chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Neuralgia, Pyrexia, Troponin I increased, Vaccination complication
Clinical narrative: 17 Y 7 M generally healthy male who presents with acute onset of chest pain/pressure worsening Friday. He received COVID booster on 1/24/22, had intense fevers, myalgias, "nerve pain" all over body the 24-36hours after the booster. He was pretty much recovering by Wednesday and went to school since Thursday. However, on Friday, by 11:30am, he was feeling very tired and out-of-it. He started feeling chest pressure and pain. Denies tingling/numbness/radiation. Currently, he says he feels a little pressure at the chest right above the epigastric area--more like pressure rather than sharp. At one point, he did feel sharp pain but the general sensation of pressure was more bothering. He was seen this afternoon and referred for labs. His troponin came back elevated at 0.4 and so he was directed to the emergency room for further evaluation.    In ED: repeat troponin 0.44, bedside echocardiogram showed good LV function and no effusion. Rest of labs reassuring. After discussion with cardiology, patient admitted for further management. on 1/31/22:17 y.o. M with post COVID vaccine-related myocarditis, admitted with intermittent chest pain and elevated troponin, awaiting troponin level <0.5. Overall down-trended from peak troponin of 3.55 but with mild uptrend in troponin to 1.16 from 0.95. Chest pain improved with q8h motrin, now with only intermittent chest pain (at decr level from prior) and no SOB. Plan: Trending troponin q12h until trop <0.5. 1/28 EKG: NSR, RSR' in V1/V2 prob normal variant per Cards. Also on nicotine patch 14mg/24h started 1/29/22 in s/o hx vaping and desire to quit.    Dispo plan & recs per Cardiology: Plan for outpt cards f/u appt, no strenuous activities for 30 days after discharge and no competitive sports for 3 months until he can be cleared with a normal treadmill test. Recheck troponin 1 week after discharge. Will need nicotine patch wean - should be on (14 mg/day) for 2 weeks then step down to step 3 (7 mg/day) for 2 weeks.   Exam notable for CV: mildly bradycardic rate, normal rhythm, normal S1/S2, no point tenderness of chest on palpation. Cap refill < 2 sec, normal pulse. Pulm: CTAB. Abd: soft, NT, ND.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Blood test, Chest pain, Chills, Delirium, Dyspnoea
Clinical narrative: 17 Y 7 M generally healthy male who presents with acute onset of chest pain/pressure worsening Friday. He received COVID booster on 1/24/22, had intense fevers, myalgias, "nerve pain" all over body the 24-36hours after the booster. He was pretty much recovering by Wednesday and went to school since Thursday. However, on Friday, by 11:30am, he was feeling very tired and out-of-it. He started feeling chest pressure and pain. Denies tingling/numbness/radiation. Currently, he says he feels a little pressure at the chest right above the epigastric area--more like pressure rather than sharp. At one point, he did feel sharp pain but the general sensation of pressure was more bothering. He was seen this afternoon and referred for labs. His troponin came back elevated at 0.4 and so he was directed to the emergency room for further evaluation.    In ED: repeat troponin 0.44, bedside echocardiogram showed good LV function and no effusion. Rest of labs reassuring. After discussion with cardiology, patient admitted for further management. on 1/31/22:17 y.o. M with post COVID vaccine-related myocarditis, admitted with intermittent chest pain and elevated troponin, awaiting troponin level <0.5. Overall down-trended from peak troponin of 3.55 but with mild uptrend in troponin to 1.16 from 0.95. Chest pain improved with q8h motrin, now with only intermittent chest pain (at decr level from prior) and no SOB. Plan: Trending troponin q12h until trop <0.5. 1/28 EKG: NSR, RSR' in V1/V2 prob normal variant per Cards. Also on nicotine patch 14mg/24h started 1/29/22 in s/o hx vaping and desire to quit.    Dispo plan & recs per Cardiology: Plan for outpt cards f/u appt, no strenuous activities for 30 days after discharge and no competitive sports for 3 months until he can be cleared with a normal treadmill test. Recheck troponin 1 week after discharge. Will need nicotine patch wean - should be on (14 mg/day) for 2 weeks then step down to step 3 (7 mg/day) for 2 weeks.   Exam notable for CV: mildly bradycardic rate, normal rhythm, normal S1/S2, no point tenderness of chest on palpation. Cap refill < 2 sec, normal pulse. Pulm: CTAB. Abd: soft, NT, ND.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Echocardiogram, Electrocardiogram, Myocarditis, Neuralgia, Pain
