chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary mass, Rales, Respiratory failure, Small cell lung cancer, Squamous cell carcinoma
Clinical narrative: Narrative:  a 85 yo M with recently diagnosed SCC receiving VP-16 and carboplatin, admitted 09/10/2021 (TO PRESENT) with acute resp failure secondary to covid pneumonia. PATIENT remains on continuous bipap - sats 100%. Much more alert today, actually stated that he felt much better. Alert to person, place, year CV: RRR with systolic murmur Lungs: crackles throughout Abd: soft, mildly distended, nttp, pos BS Ext: 1+ BLE pitting edema A/P 1. Acute hypercarbic and hypoxic respiraty failure/COVID 19 pneumonia - secondary to covid-19, however, complicated by lung masses and L pleural effusion (malignant) - have requested trial of high flow - can d/c bipap - to allow patient to eat, sats remain 100% on bipap - continue remdesivir and IV solumedrol - not a candidate for IL or immunomodulators given SCC s/p chemo - overall prognosis still very poor - completed 5 days IV zosyn for possible superimposed bacterial pneumonia - heparin drip changed to treatment dose lovenox as patient with poor IV access and needs IV line for PPN, may need central line vs PICC if unable to wean from bipap and tolerate diet soon - monitor inflammatory markers - IV lasix changed to 80 mg bid for CHF (BNP 700s, monitor)- improved - will reduce to daily dosing given metabollic alkalosis 2. Small cell lung ca stage IIIa - followed by oncology, s/p chemo 09/08/2021 as above - very poor overall prognosis in setting underlying fibrosis/possible ILD and acute infection 3. FEN - D5 1/2 NS to be replaced by PPN today - hopeful that can start oral diet if able to change from bipap to high flow 4. Chronic medical conditions Hypertension - Continue metoprolol 6.25mg PO BID Diabetes Mellitus - aspart tid, adding lantus 10 units daily Diabetic neuropathy and nephropathy - Continue gabapentin. Hyperlipidemia - Continue Simvistatin RLS - ropinirole Overall prognosis very poor given chronic medical conditions, lung cancer, asbestosis
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Blood gases abnormal, COVID-19 pneumonia, Dyspnoea
Clinical narrative: Narrative: Admission Date: September 13, 2021 Discharge Date: September 15, 2021 Discharge Type: Regular PRINCIPAL DIAGNOSIS: 1. Acute hypoxic respiratory failure ADDITIONAL DIAGNOSES: 1. Acute SARS-CoV-2 pneumonia. 2. Superimposed bacterial pneumonia 3. Prediabetes 4. History of pulmonary embolism and infarction 5. History of tuberculosis 6. History of tobacco use 7. Chronic sinusitis 8. Chronic post-traumatic stress disorder 9. Chronic insomnia PROCEDURES: 09/13/2021 CT angiogram of chest with contrast: Impression: 1) No radiographic evidence of pulmonary emboli. 2) Extensive interstitial infiltrates along with volume loss involving the right lung. HISTORY OF PRESENT ILLNESS: PATIENT is a 67 year-old male with a history of prediabetes, h/o PE with infarction, h/o TB, h/o tobacco use, chronic sinusitis, PTSD, and insomnia, who presented to the emergency department on 09/13/21 with complaint of persistent shortness of breath since being discharged from outside Hospital one week prior. He said the shortness of breath was mainly during exertion. He denied any fever, chills, increase in cough, abdominal symptoms, or urinary symptoms. He had tested positive for COVID-19 virus on 08/20/21, and was admitted to outside Hospital from 08/23-09/06/21. He received REGEN-COV (casirivimab & imdevimab monoclonal antibodies) on 08/23/21. He also received 5 days of IV remdesivir therapy from 08/24-08/28/21. He was discharged on 4 liters oxygen for home use. Of note, he had received one dose of Janssen COVID-19 vaccination on 04/09/21. In the ED on 09/13/21, a CT angiogram of the chest showed extensive right lung interstitial infiltrates, but no evidence of any pulmonary emboli. On ABG, pO2 was 73.9 on 4 liters oxygen. HOSPITAL COURSE: PATIENT was admitted to the Medical Step Down Unit on 09/13/21 for treatment of acute hypoxic respiratory failure, acute COVID-19 pneumonia with presumed superimposed bacterial pneumonia. He was placed on 6 liters of oxygen, and started on cefepime IV antibiotic. He was also treated with IV methylprednisolone, prn albuterol inhaler, and prn tylenol. His symptoms improved, and he was transferred to the general medical floor on 09/14/21. That day, he was successfully weaned to 4 liters, which was his home prescription. PATIENT was medically stable for discharge home on 09/15/21.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea exertional, Lung infiltration, PO2 decreased, Pneumonia bacterial, Scan with contrast abnormal
Clinical narrative: Narrative: Admission Date: September 13, 2021 Discharge Date: September 15, 2021 Discharge Type: Regular PRINCIPAL DIAGNOSIS: 1. Acute hypoxic respiratory failure ADDITIONAL DIAGNOSES: 1. Acute SARS-CoV-2 pneumonia. 2. Superimposed bacterial pneumonia 3. Prediabetes 4. History of pulmonary embolism and infarction 5. History of tuberculosis 6. History of tobacco use 7. Chronic sinusitis 8. Chronic post-traumatic stress disorder 9. Chronic insomnia PROCEDURES: 09/13/2021 CT angiogram of chest with contrast: Impression: 1) No radiographic evidence of pulmonary emboli. 