chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Hyponatraemia, Hypophosphataemia, Hypoxia, Laser therapy, Nephrolithiasis
Clinical narrative: Patient is a 64 y.o. female patient of MD with history of left obstructive nephropathy s/p stent 12/02/2023 with Dr., nephrolithiasis, HTN, HLD, hypothyroidism, hepatic steatosis, prediabetes, OSA on cpap presented on 12/2/2023 with as transfer from facility for septic obstructing stone. Staff consulted by Hospitalists, Generic for continued medical management.    Assessment and plan   Acute post op hypoxic respiratory failure COVID 19 infection S/p intubation, extubated 12/03 now on RA Developed post op hypoxia CXR 12/02/2023 lungs clear  Blood cultures 12/04 pending Echocardiogram EF 75%. Received remdesivir, dexamethasone per ID   In hospital.   Urosepsis UTI  L sided obstructing stone resulting in L hydronephrosis Bacteremia. S/p cystoscopy with stent insertion with laser 12/2/23 On admission WBC 22.28  CT mild to moderate upstream hydroureteronephrosis, moderate L perinephric stranding  UA showed WBC- 103, large LE, many bacteria, 10 RBC  12/02 blood cultures: Pan susceptible Proteus  12/02 urine cultures ESBL E. Coli 12/02 urine cultures left kidney Pan susceptible Proteus. 12/04 repeat blood cultures NGTD. Urology Following, Foley discontinued. ID consulted-currently on ertapenem. Patient transition to oral ciprofloxacin 750 mg p.o. twice daily for 2 weeks per ID recommendations at discharge.   Atrial fibrillation with RVR. Patient went into atrial fibrillation with RVR last night. Reportedly had remote history of atrial fibrillation in 2015 which spontaneously converted. Evaluated by Dr. cardiology.  Recommend metoprolol for rate control and Eliquis for anticoagulation. Patient to undergo urologic procedure as outpatient.  Per cardiology patient can hold Eliquis 3 days prior to the planned procedure. Just prior to discharge patient converted to sinus rhythm. Had discussion at length with daughter on the phone.Discussed with the patient. Recommend to continue Eliquis. Metoprolol 25 mg p.o. twice daily.   Advised to watch blood pressure and heart rate at home. If heart rate<65, recommend to hold metoprolol.     AKI-resolved Creatinine 1.42 at peak on 12/02 Resolved.     Heart murmur Right second intercostal space Echo as above Mild hyponatremia Hypocalcemia Hypophosphatemia Corrected.   Acute blood loss anemia Has blood in foley collection container Baseline Hgb 12.3-13 Current hgb ~10. Monitor     HTN Home regimen amlodipine-benazepril 5 mg - 20 mg 2 capsule by mouth daily. Advised to stop benazepril. Prescription sent for amlodipine 5 mg daily in addition to metoprolol 25 mg p.o. twice daily. Discussed with daughter on the phone who is an RN to monitor blood pressures and heart rate at home. Discussed with patient and her husband. Hold metoprolol if heart rate<65.   Bradycardia Asymptomatic ?  From remdesivir. Resolved. Discussed with Dr. okay to continue remdesivir.       HLD  Can continue fenofibrate   Hypothyroidism TSH: Within normal limits Continue synthroid dose    GERD Continue protonix    OSA Continue CPAP
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Obstructive nephropathy, Postoperative respiratory failure, Proteus test positive, Red blood cells urine positive, Respiratory failure
Clinical narrative: Patient is a 64 y.o. female patient of MD with history of left obstructive nephropathy s/p stent 12/02/2023 with Dr., nephrolithiasis, HTN, HLD, hypothyroidism, hepatic steatosis, prediabetes, OSA on cpap presented on 12/2/2023 with as transfer from facility for septic obstructing stone. Staff consulted by Hospitalists, Generic for continued medical management.    Assessment and plan   Acute post op hypoxic respiratory failure COVID 19 infection S/p intubation, extubated 12/03 now on RA Developed post op hypoxia CXR 12/02/2023 lungs clear  Blood cultures 12/04 pending Echocardiogram EF 75%. Received remdesivir, dexamethasone per ID   In hospital.   Urosepsis UTI  L sided obstructing stone resulting in L hydronephrosis Bacteremia. S/p cystoscopy with stent insertion with laser 12/2/23 On admission WBC 22.28  CT mild to moderate upstream hydroureteronephrosis, moderate L perinephric stranding  UA showed WBC- 103, large LE, many bacteria, 10 RBC  12/02 blood cultures: Pan susceptible Proteus  12/02 urine cultures ESBL E. Coli 12/02 urine cultures left kidney Pan susceptible Proteus. 