Clinical narrative: 17 Y 7 M generally healthy male who presents with acute onset of chest pain/pressure worsening Friday. He received COVID booster on 1/24/22, had intense fevers, myalgias, "nerve pain" all over body the 24-36hours after the booster. He was pretty much recovering by Wednesday and went to school since Thursday. However, on Friday, by 11:30am, he was feeling very tired and out-of-it. He started feeling chest pressure and pain. Denies tingling/numbness/radiation. Currently, he says he feels a little pressure at the chest right above the epigastric area--more like pressure rather than sharp. At one point, he did feel sharp pain but the general sensation of pressure was more bothering. He was seen this afternoon and referred for labs. His troponin came back elevated at 0.4 and so he was directed to the emergency room for further evaluation.    In ED: repeat troponin 0.44, bedside echocardiogram showed good LV function and no effusion. Rest of labs reassuring. After discussion with cardiology, patient admitted for further management. on 1/31/22:17 y.o. M with post COVID vaccine-related myocarditis, admitted with intermittent chest pain and elevated troponin, awaiting troponin level <0.5. Overall down-trended from peak troponin of 3.55 but with mild uptrend in troponin to 1.16 from 0.95. Chest pain improved with q8h motrin, now with only intermittent chest pain (at decr level from prior) and no SOB. Plan: Trending troponin q12h until trop <0.5. 1/28 EKG: NSR, RSR' in V1/V2 prob normal variant per Cards. Also on nicotine patch 14mg/24h started 1/29/22 in s/o hx vaping and desire to quit.    Dispo plan & recs per Cardiology: Plan for outpt cards f/u appt, no strenuous activities for 30 days after discharge and no competitive sports for 3 months until he can be cleared with a normal treadmill test. Recheck troponin 1 week after discharge. Will need nicotine patch wean - should be on (14 mg/day) for 2 weeks then step down to step 3 (7 mg/day) for 2 weeks.   Exam notable for CV: mildly bradycardic rate, normal rhythm, normal S1/S2, no point tenderness of chest on palpation. Cap refill < 2 sec, normal pulse. Pulm: CTAB. Abd: soft, NT, ND.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Pyrexia
Clinical narrative: 17 Y 7 M generally healthy male who presents with acute onset of chest pain/pressure worsening Friday. He received COVID booster on 1/24/22, had intense fevers, myalgias, "nerve pain" all over body the 24-36hours after the booster. He was pretty much recovering by Wednesday and went to school since Thursday. However, on Friday, by 11:30am, he was feeling very tired and out-of-it. He started feeling chest pressure and pain. Denies tingling/numbness/radiation. Currently, he says he feels a little pressure at the chest right above the epigastric area--more like pressure rather than sharp. At one point, he did feel sharp pain but the general sensation of pressure was more bothering. He was seen this afternoon and referred for labs. His troponin came back elevated at 0.4 and so he was directed to the emergency room for further evaluation.    In ED: repeat troponin 0.44, bedside echocardiogram showed good LV function and no effusion. Rest of labs reassuring. After discussion with cardiology, patient admitted for further management. on 1/31/22:17 y.o. M with post COVID vaccine-related myocarditis, admitted with intermittent chest pain and elevated troponin, awaiting troponin level <0.5. Overall down-trended from peak troponin of 3.55 but with mild uptrend in troponin to 1.16 from 0.95. Chest pain improved with q8h motrin, now with only intermittent chest pain (at decr level from prior) and no SOB. Plan: Trending troponin q12h until trop <0.5. 1/28 EKG: NSR, RSR' in V1/V2 prob normal variant per Cards. Also on nicotine patch 14mg/24h started 1/29/22 in s/o hx vaping and desire to quit.    Dispo plan & recs per Cardiology: Plan for outpt cards f/u appt, no strenuous activities for 30 days after discharge and no competitive sports for 3 months until he can be cleared with a normal treadmill test. Recheck troponin 1 week after discharge. Will need nicotine patch wean - should be on (14 mg/day) for 2 weeks then step down to step 3 (7 mg/day) for 2 weeks.   Exam notable for CV: mildly bradycardic rate, normal rhythm, normal S1/S2, no point tenderness of chest on palpation. Cap refill < 2 sec, normal pulse. Pulm: CTAB. Abd: soft, NT, ND.
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Incorrect dose administered, Product preparation issue
Clinical narrative: Patient inadvertently received 0.3mL of undiluted Pfizer vaccine. Patient initially reported no symptoms on day of injection 2/14/2022, but patient called on 2/24/2022 to seek advice. She reported constant fatigue, headaches and occasional arm numbness in injection site arm (left). As of a few days ago, neck pain and stiffness. Due to the patient's reported head and neck complications, I recommended the patient seek immediate medical care. The patient agreed. No other details yet.
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Headache, Hypoaesthesia, Incorrect product formulation administered, Musculoskeletal stiffness
Clinical narrative: Patient inadvertently received 0.3mL of undiluted Pfizer vaccine. Patient initially reported no symptoms on day of injection 2/14/2022, but patient called on 2/24/2022 to seek advice. She reported constant fatigue, headaches and occasional arm numbness in injection site arm (left). As of a few days ago, neck pain and stiffness. Due to the patient's reported head and neck complications, I recommended the patient seek immediate medical care. The patient agreed. No other details yet.
