chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Hypervolaemia, Influenza like illness, Left ventricular failure, Legionella test, Lipids normal
Clinical narrative: Patient is a 81 y.o. female patient of No, Physician with history of HTN, HLD, macular degeneration who presented to Hospital with flu like symptom .   New onset atrial fibrillation with RVR Possible non-STEMI Prolonged Qtc  Acute on chronic systolic and diastolic heart failure exacerbation Sp a total of 30 mg IV Cardizem bolus and Lovenox 1mg/kg at Ashland FSED.  ChadVasc score: 4 (sex, age, HTN) Consult Cardiology, pending evaluation Check EKG - showing QTC >500, give 2 gram Mag Sulfate then repeat EKG. Echocardiogram report reviewed ejection fraction 20% and findings of mild diastolic dysfunction TSH.  Within normal limits Serial Troponin, elevated but steady Lipid panel within normal limit A1c 5.8 Continue aspirin, statin.  Continue heparin drip, cardiology on board consider CCTA left atrial appendage study and DCCV Start Cardizem drip on 8/25 then switch to esmolol drip per cardiology recommendation Continue IV Lasix S/p Esmolol DC Atrial flutter Discussed with cardiology at this point no plan for ischemic evaluation as an inpatient consideration outpatient stress test Status post heparin drip Continue aspirin, statin, beta-blocker, ARB and calcium channel blocker   Acute Hypoxemic Respiratory Failure multifactorial secondary to fluid overload and COVID infection Currently requiring 3L per NC. Low flow oxygen protocol. Wean as tolerated. Scheduled/PRN bronchodilators sputum culture in progress urine antigens (strep/legionella), positive for Streptococcus pneumonia Continue IV rocephin  day 5 Continue IV steroids and remdesivir, tomorrow will be day 5 then discontinue remdesivir DC oxygen via nasal cannula to assess oxygen on room air if remains stable above 95, consider discontinue IV dexamethasone We will discontinue IV dexamethasone Completing course of remdesivir today   Covid-19 Virus Infection Streptococcus pneumonia antigen bacterial pneumonia Date of onset of symptoms: 8/21/2023 Symptoms present on admission: headache, nausea, cough, weakness, fatigue, sore throat, diarrhea Date of covid positive test: 08/24/2023 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: 3L Current oxygen requirements: 3L Medical therapy: steroids, PRN IV Lasix.  Consultants following: cardiology and ID Anticipated special isolation end date: 8/30/2023. Follow blood and sputum cultures.  Negative so far  IV Rocephin since 8/25 IV remdesivir since 8/25, stop date 8/30 Consult ID, follow ID recommendations   Essential Hypertension Continue Amlodipine and Metoprolol.   Dyslipidemia Continue Atorvastatin.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Oropharyngeal pain, Pneumonia bacterial, Pneumonia streptococcal, SARS-CoV-2 test positive
Clinical narrative: Patient is a 81 y.o. female patient of No, Physician with history of HTN, HLD, macular degeneration who presented to Hospital with flu like symptom .   New onset atrial fibrillation with RVR Possible non-STEMI Prolonged Qtc  Acute on chronic systolic and diastolic heart failure exacerbation Sp a total of 30 mg IV Cardizem bolus and Lovenox 1mg/kg at Ashland FSED.  ChadVasc score: 4 (sex, age, HTN) Consult Cardiology, pending evaluation Check EKG - showing QTC >500, give 2 gram Mag Sulfate then repeat EKG. Echocardiogram report reviewed ejection fraction 20% and findings of mild diastolic dysfunction TSH.  Within normal limits Serial Troponin, elevated but steady Lipid panel within normal limit A1c 5.8 Continue aspirin, statin.  Continue heparin drip, cardiology on board consider CCTA left atrial appendage study and DCCV Start Cardizem drip on 8/25 then switch to esmolol drip per cardiology recommendation Continue IV Lasix S/p Esmolol DC Atrial flutter Discussed with cardiology at this point no plan for ischemic evaluation as an inpatient consideration outpatient stress test Status post heparin drip Continue aspirin, statin, beta-blocker, ARB and calcium channel blocker   Acute Hypoxemic Respiratory Failure multifactorial secondary to fluid overload and COVID infection Currently requiring 3L per NC. Low flow oxygen protocol. Wean as tolerated. Scheduled/PRN bronchodilators sputum culture in progress urine antigens (strep/legionella), positive for Streptococcus pneumonia Continue IV rocephin  day 5 Continue IV steroids and remdesivir, tomorrow will be day 5 then discontinue remdesivir DC oxygen via nasal cannula to assess oxygen on room air if remains stable above 95, consider discontinue IV dexamethasone We will discontinue IV dexamethasone Completing course of remdesivir today   Covid-19 Virus Infection Streptococcus pneumonia antigen bacterial pneumonia Date of onset of symptoms: 8/21/2023 Symptoms present on admission: headache, nausea, cough, weakness, fatigue, sore throat, diarrhea Date of covid positive test: 08/24/2023 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: 3L Current oxygen requirements: 3L Medical therapy: steroids, PRN IV Lasix.  Consultants following: cardiology and ID Anticipated special isolation end date: 8/30/2023. Follow blood and sputum cultures.  Negative so far  IV Rocephin since 8/25 IV remdesivir since 8/25, stop date 8/30 Consult ID, follow ID recommendations   Essential Hypertension Continue Amlodipine and Metoprolol.   Dyslipidemia Continue Atorvastatin.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Sputum culture, Streptococcus test positive, Troponin increased, Urine antigen test