12/04 repeat blood cultures NGTD. Urology Following, Foley discontinued. ID consulted-currently on ertapenem. Patient transition to oral ciprofloxacin 750 mg p.o. twice daily for 2 weeks per ID recommendations at discharge.   Atrial fibrillation with RVR. Patient went into atrial fibrillation with RVR last night. Reportedly had remote history of atrial fibrillation in 2015 which spontaneously converted. Evaluated by Dr. cardiology.  Recommend metoprolol for rate control and Eliquis for anticoagulation. Patient to undergo urologic procedure as outpatient.  Per cardiology patient can hold Eliquis 3 days prior to the planned procedure. Just prior to discharge patient converted to sinus rhythm. Had discussion at length with daughter on the phone.Discussed with the patient. Recommend to continue Eliquis. Metoprolol 25 mg p.o. twice daily.   Advised to watch blood pressure and heart rate at home. If heart rate<65, recommend to hold metoprolol.     AKI-resolved Creatinine 1.42 at peak on 12/02 Resolved.     Heart murmur Right second intercostal space Echo as above Mild hyponatremia Hypocalcemia Hypophosphatemia Corrected.   Acute blood loss anemia Has blood in foley collection container Baseline Hgb 12.3-13 Current hgb ~10. Monitor     HTN Home regimen amlodipine-benazepril 5 mg - 20 mg 2 capsule by mouth daily. Advised to stop benazepril. Prescription sent for amlodipine 5 mg daily in addition to metoprolol 25 mg p.o. twice daily. Discussed with daughter on the phone who is an RN to monitor blood pressures and heart rate at home. Discussed with patient and her husband. Hold metoprolol if heart rate<65.   Bradycardia Asymptomatic ?  From remdesivir. Resolved. Discussed with Dr. okay to continue remdesivir.       HLD  Can continue fenofibrate   Hypothyroidism TSH: Within normal limits Continue synthroid dose    GERD Continue protonix    OSA Continue CPAP
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Sepsis, Sinus rhythm, Ureteral stent insertion, Urinary tract infection, Urosepsis
Clinical narrative: Patient is a 64 y.o. female patient of MD with history of left obstructive nephropathy s/p stent 12/02/2023 with Dr., nephrolithiasis, HTN, HLD, hypothyroidism, hepatic steatosis, prediabetes, OSA on cpap presented on 12/2/2023 with as transfer from facility for septic obstructing stone. Staff consulted by Hospitalists, Generic for continued medical management.    Assessment and plan   Acute post op hypoxic respiratory failure COVID 19 infection S/p intubation, extubated 12/03 now on RA Developed post op hypoxia CXR 12/02/2023 lungs clear  Blood cultures 12/04 pending Echocardiogram EF 75%. Received remdesivir, dexamethasone per ID   In hospital.   Urosepsis UTI  L sided obstructing stone resulting in L hydronephrosis Bacteremia. S/p cystoscopy with stent insertion with laser 12/2/23 On admission WBC 22.28  CT mild to moderate upstream hydroureteronephrosis, moderate L perinephric stranding  UA showed WBC- 103, large LE, many bacteria, 10 RBC  12/02 blood cultures: Pan susceptible Proteus  12/02 urine cultures ESBL E. Coli 12/02 urine cultures left kidney Pan susceptible Proteus. 12/04 repeat blood cultures NGTD. Urology Following, Foley discontinued. ID consulted-currently on ertapenem. Patient transition to oral ciprofloxacin 750 mg p.o. twice daily for 2 weeks per ID recommendations at discharge.   Atrial fibrillation with RVR. Patient went into atrial fibrillation with RVR last night. Reportedly had remote history of atrial fibrillation in 2015 which spontaneously converted. Evaluated by Dr. cardiology.  Recommend metoprolol for rate control and Eliquis for anticoagulation. Patient to undergo urologic procedure as outpatient.  Per cardiology patient can hold Eliquis 3 days prior to the planned procedure. Just prior to discharge patient converted to sinus rhythm. Had discussion at length with daughter on the phone.Discussed with the patient. Recommend to continue Eliquis. Metoprolol 25 mg p.o. twice daily.   Advised to watch blood pressure and heart rate at home. If heart rate<65, recommend to hold metoprolol.     AKI-resolved Creatinine 1.42 at peak on 12/02 Resolved.     