia
Clinical narrative: Patient is a 73 y.o. female patient of No, Physician with history of MS who presented to Hospital with weakness and confusion.   Acute metabolic encephalopathy, resolved Generalized weakness Abnormal CT head One day of  generalized weakness, inability to get up, confusion, likely in the setting of COVID with underlying multiple sclerosis and underlying cognitive dysfunction CT head on admission with calcifications in the basal ganglia, pineal gland and likely mineralization involving the right cerebellum, less likely hemorrhage No evidence of UTI Neurology consulted, MRI no acute changes.  No furhter work-up recommended Therapy and SW consulted, planning for SNF Currently close to baseline but patient is normally oriented to time as she is currently oriented to person, place and year Check abdominal x-ray for stool burden, schedule melatonin nightly for optimize sleep-wake cycle   Multiple sclerosis Diagnosed in 2008, and follow with neurologist but does not follow with anyone since moving down to city On Rebif MWF, no recent flare Given severe weakness with underlying MS, Neurology consulted MRI as above Outpatient follow up in MS clinic  Resumed Rebif as both Neuro and ID cleared for it- patient's family to bring in supply   COVID-19 virus infection Date of onset of symptoms: 10/26 Symptoms present on admission: weakness, confusion, mild cough Date of covid positive test: 10/27 Vaccination status: vaccinated with initial series, no boosters Imaging: CXR with pulmonary venous hypertension/pulmonary vascular congestion with some cephalization present Oxygen requirements on admission: room air Current oxygen requirements: room air Medical therapy: Paxlovid Consultants following: ID for Paxlovid therapy (complete course on discharge) Anticipated special isolation end date: ten days from positive test   Tachycardia, resolved Occurred overnight into 10/31, unclear etiology EKG personally reviewed and showed regular rate, L axis deviation, TWI in aVR consistent with previous EKG Give IVF and monitor   Neurogenic bladder On oxybutynin at home Continue here as Detrol   Hypertension Patient with elevated blood pressure, no history of and not on medications No other etiology for elevated blood pressure  Start low dose amlodipine, increase to 5 mg daily - BP improved   Constipation Noted on Ab xray Continue daily miralax and colace, use prn senna
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Accelerated hypertension, Anaemia macrocytic, Atrial fibrillation, COVID-19, Hyperglycaemia
Clinical narrative: Hospitalization for urinary tract infection, atrial fibrillation with RVR, COVID-19 infection, acute metabolic encephalopathy, lower lobe interstitial edema, elevated troponin level, accelerated hypertension, hyperglycemia, macrocytic anemia, seizure disorder, physical deconditioning on dates 12/13/2023- 12/19/2023. Treated with vitamin C 500 mg PO daily, zinc 50 mg PO daily.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Metabolic encephalopathy, Physical deconditioning, Pulmonary oedema, Seizure, Troponin increased
Clinical narrative: Hospitalization for urinary tract infection, atrial fibrillation with RVR, COVID-19 infection, acute metabolic encephalopathy, lower lobe interstitial edema, elevated troponin level, accelerated hypertension, hyperglycemia, macrocytic anemia, seizure disorder, physical deconditioning on dates 12/13/2023- 12/19/2023. Treated with vitamin C 500 mg PO daily, zinc 50 mg PO daily.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary tract infection
Clinical narrative: Hospitalization for urinary tract infection, atrial fibrillation with RVR, COVID-19 infection, acute metabolic encephalopathy, lower lobe interstitial edema, elevated troponin level, accelerated hypertension, hyperglycemia, macrocytic anemia, seizure disorder, physical deconditioning on dates 12/13/2023- 12/19/2023. Treated with vitamin C 500 mg PO daily, zinc 50 mg PO daily.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Asthenia, Blood creatinine increased, Blood gases abnormal
