chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope, Thrombocytopenia, Troponin normal, Ultrasound Doppler abnormal, Urinary tract infection
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Urine analysis abnormal, Urine leukocyte esterase positive, White blood cells urine positive
Clinical narrative: Patient was complaining of fatigue, lightheadedness, productive cough progressively worsening over the last few days, some shortness of breath, at baseline, no fever or chills, she did have exposure to corona virus disease 19 few weeks ago, she has received 1 dose of J NJ vaccine, no chest pain. Evaluation in the emergency department revealed elevated blood pressure at 174/76, elevated temperature at 99.4° F, procalcitonin was mildly elevated at 0.12, salicylate level less than 2, urine analysis suggestive of urinary tract infection with 35 white blood cells per high-power field, positive nitrate and moderate leukocyte esterase, CBC showed mild thrombocytopenia with platelet count 129, troponin normal, acetaminophen level less than 2, comprehensive metabolic panel showed elevated BUN at 25 and creatinine at 1.2, elevated calculated globulin at 4.1, CK total 34, magnesium 2.1, lactic acid 1.3, ethanol level less than 3. Chest x-ray did not show acute cardiopulmonary process.  Patient EKG showed normal sinus rhythm, left bundle branch block.  She was admitted for further care.   Hospital Course:  Patient was treated with ceftriaxone for urinary tract infection, Proteus mirabilis on cultures, will prescribe Cipro on discharge.  She denies any shortness of breath, cough or sputum, she is already vaccinated against corona virus disease 19, she was given vitamin-C, zinc, vitamin-D.  She was given IV fluids for acute kidney injury, losartan was stopped, renal function is back to normal, she did have problems with fall on January 18th while patient was in bathroom, was seen by OT and PT. Post-acute therapy screen recommended by Occupational and Physical therapy, patient's daughter would like to take her home, she declined home health care. She had Syncopal episode while in the bathroom on January 20th in the evening, patient was given fluid bolus, no further symptoms, no acute process on head CT, Carotid Doppler showed Extensive hard and soft atheromatous plaque at the carotid bifurcation bilaterally. Hemodynamically there is stenosis in the range of 50-69% in the origin of the ICAs bilaterally somewhat more on the right compared to left.  Moderate atherosclerotic stenosis in the origin of the left ECA. Antegrade flow is seen in the vertebral arteries bilaterally, echocardiogram showed preserved left ventricular systolic function, her daughter declined further workup and requested discharge home, declined home care as well, will discharge home, close follow up with PCP
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Dysgeusia, Hypophagia, Oropharyngeal pain, Pyrexia
Clinical narrative: Starting 07/28/2022, I developed a sore throat. On 07/29/2022 - 07/30/2022, I developed a fever. I never had shortness of breath or cough, just a runny nose. I was tested at CVS on 07/29/2022 and it was positive. The fever lasted for about a day and a half and went away on its own. I did a telehealth visit on that Tuesday and was prescribed Paxlovid. I did it for 3 of the 5 days then stopped. I got a really bad metallic taste in my mouth causing me to not eat. Therefore, I stopped taking it.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: Starting 07/28/2022, I developed a sore throat. On 07/29/2022 - 07/30/2022, I developed a fever. I never had shortness of breath or cough, just a runny nose. I was tested at CVS on 07/29/2022 and it was positive. The fever lasted for about a day and a half and went away on its own. I did a telehealth visit on that Tuesday and was prescribed Paxlovid. I did it for 3 of the 5 days then stopped. I got a really bad metallic taste in my mouth causing me to not eat. Therefore, I stopped taking it.