Heart murmur Right second intercostal space Echo as above Mild hyponatremia Hypocalcemia Hypophosphatemia Corrected.   Acute blood loss anemia Has blood in foley collection container Baseline Hgb 12.3-13 Current hgb ~10. Monitor     HTN Home regimen amlodipine-benazepril 5 mg - 20 mg 2 capsule by mouth daily. Advised to stop benazepril. Prescription sent for amlodipine 5 mg daily in addition to metoprolol 25 mg p.o. twice daily. Discussed with daughter on the phone who is an RN to monitor blood pressures and heart rate at home. Discussed with patient and her husband. Hold metoprolol if heart rate<65.   Bradycardia Asymptomatic ?  From remdesivir. Resolved. Discussed with Dr. okay to continue remdesivir.       HLD  Can continue fenofibrate   Hypothyroidism TSH: Within normal limits Continue synthroid dose    GERD Continue protonix    OSA Continue CPAP
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: White blood cell count increased, White blood cells urine positive
Clinical narrative: Patient is a 64 y.o. female patient of MD with history of left obstructive nephropathy s/p stent 12/02/2023 with Dr., nephrolithiasis, HTN, HLD, hypothyroidism, hepatic steatosis, prediabetes, OSA on cpap presented on 12/2/2023 with as transfer from facility for septic obstructing stone. Staff consulted by Hospitalists, Generic for continued medical management.    Assessment and plan   Acute post op hypoxic respiratory failure COVID 19 infection S/p intubation, extubated 12/03 now on RA Developed post op hypoxia CXR 12/02/2023 lungs clear  Blood cultures 12/04 pending Echocardiogram EF 75%. Received remdesivir, dexamethasone per ID   In hospital.   Urosepsis UTI  L sided obstructing stone resulting in L hydronephrosis Bacteremia. S/p cystoscopy with stent insertion with laser 12/2/23 On admission WBC 22.28  CT mild to moderate upstream hydroureteronephrosis, moderate L perinephric stranding  UA showed WBC- 103, large LE, many bacteria, 10 RBC  12/02 blood cultures: Pan susceptible Proteus  12/02 urine cultures ESBL E. Coli 12/02 urine cultures left kidney Pan susceptible Proteus. 12/04 repeat blood cultures NGTD. Urology Following, Foley discontinued. ID consulted-currently on ertapenem. Patient transition to oral ciprofloxacin 750 mg p.o. twice daily for 2 weeks per ID recommendations at discharge.   Atrial fibrillation with RVR. Patient went into atrial fibrillation with RVR last night. Reportedly had remote history of atrial fibrillation in 2015 which spontaneously converted. Evaluated by Dr. cardiology.  Recommend metoprolol for rate control and Eliquis for anticoagulation. Patient to undergo urologic procedure as outpatient.  Per cardiology patient can hold Eliquis 3 days prior to the planned procedure. Just prior to discharge patient converted to sinus rhythm. Had discussion at length with daughter on the phone.Discussed with the patient. Recommend to continue Eliquis. Metoprolol 25 mg p.o. twice daily.   Advised to watch blood pressure and heart rate at home. If heart rate<65, recommend to hold metoprolol.     AKI-resolved Creatinine 1.42 at peak on 12/02 Resolved.     Heart murmur Right second intercostal space Echo as above Mild hyponatremia Hypocalcemia Hypophosphatemia Corrected.   Acute blood loss anemia Has blood in foley collection container Baseline Hgb 12.3-13 Current hgb ~10. Monitor     HTN Home regimen amlodipine-benazepril 5 mg - 20 mg 2 capsule by mouth daily. Advised to stop benazepril. Prescription sent for amlodipine 5 mg daily in addition to metoprolol 25 mg p.o. twice daily. Discussed with daughter on the phone who is an RN to monitor blood pressures and heart rate at home. Discussed with patient and her husband. Hold metoprolol if heart rate<65.   Bradycardia Asymptomatic ?  From remdesivir. Resolved. Discussed with Dr. okay to continue remdesivir.       HLD  Can continue fenofibrate   Hypothyroidism TSH: Within normal limits Continue synthroid dose    GERD Continue protonix    OSA Continue CPAP
Age: 30.0
Sex: F
Vaccine: RSV
Symptoms: Abdominal pain upper, Back pain, Exposure during pregnancy, Nausea, Pain in extremity
Clinical narrative: Delivery date, 34 weeks pregnant, 3rd pregnancy, 1 miscarriage in 2021, Adverse event from rsv vaccine: nausea, lower back and sciatic leg pain, weakness, and mild stomach pain.
