chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 4.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain upper, Cough, Headache, Influenza virus test negative, Loss of personal independence in daily activities
Clinical narrative: On 12/12/2022, he started having a snotty nose. He slept fine that night, but we kept him home from school because the color of his snot. Then, he began to run a fever on 12/14/22. We gave him Motrin that night and he ran a fever for about 24 hours. His fever got up to 103. That night his stomach was hurting and had a headache. We took him to the doctor, and he tested negative for Flu, COVID-19, and RSV. He is feeling better, but he still has a little cough and some dry sinuses.
Age: 4.0
Sex: M
Vaccine: COVID19
Symptoms: Paranasal sinus hyposecretion, Pyrexia, Respiratory syncytial virus test negative, Rhinorrhoea, SARS-CoV-2 test negative
Clinical narrative: On 12/12/2022, he started having a snotty nose. He slept fine that night, but we kept him home from school because the color of his snot. Then, he began to run a fever on 12/14/22. We gave him Motrin that night and he ran a fever for about 24 hours. His fever got up to 103. That night his stomach was hurting and had a headache. We took him to the doctor, and he tested negative for Flu, COVID-19, and RSV. He is feeling better, but he still has a little cough and some dry sinuses.
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (ex. temp./location)-
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Cervix carcinoma, Metastases to central nervous system
Clinical narrative: after the injection she had abdominal pain she was diagnose with cervical cancer stage v and to present date is getting worse now it been present in the brain
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site pain
Clinical narrative: pain at the injection site
Age: 6.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: drawn from previous day's vial that had not been disposed of
Age: 76.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: COVID-19, Cough, Malaise, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: My COVID-19 Infection  symptoms started on 11/24/2022 in the evening around 06:00PM. I wasn't feeling well. I had a  low grade fever, cough  and a scratchy throat. On 11/25/2022 I did a COVID-19 home test which was positive. I took my husband to the ER but they told us that we need to have underline condition to get medication for COVID-19.  I called my doctor and he prescribed me with Paxlovid  but I didn't take the medication because it messes with the  medication  I am taking  . Instead he prescribed me with Molnupiravir for 5 days.  I am also taking Guaifenesin as per needed depending on my cough.
Age: 76.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Throat irritation
Clinical narrative: My COVID-19 Infection  symptoms started on 11/24/2022 in the evening around 06:00PM. I wasn't feeling well. I had a  low grade fever, cough  and a scratchy throat. On 11/25/2022 I did a COVID-19 home test which was positive. I took my husband to the ER but they told us that we need to have underline condition to get medication for COVID-19.  I called my doctor and he prescribed me with Paxlovid  but I didn't take the medication because it messes with the  medication  I am taking  . Instead he prescribed me with Molnupiravir for 5 days.  I am also taking Guaifenesin as per needed depending on my cough.
Age: 7.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: drawn up from vial from previous day that was not disposed
Age: 69.0
Sex: F
Vaccine: COVID19-2, UNK
Symptoms: COVID-19, Chest discomfort, Cough, Decreased appetite, Diarrhoea
Clinical narrative: I started coughing a little bit but did not initially feel bad. I took cough medication that night. By the next morning I woke up and my chest felt very heavy. I scheduled an appointment with my provider after I had taken a COVID-19 Home Test that came back positive. They retested me and it was positive. They called in a prescription in, and I began taking it on December 21, 2022. The coughing has improved but I am now nauseous with a headache as well as diarrhea throughout the night. I don't really have an appetite, but I am drinking a lot of fluid. My oxygen level has been between 97 and 98. I have not recovered from these symptoms. I was also prescribed an albuterol inhaler.