Clinical narrative: Patient is a 81 y.o. female patient of No, Physician with history of HTN, HLD, macular degeneration who presented to Hospital with flu like symptom .   New onset atrial fibrillation with RVR Possible non-STEMI Prolonged Qtc  Acute on chronic systolic and diastolic heart failure exacerbation Sp a total of 30 mg IV Cardizem bolus and Lovenox 1mg/kg at Ashland FSED.  ChadVasc score: 4 (sex, age, HTN) Consult Cardiology, pending evaluation Check EKG - showing QTC >500, give 2 gram Mag Sulfate then repeat EKG. Echocardiogram report reviewed ejection fraction 20% and findings of mild diastolic dysfunction TSH.  Within normal limits Serial Troponin, elevated but steady Lipid panel within normal limit A1c 5.8 Continue aspirin, statin.  Continue heparin drip, cardiology on board consider CCTA left atrial appendage study and DCCV Start Cardizem drip on 8/25 then switch to esmolol drip per cardiology recommendation Continue IV Lasix S/p Esmolol DC Atrial flutter Discussed with cardiology at this point no plan for ischemic evaluation as an inpatient consideration outpatient stress test Status post heparin drip Continue aspirin, statin, beta-blocker, ARB and calcium channel blocker   Acute Hypoxemic Respiratory Failure multifactorial secondary to fluid overload and COVID infection Currently requiring 3L per NC. Low flow oxygen protocol. Wean as tolerated. Scheduled/PRN bronchodilators sputum culture in progress urine antigens (strep/legionella), positive for Streptococcus pneumonia Continue IV rocephin  day 5 Continue IV steroids and remdesivir, tomorrow will be day 5 then discontinue remdesivir DC oxygen via nasal cannula to assess oxygen on room air if remains stable above 95, consider discontinue IV dexamethasone We will discontinue IV dexamethasone Completing course of remdesivir today   Covid-19 Virus Infection Streptococcus pneumonia antigen bacterial pneumonia Date of onset of symptoms: 8/21/2023 Symptoms present on admission: headache, nausea, cough, weakness, fatigue, sore throat, diarrhea Date of covid positive test: 08/24/2023 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: 3L Current oxygen requirements: 3L Medical therapy: steroids, PRN IV Lasix.  Consultants following: cardiology and ID Anticipated special isolation end date: 8/30/2023. Follow blood and sputum cultures.  Negative so far  IV Rocephin since 8/25 IV remdesivir since 8/25, stop date 8/30 Consult ID, follow ID recommendations   Essential Hypertension Continue Amlodipine and Metoprolol.   Dyslipidemia Continue Atorvastatin.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Vertigo
Clinical narrative: Vertigo while exercising (yoga) became apparent 10/2.  Spinning while looking down or up or any quick movement.  Not severe but persistent through today.  I have had vertigo before, approximately 8 years ago and very infrequently since then, maybe 2 or 3 times.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram cerebral normal, Arteriogram carotid normal, Blood culture negative, C-reactive protein, COVID-19
Clinical narrative: Patient is a 60 y.o. female patient of MD with history of long QT syndrome s/p dual-chamber ICD insertion and failure with new insertion of an ICD on November 2022., paroxysmal A-fib, factor V Leyden deficiency, presented to Hospital with right-sided weakness,   Fever and cough for 3 days   Covid 19 Fever Chest x-ray-Lungs are free of focal infiltrates CRP-9.0 Sedrate-36 Blood Cx-no growth Urine Cx-no growth Urinalysis -negative ID following Remdesivir IV-completed 3 doses Decadron 6 mg oral daily-completed Albuterol inhalers prn Oxygen as needed     Right-sided weakness Acute CVA CT head- negative Right shoulder x-ray- negative  Neurology signed off- follow up outpatient for EMG PT/OT CTA head/neck-negative Continue ASA   A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA     Factor V Leiden deficiency Patient is following with an outpatient physician Monitor for now for any signs of bleeding   Hypertension Hold amlodipine start metoprolol and spironolactone
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac device replacement, Cerebrovascular accident, Chest X-ray normal, Computerised tomogram head normal, Cough
Clinical narrative: Patient is a 60 y.o. female patient of MD with history of long QT syndrome s/p dual-chamber ICD insertion and failure with new insertion of an ICD on November 2022., paroxysmal A-fib, factor V Leyden deficiency, presented to Hospital with right-sided weakness,   Fever and cough for 3 days   Covid 19 Fever Chest x-ray-Lungs are free of focal infiltrates CRP-9.0 Sedrate-36 Blood Cx-no growth Urine Cx-no growth Urinalysis -negative ID following Remdesivir IV-completed 3 doses Decadron 6 mg oral daily-completed Albuterol inhalers prn Oxygen as needed     Right-sided weakness Acute CVA CT head- negative Right shoulder x-ray- negative  Neurology signed off- follow up outpatient for EMG PT/OT CTA head/neck-negative Continue ASA   A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA     Factor V Leiden deficiency Patient is following with an outpatient physician Monitor for now for any signs of bleeding   Hypertension Hold amlodipine start metoprolol and spironolactone
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Culture urine negative, Echocardiogram abnormal, Ejection fraction, Ejection fraction normal, Hemiparesis
Clinical narrative: Patient is a 60 y.o. female patient of MD with history of long QT syndrome s/p dual-chamber ICD insertion and failure with new insertion of an ICD on November 2022., paroxysmal A-fib, factor V Leyden deficiency, presented to Hospital with right-sided weakness,   Fever and cough for 3 days   Covid 19 Fever Chest x-ray-Lungs are free of focal infiltrates CRP-9.0 Sedrate-36 Blood Cx-no growth Urine Cx-no growth Urinalysis -negative ID following Remdesivir IV-completed 3 doses Decadron 6 mg oral daily-completed Albuterol inhalers prn Oxygen as needed     Right-sided weakness Acute CVA CT head- negative Right shoulder x-ray- negative  Neurology signed off- follow up outpatient for EMG PT/OT CTA head/neck-negative Continue ASA   A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA     Factor V Leiden deficiency Patient is following with an outpatient physician Monitor for now for any signs of bleeding   Hypertension Hold amlodipine start metoprolol and spironolactone