Age: 94.0
Sex: M
Vaccine: FLU4
Symptoms: Abdominal pain, Chest discomfort, Chest pain, Injection site erythema
Clinical narrative: Site: Redness at Injection Site-Mild, Systemic: Abdominal Pain-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium
Age: 17.0
Sex: M
Vaccine: MNQ
Symptoms: Extra dose administered, No adverse event, Product communication issue, Wrong product administered
Clinical narrative: Patient presented with mother to receive second dose in meningitis vaccine series. Due to error of miscommunication via provider patient was provided with dose of Menveo vaccination. Upon further conversation it was discovered patient previously completed this series and the desired vaccination was Meningitis B. Patient and guardian informed of incorrect vaccine administered. No symptoms reported at that time.
Age: 12.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: 12 year old individual presented to the health dept for their 2nd Pfizer monovalent dose. A Pfizer bivalent dose was given instead of a Pfizer monovalent dose.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Atelectasis, Bacterial disease carrier, Blood culture positive
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood lactic acid, Brain natriuretic peptide increased, COVID-19, COVID-19 pneumonia, Chemotherapy
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram abdomen abnormal, Fatigue, Haemoglobin decreased, Lung infiltration, Lung neoplasm malignant
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Nausea, Pleural effusion, SARS-CoV-2 test positive, Sepsis, Staphylococcus test positive
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Troponin increased, Vomiting, White blood cell count increased
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Acute respiratory failure, Aspiration, Barium swallow, Blood lactic acid increased
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood pH decreased, Chest X-ray abnormal, Dysphagia, Dyspnoea, Lung infiltration
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Nausea, PCO2 increased, Pleural effusion, Pneumonia, Positive airway pressure therapy
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Respiratory acidosis, Respiratory failure, Troponin T, Vomiting, White blood cell count increased
Clinical narrative: Admission Date: 10/12/2022 Discharge Date: 10/16/2022    Admitting Diagnoses: Pneumonia due to COVID-19 virus PRESENTING PROBLEM:  Hypoxia [R09.02] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: Patient is a 83 y.o. male who presents today with a history of a dental carcinoma left lung, cardiomyopathy, AFib, chronic obstructive pulmonary disease.  Patient currently is receiving chemo for his lung cancer.  Last chemo treatment was 3 weeks ago.  On Monday patient began to feel increased fatigue so he decided to take a COVID test at home which ended up being positive.  Tuesday patient began to experience nausea and vomiting which did that go away.  He then decided he would go to the emergency department to be evaluated.  Patient denied fevers, chills, chest pain, abdominal pain.  Upon arrival patient was hypoxic.  Patient's baseline is 2 L but was requiring 6 L nasal cannula upon arrival.  CTA thorax was obtained which showed right upper lobe infiltrate which was likely pneumonia.  Due to patient's WBC of 12.42 and lactic acid of 3.2 patient was placed on Rocephin and doxycycline.  Patient did meet severe sepsis criteria based on WBC, lactic acid, no source of infection and respiratory rate.  Other lab work showed BNP 3790, initial troponin of 43, hemoglobin 12.5.  Repeat troponin was 41 for delta -2. CT abdomen pelvis was obtained due to nausea and vomiting.  Imaging showed  no acute inflammatory changes in the abdomen or pelvis.  Moderate left pleural effusion and adjacent left basilar atelectasis.  Hospitalist services was contacted and accepted patient for severe sepsis, acute on chronic respiratory failure and COVID-19.   Patient was admitted and treated with steroids and remdesivir.  He was also given empiric antibiotics and bronchodilators.  His condition improved slowly.  He did have 2 positive blood cultures for Staphylococcus capitis.  He was started on vancomycin empirically and Infectious Disease was consulted.  It was felt this likely represented colonization rather than true infection.  Follow-up blood cultures were negative and vancomycin was discontinued.  He was able to be weaned off oxygen.  He completed a 5 day course of antibiotics while hospitalized as well as a course of remdesivir.  He was discharged home in stable condition with plans for follow-up with his primary care provider.
