chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Blood creatinine normal, Blood glucose increased, Blood potassium normal, Blood sodium normal, Blood urea normal
Clinical narrative: HOSPITALIST HISTORY AND PHYSICAL  DATE OF ADMISSION: 3/15/2021   DATE OF H&P:  3/16/2021   PATIENT DEMOGRAPHIC: 71 year-old female  MODE OF ARRIVAL: EMS. _____________________________________________________________  CHIEF COMPLAINT: Dyspnea and mild cough.  HISTORY OF PRESENT ILLNESS: 71 year-old T2 diabetic female who presented to the ED late yesterday for evaluation of increasing shortness of breath. Also, reports she's had a nonproductive cough for several days. Yesterday, her breathing just sufficiently severe that she could not walk through the house without stopping to catch her breath. No chest pain. She ultimately decided to summon EMS. They reported that her initial SaO2 values to be in the low to mid 80% range. She was placed on 2 L/min of supplemental oxygen and given a SABA updraft in route.  When she arrived at the ED, her SaO2 registered 92%. She denies any prior history of asthma or COPD.  No ischemic or valvular heart disease. No history of CHF. No orthopnea. No pedal edema. No high fever. Of note, she completed her second COVID19 vaccination approximately 10 days prior to onset of her chief symptoms as described. In the ED, her chest x-ray was felt to show no evidence of acute cardiopulmonary disease. Her d-dimer was normal. However, a CTA of the chest revealed extensive centrilobular ground-glass nodularity throughout the lungs. No pulmonary embolus or signs of right heart strain. Patient admitted with atypical pneumonia/pneumonitis and associated dyspnea, cough and hypoxemia.  ASSESSMENT: 71-year-old T2 diabetic with hypertension presents with increasing shortness of breath and nonproductive cough, onset approximately 10 days post second COVID-19 vaccination. CTA of chest reveals an atypical pattern of extensive centrilobular ground glass nodularity. Clinically she has associated mild bronchospasm and hypoxemia.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide normal, Bronchospasm, Carbon dioxide normal, Chest X-ray, Computerised tomogram thorax
Clinical narrative: HOSPITALIST HISTORY AND PHYSICAL  DATE OF ADMISSION: 3/15/2021   DATE OF H&P:  3/16/2021   PATIENT DEMOGRAPHIC: 71 year-old female  MODE OF ARRIVAL: EMS. _____________________________________________________________  CHIEF COMPLAINT: Dyspnea and mild cough.  HISTORY OF PRESENT ILLNESS: 71 year-old T2 diabetic female who presented to the ED late yesterday for evaluation of increasing shortness of breath. Also, reports she's had a nonproductive cough for several days. Yesterday, her breathing just sufficiently severe that she could not walk through the house without stopping to catch her breath. No chest pain. She ultimately decided to summon EMS. They reported that her initial SaO2 values to be in the low to mid 80% range. She was placed on 2 L/min of supplemental oxygen and given a SABA updraft in route.  When she arrived at the ED, her SaO2 registered 92%. She denies any prior history of asthma or COPD.  No ischemic or valvular heart disease. No history of CHF. No orthopnea. No pedal edema. No high fever. Of note, she completed her second COVID19 vaccination approximately 10 days prior to onset of her chief symptoms as described. In the ED, her chest x-ray was felt to show no evidence of acute cardiopulmonary disease. Her d-dimer was normal. However, a CTA of the chest revealed extensive centrilobular ground-glass nodularity throughout the lungs. No pulmonary embolus or signs of right heart strain. Patient admitted with atypical pneumonia/pneumonitis and associated dyspnea, cough and hypoxemia.  ASSESSMENT: 71-year-old T2 diabetic with hypertension presents with increasing shortness of breath and nonproductive cough, onset approximately 10 days post second COVID-19 vaccination. CTA of chest reveals an atypical pattern of extensive centrilobular ground glass nodularity. Clinically she has associated mild bronchospasm and hypoxemia.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dyspnoea, Fibrin D dimer normal, Globulin, Haematocrit normal
Clinical narrative: HOSPITALIST HISTORY AND PHYSICAL  DATE OF ADMISSION: 3/15/2021   DATE OF H&P:  3/16/2021   PATIENT DEMOGRAPHIC: 71 year-old female  MODE OF ARRIVAL: EMS. _____________________________________________________________  CHIEF COMPLAINT: Dyspnea and mild cough.  HISTORY OF PRESENT ILLNESS: 71 year-old T2 diabetic female who presented to the ED late yesterday for evaluation of increasing shortness of breath. Also, reports she's had a nonproductive cough for several days. Yesterday, her breathing just sufficiently severe that she could not walk through the house without stopping to catch her breath. No chest pain. She ultimately decided to summon EMS. They reported that her initial SaO2 values to be in the low to mid 80% range. She was placed on 2 L/min of supplemental oxygen and given a SABA updraft in route.  When she arrived at the ED, her SaO2 registered 92%. She denies any prior history of asthma or COPD.  No ischemic or valvular heart disease. No history of CHF. No orthopnea. No pedal edema. No high fever. Of note, she completed her second COVID19 vaccination approximately 10 days prior to onset of her chief symptoms as described. In the ED, her chest x-ray was felt to show no evidence of acute cardiopulmonary disease. Her d-dimer was normal. However, a CTA of the chest revealed extensive centrilobular ground-glass nodularity throughout the lungs. No pulmonary embolus or signs of right heart strain. Patient admitted with atypical pneumonia/pneumonitis and associated dyspnea, cough and hypoxemia.  ASSESSMENT: 71-year-old T2 diabetic with hypertension presents with increasing shortness of breath and nonproductive cough, onset approximately 10 days post second COVID-19 vaccination. CTA of chest reveals an atypical pattern of extensive centrilobular ground glass nodularity. Clinically she has associated mild bronchospasm and hypoxemia.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoglobin normal, Hypoxia, Lung opacity, Oxygen saturation decreased, Platelet count normal