Clinical narrative: This is a 72-year-old female past medical history of asthma, COPD, GERD, hypertension, CKD stage III, non-insulin-dependent diabetes, chronic anemia, anxiety/depression, migraines, history of pneumonia, prior history of COVID-19 infection in 2020, who presents to the emergency department with progressive shortness of breath for the past 3 to 5 days.  Patient stated she has been feeling generalized malaise, weak, fever at home, intermittent diarrhea, denies any chest pain, nausea, vomiting.  She did have nonbloody diarrhea 2-3 episodes, denies abdominal pain.  Denies any home oxygen use, has been previously COVID-19 vaccinated.   Upon arrival to the ED patient was tachypneic, tachycardic, low-grade fever 100.1, oxygen saturation in the 70s.  VBG with respiratory alkalosis, blood glucose 218, BUN/creatinine 39/1.34, troponin 17, repeat 20, CRP 2018, lactic acid 2.8, WBC 13.1, H/H90.8/31, tested positive for COVID-19.  CTA chest showed no PE, did show left greater than right basal consolidation, consistent with multifocal infection, colonic diverticulosis, patient received vancomycin, Zosyn, Decadron, IV fluids in the ED.  She is otherwise ill-appearing, alert and oriented x4, CODE STATUS discussed wishes to be DNR CCA DNI.   Clinical Summary Admitted with acute hypoxic respiratory failure secondary to COVID-19 and suspected secondary bacterial pneumonia, she was initiated on dexamethasone, remdesivir, broad-spectrum antibiotics.  She requires 4 L nasal cannula at night.  She was able to be weaned to her home oxygen requirements, able to ambulate on her own.  She was discharged with complete 10-day course of dexamethasone and coverage for community-acquired pneumonia.  There was some suspicion of aspiration on her final but unable to determine if she had aspiration event or if this is secondary to superimposed bacterial pneumonia.    Discharge diagnosis Acute on chronic hypoxic Respiratory Failure  secondary bacterial pneumonia, unable to determine if aspiration pneumonia Sepsis due to COVID-19 Acute COPD Exacerbation COVID-19
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Blood glucose increased, Blood lactic acid, Blood urea increased, C-reactive protein increased, COVID-19
Clinical narrative: This is a 72-year-old female past medical history of asthma, COPD, GERD, hypertension, CKD stage III, non-insulin-dependent diabetes, chronic anemia, anxiety/depression, migraines, history of pneumonia, prior history of COVID-19 infection in 2020, who presents to the emergency department with progressive shortness of breath for the past 3 to 5 days.  Patient stated she has been feeling generalized malaise, weak, fever at home, intermittent diarrhea, denies any chest pain, nausea, vomiting.  She did have nonbloody diarrhea 2-3 episodes, denies abdominal pain.  Denies any home oxygen use, has been previously COVID-19 vaccinated.   Upon arrival to the ED patient was tachypneic, tachycardic, low-grade fever 100.1, oxygen saturation in the 70s.  VBG with respiratory alkalosis, blood glucose 218, BUN/creatinine 39/1.34, troponin 17, repeat 20, CRP 2018, lactic acid 2.8, WBC 13.1, H/H90.8/31, tested positive for COVID-19.  CTA chest showed no PE, did show left greater than right basal consolidation, consistent with multifocal infection, colonic diverticulosis, patient received vancomycin, Zosyn, Decadron, IV fluids in the ED.  She is otherwise ill-appearing, alert and oriented x4, CODE STATUS discussed wishes to be DNR CCA DNI.   Clinical Summary Admitted with acute hypoxic respiratory failure secondary to COVID-19 and suspected secondary bacterial pneumonia, she was initiated on dexamethasone, remdesivir, broad-spectrum antibiotics.  She requires 4 L nasal cannula at night.  She was able to be weaned to her home oxygen requirements, able to ambulate on her own.  She was discharged with complete 10-day course of dexamethasone and coverage for community-acquired pneumonia.  There was some suspicion of aspiration on her final but unable to determine if she had aspiration event or if this is secondary to superimposed bacterial pneumonia.    Discharge diagnosis Acute on chronic hypoxic Respiratory Failure  secondary bacterial pneumonia, unable to determine if aspiration pneumonia Sepsis due to COVID-19 Acute COPD Exacerbation COVID-19