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertension, Left atrial enlargement, Pyrexia, Red blood cell sedimentation rate increased, Urine analysis normal
Clinical narrative: Patient is a 60 y.o. female patient of MD with history of long QT syndrome s/p dual-chamber ICD insertion and failure with new insertion of an ICD on November 2022., paroxysmal A-fib, factor V Leyden deficiency, presented to Hospital with right-sided weakness,   Fever and cough for 3 days   Covid 19 Fever Chest x-ray-Lungs are free of focal infiltrates CRP-9.0 Sedrate-36 Blood Cx-no growth Urine Cx-no growth Urinalysis -negative ID following Remdesivir IV-completed 3 doses Decadron 6 mg oral daily-completed Albuterol inhalers prn Oxygen as needed     Right-sided weakness Acute CVA CT head- negative Right shoulder x-ray- negative  Neurology signed off- follow up outpatient for EMG PT/OT CTA head/neck-negative Continue ASA   A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA     Factor V Leiden deficiency Patient is following with an outpatient physician Monitor for now for any signs of bleeding   Hypertension Hold amlodipine start metoprolol and spironolactone
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: X-ray limb normal
Clinical narrative: Patient is a 60 y.o. female patient of MD with history of long QT syndrome s/p dual-chamber ICD insertion and failure with new insertion of an ICD on November 2022., paroxysmal A-fib, factor V Leyden deficiency, presented to Hospital with right-sided weakness,   Fever and cough for 3 days   Covid 19 Fever Chest x-ray-Lungs are free of focal infiltrates CRP-9.0 Sedrate-36 Blood Cx-no growth Urine Cx-no growth Urinalysis -negative ID following Remdesivir IV-completed 3 doses Decadron 6 mg oral daily-completed Albuterol inhalers prn Oxygen as needed     Right-sided weakness Acute CVA CT head- negative Right shoulder x-ray- negative  Neurology signed off- follow up outpatient for EMG PT/OT CTA head/neck-negative Continue ASA   A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA A-fib Long QT syndrome S/p dual-chamber ICD insertion 2005, removed in 2012 due to failure Last echo in 2022 showed LVEF of 75%, enlarged LA, Continue metoprolol, ASA     Factor V Leiden deficiency Patient is following with an outpatient physician Monitor for now for any signs of bleeding   Hypertension Hold amlodipine start metoprolol and spironolactone
Age: 70.0
Sex: M
Vaccine: FLU4
Symptoms: Abdominal discomfort, Diarrhoea, Dyspnoea, Paraesthesia
Clinical narrative: Patient called and reported today that he woke up at 2:30 am with Diarrhea, Tingling  in bilateral legs, upset stomach and trouble breathing.  Informed patient to contact his Doctors office.  Refused ER treatment last night.  Used nebulizers.  Still not feeling 100% at time of call.
Age: 0.5
Sex: M
Vaccine: HEPA, VARCEL
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Vaccines were give too early.   Dr. instructed  mom to call her on her personal phone if patient shows any change  of behavior.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Hives . Hives are getting worse
Age: 9.0
Sex: F
Vaccine: FLUN4
Symptoms: Rash, Rash pruritic, Urticaria
Clinical narrative: Mother reported that child woke up on Wednesday, September 20 with welts on one side of her face, and top of forehead, but child reported to mother she felt fine and went to school. Per mother at the end of the day the child had a rash on her hands and "all over her body".  Mother to child to local urgent care. Was evaluated but provider unable to determine the type of rash, but indicated to the mother the rash on child's hand "may have been poison ivy".  Was given steroid treatment for less than 7 days (unsure of name or duration of treatment regimen).  Mother states the child went to school the following day, September 21, as she indicated she "felt fine".  Mother states she wasn't sure how well her daughter felt or if she didn't want to miss the school field trip that day (9/21/23).  per mother, the rash on 9/21/23 was a faint rash on her face with two spots on her cheek, one on her eyelid, and a cluster on her forehead and hand, with the hand being "Itchy".  I spoke with the school nurse who indicated she did not closely observe the child as she was getting on the field trip bus, but she did not notice any large rash or cluster on the child's face or forehead.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood iron decreased, COVID-19, COVID-19 pneumonia, Cardiac failure congestive
Clinical narrative: Patient is a 47 y.o. female with a history of diabetes, hypertension, TIA who presented from home on 9/2/2023 with COVID-19 pneumonia.  She also developed steroid-induced hyperglycemia requiring non-DKA insulin drip.  Patient was treated with remdesivir, Decadron, and IV Lasix.  Patient was initially on heated high flow nasal cannula at 75% / 30 L, and she was weaned to 2 L nasal cannula oxygen.  Patient completed remdesivir course in the hospital.  Patient will continue with Decadron as an outpatient to complete a 10-day course.  She will be discharged with home oxygen, and this can be weaned as an outpatient.  For her diabetes, she will be discharged with Lantus 40 units twice daily along with her Humalog 18 units 3 times daily.  Once her Decadron has been completed, she can decrease her Lantus to home dose 6 units daily and Humalog 18 units 3 times daily.  She will get home health care for outpatient PT/OT.          Assessment and Plan COVID-19 Pneumonia - Presented with: dyspnea, cough, but resolved - Positive COVID-19: 8/31/23 - Vaccination status: vaccinated with 2 doses, no boosters - CTPE on admission showed no PE, B/L GG opacities and consolidative opacities- edema vs PNA; B/L pleural effusions - Oxygen status: Discharged with 2 liters  - Decadron: Yes. Expected end date 9/11 - Remdesivir: Completed 5-day course in the hospital  Acute Hypoxemic Respiratory Failure -Secondary to COVID-19 and CHF -Resolved -Patient will go home with 2 L of oxygen, and this can be weaned as an outpatient.   