Age: 69.0
Sex: F
Vaccine: COVID19-2, UNK
Symptoms: Headache, Nausea, SARS-CoV-2 test positive
Clinical narrative: I started coughing a little bit but did not initially feel bad. I took cough medication that night. By the next morning I woke up and my chest felt very heavy. I scheduled an appointment with my provider after I had taken a COVID-19 Home Test that came back positive. They retested me and it was positive. They called in a prescription in, and I began taking it on December 21, 2022. The coughing has improved but I am now nauseous with a headache as well as diarrhea throughout the night. I don't really have an appetite, but I am drinking a lot of fluid. My oxygen level has been between 97 and 98. I have not recovered from these symptoms. I was also prescribed an albuterol inhaler.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Anxiety, Blood gases abnormal, Blood potassium increased, COVID-19, Chest X-ray abnormal
Clinical narrative: Patient is a 62 y.o. female patient of  CNP with history of copd presented to Hospital with sob   Outpatient Pulm Summary 62 y/o female with very severe COPD and chronic hypoxemic respiratory failure.  She also is heterozygous for alpha-1 anti-trypsin deficiency and has been tobacco free for over a year.  She continues on Symbicort and Spiriva along with prn albuterol.  She is very limited from a functional status standpoint.  She is dyspneic from room to room and no longer does any house work.  Her primary goal is to control her symptoms.  She does report significant anxiety for which she has been on short acting benzodiazepines.  She was recently started on buspar as well by her PCP.  She is worried it will not control her anxiety.  I did review her overall code status which she confirmed was DNR and that she would not want mechanical ventilation.  Her shortness of breath is continuous.  She has a chronic non-productive cough .    Per pulmonology she is hospice appropriate but the pt is not ready yet.    Quite dyspneic at baseline.  Very short of breath with moving around her house.  She has Palliative Care following her and continues on her Norco and Xanax.  She is on prednisone, Symbicort, Spiriva, and nebulizers. She refuses BiPAP and states that she is not ready for hospice.  The pt also tested positive for COVID on 11/11. Negative for Flu   COPD exacerbation END stage COPD Acute on Chronic Hypercapnic respiratory failure Per pulmonary notes patient is quite dyspneic at baseline At this time patient is following with palliative on Xanax and Norco.   Pt to consider hospice. But is not ready for hospice.   She does not want routine ABGs for hypercapnic respiratory failure PCO2 94.  Now tolerating AVAPS. Pulmonary has signed off. Continue Symbicort Spiriva along with albuterol every 6 hours. Discharged on AVAPS at nighttime.   COVID 19 infection Noted CXR on 11/13 consistent with COVID and COPD.  On remdesivir and Decadron for 6 days. Was seen by ID. Discharged on prednisone home dose 10 mg daily. Continue 4 L nasal cannula   Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.    Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.     Pallative Patient under palliative Cont norco and xanax. Per the pt she is not ready for hospice. .
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chronic obstructive pulmonary disease, Chronic respiratory failure, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Patient is a 62 y.o. female patient of  CNP with history of copd presented to Hospital with sob   Outpatient Pulm Summary 62 y/o female with very severe COPD and chronic hypoxemic respiratory failure.  She also is heterozygous for alpha-1 anti-trypsin deficiency and has been tobacco free for over a year.  She continues on Symbicort and Spiriva along with prn albuterol.  She is very limited from a functional status standpoint.  She is dyspneic from room to room and no longer does any house work.  Her primary goal is to control her symptoms.  She does report significant anxiety for which she has been on short acting benzodiazepines.  She was recently started on buspar as well by her PCP.  She is worried it will not control her anxiety.  I did review her overall code status which she confirmed was DNR and that she would not want mechanical ventilation.  Her shortness of breath is continuous.  She has a chronic non-productive cough .    Per pulmonology she is hospice appropriate but the pt is not ready yet.    Quite dyspneic at baseline.  Very short of breath with moving around her house.  She has Palliative Care following her and continues on her Norco and Xanax.  She is on prednisone, Symbicort, Spiriva, and nebulizers. She refuses BiPAP and states that she is not ready for hospice.  The pt also tested positive for COVID on 11/11. Negative for Flu   COPD exacerbation END stage COPD Acute on Chronic Hypercapnic respiratory failure Per pulmonary notes patient is quite dyspneic at baseline At this time patient is following with palliative on Xanax and Norco.   Pt to consider hospice. But is not ready for hospice.   She does not want routine ABGs for hypercapnic respiratory failure PCO2 94.  Now tolerating AVAPS. Pulmonary has signed off. Continue Symbicort Spiriva along with albuterol every 6 hours. Discharged on AVAPS at nighttime.   COVID 19 infection Noted CXR on 11/13 consistent with COVID and COPD.  On remdesivir and Decadron for 6 days. Was seen by ID. Discharged on prednisone home dose 10 mg daily. Continue 4 L nasal cannula   Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.    Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.     Pallative Patient under palliative Cont norco and xanax. Per the pt she is not ready for hospice. .