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Neck pain
Clinical narrative: Patient inadvertently received 0.3mL of undiluted Pfizer vaccine. Patient initially reported no symptoms on day of injection 2/14/2022, but patient called on 2/24/2022 to seek advice. She reported constant fatigue, headaches and occasional arm numbness in injection site arm (left). As of a few days ago, neck pain and stiffness. Due to the patient's reported head and neck complications, I recommended the patient seek immediate medical care. The patient agreed. No other details yet.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Aldolase, Angiogram, Blood lactic acid, C-reactive protein
Clinical narrative: Per PCP, hospital follow up note, 2-18-22 Patient is a 57-year-old female status post pancreas and kidney transplant who presents today for follow-up after recent hospitalization for altered mental status, transaminitis of unclear etiology.  She is doing much better at today's visit as compared to her visit last week prior to her hospital stay   1.  Transaminitis-LFTs were improving at the time of discharge.  Etiology is unclear but the patient's pravastatin and Tylenol were discontinued appropriately given her LFT elevations.  I have asked her renal clinic to redraw her LFTs next week and we will likely discuss restarting at least the pravastatin when she follows up with me next week.  Of note, the patient's transaminitis did occur after receiving the Covid vaccination and this is the second time she has become ill within a week of receiving the Covid vaccine requiring hospital stay.  I have filed a report with the vaccine adverse drug event reporting system.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray abnormal, Chills, Computerised tomogram abdomen, Decreased appetite, Echocardiogram
Clinical narrative: Per PCP, hospital follow up note, 2-18-22 Patient is a 57-year-old female status post pancreas and kidney transplant who presents today for follow-up after recent hospitalization for altered mental status, transaminitis of unclear etiology.  She is doing much better at today's visit as compared to her visit last week prior to her hospital stay   1.  Transaminitis-LFTs were improving at the time of discharge.  Etiology is unclear but the patient's pravastatin and Tylenol were discontinued appropriately given her LFT elevations.  I have asked her renal clinic to redraw her LFTs next week and we will likely discuss restarting at least the pravastatin when she follows up with me next week.  Of note, the patient's transaminitis did occur after receiving the Covid vaccination and this is the second time she has become ill within a week of receiving the Covid vaccine requiring hospital stay.  I have filed a report with the vaccine adverse drug event reporting system.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Full blood count, Hepatobiliary scan, Malaise, Metabolic function test, Nausea
Clinical narrative: Per PCP, hospital follow up note, 2-18-22 Patient is a 57-year-old female status post pancreas and kidney transplant who presents today for follow-up after recent hospitalization for altered mental status, transaminitis of unclear etiology.  She is doing much better at today's visit as compared to her visit last week prior to her hospital stay   1.  Transaminitis-LFTs were improving at the time of discharge.  Etiology is unclear but the patient's pravastatin and Tylenol were discontinued appropriately given her LFT elevations.  I have asked her renal clinic to redraw her LFTs next week and we will likely discuss restarting at least the pravastatin when she follows up with me next week.  Of note, the patient's transaminitis did occur after receiving the Covid vaccination and this is the second time she has become ill within a week of receiving the Covid vaccine requiring hospital stay.  I have filed a report with the vaccine adverse drug event reporting system.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pain, Pneumonia aspiration, Procalcitonin, Red blood cell sedimentation rate, Respiratory viral panel
Clinical narrative: Per PCP, hospital follow up note, 2-18-22 Patient is a 57-year-old female status post pancreas and kidney transplant who presents today for follow-up after recent hospitalization for altered mental status, transaminitis of unclear etiology.  She is doing much better at today's visit as compared to her visit last week prior to her hospital stay   1.  Transaminitis-LFTs were improving at the time of discharge.  Etiology is unclear but the patient's pravastatin and Tylenol were discontinued appropriately given her LFT elevations.  I have asked her renal clinic to redraw her LFTs next week and we will likely discuss restarting at least the pravastatin when she follows up with me next week.  Of note, the patient's transaminitis did occur after receiving the Covid vaccination and this is the second time she has become ill within a week of receiving the Covid vaccine requiring hospital stay.  I have filed a report with the vaccine adverse drug event reporting system.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Transaminases increased, Ultrasound abdomen
Clinical narrative: Per PCP, hospital follow up note, 2-18-22 Patient is a 57-year-old female status post pancreas and kidney transplant who presents today for follow-up after recent hospitalization for altered mental status, transaminitis of unclear etiology.  She is doing much better at today's visit as compared to her visit last week prior to her hospital stay   1.  Transaminitis-LFTs were improving at the time of discharge.  Etiology is unclear but the patient's pravastatin and Tylenol were discontinued appropriately given her LFT elevations.  I have asked her renal clinic to redraw her LFTs next week and we will likely discuss restarting at least the pravastatin when she follows up with me next week.  Of note, the patient's transaminitis did occur after receiving the Covid vaccination and this is the second time she has become ill within a week of receiving the Covid vaccine requiring hospital stay.  I have filed a report with the vaccine adverse drug event reporting system.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Illness, Mental status changes, Transaminases increased
Clinical narrative: Per PCP, hospital follow up note, 2-18-22 Patient is a 57-year-old female status post pancreas and kidney transplant who presents today for follow-up after recent hospitalization for altered mental status, transaminitis of unclear etiology.  She is doing much better at today's visit as compared to her visit last week prior to her hospital stay   1.  Transaminitis-LFTs were improving at the time of discharge.  Etiology is unclear but the patient's pravastatin and Tylenol were discontinued appropriately given her LFT elevations.  I have asked her renal clinic to redraw her LFTs next week and we will likely discuss restarting at least the pravastatin when she follows up with me next week.  Of note, the patient's transaminitis did occur after receiving the Covid vaccination and this is the second time she has become ill within a week of receiving the Covid vaccine requiring hospital stay.  I have filed a report with the vaccine adverse drug event reporting system.