Age: 30.0
Sex: F
Vaccine: RSV
Symptoms: Sciatica
Clinical narrative: Delivery date, 34 weeks pregnant, 3rd pregnancy, 1 miscarriage in 2021, Adverse event from rsv vaccine: nausea, lower back and sciatic leg pain, weakness, and mild stomach pain.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Dyspnoea, Hypercapnia
Clinical narrative: Patient with history of COPD. She was diagnosed with COVID on 10/30/23. Patient was admitted 11/5/23 - 11/7/23 for acute hypoxic hypercapnic respiratory failure secondary to COVID pneumonia. She initially required BiPAP for WOB and hypercapnia, however she improved to tolerate 2-4 lpm for respiratory support. Of note, the patient has received the Spikevax-MOD 100mcg vaccine (administered 1/20/21; 2/17/21; 11/1/21) and the Pfizer Bivalent COVID vaccine (administered 10/28/22).
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Positive airway pressure therapy, Respiratory failure
Clinical narrative: Patient with history of COPD. She was diagnosed with COVID on 10/30/23. Patient was admitted 11/5/23 - 11/7/23 for acute hypoxic hypercapnic respiratory failure secondary to COVID pneumonia. She initially required BiPAP for WOB and hypercapnia, however she improved to tolerate 2-4 lpm for respiratory support. Of note, the patient has received the Spikevax-MOD 100mcg vaccine (administered 1/20/21; 2/17/21; 11/1/21) and the Pfizer Bivalent COVID vaccine (administered 10/28/22).
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Chills, Cough
Clinical narrative: The patient was brought to the ED via EMS on 11/6/23 for shortness of breath, cough, body aches, fever, chills, and low energy. She reported testing positive for COVID the day prior (11/5/23). Repeat PCR test on 11/6/23 also resulted positive for COVID. Patient was admitted 11/6/23 - 11/14/23 for acute hypoxic respiratory failure and COVID-19, among other diagnoses. Initially patient required 2-3 L supplemental O2, however was able to wean off during admission. Of note, the patient has received the Pfizer monovalent COVID vaccine (given 2/18/21; 3/11/21), Spikevax-MOD 100 mcg (12/10/21), and Pfizer Bivalent COVID vaccine (given 1/18/23).
Age: 79.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: The patient was brought to the ED via EMS on 11/6/23 for shortness of breath, cough, body aches, fever, chills, and low energy. She reported testing positive for COVID the day prior (11/5/23). Repeat PCR test on 11/6/23 also resulted positive for COVID. Patient was admitted 11/6/23 - 11/14/23 for acute hypoxic respiratory failure and COVID-19, among other diagnoses. Initially patient required 2-3 L supplemental O2, however was able to wean off during admission. Of note, the patient has received the Pfizer monovalent COVID vaccine (given 2/18/21; 3/11/21), Spikevax-MOD 100 mcg (12/10/21), and Pfizer Bivalent COVID vaccine (given 1/18/23).
Age: 77.0
Sex: F
Vaccine: RSV
Symptoms: Feeling hot, Paraesthesia, Pruritus
Clinical narrative: Pins and needles, hot, kind of itcy on buttocks and across abdomen.   Worse when standing or moving about
Age: 35.0
Sex: F
Vaccine: RSV
Symptoms: Exposure during pregnancy, Extra dose administered, No adverse event
Clinical narrative: n/a; Patient received vaccine twice in 1 week. Once on 1/3/24 during obstetrics visit and another on 1/5/24 during another obstetrics visit. No adverse affects noted after 15 minutes of observation.  Patient is a G1P0, 35w3d with an estimated due date of 2/6/24.