Acute heart failure with preserved ejection fraction -Secondary to above -Echocardiogram 9/5/2023 demonstrated ejection fraction 69% with normal right ventricular systolic function. -Resolved with IV diuretics -Patient will be discharged with Lasix 40 mg p.o. daily.     Hyponatremia-- >resolved - Secondary to volume overload and COVID - Resolved   IDDM2 With Hyperglycemia - Hba1c 9% - Home regimen lantus 60 units, novolog 18 units TID plus sliding scale. In process of switching Ozempic to Mounjaro - Noncompliance with dietary indiscretion and overeating due to depression and recent stroke -During hospitalization, patient was treated with insulin drip -Switch to basal bolus insulin regimen on 9/3/2023  -Patiently discharged with Lantus to 4 units twice daily, and continue with Humalog 18 units 3 times daily -Once Decadron course completed, patient can resume her home insulin dosages. Chronic Microcytic Anemia - Partly related to menstruation - No signs active bleeding. Iron studies with low Fe but normal ferritin and low normal TIBC   H/o- MoyaMoya disease CVA with left-sided weakness - s/p STA-MCA bypass in 2020 -Follows with health stroke chronic -Continue with ASA; - hold statin given recent use of paxlovid outpatient    Morbid obesity - BMI 49 - lifestyle modification for weight loss imperative - Can be switched to Mounjaro as an outpatient   Seizure Disorder - Continue with lamotrigine
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Computerised tomogram thorax abnormal, Condition aggravated, Cough, Depression
Clinical narrative: Patient is a 47 y.o. female with a history of diabetes, hypertension, TIA who presented from home on 9/2/2023 with COVID-19 pneumonia.  She also developed steroid-induced hyperglycemia requiring non-DKA insulin drip.  Patient was treated with remdesivir, Decadron, and IV Lasix.  Patient was initially on heated high flow nasal cannula at 75% / 30 L, and she was weaned to 2 L nasal cannula oxygen.  Patient completed remdesivir course in the hospital.  Patient will continue with Decadron as an outpatient to complete a 10-day course.  She will be discharged with home oxygen, and this can be weaned as an outpatient.  For her diabetes, she will be discharged with Lantus 40 units twice daily along with her Humalog 18 units 3 times daily.  Once her Decadron has been completed, she can decrease her Lantus to home dose 6 units daily and Humalog 18 units 3 times daily.  She will get home health care for outpatient PT/OT.          Assessment and Plan COVID-19 Pneumonia - Presented with: dyspnea, cough, but resolved - Positive COVID-19: 8/31/23 - Vaccination status: vaccinated with 2 doses, no boosters - CTPE on admission showed no PE, B/L GG opacities and consolidative opacities- edema vs PNA; B/L pleural effusions - Oxygen status: Discharged with 2 liters  - Decadron: Yes. Expected end date 9/11 - Remdesivir: Completed 5-day course in the hospital  Acute Hypoxemic Respiratory Failure -Secondary to COVID-19 and CHF -Resolved -Patient will go home with 2 L of oxygen, and this can be weaned as an outpatient.   Acute heart failure with preserved ejection fraction -Secondary to above -Echocardiogram 9/5/2023 demonstrated ejection fraction 69% with normal right ventricular systolic function. -Resolved with IV diuretics -Patient will be discharged with Lasix 40 mg p.o. daily.     Hyponatremia-- >resolved - Secondary to volume overload and COVID - Resolved   IDDM2 With Hyperglycemia - Hba1c 9% - Home regimen lantus 60 units, novolog 18 units TID plus sliding scale. In process of switching Ozempic to Mounjaro - Noncompliance with dietary indiscretion and overeating due to depression and recent stroke -During hospitalization, patient was treated with insulin drip -Switch to basal bolus insulin regimen on 9/3/2023  -Patiently discharged with Lantus to 4 units twice daily, and continue with Humalog 18 units 3 times daily -Once Decadron course completed, patient can resume her home insulin dosages. Chronic Microcytic Anemia - Partly related to menstruation - No signs active bleeding. Iron studies with low Fe but normal ferritin and low normal TIBC   H/o- MoyaMoya disease CVA with left-sided weakness - s/p STA-MCA bypass in 2020 -Follows with health stroke chronic -Continue with ASA; - hold statin given recent use of paxlovid outpatient    Morbid obesity - BMI 49 - lifestyle modification for weight loss imperative - Can be switched to Mounjaro as an outpatient   Seizure Disorder - Continue with lamotrigine
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Diet noncompliance, Diuretic therapy, Dyspnoea, Eating disorder, Echocardiogram normal
Clinical narrative: Patient is a 47 y.o. female with a history of diabetes, hypertension, TIA who presented from home on 9/2/2023 with COVID-19 pneumonia.  She also developed steroid-induced hyperglycemia requiring non-DKA insulin drip.  Patient was treated with remdesivir, Decadron, and IV Lasix.  Patient was initially on heated high flow nasal cannula at 75% / 30 L, and she was weaned to 2 L nasal cannula oxygen.  Patient completed remdesivir course in the hospital.  Patient will continue with Decadron as an outpatient to complete a 10-day course.  She will be discharged with home oxygen, and this can be weaned as an outpatient.  For her diabetes, she will be discharged with Lantus 40 units twice daily along with her Humalog 18 units 3 times daily.  Once her Decadron has been completed, she can decrease her Lantus to home dose 6 units daily and Humalog 18 units 3 times daily.  She will get home health care for outpatient PT/OT.          