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea exertional, Hyperkalaemia, Influenza virus test negative, Loss of personal independence in daily activities, Mobility decreased
Clinical narrative: Patient is a 62 y.o. female patient of  CNP with history of copd presented to Hospital with sob   Outpatient Pulm Summary 62 y/o female with very severe COPD and chronic hypoxemic respiratory failure.  She also is heterozygous for alpha-1 anti-trypsin deficiency and has been tobacco free for over a year.  She continues on Symbicort and Spiriva along with prn albuterol.  She is very limited from a functional status standpoint.  She is dyspneic from room to room and no longer does any house work.  Her primary goal is to control her symptoms.  She does report significant anxiety for which she has been on short acting benzodiazepines.  She was recently started on buspar as well by her PCP.  She is worried it will not control her anxiety.  I did review her overall code status which she confirmed was DNR and that she would not want mechanical ventilation.  Her shortness of breath is continuous.  She has a chronic non-productive cough .    Per pulmonology she is hospice appropriate but the pt is not ready yet.    Quite dyspneic at baseline.  Very short of breath with moving around her house.  She has Palliative Care following her and continues on her Norco and Xanax.  She is on prednisone, Symbicort, Spiriva, and nebulizers. She refuses BiPAP and states that she is not ready for hospice.  The pt also tested positive for COVID on 11/11. Negative for Flu   COPD exacerbation END stage COPD Acute on Chronic Hypercapnic respiratory failure Per pulmonary notes patient is quite dyspneic at baseline At this time patient is following with palliative on Xanax and Norco.   Pt to consider hospice. But is not ready for hospice.   She does not want routine ABGs for hypercapnic respiratory failure PCO2 94.  Now tolerating AVAPS. Pulmonary has signed off. Continue Symbicort Spiriva along with albuterol every 6 hours. Discharged on AVAPS at nighttime.   COVID 19 infection Noted CXR on 11/13 consistent with COVID and COPD.  On remdesivir and Decadron for 6 days. Was seen by ID. Discharged on prednisone home dose 10 mg daily. Continue 4 L nasal cannula   Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.    Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.     Pallative Patient under palliative Cont norco and xanax. Per the pt she is not ready for hospice. .
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: PCO2 increased, Refusal of treatment by patient, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Patient is a 62 y.o. female patient of  CNP with history of copd presented to Hospital with sob   Outpatient Pulm Summary 62 y/o female with very severe COPD and chronic hypoxemic respiratory failure.  She also is heterozygous for alpha-1 anti-trypsin deficiency and has been tobacco free for over a year.  She continues on Symbicort and Spiriva along with prn albuterol.  She is very limited from a functional status standpoint.  She is dyspneic from room to room and no longer does any house work.  Her primary goal is to control her symptoms.  She does report significant anxiety for which she has been on short acting benzodiazepines.  She was recently started on buspar as well by her PCP.  She is worried it will not control her anxiety.  I did review her overall code status which she confirmed was DNR and that she would not want mechanical ventilation.  Her shortness of breath is continuous.  She has a chronic non-productive cough .    Per pulmonology she is hospice appropriate but the pt is not ready yet.    Quite dyspneic at baseline.  Very short of breath with moving around her house.  She has Palliative Care following her and continues on her Norco and Xanax.  She is on prednisone, Symbicort, Spiriva, and nebulizers. She refuses BiPAP and states that she is not ready for hospice.  The pt also tested positive for COVID on 11/11. Negative for Flu   COPD exacerbation END stage COPD Acute on Chronic Hypercapnic respiratory failure Per pulmonary notes patient is quite dyspneic at baseline At this time patient is following with palliative on Xanax and Norco.   Pt to consider hospice. But is not ready for hospice.   She does not want routine ABGs for hypercapnic respiratory failure PCO2 94.  Now tolerating AVAPS. Pulmonary has signed off. Continue Symbicort Spiriva along with albuterol every 6 hours. Discharged on AVAPS at nighttime.   COVID 19 infection Noted CXR on 11/13 consistent with COVID and COPD.  On remdesivir and Decadron for 6 days. Was seen by ID. Discharged on prednisone home dose 10 mg daily. Continue 4 L nasal cannula   Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.    Hyperkalemia- resolved. K 6.0 on 11/13, sample Hemolyzed.     Pallative Patient under palliative Cont norco and xanax. Per the pt she is not ready for hospice. .