Age: 87.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, Chronic obstructive pulmonary disease, Condition aggravated, Cough
Clinical narrative: Patient with history of COPD. He was seen in the ED on 11/10/23 with shortness of breath and nonproductive cough. A COVID PCR test collected in the ED resulted positive. Patient was admitted 11/10/23 - 11/11/23 with diagnoses including acute exacerbation of COPD, acute hypoxic respiratory failure, and COVID-19 infection, among other diagnoses. Patient initially required 2L nasal cannula but was weaned to room air prior to discharge. Of note, the patient has received the Pfizer monovalent COVID vaccine (given 3/6/21; 3/27/21; 9/30/21; 5/5/22) and the Pfizer Bivalent COVID vaccine (given 10/27/22).
Age: 87.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Patient with history of COPD. He was seen in the ED on 11/10/23 with shortness of breath and nonproductive cough. A COVID PCR test collected in the ED resulted positive. Patient was admitted 11/10/23 - 11/11/23 with diagnoses including acute exacerbation of COPD, acute hypoxic respiratory failure, and COVID-19 infection, among other diagnoses. Patient initially required 2L nasal cannula but was weaned to room air prior to discharge. Of note, the patient has received the Pfizer monovalent COVID vaccine (given 3/6/21; 3/27/21; 9/30/21; 5/5/22) and the Pfizer Bivalent COVID vaccine (given 10/27/22).
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Ammonia increased, Atrial fibrillation, Blood creatinine increased, Blood culture negative
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood lactic acid, Blood thyroid stimulating hormone decreased, COVID-19 pneumonia, Chest X-ray abnormal, Chronic kidney disease
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Computerised tomogram head normal, Condition aggravated, Confusional state, Delirium, Dementia
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Depressed level of consciousness, Dyspnoea, Escherichia infection, Haematoma, Hypoxia
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Illness, International normalised ratio increased, Legionella test, Leukocytosis, Lung opacity
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Memory impairment, Mental status changes, Metabolic encephalopathy, Mitral valve replacement, N-terminal prohormone brain natriuretic peptide increased
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Odynophagia, Oropharyngeal candidiasis, Pleural effusion, Pneumonia, Pneumonitis
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pulmonary oedema, Pyuria, Streptococcus test negative, Swallow study abnormal, Urinary tract infection
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 82.0
Sex: F
Vaccine: COVID19-2
Symptoms: Vocal cord disorder, White blood cell count increased
Clinical narrative: Patient is a 83 y.o. female patient of MD with history of atrial fibrillation, GERD, history of tricuspid valve repair, history of mitral valve replacement, history of autoimmune hemolytic anemia presented to Hospital with shortness of breath.   Community-acquired pneumonia: resolved COVID-19 virus pneumonia: resolved Acute Respiratory Failure with Hypoxia WBC 13.65, lactic acid 1.9 on admission Chest x-ray-Moderate bilateral infrahilar lower lung opacities reflecting pulmonary edema or pneumonitis.  Correlate clinically.Small left pleural effusion. Urine strep and Legionella antigen--negative.Blood Cx - NGTD Completed remdesivir, azithromycin and ceftriaxone Date of discontinuation of isolation 12/5/2023 Encouraged I-S and PEP therapy WBC down to 12 k today . From 24 K.  No fever. Her oxygen requirements are 2 l NC with sats more than 95%. No shortness of breath. Can discontinue isolation Patient had FEES  which showed moderate-severe oropharyngeal and laryngeal candidiasis. Patient has odynophagia along with vocal cord hematoma with noa ctive bleeding started on fluconazole 400 mg on day 1 followed by 200 mg daily Day 4/7 today.  SLP recs pureed and nectar thick ENT consulted >>> Patient was unable to tolerate laryngoscopy. OP follow up Leukocytosis resolved WBC 9 K today   Acute delirium: resolved Acute metabolic Encephalopathy  Likely secondary to acute illness and undiagnosed dementia Per husband patient is very forgetful and confused at home Discontinued dexamethasone if contributing to delirium  Repeat chest x-ray improved, pyuria resolved  Mentation improved Seroquel discontinued. Did not receive dose yesterday. She is more alert and awake today CT head on 12/3/23: normal, Ammonia: 53 OP geriatric psych eval   E coli UTI: completed ceftriaxone   Paroxysmal atrial fibrillation S/p Mitral valve replacement 2023 S/p Tricuspid valve repair 2016 NT proBNP 4969  TSH 1.97 continue amiodarone, Coumadin Pharmacy consulted for Coumadin dosing Did have an episode of RVR Started metoprolol 25 mg twice daily. >>> HR is well controlled.  INR 3.1 today  CKD stage III Creatinine 1.32 on admission, was 1.5 on 8/21/2023 Cr  0.92--1.21 Creatinine stable 0.9 today