2) Extensive interstitial infiltrates along with volume loss involving the right lung. HISTORY OF PRESENT ILLNESS: PATIENT is a 67 year-old male with a history of prediabetes, h/o PE with infarction, h/o TB, h/o tobacco use, chronic sinusitis, PTSD, and insomnia, who presented to the emergency department on 09/13/21 with complaint of persistent shortness of breath since being discharged from outside Hospital one week prior. He said the shortness of breath was mainly during exertion. He denied any fever, chills, increase in cough, abdominal symptoms, or urinary symptoms. He had tested positive for COVID-19 virus on 08/20/21, and was admitted to outside Hospital from 08/23-09/06/21. He received REGEN-COV (casirivimab & imdevimab monoclonal antibodies) on 08/23/21. He also received 5 days of IV remdesivir therapy from 08/24-08/28/21. He was discharged on 4 liters oxygen for home use. Of note, he had received one dose of Janssen COVID-19 vaccination on 04/09/21. In the ED on 09/13/21, a CT angiogram of the chest showed extensive right lung interstitial infiltrates, but no evidence of any pulmonary emboli. On ABG, pO2 was 73.9 on 4 liters oxygen. HOSPITAL COURSE: PATIENT was admitted to the Medical Step Down Unit on 09/13/21 for treatment of acute hypoxic respiratory failure, acute COVID-19 pneumonia with presumed superimposed bacterial pneumonia. He was placed on 6 liters of oxygen, and started on cefepime IV antibiotic. He was also treated with IV methylprednisolone, prn albuterol inhaler, and prn tylenol. His symptoms improved, and he was transferred to the general medical floor on 09/14/21. That day, he was successfully weaned to 4 liters, which was his home prescription. PATIENT was medically stable for discharge home on 09/15/21.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Superinfection
Clinical narrative: Narrative: Admission Date: September 13, 2021 Discharge Date: September 15, 2021 Discharge Type: Regular PRINCIPAL DIAGNOSIS: 1. Acute hypoxic respiratory failure ADDITIONAL DIAGNOSES: 1. Acute SARS-CoV-2 pneumonia. 2. Superimposed bacterial pneumonia 3. Prediabetes 4. History of pulmonary embolism and infarction 5. History of tuberculosis 6. History of tobacco use 7. Chronic sinusitis 8. Chronic post-traumatic stress disorder 9. Chronic insomnia PROCEDURES: 09/13/2021 CT angiogram of chest with contrast: Impression: 1) No radiographic evidence of pulmonary emboli. 2) Extensive interstitial infiltrates along with volume loss involving the right lung. HISTORY OF PRESENT ILLNESS: PATIENT is a 67 year-old male with a history of prediabetes, h/o PE with infarction, h/o TB, h/o tobacco use, chronic sinusitis, PTSD, and insomnia, who presented to the emergency department on 09/13/21 with complaint of persistent shortness of breath since being discharged from outside Hospital one week prior. He said the shortness of breath was mainly during exertion. He denied any fever, chills, increase in cough, abdominal symptoms, or urinary symptoms. He had tested positive for COVID-19 virus on 08/20/21, and was admitted to outside Hospital from 08/23-09/06/21. He received REGEN-COV (casirivimab & imdevimab monoclonal antibodies) on 08/23/21. He also received 5 days of IV remdesivir therapy from 08/24-08/28/21. He was discharged on 4 liters oxygen for home use. Of note, he had received one dose of Janssen COVID-19 vaccination on 04/09/21. In the ED on 09/13/21, a CT angiogram of the chest showed extensive right lung interstitial infiltrates, but no evidence of any pulmonary emboli. On ABG, pO2 was 73.9 on 4 liters oxygen. HOSPITAL COURSE: PATIENT was admitted to the Medical Step Down Unit on 09/13/21 for treatment of acute hypoxic respiratory failure, acute COVID-19 pneumonia with presumed superimposed bacterial pneumonia. He was placed on 6 liters of oxygen, and started on cefepime IV antibiotic. He was also treated with IV methylprednisolone, prn albuterol inhaler, and prn tylenol. His symptoms improved, and he was transferred to the general medical floor on 09/14/21. That day, he was successfully weaned to 4 liters, which was his home prescription. PATIENT was medically stable for discharge home on 09/15/21.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Malaise
Clinical narrative: Narrative:  Pt was not feeling well 2 days prior to death; did not want to go to hospital; passed away sleeping
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Aggression, COVID-19, Confusional state, Death, SARS-CoV-2 test positive
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 12/22, Pfizer, dose #1 (non-agency) 01/12, Pfizer, dose #2 (non-agency) 08/06 pt cc: unknown exposure: unknown 08/06 COVID swab, result: detected 08/06 pt admitted to medicine from non-agency Nursing home, pt is confused, combative 08/16 pt deceased
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood creatinine increased, Blood glucose increased, Blood lactate dehydrogenase increased, Blood lactic acid
Clinical narrative: Narrative: Prolonged hospitalization (8/22-9/13) for acute hypoxic respiratory failure due to COVID-19 in fully vaccinated patient. Multiple co-morbidities as outlined in report. Secondary diagnoses on discharge include: septic shock, possible superimposed bacterial pneumonia, acute tubular necrosis on CKD stage III, hyperkalemia, complicated UTI and pulmonary hypertension. Received dexamethasone and supplemental oxygen (including times of HHF 50L 70%) for COVID. Also received antibiotics, hyperkalemia treatments, temporary HD, levophed. Discharged to home. Hypoxia improved but not resolved. Requiring 2L NC oxygen with exertion at discharge.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Blood sodium decreased, Blood urea increased, COVID-19, Chest X-ray abnormal, Chronic kidney disease