Clinical narrative: HOSPITALIST HISTORY AND PHYSICAL  DATE OF ADMISSION: 3/15/2021   DATE OF H&P:  3/16/2021   PATIENT DEMOGRAPHIC: 71 year-old female  MODE OF ARRIVAL: EMS. _____________________________________________________________  CHIEF COMPLAINT: Dyspnea and mild cough.  HISTORY OF PRESENT ILLNESS: 71 year-old T2 diabetic female who presented to the ED late yesterday for evaluation of increasing shortness of breath. Also, reports she's had a nonproductive cough for several days. Yesterday, her breathing just sufficiently severe that she could not walk through the house without stopping to catch her breath. No chest pain. She ultimately decided to summon EMS. They reported that her initial SaO2 values to be in the low to mid 80% range. She was placed on 2 L/min of supplemental oxygen and given a SABA updraft in route.  When she arrived at the ED, her SaO2 registered 92%. She denies any prior history of asthma or COPD.  No ischemic or valvular heart disease. No history of CHF. No orthopnea. No pedal edema. No high fever. Of note, she completed her second COVID19 vaccination approximately 10 days prior to onset of her chief symptoms as described. In the ED, her chest x-ray was felt to show no evidence of acute cardiopulmonary disease. Her d-dimer was normal. However, a CTA of the chest revealed extensive centrilobular ground-glass nodularity throughout the lungs. No pulmonary embolus or signs of right heart strain. Patient admitted with atypical pneumonia/pneumonitis and associated dyspnea, cough and hypoxemia.  ASSESSMENT: 71-year-old T2 diabetic with hypertension presents with increasing shortness of breath and nonproductive cough, onset approximately 10 days post second COVID-19 vaccination. CTA of chest reveals an atypical pattern of extensive centrilobular ground glass nodularity. Clinically she has associated mild bronchospasm and hypoxemia.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonitis, Protein total normal, SARS-CoV-2 test negative, Troponin I normal, White blood cell count increased
Clinical narrative: HOSPITALIST HISTORY AND PHYSICAL  DATE OF ADMISSION: 3/15/2021   DATE OF H&P:  3/16/2021   PATIENT DEMOGRAPHIC: 71 year-old female  MODE OF ARRIVAL: EMS. _____________________________________________________________  CHIEF COMPLAINT: Dyspnea and mild cough.  HISTORY OF PRESENT ILLNESS: 71 year-old T2 diabetic female who presented to the ED late yesterday for evaluation of increasing shortness of breath. Also, reports she's had a nonproductive cough for several days. Yesterday, her breathing just sufficiently severe that she could not walk through the house without stopping to catch her breath. No chest pain. She ultimately decided to summon EMS. They reported that her initial SaO2 values to be in the low to mid 80% range. She was placed on 2 L/min of supplemental oxygen and given a SABA updraft in route.  When she arrived at the ED, her SaO2 registered 92%. She denies any prior history of asthma or COPD.  No ischemic or valvular heart disease. No history of CHF. No orthopnea. No pedal edema. No high fever. Of note, she completed her second COVID19 vaccination approximately 10 days prior to onset of her chief symptoms as described. In the ED, her chest x-ray was felt to show no evidence of acute cardiopulmonary disease. Her d-dimer was normal. However, a CTA of the chest revealed extensive centrilobular ground-glass nodularity throughout the lungs. No pulmonary embolus or signs of right heart strain. Patient admitted with atypical pneumonia/pneumonitis and associated dyspnea, cough and hypoxemia.  ASSESSMENT: 71-year-old T2 diabetic with hypertension presents with increasing shortness of breath and nonproductive cough, onset approximately 10 days post second COVID-19 vaccination. CTA of chest reveals an atypical pattern of extensive centrilobular ground glass nodularity. Clinically she has associated mild bronchospasm and hypoxemia.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
Clinical narrative: Swollen injection site, bright red and warm
Age: 26.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal discomfort, Chills, Fatigue, Myalgia
Clinical narrative: Chills, upset stomach, muscle ache, fatigue upon waking up on 3/16/21. Lasted through the day, remained bedridden for the most part. Symptoms became slightly alleviated at approximately 7:00 PM, did not take pain relievers.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Fatigue
Clinical narrative: 6 or 7 hours after receiving the vaccine I began to feel chills.  About 10 hours later (12:30 am) I had a temperature of 101.  I took some ibuprofen.  The next day I was chilled for most of the day, finally feeling somewhat better around 6pm.  I was tired during the day as well.
