Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Ejection fraction decreased, Enterovirus test negative, Hiatus hernia, Human metapneumovirus test
Clinical narrative: COVID-19 SOB (shortness of breath) Cough Suspected COVID-19 virus infection Care Coordination Progress Note RN (Registered Nurse)    COVID 19 MAB Infusion Navigator Initial Patient Assessment   Ordering Prescriber has completed required FDA EUA elements.    COVID-19 Positive Result Date (and on chart/file): 5/8/21   Start of Symptoms Date: 5/6/21  Meets Criteria:   ANY AGE: ? Body mass index (BMI) ?35 ? Chronic kidney disease ? Diabetes ? Immunosuppressive disease AGE SPECIFIC: ? ? 65 years of age       ? ?55 years of age AND had Cardiovascular Disease OR Hypertension OR COPD/other chronic respiratory disease   ED to Hosp-Admission Discharged  5/10/2021 - 5/18/2021 (8 days) Treatment team Sepsis due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (CMS/HCC) Principal problem Discharge Summary Discharge Summary   BRIEF OVERVIEW Admitting Provider: MD Discharge Provider: DO Primary Care Physician at Discharge: MD    Admission Date: 5/10/2021     Discharge Date: 5/18/2021   Discharge Diagnosis  Medical Problems     Hospital Problems        POA    * (Principal) Sepsis due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (CMS/HCC) Yes    Overview Signed 5/14/2021 10:50 AM      05/11/2021 Dexamethasone 05/11/2021 Remdesivir            Essential hypertension Yes         CLL (chronic lymphocytic leukemia) (CMS/HCC) Yes         OSA (obstructive sleep apnea) Yes         Persistent atrial fibrillation (CMS/HCC) Yes        DETAILS OF HOSPITAL STAY   Presenting Problem/History of Present Illness/Reason for Admission Patient is an 82-year-old male with past medical history significant for CLL, obstructive sleep apnea, obesity and persistent atrial fibrillation who presented to the ER on 5/10 for evaluation of progressively worsening shortness of breath after recently being diagnosed with Covid?19.  ER work-up concerning for severe sepsis with acute hypoxic respiratory failure for which he was admitted to the PCU under the hospitalist service.   Hospital Course He was treated with dexamethasone and remdesivir but remained hypoxic requiring alternating trials of high flow nasal cannula and BiPAP for which pulmonology was consulted on 5/12.  Unfortunately, he did not tolerate prone positioning.  Despite his advanced age and several risk factors, he slowly but surely progressed from a pulmonary standpoint.  He was weaned off high flow oxygen 2 days ago and deemed stable for downgrade to MedSurg with telemetry at that time.  Since then he has continued to recover well, now requiring 6 L of oxygen with activity and 4 L at all other times.  He is anxious to be discharged home and appears medically stable to do so with home health care services, remote patient monitoring and outpatient pulmonology follow-up with PAL as prior to hospitalization.  Prior to discharge, all questions were answered and patient and his son expressed understanding, appreciation and agreement with the discharge plan at this time.   Treatments: IV hydration, analgesia: acetaminophen, cardiac meds: metoprolol, furosemide and aldactone, anticoagulation: eliquis, steroids: dexamethasone, respiratory therapy: O2 and remdesivir