Sex: U
Vaccine: COVID19, COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: clinics administered 957 booster doses inclusive of both manufacturers (Pfizer (877 doses) & Moderna (80 doses)) after the ACIP guidance provided on 9/1/2022 stating that the monovalent formulations were not approved for booster dosing. Prior to the new guidelines, monovalent formulations were approved for booster dosing. While this is not a event that would cause harm to the patient, the administrations were outside of the new guidance. CDC partners confirmed that one VAERS report should be submitted.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age, Product administration error, Wrong product administered
Clinical narrative: A vaccine administration error,  no adverse affect noted.  A five year old child received the 6month-4 year old dose of Pfizer Covid vaccine.   Siblings came into clinic for 1st in series Covid vaccines.  Siblings were age 4 and age 5.  The vaccinating Nurse had two Pfizer vaccines ready to administer, one 6mos -4 yr dose.  One 5yr-11yr dose.   The Nurse confirmed with Mom verbally child's name of the 4 year old, and handed Mom the vaccine card for the 4 year old sibling to also confirm. Mom acknowledged. Nurse administered the appropriate dose for a 4 year old.  Mom looked at the card closer and stated no, this child that just received the 4 yr dose is the 5 year old sibling.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Bed sharing, Exposure to SARS-CoV-2, Oropharyngeal pain, Productive cough, Rhinitis
Clinical narrative: 09/13/2022 I came down with COVID-19. I was exposed by my spouse. My symptoms were rhinitis and a sore throat. I tested with an at home COVID-19 test and it came out positive. I was prescribed PAXLOVID and my symptoms went away around 24 hours. 10 days later my symptoms came back and they dragged on for about 21 days. I did develop a mildly productive cough with no shortness of breath or wheezing. I am feeling much better and am now back to my normal self.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 09/13/2022 I came down with COVID-19. I was exposed by my spouse. My symptoms were rhinitis and a sore throat. I tested with an at home COVID-19 test and it came out positive. I was prescribed PAXLOVID and my symptoms went away around 24 hours. 10 days later my symptoms came back and they dragged on for about 21 days. I did develop a mildly productive cough with no shortness of breath or wheezing. I am feeling much better and am now back to my normal self.
Age: 7.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient was starting the Covid vaccines he should of gotten the regular 5-11 instead he received the Bivalent  5-11
Age: 12.0
Sex: M
Vaccine: MNQ
Symptoms: No adverse event, Product preparation issue, Single component of a two-component product administered, Vaccination error
Clinical narrative: Vaccine Error: Vaccine was not mixed correctly. Only the MenCYW-135 Liquid Conjugate Component was administered. Family contacted. Father reported no adverse outcomes at this time.
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Condition aggravated, Cutaneous vasculitis, Full blood count, Platelet count decreased, Rash
Clinical narrative: rash: cutaneous vasculitis, mild thrombocytopenia, no apparent visceral involvement.  He also had Seqiris fluad lot 346355 same time
Age: 75.0
Sex: M
Vaccine: COVID19-2
Symptoms: Red blood cell sedimentation rate, Thrombocytopenia, Urine analysis
Clinical narrative: rash: cutaneous vasculitis, mild thrombocytopenia, no apparent visceral involvement.  He also had Seqiris fluad lot 346355 same time
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, C-reactive protein increased, COVID-19, Chest X-ray normal, Computerised tomogram abdomen normal
Clinical narrative: The patient is a 89 y male with past medical history of atrial flutter, type 2 diabetes mellitus, chronic obstructive pulmonary disease and macular degeneration  who was admitted on 11/16/2021 because of complaints of fall.  Patient apparently got up to use the restroom and stumbled and fell and hit a dresser. He also reported generalized weakness couple of days prior to admission.  Workup in the ED showed COVID-19 positive.  Labs showed elevated CRP, D-dimer but normal ferritin and negative procalcitonin.  Chest x-ray did not show any acute pathology.  Patient reported left flank pain secondary to hitting the drawer, CT abdomen pelvis did not show any acute pathology.  Patient had spiking fever during hospital stay.He later became hypoxic requiring 2 to 4 L and was started on Decadron. Patient improved and was weaned off O2. Patient however was very weak and therapies recommended post acute. Hospital stay was extended due to facilities requiring 10 day isolation which patient finished here. Arrangements were made for patient to go to nursing facility.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Fibrin D dimer increased, Flank pain, Hypoxia, Injury