Clinical narrative: Narrative: Prolonged hospitalization (8/22-9/13) for acute hypoxic respiratory failure due to COVID-19 in fully vaccinated patient. Multiple co-morbidities as outlined in report. Secondary diagnoses on discharge include: septic shock, possible superimposed bacterial pneumonia, acute tubular necrosis on CKD stage III, hyperkalemia, complicated UTI and pulmonary hypertension. Received dexamethasone and supplemental oxygen (including times of HHF 50L 70%) for COVID. Also received antibiotics, hyperkalemia treatments, temporary HD, levophed. Discharged to home. Hypoxia improved but not resolved. Requiring 2L NC oxygen with exertion at discharge.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Haemodialysis, Haemoglobin decreased, Hyperkalaemia, Hypoxia, Lung opacity
Clinical narrative: Narrative: Prolonged hospitalization (8/22-9/13) for acute hypoxic respiratory failure due to COVID-19 in fully vaccinated patient. Multiple co-morbidities as outlined in report. Secondary diagnoses on discharge include: septic shock, possible superimposed bacterial pneumonia, acute tubular necrosis on CKD stage III, hyperkalemia, complicated UTI and pulmonary hypertension. Received dexamethasone and supplemental oxygen (including times of HHF 50L 70%) for COVID. Also received antibiotics, hyperkalemia treatments, temporary HD, levophed. Discharged to home. Hypoxia improved but not resolved. Requiring 2L NC oxygen with exertion at discharge.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary hypertension, Renal tubular necrosis, SARS-CoV-2 test positive, Septic shock, Urinary tract infection
Clinical narrative: Narrative: Prolonged hospitalization (8/22-9/13) for acute hypoxic respiratory failure due to COVID-19 in fully vaccinated patient. Multiple co-morbidities as outlined in report. Secondary diagnoses on discharge include: septic shock, possible superimposed bacterial pneumonia, acute tubular necrosis on CKD stage III, hyperkalemia, complicated UTI and pulmonary hypertension. Received dexamethasone and supplemental oxygen (including times of HHF 50L 70%) for COVID. Also received antibiotics, hyperkalemia treatments, temporary HD, levophed. Discharged to home. Hypoxia improved but not resolved. Requiring 2L NC oxygen with exertion at discharge.
Age: 93.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood sodium decreased, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia
Clinical narrative: Narrative: Patient admitted 9/7 to 9/15 for management of COVID-19 pneumonia despite being fully vaccinated. Patient presented from care facility (tested positive at care facility) due to concerns for hypoxia, with progressive confusion and weakness. In ED hypoxic requiring 4L NC and febrile to 101.2. Patient received supplemental oxygen, dexamethasone and remdesivir. He clinically improved and hypoxemia resolved. During hospitalization also found to have positive urine culture and treated with antibiotics. Discharged to care facility in stable condition on room air. Plans for acute rehabilitation due to severe physical decondition and generalized weakness.
Age: 93.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Confusional state, Culture urine positive, Haemoglobin decreased, Hypoxia
Clinical narrative: Narrative: Patient admitted 9/7 to 9/15 for management of COVID-19 pneumonia despite being fully vaccinated. Patient presented from care facility (tested positive at care facility) due to concerns for hypoxia, with progressive confusion and weakness. In ED hypoxic requiring 4L NC and febrile to 101.2. Patient received supplemental oxygen, dexamethasone and remdesivir. He clinically improved and hypoxemia resolved. During hospitalization also found to have positive urine culture and treated with antibiotics. Discharged to care facility in stable condition on room air. Plans for acute rehabilitation due to severe physical decondition and generalized weakness.
Age: 93.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Mean cell volume increased, Nitrite urine absent, Physical deconditioning, Platelet count normal
Clinical narrative: Narrative: Patient admitted 9/7 to 9/15 for management of COVID-19 pneumonia despite being fully vaccinated. Patient presented from care facility (tested positive at care facility) due to concerns for hypoxia, with progressive confusion and weakness. In ED hypoxic requiring 4L NC and febrile to 101.2. Patient received supplemental oxygen, dexamethasone and remdesivir. He clinically improved and hypoxemia resolved. During hospitalization also found to have positive urine culture and treated with antibiotics. Discharged to care facility in stable condition on room air. Plans for acute rehabilitation due to severe physical decondition and generalized weakness.
Age: 93.0
Sex: M
Vaccine: COVID19
Symptoms: Protein total increased, Pyrexia, Pyuria, SARS-CoV-2 test positive, Urine analysis abnormal
Clinical narrative: Narrative: Patient admitted 9/7 to 9/15 for management of COVID-19 pneumonia despite being fully vaccinated. Patient presented from care facility (tested positive at care facility) due to concerns for hypoxia, with progressive confusion and weakness. In ED hypoxic requiring 4L NC and febrile to 101.2. Patient received supplemental oxygen, dexamethasone and remdesivir. He clinically improved and hypoxemia resolved. During hospitalization also found to have positive urine culture and treated with antibiotics. Discharged to care facility in stable condition on room air. Plans for acute rehabilitation due to severe physical decondition and generalized weakness.