Age: 15.0
Sex: M
Vaccine: HEPAB, HEPAB
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse event, Twinrix not advised for adolescent population.
Age: 91.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Death
Clinical narrative: tested positive with Covid 19 on 12/6/21  Death in facility on 12/16/21
Age: 91.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
Clinical narrative: tested positive with Covid 19 on 12/6/21  Death in facility on 12/16/21
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Discomfort, Dyspnoea, Pain
Clinical narrative: I had constant chest pain on the left side of my chest for 2 days on 2/9 to 2/10. It was very uncomfortable and the pain did cause difficulty breathing.  The pain and my concern was not great enough to warrant a trip to the doctor or emergency department.  I did not make the connection between the vaccine and the pain until after it had resolved.  The pain was consistently a 5/10 on a 0-10 pain scale.
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Electrocardiogram ST segment elevation, Troponin increased
Clinical narrative: The patient developed chest pain and shortness of breath three days after vaccine administration on 2/21/22, and these symptoms progressed to significant chest pain prompting an ED visit early on 2/23/22 with subsequent admission to the hospital.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Fatigue, Herpes zoster, Neuralgia, Rash
Clinical narrative: Rash on lt upper back?-Got shingles on my left torso, painful nerve pin, given steroid and acyclovir, fatigue
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Lip swelling, Oral pruritus, Rash, Throat irritation, Tongue pruritus
Clinical narrative: Itchy throat, mouth and tongue Rash, hives, swollen lips
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Itchy throat, mouth and tongue Rash, hives, swollen lips
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Mechanical urticaria, Pruritus, Swelling, Urticaria
Clinical narrative: I developed dermatographia about 12 days after the Moderna booster. I still have it and it is showing no signs of going away. I get itchy raised welts whenever and wherever something puts pressure on my skin (scratching, rubbing, etc). There is no cure or treatment other than antihistamines, which do not usually work.  This condition may last years and may even be permanent.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Headache, Loss of personal independence in daily activities, Mobility decreased, Myalgia
Clinical narrative: 7 days of joint of muscle pain preventing getting out of bed. hurts to lay in be at a pain level 10/10.  Headach lasting for 3 weeks straight, different in severity and pain location and type when compared to migraine. Unable to preform ADLs for over three weeks. TX with Toradol with no relief.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Pain
Clinical narrative: 7 days of joint of muscle pain preventing getting out of bed. hurts to lay in be at a pain level 10/10.  Headach lasting for 3 weeks straight, different in severity and pain location and type when compared to migraine. Unable to preform ADLs for over three weeks. TX with Toradol with no relief.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Atrial fibrillation, Chest discomfort, Electrocardiogram abnormal, Left ventricular hypertrophy
Clinical narrative: 4 Abnormal ECG readings, Atrial Fibriliation readings, chest tightness
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Electrocardiogram, Gastrooesophageal reflux disease, Mechanical urticaria
Clinical narrative: dermatographia that has continued to the present day (about 3 months so far), taking Zyrtec once a day, also acid reflux that just happened to start within 24 hours of the dermatographia  (acute chest pain out of the blue, but has occurred only 8-10 times in the last 3 months, but never occurred prior to the onset of dermatographia), taking Pepcid twice a day for the reflux
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Deep vein thrombosis, Pain in extremity, Pulmonary embolism
Clinical narrative: DVT and PE  Symptoms of RLE pain started 10 days ago (around 2/14 or about 3 weeks after his second COVID shot in initial series)
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Exercise tolerance decreased, Hyperhidrosis, Insomnia, Pruritus, Rash
Clinical narrative: Since 11 January he has complained of recurrent episodes of localized itching and rashes described as raised, red, itchy whelts which can occur anywhere on his body and typically occur at sites of pressure or where his skin is scraped or scratched. He also notes lesions after sweating. His symptoms led him to present to the ER on 18 January where he received oral antihistamine and oral corticosteroid. Lesions last less than 24 hours, affect his palms and soles, and resolve without post-inflammatory changes. He denies generalized cutaneous, laryngeal, pulmonary, GI/GU, neurologic, and cardiovascular symptoms with these episodes. Episodes not associated with exercise, heat, cold, foods, medications, NSAIDs, IV contrast, latex exposure, infections, or insect bites/stings. He received his Moderna COVID-19 vaccine booster dose on 5 January, six days prior to onset of his symptoms. He has used oral antihistamines with improvement in his symptoms. She denies constitutional symptoms. UCT score today is 7 (0, 1, 0, 2, 0, 0, 3, 1). He reports his symptoms have limited his ability to exercise and adversely impacted his sleep, especially since he ran out of Zyrtec. He reports he also developed itching and hives for several weeks after his second dose of the Moderna COVID-19 vaccine which then resolved spontaneously.