Clinical narrative: The patient is a 89 y male with past medical history of atrial flutter, type 2 diabetes mellitus, chronic obstructive pulmonary disease and macular degeneration  who was admitted on 11/16/2021 because of complaints of fall.  Patient apparently got up to use the restroom and stumbled and fell and hit a dresser. He also reported generalized weakness couple of days prior to admission.  Workup in the ED showed COVID-19 positive.  Labs showed elevated CRP, D-dimer but normal ferritin and negative procalcitonin.  Chest x-ray did not show any acute pathology.  Patient reported left flank pain secondary to hitting the drawer, CT abdomen pelvis did not show any acute pathology.  Patient had spiking fever during hospital stay.He later became hypoxic requiring 2 to 4 L and was started on Decadron. Patient improved and was weaned off O2. Patient however was very weak and therapies recommended post acute. Hospital stay was extended due to facilities requiring 10 day isolation which patient finished here. Arrangements were made for patient to go to nursing facility.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test abnormal, Procalcitonin normal, Pyrexia, SARS-CoV-2 test positive, Serum ferritin normal
Clinical narrative: The patient is a 89 y male with past medical history of atrial flutter, type 2 diabetes mellitus, chronic obstructive pulmonary disease and macular degeneration  who was admitted on 11/16/2021 because of complaints of fall.  Patient apparently got up to use the restroom and stumbled and fell and hit a dresser. He also reported generalized weakness couple of days prior to admission.  Workup in the ED showed COVID-19 positive.  Labs showed elevated CRP, D-dimer but normal ferritin and negative procalcitonin.  Chest x-ray did not show any acute pathology.  Patient reported left flank pain secondary to hitting the drawer, CT abdomen pelvis did not show any acute pathology.  Patient had spiking fever during hospital stay.He later became hypoxic requiring 2 to 4 L and was started on Decadron. Patient improved and was weaned off O2. Patient however was very weak and therapies recommended post acute. Hospital stay was extended due to facilities requiring 10 day isolation which patient finished here. Arrangements were made for patient to go to nursing facility.
Age: 66.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Arthralgia, Headache, Muscle spasms, Musculoskeletal discomfort, Stress
Clinical narrative: Starting 09/20/2022, I developed a slight headache, severe muscle cramps and muscle aches in the neck, shoulder and right arm. I developed joint pain in the right side (knee, hip, shoulder). It lasted for a few weeks and I scheduled an appointment with the PCP. They said it was likely stress related and told me to continue doing hot tub, massage, and prescribed me cyclobenzaprine. I have residual discomfort in my right hip. I had been diagnosed with arthritis in my neck a few years ago and sometimes I get flare ups; however, I knew it wasn't a flare up because it usually doesn't last this long.
Age: 9.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Lot expired on 9/30/22 but was administered on 10/6/22. Information received from manufacturer indicates that stability data supports the use of this product through 10/19/22.
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dry eye, Ophthalmological examination, Scan, Vision blurred
Clinical narrative: Very Dry Eyes, predominantly the right eye. Blurry vision in right eye that hasn't fully come back into focus although seems to be better each day.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Constipation, Decreased appetite, Diarrhoea, Fatigue
Clinical narrative: INTESTINAL DISCOMFORT,  SORENESS, CONSTIAPTION INITIALLY, DIARRHEA BY THE THIRD DAY.  FATIGUE, MUSCLE ACHES, LOSS OF APPETITE.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Pain
Clinical narrative: INTESTINAL DISCOMFORT,  SORENESS, CONSTIAPTION INITIALLY, DIARRHEA BY THE THIRD DAY.  FATIGUE, MUSCLE ACHES, LOSS OF APPETITE.