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Back pain, Blood fibrinogen normal, Brain natriuretic peptide increased, Bronchitis viral
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 01/16, Pfizer, dose #1 02/06, Pfizer, dose #2 08/01 pt cc: cough, chills, myalgias, upper back pain exposure: unknown 08/07 COVID swab, result: detected 08/07 admitted to ED dx: COVID-19 positive, Acute viral bronchitis, Hypoxemia transfer to in-patient medicine 08/07 CXR impression: 1. Mild bilateral pulmonary opacities, possible pneumonia and/or edema. 2. Clinical correlation and follow-up are recommended. 08/08 ESR 54 08/08 FIBRINOGEN 347 08/08 DDIMER 1.63 8/12 SARS-COV-2 LINEAGE result: AY.4 08/12 SARS-COV-2 CLADE results: 21A Delta 08/12 ESR 54 08/12 DDIMER 3.0 08/16 ESR result: 22 08/15 CTA PE impression: No evidence of pulmonary embolism. 2. Cardiomegaly with left ventricular dilatation 3. Underlying emphysematous change with diffuse bilateral interstitial changes favoring edema over infection. There are a few somewhat rounded more focal airspace densities present in the posterior right upper lobe and the right lung base which could represent airspace edema, superimposed pneumonia or lung nodules. 4. Trace bilateral pleural effusions 08/17 CXR impression: Interval worsening of mixed interstitial and airspace opacities. 08/19 procalcitonin 0.18 8/19 pt 13.0, inr 1.16, fibrogen 284, ddimer 7.19 08/19 BNP result: 450.6 08/19 MRSA result: not detected 08/19 CXR impression: No significant interval change. 08/22 pt deceased
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiomegaly, Chest X-ray abnormal, Chills, Cough
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 01/16, Pfizer, dose #1 02/06, Pfizer, dose #2 08/01 pt cc: cough, chills, myalgias, upper back pain exposure: unknown 08/07 COVID swab, result: detected 08/07 admitted to ED dx: COVID-19 positive, Acute viral bronchitis, Hypoxemia transfer to in-patient medicine 08/07 CXR impression: 1. Mild bilateral pulmonary opacities, possible pneumonia and/or edema. 2. Clinical correlation and follow-up are recommended. 08/08 ESR 54 08/08 FIBRINOGEN 347 08/08 DDIMER 1.63 8/12 SARS-COV-2 LINEAGE result: AY.4 08/12 SARS-COV-2 CLADE results: 21A Delta 08/12 ESR 54 08/12 DDIMER 3.0 08/16 ESR result: 22 08/15 CTA PE impression: No evidence of pulmonary embolism. 2. Cardiomegaly with left ventricular dilatation 3. Underlying emphysematous change with diffuse bilateral interstitial changes favoring edema over infection. There are a few somewhat rounded more focal airspace densities present in the posterior right upper lobe and the right lung base which could represent airspace edema, superimposed pneumonia or lung nodules. 4. Trace bilateral pleural effusions 08/17 CXR impression: Interval worsening of mixed interstitial and airspace opacities. 08/19 procalcitonin 0.18 8/19 pt 13.0, inr 1.16, fibrogen 284, ddimer 7.19 08/19 BNP result: 450.6 08/19 MRSA result: not detected 08/19 CXR impression: No significant interval change. 08/22 pt deceased
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Emphysema, Fibrin D dimer, Hypoxia, International normalised ratio increased
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 01/16, Pfizer, dose #1 02/06, Pfizer, dose #2 08/01 pt cc: cough, chills, myalgias, upper back pain exposure: unknown 08/07 COVID swab, result: detected 08/07 admitted to ED dx: COVID-19 positive, Acute viral bronchitis, Hypoxemia transfer to in-patient medicine 08/07 CXR impression: 1. Mild bilateral pulmonary opacities, possible pneumonia and/or edema. 2. Clinical correlation and follow-up are recommended. 08/08 ESR 54 08/08 FIBRINOGEN 347 08/08 DDIMER 1.63 8/12 SARS-COV-2 LINEAGE result: AY.4 08/12 SARS-COV-2 CLADE results: 21A Delta 08/12 ESR 54 08/12 DDIMER 3.0 08/16 ESR result: 22 08/15 CTA PE impression: No evidence of pulmonary embolism. 2. Cardiomegaly with left ventricular dilatation 3. Underlying emphysematous change with diffuse bilateral interstitial changes favoring edema over infection. There are a few somewhat rounded more focal airspace densities present in the posterior right upper lobe and the right lung base which could represent airspace edema, superimposed pneumonia or lung nodules. 4. Trace bilateral pleural effusions 08/17 CXR impression: Interval worsening of mixed interstitial and airspace opacities. 08/19 procalcitonin 0.18 8/19 pt 13.0, inr 1.16, fibrogen 284, ddimer 7.19 08/19 BNP result: 450.6 08/19 MRSA result: not detected 08/19 CXR impression: No significant interval change. 08/22 pt deceased
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Left ventricular dilatation, Lung opacity, Myalgia, Pleural effusion, Procalcitonin
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 01/16, Pfizer, dose #1 02/06, Pfizer, dose #2 08/01 pt cc: cough, chills, myalgias, upper back pain exposure: unknown 08/07 COVID swab, result: detected 08/07 admitted to ED dx: COVID-19 positive, Acute viral bronchitis, Hypoxemia transfer to in-patient medicine 08/07 CXR impression: 1. Mild bilateral pulmonary opacities, possible pneumonia and/or edema. 2. Clinical correlation and follow-up are recommended. 08/08 ESR 54 08/08 FIBRINOGEN 347 08/08 DDIMER 1.63 8/12 SARS-COV-2 LINEAGE result: AY.4 08/12 SARS-COV-2 CLADE results: 21A Delta 08/12 ESR 54 08/12 DDIMER 3.0 08/16 ESR result: 22 08/15 CTA PE impression: No evidence of pulmonary embolism. 2. Cardiomegaly with left ventricular dilatation 3. Underlying emphysematous change with diffuse bilateral interstitial changes favoring edema over infection. There are a few somewhat rounded more focal airspace densities present in the posterior right upper lobe and the right lung base which could represent airspace edema, superimposed pneumonia or lung nodules. 4. Trace bilateral pleural effusions 08/17 CXR impression: Interval worsening of mixed interstitial and airspace opacities. 08/19 procalcitonin 0.18 8/19 pt 13.0, inr 1.16, fibrogen 284, ddimer 7.19 08/19 BNP result: 450.6 08/19 MRSA result: not detected 08/19 CXR impression: No significant interval change. 08/22 pt deceased