Assessment and Plan COVID-19 Pneumonia - Presented with: dyspnea, cough, but resolved - Positive COVID-19: 8/31/23 - Vaccination status: vaccinated with 2 doses, no boosters - CTPE on admission showed no PE, B/L GG opacities and consolidative opacities- edema vs PNA; B/L pleural effusions - Oxygen status: Discharged with 2 liters  - Decadron: Yes. Expected end date 9/11 - Remdesivir: Completed 5-day course in the hospital  Acute Hypoxemic Respiratory Failure -Secondary to COVID-19 and CHF -Resolved -Patient will go home with 2 L of oxygen, and this can be weaned as an outpatient.   Acute heart failure with preserved ejection fraction -Secondary to above -Echocardiogram 9/5/2023 demonstrated ejection fraction 69% with normal right ventricular systolic function. -Resolved with IV diuretics -Patient will be discharged with Lasix 40 mg p.o. daily.     Hyponatremia-- >resolved - Secondary to volume overload and COVID - Resolved   IDDM2 With Hyperglycemia - Hba1c 9% - Home regimen lantus 60 units, novolog 18 units TID plus sliding scale. In process of switching Ozempic to Mounjaro - Noncompliance with dietary indiscretion and overeating due to depression and recent stroke -During hospitalization, patient was treated with insulin drip -Switch to basal bolus insulin regimen on 9/3/2023  -Patiently discharged with Lantus to 4 units twice daily, and continue with Humalog 18 units 3 times daily -Once Decadron course completed, patient can resume her home insulin dosages. Chronic Microcytic Anemia - Partly related to menstruation - No signs active bleeding. Iron studies with low Fe but normal ferritin and low normal TIBC   H/o- MoyaMoya disease CVA with left-sided weakness - s/p STA-MCA bypass in 2020 -Follows with health stroke chronic -Continue with ASA; - hold statin given recent use of paxlovid outpatient    Morbid obesity - BMI 49 - lifestyle modification for weight loss imperative - Can be switched to Mounjaro as an outpatient   Seizure Disorder - Continue with lamotrigine
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Ejection fraction normal, Glycosylated haemoglobin increased, Hyperglycaemia, Hypervolaemia, Hyponatraemia
Clinical narrative: Patient is a 47 y.o. female with a history of diabetes, hypertension, TIA who presented from home on 9/2/2023 with COVID-19 pneumonia.  She also developed steroid-induced hyperglycemia requiring non-DKA insulin drip.  Patient was treated with remdesivir, Decadron, and IV Lasix.  Patient was initially on heated high flow nasal cannula at 75% / 30 L, and she was weaned to 2 L nasal cannula oxygen.  Patient completed remdesivir course in the hospital.  Patient will continue with Decadron as an outpatient to complete a 10-day course.  She will be discharged with home oxygen, and this can be weaned as an outpatient.  For her diabetes, she will be discharged with Lantus 40 units twice daily along with her Humalog 18 units 3 times daily.  Once her Decadron has been completed, she can decrease her Lantus to home dose 6 units daily and Humalog 18 units 3 times daily.  She will get home health care for outpatient PT/OT.          Assessment and Plan COVID-19 Pneumonia - Presented with: dyspnea, cough, but resolved - Positive COVID-19: 8/31/23 - Vaccination status: vaccinated with 2 doses, no boosters - CTPE on admission showed no PE, B/L GG opacities and consolidative opacities- edema vs PNA; B/L pleural effusions - Oxygen status: Discharged with 2 liters  - Decadron: Yes. Expected end date 9/11 - Remdesivir: Completed 5-day course in the hospital  Acute Hypoxemic Respiratory Failure -Secondary to COVID-19 and CHF -Resolved -Patient will go home with 2 L of oxygen, and this can be weaned as an outpatient.   Acute heart failure with preserved ejection fraction -Secondary to above -Echocardiogram 9/5/2023 demonstrated ejection fraction 69% with normal right ventricular systolic function. -Resolved with IV diuretics -Patient will be discharged with Lasix 40 mg p.o. daily.     Hyponatremia-- >resolved - Secondary to volume overload and COVID - Resolved   IDDM2 With Hyperglycemia - Hba1c 9% - Home regimen lantus 60 units, novolog 18 units TID plus sliding scale. In process of switching Ozempic to Mounjaro - Noncompliance with dietary indiscretion and overeating due to depression and recent stroke -During hospitalization, patient was treated with insulin drip -Switch to basal bolus insulin regimen on 9/3/2023  -Patiently discharged with Lantus to 4 units twice daily, and continue with Humalog 18 units 3 times daily -Once Decadron course completed, patient can resume her home insulin dosages. Chronic Microcytic Anemia - Partly related to menstruation - No signs active bleeding. Iron studies with low Fe but normal ferritin and low normal TIBC   H/o- MoyaMoya disease CVA with left-sided weakness - s/p STA-MCA bypass in 2020 -Follows with health stroke chronic -Continue with ASA; - hold statin given recent use of paxlovid outpatient    Morbid obesity - BMI 49 - lifestyle modification for weight loss imperative - Can be switched to Mounjaro as an outpatient   Seizure Disorder - Continue with lamotrigine
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Insulin therapy, Insulin-requiring type 2 diabetes mellitus, Iron binding capacity total normal, Lung consolidation, Lung opacity