Age: 9.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: vaccine drawn from previous days vial that had not been disposed of
Age: 35.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product preparation issue, Product storage error
Clinical narrative: The patient was given a dose of the undiluted (Gray cap) Pfizer COVID-19 Bivalent booster that was not stored in an ultra-cold temperature freezer and was instead stored in the regular freezer (between -30 to -20 F). It was moved out of the regular freezer to the refrigerator after more than 3 weeks in the regular freezer. The doses were then used after more than 24 hours in the refrigerator. We have contacted Pfizer about this and according to their off-label studies they provided via PDF file, they are not able to support the temperature excursions that occurred. As per CDC guidance, the recommendation is to re-vaccinate the individual with the full authorized dose of any Bivalent vaccine (either Pfizer or Moderna) and we have communicated with the patient for re-vaccination.
Age: 5.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: vaccine drawn from previous days vial
Age: 59.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered, Product storage error
Clinical narrative: The patient was given a dose of the undiluted (Gray cap) Pfizer COVID-19 Bivalent booster that was not stored in an ultra-cold temperature freezer and was instead stored in the regular freezer (between -30 to -20 F). It was moved out of the regular freezer to the refrigerator after more than 3 weeks in the regular freezer. The doses were then used after more than 24 hours in the refrigerator. We have contacted Pfizer about this and according to their off-label studies they provided via file, they are not able to support the temperature excursions that occurred. As per CDC guidance, the recommendation is to re-vaccinate the individual with the full authorized dose of any Bivalent vaccine (either Pfizer or Moderna) and we have communicated with the patient for re-vaccination.
Age: 57.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (ex. temp./location)-
Age: 66.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: Patient was inadvertently given the Moderna Bivalent Booster COVID-19 vaccination without completing any COVID-19 vaccinations in the primary series.  Patient's representative reports no adverse events to vaccination.
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: The patient was given a dose of the undiluted (Gray cap) Pfizer COVID-19 Bivalent booster that was not stored in an ultra-cold temperature freezer and was instead stored in the regular freezer (between -30 to -20 F). It was moved out of the regular freezer to the refrigerator after more than 3 weeks in the regular freezer. The doses were then used after more than 24 hours in the refrigerator. We have contacted Pfizer about this and according to their off-label studies they provided via PDF file, they are not able to support the temperature excursions that occurred. As per guidance, the recommendation is to re-vaccinate the individual with the full authorized dose of any Bivalent vaccine (either Pfizer or Moderna) and we have communicated with the patient for re-vaccination.
Age: 64.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: pt was given pfizer bivalent dose that expired 12.22.22 at 7:30pm by error.
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Bronchitis, COVID-19, Cough, Oropharyngeal pain, Productive cough
Clinical narrative: I got a sore throat and a severe cough with a runny nose starting about a month after the vaccination.  I tested 3X for Covid and all were negative.  I didn't recover completely and kept coughing up phlegm.  On Nov 11 I tested positive for Covid with a rapid test.  I have now fully recovered
Age: 76.0
Sex: M
Vaccine: COVID19-2
Symptoms: Rhinorrhoea, SARS-CoV-2 test negative, SARS-CoV-2 test positive
Clinical narrative: I got a sore throat and a severe cough with a runny nose starting about a month after the vaccination.  I tested 3X for Covid and all were negative.  I didn't recover completely and kept coughing up phlegm.  On Nov 11 I tested positive for Covid with a rapid test.  I have now fully recovered
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Eye discharge, Headache, Oropharyngeal pain
Clinical narrative: I had contracted COVID-19 on 12/08/2022 and I had a sore throat, chest congestion, nosy and eyes running, headache, fever, cough. The doctor did prescribe Paxlovid.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I had contracted COVID-19 on 12/08/2022 and I had a sore throat, chest congestion, nosy and eyes running, headache, fever, cough. The doctor did prescribe Paxlovid.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Asthma, COVID-19, Condition aggravated, Cough