Age: 54.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Injection site pruritus, Injection site rash
Clinical narrative: covid arm, red rash on right arm on March 15, 2021 AM, 6 days after 2nd dose of Moderna Covid-19 vaccine. both shots were administer to right arm. Red rash around the shot spot 3.5 x 2.5 inches.  Itching. Took 2 benadrills at night on March 15, 2021.  no visible change AM or PM March 16, 2021.   visit internal medicine Dr. on March 16, 2021, Informed that I have "Covid-19 Arm". keep an eye on it
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Dyspnoea, Lethargy
Clinical narrative: The patient developed acute shortness of breath, lethargy, and confusion the morning after the vaccination. EMS was called and she was brought to the emergency department. After evaluation and treatment, she was hospitalized. Hospitalization lasted two days. No other source of the acute symptoms were found besides the recent vaccination.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Pain, Renal pain
Clinical narrative: Chills, body aches, headache, bilateral kidney pain
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Dysgeusia, Flushing, Rash, Tryptase
Clinical narrative: flushing, rash to chest, metallic taste
Sex: F
Vaccine: COVID19
Symptoms: Abdominal distension, Fatigue, Injection site pain, Injection site swelling, Mobility decreased
Clinical narrative: The vaccine was given fairly high up on my right deltoid on Thurs pm 3/11/21. The next day the shoulder itself (not just the injection site) was very swollen and  painful  and I had very little range of motion (on a scale of 1-10 it was worse than having a dislocated shoulder, which I have experienced) . The swelling abated in my shoulder by Friday pm but then moved up (??) my neck to the triangular place between the neck, collar bone, and trapezeid muscle and was large enough to cup my palm over. It is now 3/16/21 pm and the majority of the swelling is gone, no more pain, some residual stiffness in my neck and shoulder. I had the "normal" COVID response to the vaccine of a fever and fatigue.
Sex: F
Vaccine: COVID19
Symptoms: Musculoskeletal stiffness, Pyrexia, Swelling
Clinical narrative: The vaccine was given fairly high up on my right deltoid on Thurs pm 3/11/21. The next day the shoulder itself (not just the injection site) was very swollen and  painful  and I had very little range of motion (on a scale of 1-10 it was worse than having a dislocated shoulder, which I have experienced) . The swelling abated in my shoulder by Friday pm but then moved up (??) my neck to the triangular place between the neck, collar bone, and trapezeid muscle and was large enough to cup my palm over. It is now 3/16/21 pm and the majority of the swelling is gone, no more pain, some residual stiffness in my neck and shoulder. I had the "normal" COVID response to the vaccine of a fever and fatigue.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Anosmia, COVID-19, SARS-CoV-2 test positive
Clinical narrative: Lost sense of smell on 3/12/21
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Blood pressure measurement, Dizziness, Hypotension, Thirst
Clinical narrative: PT BECAME HYPOTENSIVE, DIZZY. BP: 90/62, HR WEAK 58-60. HYDRATED WITH WATER 16 OZ, LYING SUPINE. AFTER 10 MINUES, BP 110/60. COLOR RETURNED. DIZZINESS GONE. SENT HOME
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Feeling cold, Nausea, Pyrexia
Clinical narrative: Took 1 hour to drive to pharmacy. Noticeable effects started on way home. Started to feel nauseous, and from my neck to entire head, I felt swollen. Got home, collapsed in chair, had a faint sign of difficulty breathing, but not bad. Still felt swollen. Disappeared about 2 hours at home. Nausea getting worse. Feeling chilled, feverish, and dizzy.  Unable to sleep that night, so nauseated I couldn?t even swallow water without wanting to puke. Shot on Tuesday, didn?t feel much better till Friday. Ok now.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Sleep disorder, Swelling
Clinical narrative: Took 1 hour to drive to pharmacy. Noticeable effects started on way home. Started to feel nauseous, and from my neck to entire head, I felt swollen. Got home, collapsed in chair, had a faint sign of difficulty breathing, but not bad. Still felt swollen. Disappeared about 2 hours at home. Nausea getting worse. Feeling chilled, feverish, and dizzy.  Unable to sleep that night, so nauseated I couldn?t even swallow water without wanting to puke. Shot on Tuesday, didn?t feel much better till Friday. Ok now.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Joint range of motion decreased, Pain in extremity
Clinical narrative: Sharp pain in upper arm that feels like I am being stabbed. It radiates from my shoulder to my elbow.  I do not have a complete range of motion moving my arm at the shoulder and cannot reach my arm behind my back. Ice has been applied 3x per day since the injection and ibuprofen does not help.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pruritus, Injection site swelling, Injection site warmth, Tenderness
Clinical narrative: Today is the 8th day after 1st vaccination and I have swelling about the size of a quarter, heat and itching at the vaccine site on my left arm.  I also noticed earlier this morning around 6:45am that I had tenderness in the underneath [armpit] area of that same arm.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia
Clinical narrative: PT c/o numbness to bilateral arms and face
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Cough, Diarrhoea, Dyspnoea, Headache
Clinical narrative: sore throat, body aches, shortness of breath, headache, shoulder ache, diarrhea, coughing
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Oropharyngeal pain, Pain
Clinical narrative: sore throat, body aches, shortness of breath, headache, shoulder ache, diarrhea, coughing
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Herpes zoster, Vaccination site reaction
Clinical narrative: shingles outbreak on same area of vaccine given
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Her daughter  informed pharmacy staff that pt passed away on sunday 3/14/21
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Neck pain, Pain, Pain in extremity
Clinical narrative: The injection was given to me as if I was a dartboard . The pain I had when I got home was so bad, and ran across back of my neck to other shoulder. I feel she injected to high up and close to shoulder ...and pain went down my left arm to hand ...also pain was radiating up back of neck... this was very concerning to me... 2-3 days with this symptom
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: nausea, improved after eating and drinking
Age: 33.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Muscle twitching, Mydriasis, Seizure, Unresponsive to stimuli
Clinical narrative: After pt received Janssen J&J vaccine, pt was closing his eyes and leaning back. Per LPN, pt had seizure ~15-20sec, foot twitching, PHNs and FNP were called to scene. Pt A&O x4, but then had 2nd seizure <5min later, lasting 15-20sec, not responding to prompts. EMT called 911. Pt then A&O again x4. FNP measured pt pupils: L pupil initially 4mm, then escalated "blown", R pupil 1-2mm. HR 35, pulse ox 99%. Pt Hx of type 1 diabetes, BG 186 per paramedic. Paramedics took pt to ER.