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Rash papular, Rash pruritic, Skin lesion, Urticaria
Clinical narrative: Since 11 January he has complained of recurrent episodes of localized itching and rashes described as raised, red, itchy whelts which can occur anywhere on his body and typically occur at sites of pressure or where his skin is scraped or scratched. He also notes lesions after sweating. His symptoms led him to present to the ER on 18 January where he received oral antihistamine and oral corticosteroid. Lesions last less than 24 hours, affect his palms and soles, and resolve without post-inflammatory changes. He denies generalized cutaneous, laryngeal, pulmonary, GI/GU, neurologic, and cardiovascular symptoms with these episodes. Episodes not associated with exercise, heat, cold, foods, medications, NSAIDs, IV contrast, latex exposure, infections, or insect bites/stings. He received his Moderna COVID-19 vaccine booster dose on 5 January, six days prior to onset of his symptoms. He has used oral antihistamines with improvement in his symptoms. She denies constitutional symptoms. UCT score today is 7 (0, 1, 0, 2, 0, 0, 3, 1). He reports his symptoms have limited his ability to exercise and adversely impacted his sleep, especially since he ran out of Zyrtec. He reports he also developed itching and hives for several weeks after his second dose of the Moderna COVID-19 vaccine which then resolved spontaneously.
Age: 26.0
Sex: M
Vaccine: UNK
Symptoms: Injection site pain, Pain
Clinical narrative: A few days after getting both the flu shot and the tdap shot, in the same area of the upper left arm, I began to experience pain at the injection site. My arm had been in pain every day since. It hurts right now as I type this report.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria, Urticaria chronic
Clinical narrative: development of urticaria symptoms which have now become chronic; no angioedema or other symptoms suggestive of systemic anaphylaxis
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy bone marrow, Blood test, Thrombocytopenia
Clinical narrative: THROMBOCYTOPENIA
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asymptomatic COVID-19, COVID-19, Intensive care, Metabolic acidosis, Positive airway pressure therapy
Clinical narrative: Covid19 breakthrough.  1st vaccine received on 12/23/2020.  88 y/o male with PMHx of alzheimer's dementia, prostate CA, Colon CA s/p colectomy/colostomy with revision of colostomy due to ileostomy prolapse, DM, HTN, HLD presents to ED via EMS from ALF for respiratory distress and severe metabolic acidosis. Pt admitted to ICU and placed on BIPAP 2/13, covid test at the time was negative.  Pt retested on 02/22/2022 as standard for return to ALF and test was postitive.  Pt on IV ABX, no further covid treatment ordered per ID as pt on room air and asymptomatic.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Respiratory distress, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Covid19 breakthrough.  1st vaccine received on 12/23/2020.  88 y/o male with PMHx of alzheimer's dementia, prostate CA, Colon CA s/p colectomy/colostomy with revision of colostomy due to ileostomy prolapse, DM, HTN, HLD presents to ED via EMS from ALF for respiratory distress and severe metabolic acidosis. Pt admitted to ICU and placed on BIPAP 2/13, covid test at the time was negative.  Pt retested on 02/22/2022 as standard for return to ALF and test was postitive.  Pt on IV ABX, no further covid treatment ordered per ID as pt on room air and asymptomatic.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema
Clinical narrative: Site: Redness at Injection Site-Medium
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood pressure decreased, Blood pressure fluctuation
Clinical narrative: Blood pressure dropped significantly the day after and felt weak. Got to 88/55 then for the next 3 days was high. As a parent this made me entirely uncomfortable wondering what is happening in his body to cause fluctuations with blood pressure since this can be related to your heart.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Injection site erythema, Injection site pruritus, Injection site swelling, Pruritus
Clinical narrative: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Patient complaining of injection site redness and swelling, extremely red (pt will take antihistamine and make appt with provider to get further guidance)-Severe
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test normal, Laboratory test, Myocarditis
Clinical narrative: My husband on February 18th thought he was having a heart attack.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: Lip swelling, Rash
Clinical narrative: I awoke in the middle of the night 2 days post vaccination, with swelling to my upper lip.  After going back to sleep I awoke the next morning and my lip was more swollen than it was previously. The swelling went down by the end of the day, but was followed by rashes all over my body.  The rashes now occur anytime the skin is agitated and have been consistent since that day.  While home on leave (1 week later), I went to an urgent care facility, I was prescribed Famotidine Benadryl and Prednisone. This did work but was temporary.  I have not experienced any skin issues prior to these occurrences.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Blood immunoglobulin G, Blood immunoglobulin M, COVID-19, Computerised tomogram abdomen abnormal
Clinical narrative: Patient has been complaining of epigastric supraumbilical pain for the past 2 months and had noted periumbilical subcutaneous palpable lump. Yesterday and today pain has gotten significantly worse, patient was sent to Radiology Office for abdominal CAT scan which showed incarcerated possibly strangulated hernia. Immediately patient was sent to emergency room for further surgical evaluation for treatment. Found to be PCR Positive