Clinical narrative: 52 y.o. female patient of DO with history of asthma, obesity, vocal cord paralysis following intubation s/p tracheostomy, prior tobacco use, marijuana use. Presented with worsening dyspnea and found to have acute on chronic hypoxic respiratory failure secondary to COVID-19. Improved with treatment. Medically cleared for discharge.    Acute on chronic hypoxic respiratory failure with hypoxemia, improved In setting COVID-19, asthma exacerbation Baseline trach mask, 2.5-3L/m Improvement w/trach exchange 11/25  Pulmonology consulted   COVID-19 infection 11/20/22 + S/p Remdesivir 11/21, 24, 25 Plan for 10-day Decadron  Pulmonology consulted   Asthma exacerbation  Pt of Pulmonary  Continued Symbicort, Singulair, scheduled Duonebs, steroids  Tussi-Organidin, Tessalon perles for cough  Pulmonology consulted   Vocal cord paresis  S/p tracheostomy 5/2022  Pt of Dr. ; upcoming appt Dr.   S/p trach mask exchange 11/25 w/further improvement, due to inability to pass inner cannula    DM2 11/16/22 A1c 6.5% Requiring insulin inpatient, likely 2/2 steroid treatment Discharged home with home metformin 1g BID Advised to monitor BG & call office if > 300; can consider short term treatment in setting continued steroid-induced hyperglycemia during course    HTN Continued with home hydrochlorothiazide, lasix, losartan    Anxiety Continued home Buspar, Cymbalta, Nortriptyline nightly
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Glycosylated haemoglobin increased, Respiratory failure, SARS-CoV-2 test positive, Type 2 diabetes mellitus
Clinical narrative: 52 y.o. female patient of DO with history of asthma, obesity, vocal cord paralysis following intubation s/p tracheostomy, prior tobacco use, marijuana use. Presented with worsening dyspnea and found to have acute on chronic hypoxic respiratory failure secondary to COVID-19. Improved with treatment. Medically cleared for discharge.    Acute on chronic hypoxic respiratory failure with hypoxemia, improved In setting COVID-19, asthma exacerbation Baseline trach mask, 2.5-3L/m Improvement w/trach exchange 11/25  Pulmonology consulted   COVID-19 infection 11/20/22 + S/p Remdesivir 11/21, 24, 25 Plan for 10-day Decadron  Pulmonology consulted   Asthma exacerbation  Pt of Pulmonary  Continued Symbicort, Singulair, scheduled Duonebs, steroids  Tussi-Organidin, Tessalon perles for cough  Pulmonology consulted   Vocal cord paresis  S/p tracheostomy 5/2022  Pt of Dr. ; upcoming appt Dr.   S/p trach mask exchange 11/25 w/further improvement, due to inability to pass inner cannula    DM2 11/16/22 A1c 6.5% Requiring insulin inpatient, likely 2/2 steroid treatment Discharged home with home metformin 1g BID Advised to monitor BG & call office if > 300; can consider short term treatment in setting continued steroid-induced hyperglycemia during course    HTN Continued with home hydrochlorothiazide, lasix, losartan    Anxiety Continued home Buspar, Cymbalta, Nortriptyline nightly
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chills, Cough, Headache, Oropharyngeal pain
Clinical narrative: I woke up with a fever of over 100. I had a cough, very sore throat, really bad headache and chills during the day. My teeth were also hurting. When I called the nurse, she asked me if I had any chronic conditions or anything. I don't have anything so she said I wouldn't qualify for any oral treatments. I used ibuprofen and TYLENOL at home. I'm still testing positive today.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, SARS-CoV-2 test positive, Toothache
Clinical narrative: I woke up with a fever of over 100. I had a cough, very sore throat, really bad headache and chills during the day. My teeth were also hurting. When I called the nurse, she asked me if I had any chronic conditions or anything. I don't have anything so she said I wouldn't qualify for any oral treatments. I used ibuprofen and TYLENOL at home. I'm still testing positive today.
Age: 45.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: The patient was given a dose of the undiluted (Gray cap) Pfizer COVID-19 Bivalent booster that was not stored in an ultra-cold temperature freezer and was instead stored in the regular freezer (between -30 to -20 F). It was moved out of the regular freezer to the refrigerator after more than 3 weeks in the regular freezer. The doses were then used after more than 24 hours in the refrigerator. We have contacted Pfizer about this and according to their off-label studies they provided via PDF file, they are not able to support the temperature excursions that occurred. As per guidance, the recommendation is to re-vaccinate the individual with the full authorized dose of any Bivalent vaccine (either Pfizer or Moderna) and we have communicated with the patient for re-vaccination.