Age: 33.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood pressure decreased, Electrocardiogram abnormal, Heart rate decreased, Laboratory test normal, Loss of consciousness
Clinical narrative: After pt received Janssen J&J vaccine, pt was closing his eyes and leaning back. Per LPN, pt had seizure ~15-20sec, foot twitching, PHNs and FNP were called to scene. Pt A&O x4, but then had 2nd seizure <5min later, lasting 15-20sec, not responding to prompts. EMT called 911. Pt then A&O again x4. FNP measured pt pupils: L pupil initially 4mm, then escalated "blown", R pupil 1-2mm. HR 35, pulse ox 99%. Pt Hx of type 1 diabetes, BG 186 per paramedic. Paramedics took pt to ER.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site hypoaesthesia, Injection site paraesthesia, Somnolence
Clinical narrative: Left arm (side of vaccination) is numb with slight tingling sensation. Mind a bit groggy.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Acidosis, Blood glucose increased, Blood magnesium normal, Blood pH increased, Chest X-ray normal
Clinical narrative: Symptoms:  Patient states that he has HX of COPD and has noted an increase in SOB on Sunday. He states he is taking his ProAIr inhaler every hour and it helps for the hour, but after that his breathing gets worse. Patient states he gets SOB with lying down and walking. Patient was speaking in full sentences and states it was because he just took his inhaler medication. Patient states he is positive for chills onset Sunday. Patient did have his first dose of COVID vaccine on Thursday. Denies difficulty breathing on Thursday, and per patient could have started Saturday night. DIAGNOSIS at time of disposition:   1. Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Patient is a 64-year-old gentleman with history of chronic obstructive pulmonary disease, on p.r.n. albuterol at home as well as nightly Spiriva, coming to the emergency department for evaluation of worsening shortness of breath over the last 3 days with associated tightness with his breathing.  On arrival to the emergency department, patient is sitting forward, tachypneic, prolonged expiratory phase with diffuse expiratory wheezing.  He is saturating low 90s on room air.  He is placed on 2 L nasal cannula for comfort.  He received 2 DuoNeb treatments with EMS as well as Solu-Medrol.  I am going to treated with a continuous nebulizer treatment and obtained laboratory workup as well as chest x-ray.  Vital sign show tachycardia which is likely from his albuterol treatment, he is mildly tachypneic, otherwise stable.   Patient's laboratory workup is reassuring, troponin is negative.  Chest x-ray does not show any consolidation.  Patient does have some improvement in his symptoms after his continuous nebulizer treatment.  His VBG is repeated after treatment and shows that his pCO2 is going down however he is still slightly acidotic with the pH of 7.28.  Patient reports that he still tight in his chest, improved however uncomfortable going home.  He is still significantly wheezing on my exam, given this I did discuss this case with emergency department observation who agreed to accept for admission.  COVID testing is negative.  Patient is admitted in stable condition. Pulmonary:     Comments: Patient is sitting forward in the stretcher, he is tachypneic, prolonged expiratory phase with expiratory wheezing in all lung fields.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Chills, Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea
Clinical narrative: Symptoms:  Patient states that he has HX of COPD and has noted an increase in SOB on Sunday. He states he is taking his ProAIr inhaler every hour and it helps for the hour, but after that his breathing gets worse. Patient states he gets SOB with lying down and walking. Patient was speaking in full sentences and states it was because he just took his inhaler medication. Patient states he is positive for chills onset Sunday. Patient did have his first dose of COVID vaccine on Thursday. Denies difficulty breathing on Thursday, and per patient could have started Saturday night. DIAGNOSIS at time of disposition:   1. Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Patient is a 64-year-old gentleman with history of chronic obstructive pulmonary disease, on p.r.n. albuterol at home as well as nightly Spiriva, coming to the emergency department for evaluation of worsening shortness of breath over the last 3 days with associated tightness with his breathing.  On arrival to the emergency department, patient is sitting forward, tachypneic, prolonged expiratory phase with diffuse expiratory wheezing.  He is saturating low 90s on room air.  He is placed on 2 L nasal cannula for comfort.  He received 2 DuoNeb treatments with EMS as well as Solu-Medrol.  I am going to treated with a continuous nebulizer treatment and obtained laboratory workup as well as chest x-ray.  Vital sign show tachycardia which is likely from his albuterol treatment, he is mildly tachypneic, otherwise stable.   Patient's laboratory workup is reassuring, troponin is negative.  Chest x-ray does not show any consolidation.  Patient does have some improvement in his symptoms after his continuous nebulizer treatment.  His VBG is repeated after treatment and shows that his pCO2 is going down however he is still slightly acidotic with the pH of 7.28.  Patient reports that he still tight in his chest, improved however uncomfortable going home.  He is still significantly wheezing on my exam, given this I did discuss this case with emergency department observation who agreed to accept for admission.  COVID testing is negative.  Patient is admitted in stable condition. Pulmonary:     Comments: Patient is sitting forward in the stretcher, he is tachypneic, prolonged expiratory phase with expiratory wheezing in all lung fields.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Eosinophil count normal, Eosinophil percentage increased, Influenza A virus test negative, Influenza B virus test