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Prothrombin time prolonged, Pulmonary oedema, Red blood cell sedimentation rate increased, SARS-CoV-2 test positive, Staphylococcus test negative
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 01/16, Pfizer, dose #1 02/06, Pfizer, dose #2 08/01 pt cc: cough, chills, myalgias, upper back pain exposure: unknown 08/07 COVID swab, result: detected 08/07 admitted to ED dx: COVID-19 positive, Acute viral bronchitis, Hypoxemia transfer to in-patient medicine 08/07 CXR impression: 1. Mild bilateral pulmonary opacities, possible pneumonia and/or edema. 2. Clinical correlation and follow-up are recommended. 08/08 ESR 54 08/08 FIBRINOGEN 347 08/08 DDIMER 1.63 8/12 SARS-COV-2 LINEAGE result: AY.4 08/12 SARS-COV-2 CLADE results: 21A Delta 08/12 ESR 54 08/12 DDIMER 3.0 08/16 ESR result: 22 08/15 CTA PE impression: No evidence of pulmonary embolism. 2. Cardiomegaly with left ventricular dilatation 3. Underlying emphysematous change with diffuse bilateral interstitial changes favoring edema over infection. There are a few somewhat rounded more focal airspace densities present in the posterior right upper lobe and the right lung base which could represent airspace edema, superimposed pneumonia or lung nodules. 4. Trace bilateral pleural effusions 08/17 CXR impression: Interval worsening of mixed interstitial and airspace opacities. 08/19 procalcitonin 0.18 8/19 pt 13.0, inr 1.16, fibrogen 284, ddimer 7.19 08/19 BNP result: 450.6 08/19 MRSA result: not detected 08/19 CXR impression: No significant interval change. 08/22 pt deceased
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia, Pain in extremity, Paraesthesia, Peripheral swelling
Clinical narrative: Narrative: Patient received COVID-19 vaccine (Janseen)  on 8/25/21. About 2 weeks after receiving the vaccine he reports left calf pain (~9/8/21). A few days after the pain started, he reports numbness/tingling plantar surface of the foot and heel. He states the calf fees swollen. Was seen in the ED on 9/15/21. No family history of VTE, no other risk factors for DVT, no long distance travel. He is ambulatory, was given an outpt rx for rivaroxaban and discharged from the ED.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Dyspnoea, Endotracheal intubation, Malaise, Oxygen saturation decreased
Clinical narrative: Narrative: Patient is a 79 YO male admitted 9/15/21 for COVID-19 infection after presenting to the ED with worsening SOB and testing positive. His symptoms began 3 days prior. Of note, he was fully vaccinated. Patient was initially placed on 2L NC after desaturating to high 80s and eventually Oxymask 6L satting 94%. Remdesivir and dexamethasone were started. On 9/16, patient was intubated due to increasing oxygen requirements and inability to breathe without assistance.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Narrative: Patient is a 79 YO male admitted 9/15/21 for COVID-19 infection after presenting to the ED with worsening SOB and testing positive. His symptoms began 3 days prior. Of note, he was fully vaccinated. Patient was initially placed on 2L NC after desaturating to high 80s and eventually Oxymask 6L satting 94%. Remdesivir and dexamethasone were started. On 9/16, patient was intubated due to increasing oxygen requirements and inability to breathe without assistance.
Age: 73.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19
Clinical narrative: Narrative: Patient was admitted for severe case of COVID-19 despite receiving both doses of his vaccine on 02/10/2021 and 03/10/2021.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood glucose increased, COVID-19, COVID-19 pneumonia
Clinical narrative: Narrative:  Patient fully vaccinated for COVID-19 hospitalized for COVID-19 pneumonia. Admitted from LTC facility on 8/26/21 with COVID-19 positive status, increasing oxygen requirements, dry cough, generalized weakness, fever. Received supplemental oxygen, dexamethasone and remdesivir. Increased oxygen requirements in beginning of admission but weaned back to baseline (2L NC). Developed AKI during hospitalization; normalized by discharge. Altered mentation during hospitalization, at baseline upon discharge. Elevated blood sugars addressed during admission with insulin. Thought to be secondary to dexamethasone use and holding semaglutide therapy. Discharged back to care facility 9/7/21.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Mental status changes, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient fully vaccinated for COVID-19 hospitalized for COVID-19 pneumonia. Admitted from LTC facility on 8/26/21 with COVID-19 positive status, increasing oxygen requirements, dry cough, generalized weakness, fever. Received supplemental oxygen, dexamethasone and remdesivir. Increased oxygen requirements in beginning of admission but weaned back to baseline (2L NC). Developed AKI during hospitalization; normalized by discharge. Altered mentation during hospitalization, at baseline upon discharge. Elevated blood sugars addressed during admission with insulin. Thought to be secondary to dexamethasone use and holding semaglutide therapy. Discharged back to care facility 9/7/21.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Loss of consciousness, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Narrative: Fully vaccinated patient hospitalized for hypoxemic respiratory failure secondary to COVID-19. Admitted from home after passing out at home. Daughter found him down, notes that he had vomited and brought him in for evaluation 8/22/21. Was known to be COVID-19 positive on admission. Patient received remdesivir, dexamethasone and heated high flow oxygen. He was weaned to room air by 8/26. BP was labile during admission thought to be secondary to steroids. Medications were adjusted with recommendations for close outpatient follow up upon discharge. Patient discharged to home on 8/31 stable, on room air, with recommendations for home PT for strengthening.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Narrative: Fully vaccinated patient hospitalized for hypoxemic respiratory failure secondary to COVID-19. Admitted from home after passing out at home. Daughter found him down, notes that he had vomited and brought him in for evaluation 8/22/21. Was known to be COVID-19 positive on admission. Patient received remdesivir, dexamethasone and heated high flow oxygen. He was weaned to room air by 8/26. BP was labile during admission thought to be secondary to steroids. Medications were adjusted with recommendations for close outpatient follow up upon discharge. Patient discharged to home on 8/31 stable, on room air, with recommendations for home PT for strengthening.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac arrest, Chest pain, Death