Age: 38.0
Sex: F
Vaccine: COVID19-2
Symptoms: Product storage error
Clinical narrative: The patient was given a dose of the undiluted (Gray cap) Pfizer COVID-19 Bivalent booster that was not stored in an ultra-cold temperature freezer and was instead stored in the regular freezer (between -30 to -20 F). It was moved out of the regular freezer to the refrigerator after more than 3 weeks in the regular freezer. The doses were then used after more than 24 hours in the refrigerator. We have contacted Pfizer about this and according to their off-label studies they provided via PDF file, they are not able to support the temperature excursions that occurred. As per guidance, the recommendation is to re-vaccinate the individual with the full authorized dose of any Bivalent vaccine (either Pfizer or Moderna) and we have communicated with the patient for re-vaccination.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Acute kidney injury, Alcohol test negative, Ammonia normal, Anticoagulant therapy
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood creatinine increased, Blood culture negative, Blood folate normal, Blood thyroid stimulating hormone normal
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiac failure, Cerebral venous sinus thrombosis, Cerebral ventricle dilatation, Chest X-ray normal
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Cholangiogram, Cholecystitis acute, Computerised tomogram abdomen abnormal, Computerised tomogram head abnormal, Condition aggravated
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Culture negative, Dementia, Drug screen negative, Encephalopathy, HIV test negative
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Hepatobiliary scan abnormal, Hydrocephalus, Hypernatraemia, Hypophagia, Lethargy
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Malnutrition, Metabolic encephalopathy, Pyrexia, Respiratory viral panel, SARS-CoV-2 test positive
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Sepsis, Tachycardia, Tachypnoea, Treponema test negative, Urine analysis normal
Clinical narrative: Pt is a 75 y.o. male with a history of dementia, CAD, HFrEF, HTN, sick sinus syndrome s/p PPM and recent COVID-19 who presented to medical facility with encephalopathy and a fever. Confirmed COVID-19 positive, met sepsis criteria. Found to have acute dural sinus thrombosis, AKI, hypernatremia. He was transferred to hospital 11/10/2022 for neurology evaluation. Course complicated by acute cholecystitis and need for PCT. Course further complicated by poor PO intake, palliative followed and eventually discharged   1. Acute Dural Sinus Thrombosis: CTH at hospital shows diffuse cerebral venous sinus thrombosis. Hospital CTH unchanged CVST, no intracranial hemorrhage, diffuse ventriculomegaly. CT venogram brain 11/12/22 with stable dural venous sinus thrombosis, possible right frontal centrum semiovale stroke. IV heparin infusion and transition to Pradaxa or Warfarin.  Transitioned heparin gtt to pradaxa 11/20/22. Neurology followed.  2. Acute cholecystitis: Abd pain complaints. CT abd 11/13/22 with acute cholecystitis. Positive HIDA 11/14/22. S/p PCT with VIR 11/15/22, culture NGTD. S/p IV Zosyn. GS followed, OP follow up. VIR recommended PCT exchanges every 2-3 months. 3. Malnutrition: patient with poor PO intake. RD followed. Discussed with wife 11/18/22, would be ok with PEG if intake does not improve. PO intake improved 4. Ventriculomegaly: noted on CTV 11/12/22, out of proportion with sulci, possibly related to advanced dementia vs normal pressure hydrocephalus. Neurology followed.   5. Acute Metabolic on Chronic Encephalopathy: Hx reportedly "advanced" dementia with agiation at baseline. Patient lethargic, weak, and AAOx1 on admit. Admit alcohol, UDS, B12/folate, TSH, RPR, HIV all unremarkable, Ammonia 48. Continued home mirtazapine, quetiapine. Palliative care followed, family wants time limited trial at SNF. Improved 6. Sepsis in setting COVID-19: Presented to hospital with T101.3, tachypnea, tachycardia. Positive for COVID on home test, unknown date. Secondary to acute cholecystitis as above. Hospital resp viral PCR: COVID-19 positive. Admit CXR, UA unremarkable, blood cultures NGTD. Resolved with IV abx as above. 7. AKI on CKD-2: Baseline Cr 0.9-1.2. OLH Cr 2.06, improved with IVF. However, Cr back to 1.6 11/15/22. Improved 8. Chronic HFrEF: Per history. TTE 4/6/22 with EF 44%, moderate AV sclerosis and mild AS, abnormal septal and apical WMA due to conduction abnormality. IVF given above.  9. SSS: s/p PPM.  10. CAD: LHC 2/2021 with DES placed for 90% RCA stenosis. Continued home aspirin, statin.  11. Code Status: DNR-CCA, DNI. Palliative followed, family wants time limited trial at SNF.