Clinical narrative: Symptoms:  Patient states that he has HX of COPD and has noted an increase in SOB on Sunday. He states he is taking his ProAIr inhaler every hour and it helps for the hour, but after that his breathing gets worse. Patient states he gets SOB with lying down and walking. Patient was speaking in full sentences and states it was because he just took his inhaler medication. Patient states he is positive for chills onset Sunday. Patient did have his first dose of COVID vaccine on Thursday. Denies difficulty breathing on Thursday, and per patient could have started Saturday night. DIAGNOSIS at time of disposition:   1. Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Patient is a 64-year-old gentleman with history of chronic obstructive pulmonary disease, on p.r.n. albuterol at home as well as nightly Spiriva, coming to the emergency department for evaluation of worsening shortness of breath over the last 3 days with associated tightness with his breathing.  On arrival to the emergency department, patient is sitting forward, tachypneic, prolonged expiratory phase with diffuse expiratory wheezing.  He is saturating low 90s on room air.  He is placed on 2 L nasal cannula for comfort.  He received 2 DuoNeb treatments with EMS as well as Solu-Medrol.  I am going to treated with a continuous nebulizer treatment and obtained laboratory workup as well as chest x-ray.  Vital sign show tachycardia which is likely from his albuterol treatment, he is mildly tachypneic, otherwise stable.   Patient's laboratory workup is reassuring, troponin is negative.  Chest x-ray does not show any consolidation.  Patient does have some improvement in his symptoms after his continuous nebulizer treatment.  His VBG is repeated after treatment and shows that his pCO2 is going down however he is still slightly acidotic with the pH of 7.28.  Patient reports that he still tight in his chest, improved however uncomfortable going home.  He is still significantly wheezing on my exam, given this I did discuss this case with emergency department observation who agreed to accept for admission.  COVID testing is negative.  Patient is admitted in stable condition. Pulmonary:     Comments: Patient is sitting forward in the stretcher, he is tachypneic, prolonged expiratory phase with expiratory wheezing in all lung fields.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphocyte count decreased, Monocyte count decreased, Oxygen saturation decreased, PCO2 increased, Polymerase chain reaction
Clinical narrative: Symptoms:  Patient states that he has HX of COPD and has noted an increase in SOB on Sunday. He states he is taking his ProAIr inhaler every hour and it helps for the hour, but after that his breathing gets worse. Patient states he gets SOB with lying down and walking. Patient was speaking in full sentences and states it was because he just took his inhaler medication. Patient states he is positive for chills onset Sunday. Patient did have his first dose of COVID vaccine on Thursday. Denies difficulty breathing on Thursday, and per patient could have started Saturday night. DIAGNOSIS at time of disposition:   1. Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Patient is a 64-year-old gentleman with history of chronic obstructive pulmonary disease, on p.r.n. albuterol at home as well as nightly Spiriva, coming to the emergency department for evaluation of worsening shortness of breath over the last 3 days with associated tightness with his breathing.  On arrival to the emergency department, patient is sitting forward, tachypneic, prolonged expiratory phase with diffuse expiratory wheezing.  He is saturating low 90s on room air.  He is placed on 2 L nasal cannula for comfort.  He received 2 DuoNeb treatments with EMS as well as Solu-Medrol.  I am going to treated with a continuous nebulizer treatment and obtained laboratory workup as well as chest x-ray.  Vital sign show tachycardia which is likely from his albuterol treatment, he is mildly tachypneic, otherwise stable.   Patient's laboratory workup is reassuring, troponin is negative.  Chest x-ray does not show any consolidation.  Patient does have some improvement in his symptoms after his continuous nebulizer treatment.  His VBG is repeated after treatment and shows that his pCO2 is going down however he is still slightly acidotic with the pH of 7.28.  Patient reports that he still tight in his chest, improved however uncomfortable going home.  He is still significantly wheezing on my exam, given this I did discuss this case with emergency department observation who agreed to accept for admission.  COVID testing is negative.  Patient is admitted in stable condition. Pulmonary:     Comments: Patient is sitting forward in the stretcher, he is tachypneic, prolonged expiratory phase with expiratory wheezing in all lung fields.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Sinus tachycardia, Tachycardia, Tachypnoea
Clinical narrative: Symptoms:  Patient states that he has HX of COPD and has noted an increase in SOB on Sunday. He states he is taking his ProAIr inhaler every hour and it helps for the hour, but after that his breathing gets worse. Patient states he gets SOB with lying down and walking. Patient was speaking in full sentences and states it was because he just took his inhaler medication. Patient states he is positive for chills onset Sunday. Patient did have his first dose of COVID vaccine on Thursday. Denies difficulty breathing on Thursday, and per patient could have started Saturday night. DIAGNOSIS at time of disposition:   1. Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Patient is a 64-year-old gentleman with history of chronic obstructive pulmonary disease, on p.r.n. albuterol at home as well as nightly Spiriva, coming to the emergency department for evaluation of worsening shortness of breath over the last 3 days with associated tightness with his breathing.  On arrival to the emergency department, patient is sitting forward, tachypneic, prolonged expiratory phase with diffuse expiratory wheezing.  He is saturating low 90s on room air.  He is placed on 2 L nasal cannula for comfort.  He received 2 DuoNeb treatments with EMS as well as Solu-Medrol.  