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Umbilical hernia
Clinical narrative: Patient has been complaining of epigastric supraumbilical pain for the past 2 months and had noted periumbilical subcutaneous palpable lump. Yesterday and today pain has gotten significantly worse, patient was sent to Radiology Office for abdominal CAT scan which showed incarcerated possibly strangulated hernia. Immediately patient was sent to emergency room for further surgical evaluation for treatment. Found to be PCR Positive
Age: 38.0
Sex: F
Vaccine: UNK, UNK
Symptoms: Heavy menstrual bleeding, Injection site pain
Clinical narrative: very heavy menstrual cycle after vaccine and pain in arm at location of shot. The pain in my arm is rather painful and will not stop. The pain in my arm may be permanent, but my menstrual period may change again, but i am not sure.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Cardiac telemetry, Cardio-respiratory arrest
Clinical narrative: Moderna COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccine on 6/03/2021 and 7/01/2021. Covid19 + 2/08/22.  Presented to ED 2/8/22 after 3-4 days of Covid sxs w/increasing SOB, wheezing and body aches. Covid+. Admitted for acute on chronic resp failure 2/2 hypoxia-multifactorial 2/2 Covid PNA and COPD exacerbation. Increased O2 demand from home O2 via NC. Remained on NC overnight but was found to be off telemetry early the next morning. Pt was slumped /pulseless, and code blue was called. Intubated and regained pulse twice but then there was no further response.  Treated with decadron. Expired 02/09/22.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Death, Dyspnoea, Endotracheal intubation
Clinical narrative: Moderna COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccine on 6/03/2021 and 7/01/2021. Covid19 + 2/08/22.  Presented to ED 2/8/22 after 3-4 days of Covid sxs w/increasing SOB, wheezing and body aches. Covid+. Admitted for acute on chronic resp failure 2/2 hypoxia-multifactorial 2/2 Covid PNA and COPD exacerbation. Increased O2 demand from home O2 via NC. Remained on NC overnight but was found to be off telemetry early the next morning. Pt was slumped /pulseless, and code blue was called. Intubated and regained pulse twice but then there was no further response.  Treated with decadron. Expired 02/09/22.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoxia, Malaise, Pain, Posture abnormal, Pulse absent
Clinical narrative: Moderna COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccine on 6/03/2021 and 7/01/2021. Covid19 + 2/08/22.  Presented to ED 2/8/22 after 3-4 days of Covid sxs w/increasing SOB, wheezing and body aches. Covid+. Admitted for acute on chronic resp failure 2/2 hypoxia-multifactorial 2/2 Covid PNA and COPD exacerbation. Increased O2 demand from home O2 via NC. Remained on NC overnight but was found to be off telemetry early the next morning. Pt was slumped /pulseless, and code blue was called. Intubated and regained pulse twice but then there was no further response.  Treated with decadron. Expired 02/09/22.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Wheezing
Clinical narrative: Moderna COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccine on 6/03/2021 and 7/01/2021. Covid19 + 2/08/22.  Presented to ED 2/8/22 after 3-4 days of Covid sxs w/increasing SOB, wheezing and body aches. Covid+. Admitted for acute on chronic resp failure 2/2 hypoxia-multifactorial 2/2 Covid PNA and COPD exacerbation. Increased O2 demand from home O2 via NC. Remained on NC overnight but was found to be off telemetry early the next morning. Pt was slumped /pulseless, and code blue was called. Intubated and regained pulse twice but then there was no further response.  Treated with decadron. Expired 02/09/22.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Anaemia, COVID-19, Mental status changes, Pneumonia, SARS-CoV-2 test negative
Clinical narrative: Admitted with change in mental status, found with anemia and pneumonia.  Intermittent PCR POSITIVE OVER last few weeks (see below).
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Admitted with change in mental status, found with anemia and pneumonia.  Intermittent PCR POSITIVE OVER last few weeks (see below).
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, COVID-19 pneumonia, Confusional state
Clinical narrative: Janssen COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/10/2021. Presented to ED 1/23/22 w/Covid sxs. Admitted 1/24/22 w/acute hypoxic respiratory failure secondary to COVID-19 PNA, UTI, and AKI of neurogenic bladder. He had been progressively worsening without any improvement. Pt had worsening confusion and increasing shortness of breath, desaturating to 70s% while talking despite being on high flow O2. Transitioned to comfort care.  Tx'd with decadron, ceftriaxone, rocephin. Expired 02/08/22.
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Dyspnoea, Malaise, Neurogenic bladder, Oxygen saturation decreased
Clinical narrative: Janssen COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/10/2021. Presented to ED 1/23/22 w/Covid sxs. Admitted 1/24/22 w/acute hypoxic respiratory failure secondary to COVID-19 PNA, UTI, and AKI of neurogenic bladder. He had been progressively worsening without any improvement. Pt had worsening confusion and increasing shortness of breath, desaturating to 70s% while talking despite being on high flow O2. Transitioned to comfort care.  Tx'd with decadron, ceftriaxone, rocephin. Expired 02/08/22.