Age: 5.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Patient was administered vaccine after expiration date but the manufacture had approved stability and efficacy for date past the administered date. patient has not reported any symptoms, monitoring
Age: 52.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood pressure increased, COVID-19, Condition aggravated, Headache
Clinical narrative: 1)  diagnosed with covid less than 4 weeks following injection  (same as last booster in Fall of 2021!!!! 2)  Blood pressure spike since vaccine and Dx of Covid  (I already take 2 BP meds and BP today at Clinic was 149/98!!! 3)  Ongoing headache - but didn't start until 2 weeks after vaccine - pretty sure it is relaed to the increased BP.
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Lot expired on 9/30/22 but was administered on 10/6/22. Information received from manufacturer indicates that stability data supports the use of this product through 10/19/22.
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Fatigue
Clinical narrative: Cold symptoms 10/17-18.  Headache, chills, fever, achy, runny nose, coughing, difficulty breathing, extreme fatigue - 10/19-10/20 Runny nose, extreme fatigue - 10/21-10/23
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: Headache, Nasopharyngitis, Pain, Pyrexia, Rhinorrhoea
Clinical narrative: Cold symptoms 10/17-18.  Headache, chills, fever, achy, runny nose, coughing, difficulty breathing, extreme fatigue - 10/19-10/20 Runny nose, extreme fatigue - 10/21-10/23
Age: 63.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Cold symptoms 10/17-18.  Headache, chills, fever, achy, runny nose, coughing, difficulty breathing, extreme fatigue - 10/19-10/20 Runny nose, extreme fatigue - 10/21-10/23
Age: 72.0
Sex: M
Vaccine: COVID19-2, FLUX
Symptoms: Head discomfort, Sinus congestion
Clinical narrative: They haven't gone away. I have been experiencing pressure in the head and sinus congestion. I am going for an MRI this Monday.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pruritus, Throat tightness
Clinical narrative: Tightness in throat, Left arm itching. Administered 50 mg Benadryl. Vitals and assessment throughout remained WNL . Condition during observation unchanged, no additional airway change, swelling, or itching. Patient with extensive health hx including anaphylaxis to peanuts. After an extended observation period with MA and RN patient is stable to go home. Advised her to take at least 25 mg Benadryl prior to her next vaccine and give detailed history to staff.
Age: 40.0
Sex: F
Vaccine: COVID19, COVID19, COVID19-2
Symptoms: Biopsy skin abnormal, Chest discomfort, Pruritus, Rash, Urticaria
Clinical narrative: rash, hives, itching, tightness in chest
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Pain
Clinical narrative: Client was given her covid vaccine in her R arm approximately less than one inch from the acromion process. After receiving the vaccine, the client started complaining of pain that progressively got worse over the next day and has remained constant ever since. Pain is rated as high as 10/10 when extending her limb.
Age: 57.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Chest discomfort, Chills, Cough, Decreased appetite
Clinical narrative: On Saturday, 10/23/22 I felt like laryngitis. On Sunday, 10/24/22, I had a raw sore throat, bad laryngitis, heaviness on my chest, bad congestion and coughing, chills, bad headache, my sinuses were bad.  I felt like they were going to explode. I was very tired. No fever. I could not stay awake for the like of me.   On Monday 10/24/2022, I took a COVID-19 home test and it was positive. I did a tele visit with the doctor. The doctor prescribed the Paxlovid. On 10/25 and today I started to feel a little bit better. I still have a sore throat, but not as raw. On 10/25/22, I started having a metallic taste in my mouth. I have not eaten in 4 days. I lost my appetite totally. My nose is so stuffed.