I am going to treated with a continuous nebulizer treatment and obtained laboratory workup as well as chest x-ray.  Vital sign show tachycardia which is likely from his albuterol treatment, he is mildly tachypneic, otherwise stable.   Patient's laboratory workup is reassuring, troponin is negative.  Chest x-ray does not show any consolidation.  Patient does have some improvement in his symptoms after his continuous nebulizer treatment.  His VBG is repeated after treatment and shows that his pCO2 is going down however he is still slightly acidotic with the pH of 7.28.  Patient reports that he still tight in his chest, improved however uncomfortable going home.  He is still significantly wheezing on my exam, given this I did discuss this case with emergency department observation who agreed to accept for admission.  COVID testing is negative.  Patient is admitted in stable condition. Pulmonary:     Comments: Patient is sitting forward in the stretcher, he is tachypneic, prolonged expiratory phase with expiratory wheezing in all lung fields.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin T, Troponin normal, Wheezing
Clinical narrative: Symptoms:  Patient states that he has HX of COPD and has noted an increase in SOB on Sunday. He states he is taking his ProAIr inhaler every hour and it helps for the hour, but after that his breathing gets worse. Patient states he gets SOB with lying down and walking. Patient was speaking in full sentences and states it was because he just took his inhaler medication. Patient states he is positive for chills onset Sunday. Patient did have his first dose of COVID vaccine on Thursday. Denies difficulty breathing on Thursday, and per patient could have started Saturday night. DIAGNOSIS at time of disposition:   1. Chronic obstructive pulmonary disease with (acute) exacerbation (HCC)  Patient is a 64-year-old gentleman with history of chronic obstructive pulmonary disease, on p.r.n. albuterol at home as well as nightly Spiriva, coming to the emergency department for evaluation of worsening shortness of breath over the last 3 days with associated tightness with his breathing.  On arrival to the emergency department, patient is sitting forward, tachypneic, prolonged expiratory phase with diffuse expiratory wheezing.  He is saturating low 90s on room air.  He is placed on 2 L nasal cannula for comfort.  He received 2 DuoNeb treatments with EMS as well as Solu-Medrol.  I am going to treated with a continuous nebulizer treatment and obtained laboratory workup as well as chest x-ray.  Vital sign show tachycardia which is likely from his albuterol treatment, he is mildly tachypneic, otherwise stable.   Patient's laboratory workup is reassuring, troponin is negative.  Chest x-ray does not show any consolidation.  Patient does have some improvement in his symptoms after his continuous nebulizer treatment.  His VBG is repeated after treatment and shows that his pCO2 is going down however he is still slightly acidotic with the pH of 7.28.  Patient reports that he still tight in his chest, improved however uncomfortable going home.  He is still significantly wheezing on my exam, given this I did discuss this case with emergency department observation who agreed to accept for admission.  COVID testing is negative.  Patient is admitted in stable condition. Pulmonary:     Comments: Patient is sitting forward in the stretcher, he is tachypneic, prolonged expiratory phase with expiratory wheezing in all lung fields.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Myalgia, Pyrexia
Clinical narrative: Fever; muscle aches; headaches
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Feeling hot, Pruritus, Swelling
Clinical narrative: Large, warm oval lump and redness a little  larger than the bump.  The redness continued to grow a little larger for 2 days and the lump began to itch.   It has been 4 days and the lump and itching are still there.  The redness seems to have retuned to the size of the lump currently about 2 inches by 1 inch.  It is still warm to the touch.  There is a little tenderness.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Urticaria
Clinical narrative: PATIENT STATED AFTER 20 MINUTES OF RECEIVING THE SHOT HER FEET HAD HIVES ALL OVER THEM.  SHE TOOK SOME BENADRYL THAT NIGHT AND IT GOT BETTER AND USING HYDROCORTISONE CREAM TODAY. SAYS IT IS GETTING MUCH BETTER.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness
Clinical narrative: DIZZY-NESS
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Nausea, Pain, Pyrexia
Clinical narrative: Fever 101.6, chills, nausea, body aches
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site reaction, Swelling
Clinical narrative: Left are started to swell a week after administration. There was also a red spot at the site of administration.  The swelling started to go down the next morning and continued to decrease through the day
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Appendicectomy, Appendicitis, Blood test abnormal, Computerised tomogram abnormal
Clinical narrative: 19 hours after 2nd Moderna vaccine started severe abdominal pain and nausea with vomiting.  Diagnosed with acute appendicitis. Had appendectomy on 3/7/21.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Vomiting
Clinical narrative: 19 hours after 2nd Moderna vaccine started severe abdominal pain and nausea with vomiting.  Diagnosed with acute appendicitis. Had appendectomy on 3/7/21.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Chills, Diarrhoea, Fatigue, Headache
Clinical narrative: Immediately following vaccine:  itching and headache, then extreme fatigue and stabbing abdominal pain, followed by diarrhea.   The next morning, I felt fine and went to work,  but by 2pm, I felt like I had been hit by a truck - headache, aches, chills, felt feverish (but no fever), diarrhea.  On 3/13, felt a bit better, but still fatigued and had diarrhea.  Had chills off and on throughout the day.  3/14 felt a bit better, but had fatigue and body aches plus diarrhea.  3/15, severe body aches, chills, headache, diarrhea.  3/16 severe body aches and pains, chills, severe headache, feel feverish (but no fever).