Clinical narrative: Narrative:  59yo male pt died on 9/1/2021 after self-presented to community emergency facility for chest pain. Pt had a Cardiac Arrest & died at the ER in non-agency community hospital ER on 9/1/2021. Pt had received covid vaccines on 3/22/21 & 4/19/2021. Pt's death is not related to covid vaccines.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Asthenia, Death, General physical health deterioration, Intensive care
Clinical narrative: Narrative: 74yo in MICU unit inpatient with the following diagnoses: Hx of CVA, poa, Hypophosphatemia, not poa, AAA, with mesenteric atherosclerosis, poa, CVD, poa, HLD, poa, Bladder Cancer, poa, BPH, poa, BPH, poa, COPD, poa, History of AVR, 9/2011 for severe AS s/p mechanical valve, poa, HFrEF (EF: 35%), UTI, not poa, Troponemia, not poa, & Leukocytosis, not poa presented to agency ER on 8/19/2021 for age related debility requiring long term placement. Pt was admitted to a medicine team. Pt had declined on 9/4/2021 and was transferred to MICU. On 9/5/2021 pt died. Per Md death note - Death was caused by: Acute Hypoxic Respiratory Failure Pt had received covid vaccines on 3/9/2021 & 4/7/2021. Pt's death is not related to covid vaccines
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative:  69 yo with TBI,cad/cabg/chf/stent x 3/MI,DM,HTN,HLD,CKD,BCC,low vitamin d O2 dependent,right AKA from ,osteomyelitis died at outside agency community hospital on 9/3/2021. No information available about events leading up to pt's death. Pt had covid vaccines on on 3/8/21 & 4/21/21. Not able to determine if death is related to covid vaccines or not. This death is likely not related to the vaccinations due to comorbidities and length of time from vaccine administration.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Narrative: 66yo with hx of htn, etoh abuse, tobacco use, hbp, & hearing loss who had not been seen in his promary care for last 4 years was found deceased in his apartment by property manager on 8/31/2021. No information about pt's death available. Pt had received one covid (j&J0 vaccine on 4/28/21, likely not related to pt's death given length of time btwn vaccine & pt's date of death.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, Chest X-ray abnormal, Dyspnoea, Lung disorder
Clinical narrative: Narrative:  Full vaccinated patient admitted 8/28/2021 for acute hypoxic respiratory failure secondary to COVID-19. Positive COVID test 8/23. Presented 8/28 with O2 sat of 85% at night, fevers (103.4) and SOB. Received dexamethasone and remdesivir. Empirically treated with ceftriaxone and azithromycin. Initially on 3L oxygen and saturating > 90%. On day of discharge, on 2L. NO SOB at rest or when walking. Discharged on 9/1 in stable condition.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Full vaccinated patient admitted 8/28/2021 for acute hypoxic respiratory failure secondary to COVID-19. Positive COVID test 8/23. Presented 8/28 with O2 sat of 85% at night, fevers (103.4) and SOB. Received dexamethasone and remdesivir. Empirically treated with ceftriaxone and azithromycin. Initially on 3L oxygen and saturating > 90%. On day of discharge, on 2L. NO SOB at rest or when walking. Discharged on 9/1 in stable condition.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac disorder, Chest pain, Death, Dyspnoea
Clinical narrative: Narrative:  75yo male with the following problem list: PROBLEM LAST MOD PROVIDER HTN - Hypertension (SCT 38341003) (ICD-10-CM 08/13/2021 I10.) Hyperlipidemia (SCT 55822004) (ICD-10-CM E78.5) 08/13/2021 Gout (SCT 90560007) (ICD-10-CM M10.9) 08/13/2021 Tobacco user (SCT 110483000) (ICD-10-CM Z72.0) 08/13/2021 Squamous cell carcinoma of tongue (SCT 08/13/2021 276952000) (ICD-10-CM C02.9) Aortic valve stenosis (SCT 60573004) (ICD-10-CM 08/13/2021 I35.0) History of aortic valvuloplasty (SCT 08/13/2021 119481000119105) (ICD-10-CM Z98.890) Hearing loss (SCT 15188001) (ICD-10-CM H91.90) 08/13/2021 Had not been under facility care until 7/2021 with new cardiac diagnosis. Pt had self presented to outside community emergency facility on 8/20/21 due to chest pain & difficulty breathing. Pt then died at this hospital on 8/20/21. Pt had received a covid vaccine on 2/18/2021 at a outside source. This death is likely not related to the vaccinations due to comorbidities, age, and length of time from vaccine administration.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Aortic arteriosclerosis, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase normal, Brain natriuretic peptide normal
Clinical narrative: Narrative:  Admission Date: Aug 20,2021 Discharge Date: Aug 22,2021 Condition of patient at discharge: Stable Primary Diagnosis during Admission/Treatment: Acute on Chronic Hypoxic Respiratory failure in setting of COVID 52 y.o. male with h/o stage IV fibrocystic sarcoidosis, PH (groups III and V), APLS on coumadin, M. Abscessus in 2016, PFO with paradoxial embolic R MCA stroke, DVT, OSA on CPAP, and chronic hypoxemic respiratory failure on 3L O2, presented to the Emergency Dept with SOB, CP and increased sputum production. Patient reported that during the past week he has had a gradual development of his symptoms. Original onset began when he thought he was developing heartburn due to his GERD. However, the next day, he began to develop a heaviness in his chest. Symptoms began to progress where he was developing DOE and the heaviness in his chest was present upon waking. Pt stated he was unsure of where he got covid and is currently vaccinated with Moderna x 2 (1/14/2021 and 2/11/2021). He denies fever, chills, n/v/d, constipation, hematuria, melena, hematochezia, urinary urgency, dysuria. While in the ED, CXR showed stable, chronic appearing pleural and parenchymal scarring. No active cardiopulmonary process. Additionally, labs showed COVID+, ultra CRP 0.44, BNP <100, INR-1.5, CPK-143, CPK-MB-2.7 and troponin <0.02. Current diagnosis of COVID pneumonia and required 4L of O2 an admission and saturation remained around 96%. The patient was admitted briefly and discharged 2 days later in stable condition.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: C-reactive protein normal, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chest discomfort