Clinical narrative: Patient is a 47 y.o. female with a history of diabetes, hypertension, TIA who presented from home on 9/2/2023 with COVID-19 pneumonia.  She also developed steroid-induced hyperglycemia requiring non-DKA insulin drip.  Patient was treated with remdesivir, Decadron, and IV Lasix.  Patient was initially on heated high flow nasal cannula at 75% / 30 L, and she was weaned to 2 L nasal cannula oxygen.  Patient completed remdesivir course in the hospital.  Patient will continue with Decadron as an outpatient to complete a 10-day course.  She will be discharged with home oxygen, and this can be weaned as an outpatient.  For her diabetes, she will be discharged with Lantus 40 units twice daily along with her Humalog 18 units 3 times daily.  Once her Decadron has been completed, she can decrease her Lantus to home dose 6 units daily and Humalog 18 units 3 times daily.  She will get home health care for outpatient PT/OT.          Assessment and Plan COVID-19 Pneumonia - Presented with: dyspnea, cough, but resolved - Positive COVID-19: 8/31/23 - Vaccination status: vaccinated with 2 doses, no boosters - CTPE on admission showed no PE, B/L GG opacities and consolidative opacities- edema vs PNA; B/L pleural effusions - Oxygen status: Discharged with 2 liters  - Decadron: Yes. Expected end date 9/11 - Remdesivir: Completed 5-day course in the hospital  Acute Hypoxemic Respiratory Failure -Secondary to COVID-19 and CHF -Resolved -Patient will go home with 2 L of oxygen, and this can be weaned as an outpatient.   Acute heart failure with preserved ejection fraction -Secondary to above -Echocardiogram 9/5/2023 demonstrated ejection fraction 69% with normal right ventricular systolic function. -Resolved with IV diuretics -Patient will be discharged with Lasix 40 mg p.o. daily.     Hyponatremia-- >resolved - Secondary to volume overload and COVID - Resolved   IDDM2 With Hyperglycemia - Hba1c 9% - Home regimen lantus 60 units, novolog 18 units TID plus sliding scale. In process of switching Ozempic to Mounjaro - Noncompliance with dietary indiscretion and overeating due to depression and recent stroke -During hospitalization, patient was treated with insulin drip -Switch to basal bolus insulin regimen on 9/3/2023  -Patiently discharged with Lantus to 4 units twice daily, and continue with Humalog 18 units 3 times daily -Once Decadron course completed, patient can resume her home insulin dosages. Chronic Microcytic Anemia - Partly related to menstruation - No signs active bleeding. Iron studies with low Fe but normal ferritin and low normal TIBC   H/o- MoyaMoya disease CVA with left-sided weakness - s/p STA-MCA bypass in 2020 -Follows with health stroke chronic -Continue with ASA; - hold statin given recent use of paxlovid outpatient    Morbid obesity - BMI 49 - lifestyle modification for weight loss imperative - Can be switched to Mounjaro as an outpatient   Seizure Disorder - Continue with lamotrigine
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Pleural effusion, Pneumonia, Pulmonary oedema, SARS-CoV-2 test positive, Serum ferritin normal
Clinical narrative: Patient is a 47 y.o. female with a history of diabetes, hypertension, TIA who presented from home on 9/2/2023 with COVID-19 pneumonia.  She also developed steroid-induced hyperglycemia requiring non-DKA insulin drip.  Patient was treated with remdesivir, Decadron, and IV Lasix.  Patient was initially on heated high flow nasal cannula at 75% / 30 L, and she was weaned to 2 L nasal cannula oxygen.  Patient completed remdesivir course in the hospital.  Patient will continue with Decadron as an outpatient to complete a 10-day course.  She will be discharged with home oxygen, and this can be weaned as an outpatient.  For her diabetes, she will be discharged with Lantus 40 units twice daily along with her Humalog 18 units 3 times daily.  Once her Decadron has been completed, she can decrease her Lantus to home dose 6 units daily and Humalog 18 units 3 times daily.  She will get home health care for outpatient PT/OT.          Assessment and Plan COVID-19 Pneumonia - Presented with: dyspnea, cough, but resolved - Positive COVID-19: 8/31/23 - Vaccination status: vaccinated with 2 doses, no boosters - CTPE on admission showed no PE, B/L GG opacities and consolidative opacities- edema vs PNA; B/L pleural effusions - Oxygen status: Discharged with 2 liters  - Decadron: Yes. Expected end date 9/11 - Remdesivir: Completed 5-day course in the hospital  Acute Hypoxemic Respiratory Failure -Secondary to COVID-19 and CHF -Resolved -Patient will go home with 2 L of oxygen, and this can be weaned as an outpatient.   Acute heart failure with preserved ejection fraction -Secondary to above -Echocardiogram 9/5/2023 demonstrated ejection fraction 69% with normal right ventricular systolic function. -Resolved with IV diuretics -Patient will be discharged with Lasix 40 mg p.o. daily.     Hyponatremia-- >resolved - Secondary to volume overload and COVID - Resolved   IDDM2 With Hyperglycemia - Hba1c 9% - Home regimen lantus 60 units, novolog 18 units TID plus sliding scale. In process of switching Ozempic to Mounjaro - Noncompliance with dietary indiscretion and overeating due to depression and recent stroke -During hospitalization, patient was treated with insulin drip -Switch to basal bolus insulin regimen on 9/3/2023  -Patiently discharged with Lantus to 4 units twice daily, and continue with Humalog 18 units 3 times daily -Once Decadron course completed, patient can resume her home insulin dosages. Chronic Microcytic Anemia - Partly related to menstruation - No signs active bleeding. Iron studies with low Fe but normal ferritin and low normal TIBC   H/o- MoyaMoya disease CVA with left-sided weakness - s/p STA-MCA bypass in 2020 -Follows with health stroke chronic -Continue with ASA; - hold statin given recent use of paxlovid outpatient    Morbid obesity - BMI 49 - lifestyle modification for weight loss imperative - Can be switched to Mounjaro as an outpatient   Seizure Disorder - Continue with lamotrigine
Age: 59.0
Sex: F
Vaccine: FLU4
Symptoms: Autoscopy, Brain fog, Depressed level of consciousness, Dyspnoea, Flushing
Clinical narrative: Face flushed, hands numb and itchy, body became itchy, tongue feeling fat, some difficulty catching her breath, but not difficulty breathing. Went to full body itching legs, arms, and torso. Mental fuzziness/ cloudiness "out of body" experience". Took extra concentration for her. She had numbness to left side of her face that lasted to the left side of her face till 5 pm. fuzziness and fogginess dissipated around 5pm. Still episode of catching her breath, taking deep breaths here and there. Next day, most symptoms are gone, today she still has to take extra deep breaths.