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pruritus, Pyrexia
Clinical narrative: Immediately following vaccine:  itching and headache, then extreme fatigue and stabbing abdominal pain, followed by diarrhea.   The next morning, I felt fine and went to work,  but by 2pm, I felt like I had been hit by a truck - headache, aches, chills, felt feverish (but no fever), diarrhea.  On 3/13, felt a bit better, but still fatigued and had diarrhea.  Had chills off and on throughout the day.  3/14 felt a bit better, but had fatigue and body aches plus diarrhea.  3/15, severe body aches, chills, headache, diarrhea.  3/16 severe body aches and pains, chills, severe headache, feel feverish (but no fever).
Age: 94.0
Sex: F
Vaccine: COVID19
Symptoms: Failure to thrive, Hypokalaemia
Clinical narrative: First dose of Moderna COVID-19 vaccine given 1/7/21. Second dose of Moderna COVID-19 vaccine given 3/8/21. No adverse effects noted after vaccination. Resident was on hospice care since 2/27/2021 with poor food and fluid intake prior. Admitted to hospice with hypokalemia, failure to thrive.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test normal, Chest X-ray normal, Chills, Electrocardiogram normal, Laboratory test normal
Clinical narrative: Chills and fever lasted for 7 hours, rapid racing heart for 5 hours. Started 12 hours after the vaccine was administered. Took tylenol for fever. Went to er for rapid heart rate after I could t lower it for 2 hours.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Palpitations, Pyrexia
Clinical narrative: Chills and fever lasted for 7 hours, rapid racing heart for 5 hours. Started 12 hours after the vaccine was administered. Took tylenol for fever. Went to er for rapid heart rate after I could t lower it for 2 hours.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Acoustic stimulation tests normal, Hypoacusis, Tinnitus
Clinical narrative: Experienced ringing in my right ear which turned into ?pulsating? noise in sync with heart beat. My PCP recommended taking an allergy pill 1x/day and OTC allergy nasal spray 2x/day for one week. Symptoms persisted and I was referred to see an ENT. Completed a hearing test which showed diminished sense of hearing in my right ear but within normal limits. ENT recommended to monitor symptoms and to get an MRI if symptoms persist or worsen.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Injection site erythema, Injection site induration, Injection site pruritus
Clinical narrative: Fever 100.3. Chills exhaustion red circle at injection site itchy and hard
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Livedo reticularis, Pyrexia
Clinical narrative: Fever 100.3. Chills exhaustion red circle at injection site itchy and hard
Age: 82.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Death, Malaise
Clinical narrative: weakness/malaise per daughter, death on 3/14 (did have underlying medical conditions)
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Erythema, Pain in extremity, Rash erythematous, Swelling
Clinical narrative: I had my shot at 10 AM and at approximately 4 PM I felt a gush in my are in the area of the shot.  I arm began to hurt and was very sore for about 3 hrs.  The the pain started to go away and I was fine.  On Sunday 3/14; the area around the shot started to itch constantly and continued along with a red rash type area a little bigger than a tennis ball.  The area of the shot and red rash type area became swollen.  Today, 3/16; the itching has almost completely stopped but the area is still swollen and red.  I did read the side effectives and they normally develop within 1 - 3 days.  My side effects didn't really start until 10 days after the shot.  I also experienced a few chills.  I did not ready about the side effects of the shot until after I experienced them.  I'm scheduled to have my second shot on 4/2 and I'm concerned about the side effect I'm having now and if I should have the 2nd shot and/or what to expect for side effects.,
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: Nueve dias después de la aplicación, molestia y enrojecimiento en el area de inyección.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Fatigue, Headache, Injection site pain, Nausea
Clinical narrative: Moderate to severe pain sprea throughout upper left arm lasting 2 days. Chills the evening of vaccination. Severe headache upon waking up the morning after vaccination. Nausea upon waking up the morning after vaccination lasting until past mid day. Fatigue lasting 2 days.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: Moderate to severe pain sprea throughout upper left arm lasting 2 days. Chills the evening of vaccination. Severe headache upon waking up the morning after vaccination. Nausea upon waking up the morning after vaccination lasting until past mid day. Fatigue lasting 2 days.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling of eyelid, Swollen tongue, Throat irritation, Throat tightness
Clinical narrative: Pt. received first dose Pfizer COVID vaccine at 1415 and shortly developed throat itching, swollen tongue, and swollen left lower eyelid.  Baseline VS at 1418 was BP 126/82, RR 16, HR 122, O2sats 95% on RA.  States throat felt tighter and epipen was administered to left thigh at 1419.  She was examined   Lungs CTA, no stridor, CV RRR and did not appear to be in distress with breathing.  She was placed on oxygen at 2 liters.  Code blue called at 1427.  VS-BP 128/73, RR 18 HR 132 O2sats 99% on 2L post-epipen administration.  States she felt better after epipen was administered and 2 puffs albuterol.  Transported to local ER and discharged same evening.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Throat irritation, Throat tightness