Clinical narrative: Narrative:  Admission Date: Aug 20,2021 Discharge Date: Aug 22,2021 Condition of patient at discharge: Stable Primary Diagnosis during Admission/Treatment: Acute on Chronic Hypoxic Respiratory failure in setting of COVID 52 y.o. male with h/o stage IV fibrocystic sarcoidosis, PH (groups III and V), APLS on coumadin, M. Abscessus in 2016, PFO with paradoxial embolic R MCA stroke, DVT, OSA on CPAP, and chronic hypoxemic respiratory failure on 3L O2, presented to the Emergency Dept with SOB, CP and increased sputum production. Patient reported that during the past week he has had a gradual development of his symptoms. Original onset began when he thought he was developing heartburn due to his GERD. However, the next day, he began to develop a heaviness in his chest. Symptoms began to progress where he was developing DOE and the heaviness in his chest was present upon waking. Pt stated he was unsure of where he got covid and is currently vaccinated with Moderna x 2 (1/14/2021 and 2/11/2021). He denies fever, chills, n/v/d, constipation, hematuria, melena, hematochezia, urinary urgency, dysuria. While in the ED, CXR showed stable, chronic appearing pleural and parenchymal scarring. No active cardiopulmonary process. Additionally, labs showed COVID+, ultra CRP 0.44, BNP <100, INR-1.5, CPK-143, CPK-MB-2.7 and troponin <0.02. Current diagnosis of COVID pneumonia and required 4L of O2 an admission and saturation remained around 96%. The patient was admitted briefly and discharged 2 days later in stable condition.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest pain, Cough, Dyspnoea, Dyspnoea exertional, International normalised ratio increased
Clinical narrative: Narrative:  Admission Date: Aug 20,2021 Discharge Date: Aug 22,2021 Condition of patient at discharge: Stable Primary Diagnosis during Admission/Treatment: Acute on Chronic Hypoxic Respiratory failure in setting of COVID 52 y.o. male with h/o stage IV fibrocystic sarcoidosis, PH (groups III and V), APLS on coumadin, M. Abscessus in 2016, PFO with paradoxial embolic R MCA stroke, DVT, OSA on CPAP, and chronic hypoxemic respiratory failure on 3L O2, presented to the Emergency Dept with SOB, CP and increased sputum production. Patient reported that during the past week he has had a gradual development of his symptoms. Original onset began when he thought he was developing heartburn due to his GERD. However, the next day, he began to develop a heaviness in his chest. Symptoms began to progress where he was developing DOE and the heaviness in his chest was present upon waking. Pt stated he was unsure of where he got covid and is currently vaccinated with Moderna x 2 (1/14/2021 and 2/11/2021). He denies fever, chills, n/v/d, constipation, hematuria, melena, hematochezia, urinary urgency, dysuria. While in the ED, CXR showed stable, chronic appearing pleural and parenchymal scarring. No active cardiopulmonary process. Additionally, labs showed COVID+, ultra CRP 0.44, BNP <100, INR-1.5, CPK-143, CPK-MB-2.7 and troponin <0.02. Current diagnosis of COVID pneumonia and required 4L of O2 an admission and saturation remained around 96%. The patient was admitted briefly and discharged 2 days later in stable condition.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Pleural fibrosis, Pleural thickening, Pulmonary fibrosis, Respiratory failure
Clinical narrative: Narrative:  Admission Date: Aug 20,2021 Discharge Date: Aug 22,2021 Condition of patient at discharge: Stable Primary Diagnosis during Admission/Treatment: Acute on Chronic Hypoxic Respiratory failure in setting of COVID 52 y.o. male with h/o stage IV fibrocystic sarcoidosis, PH (groups III and V), APLS on coumadin, M. Abscessus in 2016, PFO with paradoxial embolic R MCA stroke, DVT, OSA on CPAP, and chronic hypoxemic respiratory failure on 3L O2, presented to the Emergency Dept with SOB, CP and increased sputum production. Patient reported that during the past week he has had a gradual development of his symptoms. Original onset began when he thought he was developing heartburn due to his GERD. However, the next day, he began to develop a heaviness in his chest. Symptoms began to progress where he was developing DOE and the heaviness in his chest was present upon waking. Pt stated he was unsure of where he got covid and is currently vaccinated with Moderna x 2 (1/14/2021 and 2/11/2021). He denies fever, chills, n/v/d, constipation, hematuria, melena, hematochezia, urinary urgency, dysuria. While in the ED, CXR showed stable, chronic appearing pleural and parenchymal scarring. No active cardiopulmonary process. Additionally, labs showed COVID+, ultra CRP 0.44, BNP <100, INR-1.5, CPK-143, CPK-MB-2.7 and troponin <0.02. Current diagnosis of COVID pneumonia and required 4L of O2 an admission and saturation remained around 96%. The patient was admitted briefly and discharged 2 days later in stable condition.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Sputum increased, Tracheal disorder, Troponin normal