Age: 59.0
Sex: F
Vaccine: FLU4
Symptoms: Hypoaesthesia, Pruritus, Swollen tongue
Clinical narrative: Face flushed, hands numb and itchy, body became itchy, tongue feeling fat, some difficulty catching her breath, but not difficulty breathing. Went to full body itching legs, arms, and torso. Mental fuzziness/ cloudiness "out of body" experience". Took extra concentration for her. She had numbness to left side of her face that lasted to the left side of her face till 5 pm. fuzziness and fogginess dissipated around 5pm. Still episode of catching her breath, taking deep breaths here and there. Next day, most symptoms are gone, today she still has to take extra deep breaths.
Age: 79.0
Sex: F
Vaccine: FLU4, RSV
Symptoms: Asthenia, Chills, Fear, Headache, Hyperhidrosis
Clinical narrative: Paralyzing weakness in bed; Headache; Chills, fever, and extreme sweating over a period of approximately 4 hours in total. Alone so could not leave bed safely to get to thermometer to take temperature. After around the 5th hour and after the sweating had subsided the temperature came in at 99.5 degrees. Sleep resumed and weakness continued until around 5:00 PM on the 29th. Slept well that night and felt stronger as of mid-morning on the 30th. Quite relieved because it was a scary experience. I feel it was the RSV because I have had Flu shots repeatedly over many years with no adverse events.
Age: 79.0
Sex: F
Vaccine: FLU4, RSV
Symptoms: Pyrexia
Clinical narrative: Paralyzing weakness in bed; Headache; Chills, fever, and extreme sweating over a period of approximately 4 hours in total. Alone so could not leave bed safely to get to thermometer to take temperature. After around the 5th hour and after the sweating had subsided the temperature came in at 99.5 degrees. Sleep resumed and weakness continued until around 5:00 PM on the 29th. Slept well that night and felt stronger as of mid-morning on the 30th. Quite relieved because it was a scary experience. I feel it was the RSV because I have had Flu shots repeatedly over many years with no adverse events.
Age: 9.0
Sex: F
Vaccine: HPV9
Symptoms: Blood pressure decreased, Feeling hot, Head injury, Headache, Syncope
Clinical narrative: patient complained of headache at check out desk and then had syncopal episode in which she hit back of her head. During observation after event, her initial blood pressure was normal but then her blood pressure began to drop. She complained of feeling hot. Her blood pressure continued to drop and eventually was sent to ER via EMS
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Muscle twitching
Clinical narrative: Left eye to side of mouth switching a couple times a day lasting an hour.  Eye twitches as well as lid. Under nose to side of mouth.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Blood cholesterol increased, COVID-19, COVID-19 pneumonia, Dyspnoea, Hypoxia
Clinical narrative: Patient is a 40 y.o. female patient of MD was in hospital with COVID-19 related respiratory symptoms with hypoxia.  She has been vaccinated.  Rule out COVID due to lack of the booster and she has, shortness of breath and had hypoxia with pulse ox documented to be 83% in the emergency room.  She was diagnosed to have COVID-related respiratory illness and due to hypoxia was found to be candidate for remdesivir which was given to her in the ER and continued.  She was given steroid pulse oximetry her nose swab was positive for MRSA she needing Bactroban and getting escalation due to COVID.  She has unremarkable other labs and although her cholesterol was high she is being treated for the same she has been pleasant awake oriented for diagnosis and she is being discharged home with a prescription of prednisone and Lipitor and no need for antibiotics we will continue Bactroban on discharge she will benefit from COVID booster vaccine and advised to control metabolic syndrome.  She does not smoke although her fiancé does.  She is being discharged and will follow up in clinic in 7 days that she was given instructions about COVID and his contagiousness and possibility of other family members having similar illness.    Pneumonia due to COVID-19 virus She has lower respiratory tract symptoms with hypoxia with COVID-related infection she will be treated with the help of IV remdesivir steroids oxygen breathing treatments as well as remdesivir.  She will be treated with fluids fluids monitor the labs.    91223: She is doing better Continue oral steroids on discharge   Hyperlipidemia She has hyperlipidemia history check a lipid panel and treat accordingly  91223: Her lipid panel is abnormal start Lipitor on discharge   Hypertension She has hypertension blood pressure has been normal    Depression She has depression currently on medicine for the same she will be treated with the help of antidepressant  She has been on Seroquel she is doing well currently on medications for the same
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test normal, Lipids abnormal, Metabolic syndrome, Respiratory symptom, Staphylococcus test positive
Clinical narrative: Patient is a 40 y.o. female patient of MD was in hospital with COVID-19 related respiratory symptoms with hypoxia.  She has been vaccinated.  Rule out COVID due to lack of the booster and she has, shortness of breath and had hypoxia with pulse ox documented to be 83% in the emergency room.  She was diagnosed to have COVID-related respiratory illness and due to hypoxia was found to be candidate for remdesivir which was given to her in the ER and continued.  She was given steroid pulse oximetry her nose swab was positive for MRSA she needing Bactroban and getting escalation due to COVID.  She has unremarkable other labs and although her cholesterol was high she is being treated for the same she has been pleasant awake oriented for diagnosis and she is being discharged home with a prescription of prednisone and Lipitor and no need for antibiotics we will continue Bactroban on discharge she will benefit from COVID booster vaccine and advised to control metabolic syndrome.  She does not smoke although her fiancé does.  She is being discharged and will follow up in clinic in 7 days that she was given instructions about COVID and his contagiousness and possibility of other family members having similar illness.    Pneumonia due to COVID-19 virus She has lower respiratory tract symptoms with hypoxia with COVID-related infection she will be treated with the help of IV remdesivir steroids oxygen breathing treatments as well as remdesivir.  She will be treated with fluids fluids monitor the labs.    91223: She is doing better Continue oral steroids on discharge   Hyperlipidemia She has hyperlipidemia history check a lipid panel and treat accordingly  91223: Her lipid panel is abnormal start Lipitor on discharge   Hypertension She has hypertension blood pressure has been normal    Depression She has depression currently on medicine for the same she will be treated with the help of antidepressant  She has been on Seroquel she is doing well currently on medications for the same
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Blister rupture, Pain, Pain in extremity
Clinical narrative: large blister that formed on her R forearm a day after receiving her covid spikevax and flu shot. Covid on the right and flu in the left. Blister formed on day 2 and stayed intact until 10/2 when it ruptured a clear fluid. Area was still sore and she was not experiencing pain int he remainder of hte upper extremity. She said she had typical soreness in each arm after the vaccines as she would expect. No hx of reaction.