Clinical narrative: throat itchiness and tightness, which improved after oral Benadryl
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Hives neck, face, upper left chest. Raised welts, urticaria. Good relief with Benadryl 25mg po prn. No relief with Hydrocortisone cream. No difficulty breathing or swallowing.  Reaction continues into day 3. Notified my internist who is sending a request to be seen by an allergist. Internist recommends I withhold second dose of Moderna scheduled for April 10th.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus
Clinical narrative: Large red itchy area around injection site
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site warmth, Skin reaction
Clinical narrative: Minor "covid arm" experienced several days after vaccination.  Redness blotching at site of vaccine shot, about 2 inches in diameter.  Area is warm to touch.  No itching. Slight soreness experienced with area is touched.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Headache, Tinnitus
Clinical narrative: Chills, joint soreness, ringing in the ears, headache
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Choking, Dysphagia, Headache, Hypersensitivity, Hypoaesthesia
Clinical narrative: Within 30 minutes of vaccine entire left side had numbness and tingling from left toes to left eye with radiating pain in head and swelling of neck and throat.  Numbness subsided within 24 hours followed by pain and sensitivities on entire left side for the next 24 hours. Swelling in throat continued for the next 24 hours following vaccine peaking the next day 36 hours after vaccine.  Significant trouble swallowing liquids including salvia.  Choking on solid foods the day following vaccine.  Lips tingling continued for 48 hours after vaccine and subsided at end second day 3/12.  Throat and esophagus swelling continues  to this day - 6 days after vaccine with only slight improvement in swelling.  Swallowing is still difficult as of 6 days following 1st vaccine. Spoke with EMT at vaccine site who recommended Benadryl.  Benadryl started within 1.5 hours of vaccine administration. Contacted allergist who recommended 2-3 x dose of antihistamines for swelling.   A dose of 3x was done for 4 days and decreased to  2x dose of antihistamines on Monday and continue at that level at time of report today.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Paraesthesia, Paraesthesia oral, Pharyngeal swelling, Swelling
Clinical narrative: Within 30 minutes of vaccine entire left side had numbness and tingling from left toes to left eye with radiating pain in head and swelling of neck and throat.  Numbness subsided within 24 hours followed by pain and sensitivities on entire left side for the next 24 hours. Swelling in throat continued for the next 24 hours following vaccine peaking the next day 36 hours after vaccine.  Significant trouble swallowing liquids including salvia.  Choking on solid foods the day following vaccine.  Lips tingling continued for 48 hours after vaccine and subsided at end second day 3/12.  Throat and esophagus swelling continues  to this day - 6 days after vaccine with only slight improvement in swelling.  Swallowing is still difficult as of 6 days following 1st vaccine. Spoke with EMT at vaccine site who recommended Benadryl.  Benadryl started within 1.5 hours of vaccine administration. Contacted allergist who recommended 2-3 x dose of antihistamines for swelling.   A dose of 3x was done for 4 days and decreased to  2x dose of antihistamines on Monday and continue at that level at time of report today.
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Headache, Oropharyngeal pain, Pain, Pyrexia
Clinical narrative: Light headedness, sore throat, headache, body aches, high fever 104.5
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Fatigue, Headache, Influenza virus test negative, Oropharyngeal pain
Clinical narrative: I started having Covid symptoms 2 days after my first vaccine.  Sore throat, fever, body aches, headache, extreme fatigue, etc. I tested positive 3 days later.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Streptococcus test negative
Clinical narrative: I started having Covid symptoms 2 days after my first vaccine.  Sore throat, fever, body aches, headache, extreme fatigue, etc. I tested positive 3 days later.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal discomfort, Abdominal pain upper, Diarrhoea, Nausea, Vomiting
Clinical narrative: Experienced nausea and upset stomach. Vomited approximately 2 hours after initial symptoms with stomach cramps and diarrhea following into the next day.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Bone pain, Chills, Mobility decreased, Nausea, Pain in extremity
Clinical narrative: Pain in arm started a couple of hours after the shot. Continued for 2 more days. Very painful, barely able to raise arm or rest on the right side of body. Achy bones, chills, and fever began several hours after the shot and continued for the next day. Fever of 100+ during the first night and partly through the next day. Intense nausea the first night and the day after the shot, including throwing up. Symptoms alleviated with tylenol.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Vomiting
Clinical narrative: Pain in arm started a couple of hours after the shot. Continued for 2 more days. Very painful, barely able to raise arm or rest on the right side of body. Achy bones, chills, and fever began several hours after the shot and continued for the next day. Fever of 100+ during the first night and partly through the next day. Intense nausea the first night and the day after the shot, including throwing up. Symptoms alleviated with tylenol.