Age: 94.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test, Urinary tract infection
Clinical narrative: Janssen COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/10/2021. Presented to ED 1/23/22 w/Covid sxs. Admitted 1/24/22 w/acute hypoxic respiratory failure secondary to COVID-19 PNA, UTI, and AKI of neurogenic bladder. He had been progressively worsening without any improvement. Pt had worsening confusion and increasing shortness of breath, desaturating to 70s% while talking despite being on high flow O2. Transitioned to comfort care.  Tx'd with decadron, ceftriaxone, rocephin. Expired 02/08/22.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myocardial infarction, Acute respiratory failure, COVID-19, Cardiac failure congestive, Chest X-ray abnormal
Clinical narrative: Moderna COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccine on 1/14/2021 and 2/10/2021. Presented to ED on 1/25/22 SOB onset 1/21. Admitted for acute on chronic resp failure, multifactorial 2/2 severe Covid19 infx and acute CHF c/b underlying pulmonary fibrosis, COPD. CXR: Worsening airspace opacities compared to CXR 12/21/2021. Recently NSTEMI with multivessel CAD. During admission continued to decline and have difficulty breathing. Pt was transitioned to comfort care/ DNR. Treated with prednisone, remdesivir, and decadron. Pt expired 02/09/22.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Coronary artery disease, Death, Dyspnoea, Lung opacity
Clinical narrative: Moderna COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccine on 1/14/2021 and 2/10/2021. Presented to ED on 1/25/22 SOB onset 1/21. Admitted for acute on chronic resp failure, multifactorial 2/2 severe Covid19 infx and acute CHF c/b underlying pulmonary fibrosis, COPD. CXR: Worsening airspace opacities compared to CXR 12/21/2021. Recently NSTEMI with multivessel CAD. During admission continued to decline and have difficulty breathing. Pt was transitioned to comfort care/ DNR. Treated with prednisone, remdesivir, and decadron. Pt expired 02/09/22.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Moderna COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccine on 1/14/2021 and 2/10/2021. Presented to ED on 1/25/22 SOB onset 1/21. Admitted for acute on chronic resp failure, multifactorial 2/2 severe Covid19 infx and acute CHF c/b underlying pulmonary fibrosis, COPD. CXR: Worsening airspace opacities compared to CXR 12/21/2021. Recently NSTEMI with multivessel CAD. During admission continued to decline and have difficulty breathing. Pt was transitioned to comfort care/ DNR. Treated with prednisone, remdesivir, and decadron. Pt expired 02/09/22.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute myocardial infarction, Acute respiratory failure, Blood culture positive, COVID-19, Chest X-ray abnormal
Clinical narrative: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Received Moderna Vaccines on 1/12/2021, 2/11/2021, and 8/24/2021. Admitted 2/3/22 for acute hypoxic resp failure 2/2 Covid 19 w/superimposed bacterial PNA c/b sepsis, NSTEMI, and sepsis. Intubated 2/4/22. Tx'd w/antibiotics, pressors, steroids, and remdesivir. Respiratory status continued to decompensate. Extubated to comfort measures and expired 2/20/2022 at 0920.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Death, Endotracheal intubation, Interstitial lung disease, Pneumonia bacterial, SARS-CoV-2 test positive
Clinical narrative: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Received Moderna Vaccines on 1/12/2021, 2/11/2021, and 8/24/2021. Admitted 2/3/22 for acute hypoxic resp failure 2/2 Covid 19 w/superimposed bacterial PNA c/b sepsis, NSTEMI, and sepsis. Intubated 2/4/22. Tx'd w/antibiotics, pressors, steroids, and remdesivir. Respiratory status continued to decompensate. Extubated to comfort measures and expired 2/20/2022 at 0920.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Sepsis, Staphylococcus test positive, Streptococcus test positive, Superinfection
Clinical narrative: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Received Moderna Vaccines on 1/12/2021, 2/11/2021, and 8/24/2021. Admitted 2/3/22 for acute hypoxic resp failure 2/2 Covid 19 w/superimposed bacterial PNA c/b sepsis, NSTEMI, and sepsis. Intubated 2/4/22. Tx'd w/antibiotics, pressors, steroids, and remdesivir. Respiratory status continued to decompensate. Extubated to comfort measures and expired 2/20/2022 at 0920.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Asthenia, COVID-19, COVID-19 pneumonia, Chronic kidney disease
Clinical narrative: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 4/8/2021 and 5/6/2021. Hospitalized for COVID 1/11/2022 - 1/30/2022 tx'd w/O2, steroids, remdesivir, and antibiotics. Presented to ED 2/4/2022 w/weakness and SOB. Admitted for acute hyposic resp failure 2/2 Covid PNA c/b acute on chronic hypoxic resp failure, CKD3, T2DM. Tx'd w/O2, dexamethasone, antibiotics, pressors. Respiratory status continued to decline, intubated 2/11. On 2/17/2022 transitioned to comfort care and expired.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Death, Dyspnoea, Endotracheal intubation, Respiratory disorder, Respiratory failure
Clinical narrative: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 4/8/2021 and 5/6/2021. Hospitalized for COVID 1/11/2022 - 1/30/2022 tx'd w/O2, steroids, remdesivir, and antibiotics. Presented to ED 2/4/2022 w/weakness and SOB. Admitted for acute hyposic resp failure 2/2 Covid PNA c/b acute on chronic hypoxic resp failure, CKD3, T2DM. Tx'd w/O2, dexamethasone, antibiotics, pressors. Respiratory status continued to decline, intubated 2/11. On 2/17/2022 transitioned to comfort care and expired.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Type 2 diabetes mellitus
Clinical narrative: Moderna COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Moderna Vaccines on 4/8/2021 and 5/6/2021. Hospitalized for COVID 1/11/2022 - 1/30/2022 tx'd w/O2, steroids, remdesivir, and antibiotics. Presented to ED 2/4/2022 w/weakness and SOB. Admitted for acute hyposic resp failure 2/2 Covid PNA c/b acute on chronic hypoxic resp failure, CKD3, T2DM. Tx'd w/O2, dexamethasone, antibiotics, pressors. Respiratory status continued to decline, intubated 2/11. On 2/17/2022 transitioned to comfort care and expired.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 3/05/2021 and 3/26/2021. Presented to ED 2/7/22 with SOB. Admitted for acute hypoxemic respiratory failure 2/2 Covid-19 PNA c/b severe COPD, AFib with RVR. Placed on HFNC O2 and given IV metoprolol. She was on hospice at home and her prognosis was poor. Patient was transitioned to comfort care. Treated with solumedrol and ceftriaxone. Patient expired 02/12/22.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Death, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 3/05/2021 and 3/26/2021. Presented to ED 2/7/22 with SOB. Admitted for acute hypoxemic respiratory failure 2/2 Covid-19 PNA c/b severe COPD, AFib with RVR. Placed on HFNC O2 and given IV metoprolol. She was on hospice at home and her prognosis was poor. Patient was transitioned to comfort care. Treated with solumedrol and ceftriaxone. Patient expired 02/12/22.