Clinical narrative: Narrative:  Admission Date: Aug 20,2021 Discharge Date: Aug 22,2021 Condition of patient at discharge: Stable Primary Diagnosis during Admission/Treatment: Acute on Chronic Hypoxic Respiratory failure in setting of COVID 52 y.o. male with h/o stage IV fibrocystic sarcoidosis, PH (groups III and V), APLS on coumadin, M. Abscessus in 2016, PFO with paradoxial embolic R MCA stroke, DVT, OSA on CPAP, and chronic hypoxemic respiratory failure on 3L O2, presented to the Emergency Dept with SOB, CP and increased sputum production. Patient reported that during the past week he has had a gradual development of his symptoms. Original onset began when he thought he was developing heartburn due to his GERD. However, the next day, he began to develop a heaviness in his chest. Symptoms began to progress where he was developing DOE and the heaviness in his chest was present upon waking. Pt stated he was unsure of where he got covid and is currently vaccinated with Moderna x 2 (1/14/2021 and 2/11/2021). He denies fever, chills, n/v/d, constipation, hematuria, melena, hematochezia, urinary urgency, dysuria. While in the ED, CXR showed stable, chronic appearing pleural and parenchymal scarring. No active cardiopulmonary process. Additionally, labs showed COVID+, ultra CRP 0.44, BNP <100, INR-1.5, CPK-143, CPK-MB-2.7 and troponin <0.02. Current diagnosis of COVID pneumonia and required 4L of O2 an admission and saturation remained around 96%. The patient was admitted briefly and discharged 2 days later in stable condition.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chills, Confusional state, Dyspnoea, Oxygen saturation decreased
Clinical narrative: Narrative:  Patient presented to agency ER after 2 days of fever, confusion, low O2, SOB, fever and chills. Patient transferred from agency hospital as "closing down their COVID unit". and admitted to other hospital. Prior to transfer, patient received a loading dose of remdesivir and dexamethasone. Treatment plan included Remdesivir through 7/26, dexamethasone through 7/31, bronchodilators, and O2 support. Patient discharged on 7/27 with dexamethasone, benzonatate, and albuterol inhaler. Co-morbidities include HTN, T2DM, hyperlipidemia, BPH, and hypothyroidism.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient presented to agency ER after 2 days of fever, confusion, low O2, SOB, fever and chills. Patient transferred from agency hospital as "closing down their COVID unit". and admitted to other hospital. Prior to transfer, patient received a loading dose of remdesivir and dexamethasone. Treatment plan included Remdesivir through 7/26, dexamethasone through 7/31, bronchodilators, and O2 support. Patient discharged on 7/27 with dexamethasone, benzonatate, and albuterol inhaler. Co-morbidities include HTN, T2DM, hyperlipidemia, BPH, and hypothyroidism.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Angiogram pulmonary, Anticoagulant therapy, Atelectasis, Blood creatinine normal, Blood gases abnormal
Clinical narrative: Narrative:  Admission Date: AUG 29,2021 Discharge Date: AUG 30,2021 Admit Diagnosis: COVID PNEUMONIA, PULMONARY EMBOLI 76yoM with PMH significant for spontaneous pneumothroaces in his 20s s/p pleurodesis, ex smoker now with COPD, psoriasis, T2DM, NTM lung infection following with ID, and vascular dementia presented with COVID PNA 8/29/2021 despite being fully vaccinated with Pfizer's COVID vaccine on 01/22/2021 and 02/12/2021. Patient recently presented 8/26/21 with cough, congestion, and a positive COVID PCR. He was not hypoxic on room air at that time, and was discharged home after administration of Regeneron mAb. Three days later, 8/29/2021, patient presented with worsening cough, dyspnea. He reported that for the past two months, he has had intermittent hemoptysis as well. Denies NVDC, diaphoresis, fever, chills, abd pain, chest pain, numbness/tingling, further or progressive hemoptysis, changes in urinary or bowel habits. In the ED, patient is normotensive with all VSS, satting 98% ORA. Labs are significant for COVID +, D-Dimer 0.92. VBG significant for mild hypoxemia 7.4/41/18(L)/25.6. CT chest demonstrated acute pulmonary emboli to segmental branches of the right upper lobe, multifocal GGOs c/w COVID, stable RUL cavitary lung lesion with possible superimposed atypical/fungal infection. He was admitted. - Lovenox 80mg BID and then transitioned to apixaban 10mg twice daily for 7 days followed by 5mg twice daily for 6 months (planned). - Deferred Dexamethasone therapy as not on supplemental O2 - Deferred Remdesevir therapy as not on supplemental O2 The patient was discharged in stable condition on 8/30/2021.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19 pneumonia, Computerised tomogram thorax abnormal, Cough, Dyspnoea, Fibrin D dimer
Clinical narrative: Narrative:  Admission Date: AUG 29,2021 Discharge Date: AUG 30,2021 Admit Diagnosis: COVID PNEUMONIA, PULMONARY EMBOLI 76yoM with PMH significant for spontaneous pneumothroaces in his 20s s/p pleurodesis, ex smoker now with COPD, psoriasis, T2DM, NTM lung infection following with ID, and vascular dementia presented with COVID PNA 8/29/2021 despite being fully vaccinated with Pfizer's COVID vaccine on 01/22/2021 and 02/12/2021. Patient recently presented 8/26/21 with cough, congestion, and a positive COVID PCR. He was not hypoxic on room air at that time, and was discharged home after administration of Regeneron mAb. Three days later, 8/29/2021, patient presented with worsening cough, dyspnea. He reported that for the past two months, he has had intermittent hemoptysis as well. Denies NVDC, diaphoresis, fever, chills, abd pain, chest pain, numbness/tingling, further or progressive hemoptysis, changes in urinary or bowel habits. In the ED, patient is normotensive with all VSS, satting 98% ORA. Labs are significant for COVID +, D-Dimer 0.92. VBG significant for mild hypoxemia 7.4/41/18(L)/25.6. CT chest demonstrated acute pulmonary emboli to segmental branches of the right upper lobe, multifocal GGOs c/w COVID, stable RUL cavitary lung lesion with possible superimposed atypical/fungal infection. He was admitted. - Lovenox 80mg BID and then transitioned to apixaban 10mg twice daily for 7 days followed by 5mg twice daily for 6 months (planned). - Deferred Dexamethasone therapy as not on supplemental O2 - Deferred Remdesevir therapy as not on supplemental O2 The patient was discharged in stable condition on 8/30/2021.