Age: 57.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dysgeusia, Fatigue, Headache, Laryngitis, Nasal congestion
Clinical narrative: On Saturday, 10/23/22 I felt like laryngitis. On Sunday, 10/24/22, I had a raw sore throat, bad laryngitis, heaviness on my chest, bad congestion and coughing, chills, bad headache, my sinuses were bad.  I felt like they were going to explode. I was very tired. No fever. I could not stay awake for the like of me.   On Monday 10/24/2022, I took a COVID-19 home test and it was positive. I did a tele visit with the doctor. The doctor prescribed the Paxlovid. On 10/25 and today I started to feel a little bit better. I still have a sore throat, but not as raw. On 10/25/22, I started having a metallic taste in my mouth. I have not eaten in 4 days. I lost my appetite totally. My nose is so stuffed.
Age: 57.0
Sex: M
Vaccine: COVID19-2
Symptoms: Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive, Sinus disorder, Throat irritation
Clinical narrative: On Saturday, 10/23/22 I felt like laryngitis. On Sunday, 10/24/22, I had a raw sore throat, bad laryngitis, heaviness on my chest, bad congestion and coughing, chills, bad headache, my sinuses were bad.  I felt like they were going to explode. I was very tired. No fever. I could not stay awake for the like of me.   On Monday 10/24/2022, I took a COVID-19 home test and it was positive. I did a tele visit with the doctor. The doctor prescribed the Paxlovid. On 10/25 and today I started to feel a little bit better. I still have a sore throat, but not as raw. On 10/25/22, I started having a metallic taste in my mouth. I have not eaten in 4 days. I lost my appetite totally. My nose is so stuffed.
Age: 8.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect dose administered
Clinical narrative: Patient received adult dose of COVID vaccine instead of pediatric.
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient was given Pfizer monovalent doses instead of Pfizer Bivalent.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, COVID-19, Chills, Dysuria, Flank pain
Clinical narrative: COVID+ 10/14/22 - Vaccination status  - Moderna x4 + bivalent booster BRIEF OVERVIEW: Admission Date: 10/14/2022 Discharge Date: Oct 16, 2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pyelonephritis Sepsis Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present COVID-19   HOSPITAL COURSE: The patient is a 76 y.o. female who presented today to the ER secondary to flank pain and fever.  Few days ago, she started to complain of dysuria, chills and flank pain.  Yesterday, she called her PCP, had urine sample checked which was positive. She was was started on Bactrim.  Last night, she started to complain of worsening bilateral flank pains together with generalized weakness and developed fever.  She reported having nausea but denied any vomiting, cough/congestion shortness of breath or chest pain.  She did receive COVID 19 vaccine and 3 booster doses.  Imaging did not reveal pyelonephritis or hydronephrosis.  Patient was treated for urinary tract infection.  She was started on IV Rocephin and tolerated this well..  Patient did not require any therapy for COVID-19 infection.  She remained on room air during her stay.  After couple days, patient white blood cell count had normalized and she was afebrile.  She is medically stable for discharge.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Imaging procedure, Multi-organ disorder, Nausea, Pyelonephritis, Pyrexia
Clinical narrative: COVID+ 10/14/22 - Vaccination status  - Moderna x4 + bivalent booster BRIEF OVERVIEW: Admission Date: 10/14/2022 Discharge Date: Oct 16, 2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pyelonephritis Sepsis Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present COVID-19   HOSPITAL COURSE: The patient is a 76 y.o. female who presented today to the ER secondary to flank pain and fever.  Few days ago, she started to complain of dysuria, chills and flank pain.  Yesterday, she called her PCP, had urine sample checked which was positive. She was was started on Bactrim.  Last night, she started to complain of worsening bilateral flank pains together with generalized weakness and developed fever.  She reported having nausea but denied any vomiting, cough/congestion shortness of breath or chest pain.  She did receive COVID 19 vaccine and 3 booster doses.  Imaging did not reveal pyelonephritis or hydronephrosis.  Patient was treated for urinary tract infection.  She was started on IV Rocephin and tolerated this well..  Patient did not require any therapy for COVID-19 infection.  She remained on room air during her stay.  After couple days, patient white blood cell count had normalized and she was afebrile.  She is medically stable for discharge.