Age: 51.0
Sex: F
Vaccine: FLUR4
Symptoms: Neuralgia
Clinical narrative: Patient had a reaction 1 week after receiving the vaccine she had nerve pain that went down from her arm to below her breast
Age: 6.0
Sex: M
Vaccine: UNK, UNK, UNK
Symptoms: Pruritus, Pyrexia, Rash
Clinical narrative: PATIENT CAME IN ON 10/05/2023, FEVER AND RASH OVER THE BODY ITCHING
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Patient recieved the COVID vaccine when the wanted the flu shot. Patient called on Wednesday (10/4) and scheduled the appointment over the phone. Patient states that they requested a flu shot but the person putting in the appointment scheduled them for the COVID19 shot. Patient came for the vaccine appointment and it wasn't until after the vaccination was complete was it noticed the wrong vaccine was schedule.  No reactions to the vaccine as of yet but patient did not wish to receive the vaccine.
Age: 44.0
Sex: F
Vaccine: HEP
Symptoms: Erythema, Pruritus, Swelling
Clinical narrative: Recipient complained of pain and swelling the day after receiving the vaccine. Now the second day after receiving the vaccine there is noted swelling/redness and itching. Recipient advised to use warm compress.
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site inflammation, Injection site pain, Injection site warmth
Clinical narrative: Residents left arm from injection site to elbow on the outer aspect of her arm is red, warm, inflamed and painful. APRN has ordered keflex po 3 times a day for 5 days.
Age: 61.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Joint swelling, Peripheral swelling
Clinical narrative: 24 hr after shot lower legs swollen and ankles swollen and painful as of today day 2 after immunization legs still swollen and will follow up with pcp if no improvement by Friday.
Age: 66.0
Sex: F
Vaccine: RSV
Symptoms: Anticoagulant therapy, Blood test, Cardiac failure congestive, Cardiac monitoring, Catheterisation cardiac normal
Clinical narrative: Trouble swallowing and shakey 20 minutes after receiving vaccine, called EMS, transported to emergency department for evaluation of possible allergic reaction to vaccine. In ED, given Benadryl, ran multiple blood tests, found out my troponin was elevated indicating possible cardiac issue. Had multiple EKGs, chest CT scan. Started on aspirin and blood thinner. My troponin level continued to rise. I was directly admitted to hospital via ambulance. Spent 2 nights in hospital for cardiac monitoring. Continued to receive blood thinner and aspirin. Had multiple blood tests, echocardiogram, and cardiac catheterization procedure. Cardiac catheterization showed no blockages or clots. Diagnosed with stress cardiomyopathy congestive heart disease, which my doctor thinks the RSV vaccine may have triggered this diagnoses. Discharged after 2 nights. Prescribed  carvedilol 3.125mg twice a day, cardiac rehab 12 week program, blood pressure monitoring, and cardiology follow up in 2-3 weeks.
Age: 66.0
Sex: F
Vaccine: RSV
Symptoms: Computerised tomogram, Computerised tomogram thorax, Dysphagia, Echocardiogram, Electrocardiogram
Clinical narrative: Trouble swallowing and shakey 20 minutes after receiving vaccine, called EMS, transported to emergency department for evaluation of possible allergic reaction to vaccine. In ED, given Benadryl, ran multiple blood tests, found out my troponin was elevated indicating possible cardiac issue. Had multiple EKGs, chest CT scan. Started on aspirin and blood thinner. My troponin level continued to rise. I was directly admitted to hospital via ambulance. Spent 2 nights in hospital for cardiac monitoring. Continued to receive blood thinner and aspirin. Had multiple blood tests, echocardiogram, and cardiac catheterization procedure. Cardiac catheterization showed no blockages or clots. Diagnosed with stress cardiomyopathy congestive heart disease, which my doctor thinks the RSV vaccine may have triggered this diagnoses. Discharged after 2 nights. Prescribed  carvedilol 3.125mg twice a day, cardiac rehab 12 week program, blood pressure monitoring, and cardiology follow up in 2-3 weeks.