Age: 77.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myocardial infarction, Acute respiratory failure, Atrial fibrillation, COVID-19, Death
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 2/4/21 and 2/25/21. Presented to ED 2/6/22 with SOB and sxs worsened over 3 weeks. Previous Friday to admission began having fevers, prescribed azithromycin and inhalers. Tested negative for covid 2-3 times. Admitted for A-fib and acute hypoxic resp failure 2/2 Covid. Required HFNC during admission, intubated 2/8. STEMI 2/9 c/b distributive shock and bil. pleural effusions. Transitioned to comfort care. Tx'd with decadron, solumedrol, baricitinib,cefepime and vancomycin. Expired 02/09/22.
Age: 77.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Distributive shock, Dyspnoea, Endotracheal intubation, Pleural effusion, Pyrexia
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 2/4/21 and 2/25/21. Presented to ED 2/6/22 with SOB and sxs worsened over 3 weeks. Previous Friday to admission began having fevers, prescribed azithromycin and inhalers. Tested negative for covid 2-3 times. Admitted for A-fib and acute hypoxic resp failure 2/2 Covid. Required HFNC during admission, intubated 2/8. STEMI 2/9 c/b distributive shock and bil. pleural effusions. Transitioned to comfort care. Tx'd with decadron, solumedrol, baricitinib,cefepime and vancomycin. Expired 02/09/22.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 3/06/2021 and 4/01/2021. Covid + 2/6/22. Presented to ED 2/9/22 w/worsening SOB. Admitted for acute hypoxemic respiratory failure 2/2 Covid PNA, COPD exacerbation and AFib. Was on HFNC 90/60 and also had worsening delirium and confusion. Respiratory status became more labored through admission. Transitioned to comfort care/DNAR. Treated with DuoNeb, remdesivir, cefepime, and decatron. Patient last received Tocilizumab for RA 4mg/kg on 1/28/22. Patient expired 02/13/22.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Confusional state, Death, Delirium, Dyspnoea
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 3/06/2021 and 4/01/2021. Covid + 2/6/22. Presented to ED 2/9/22 w/worsening SOB. Admitted for acute hypoxemic respiratory failure 2/2 Covid PNA, COPD exacerbation and AFib. Was on HFNC 90/60 and also had worsening delirium and confusion. Respiratory status became more labored through admission. Transitioned to comfort care/DNAR. Treated with DuoNeb, remdesivir, cefepime, and decatron. Patient last received Tocilizumab for RA 4mg/kg on 1/28/22. Patient expired 02/13/22.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory disorder, SARS-CoV-2 test positive
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccine on 3/06/2021 and 4/01/2021. Covid + 2/6/22. Presented to ED 2/9/22 w/worsening SOB. Admitted for acute hypoxemic respiratory failure 2/2 Covid PNA, COPD exacerbation and AFib. Was on HFNC 90/60 and also had worsening delirium and confusion. Respiratory status became more labored through admission. Transitioned to comfort care/DNAR. Treated with DuoNeb, remdesivir, cefepime, and decatron. Patient last received Tocilizumab for RA 4mg/kg on 1/28/22. Patient expired 02/13/22.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Asthenia, Azotaemia, COVID-19, Cystitis
Clinical narrative: Pfizer COVID Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 1/14/2021, 1/31/2021 and 12/27/2021. Presented to ED 2/4/2022 c/o generalized weakness, fatigue, and high output from his ostomy. Admitted for septic shock, acute cycstitis, Covid19 requiring O2. Course c/b AKI w/azotemia, hperkalemia, metabolic acidosis and acute metabolic encephalopathy delirium. Tx'd w/decadron and Tylenol. Transitioned to comfort care instituted and expired 2/17/22.