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, COVID-19, Chest X-ray normal, Computerised tomogram head normal, Decreased appetite
Clinical narrative: Patient is a 71 y.o. male with a history of A-fib on Eliquis, Parkinson's disease, CAD s/p CABG (2017), IDDM 2, HTN who presented to RMH 11/30/2023 with several days of generalized fatigue weakness with poor appetite found to have COVID-19 infection.    1. COVID-19 infection: Positive test 11/30/2023. No hypoxia.  CXR with no significant airspace disease. ID followed; started remdesivir x 3 days. Monitored respiratory status. 2. Stroke-Like Symptoms: Follows with movement specialist for parkinson's at clinic.  Recent up titration of Sinemet to 5 times daily due to worsening symptoms at nighttime. Concern for new L facial droop and LUE weakness on admission. CT head 11/30/23 non-acute. MRI brain 12/3/23 was normal. Neuro followed 3. Elevated troponin: Minimally elevated troponin from 2023.  Patient without chest pain or anginal symptoms. ACS unlikely.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Facial paralysis, Fatigue, Magnetic resonance imaging head normal, Muscular weakness, Neurological symptom
Clinical narrative: Patient is a 71 y.o. male with a history of A-fib on Eliquis, Parkinson's disease, CAD s/p CABG (2017), IDDM 2, HTN who presented to RMH 11/30/2023 with several days of generalized fatigue weakness with poor appetite found to have COVID-19 infection.    1. COVID-19 infection: Positive test 11/30/2023. No hypoxia.  CXR with no significant airspace disease. ID followed; started remdesivir x 3 days. Monitored respiratory status. 2. Stroke-Like Symptoms: Follows with movement specialist for parkinson's at clinic.  Recent up titration of Sinemet to 5 times daily due to worsening symptoms at nighttime. Concern for new L facial droop and LUE weakness on admission. CT head 11/30/23 non-acute. MRI brain 12/3/23 was normal. Neuro followed 3. Elevated troponin: Minimally elevated troponin from 2023.  Patient without chest pain or anginal symptoms. ACS unlikely.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Troponin increased
Clinical narrative: Patient is a 71 y.o. male with a history of A-fib on Eliquis, Parkinson's disease, CAD s/p CABG (2017), IDDM 2, HTN who presented to RMH 11/30/2023 with several days of generalized fatigue weakness with poor appetite found to have COVID-19 infection.    1. COVID-19 infection: Positive test 11/30/2023. No hypoxia.  CXR with no significant airspace disease. ID followed; started remdesivir x 3 days. Monitored respiratory status. 2. Stroke-Like Symptoms: Follows with movement specialist for parkinson's at clinic.  Recent up titration of Sinemet to 5 times daily due to worsening symptoms at nighttime. Concern for new L facial droop and LUE weakness on admission. CT head 11/30/23 non-acute. MRI brain 12/3/23 was normal. Neuro followed 3. Elevated troponin: Minimally elevated troponin from 2023.  Patient without chest pain or anginal symptoms. ACS unlikely.
Age: 63.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, Chronic obstructive pulmonary disease, Condition aggravated, Endotracheal intubation
Clinical narrative: Patient with history of COPD. He was seen in the ED on 11/11/23 after he was found unresponsive at his TCU. Additionally, he was reported to have recently tested COVID positive.  A repeat COVID PCR test collected in the ED also resulted positive. He was admitted 11/11/23 - 11/16/23 initially for acute on chronic hypoxic and hypercapnic respiratory failure requiring intubation. He was extubated on 11/12/23. Discharge diagnoses included acute on chronic hypoxic and hypercapnic respiratory failure, multifactorial; COPD exacerbation; and COVID-19 infection, among other diagnoses. Of note, the patient has received four doses of the COVID vaccine - the Pfizer monovalent COVID vaccine (given 1/21/21; 2/11/21; and 10/21/21) and the Pfizer Bivalent COVID vaccine (given 10/18/22).
Age: 63.0
Sex: M
Vaccine: COVID19-2
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Unresponsive to stimuli
Clinical narrative: Patient with history of COPD. He was seen in the ED on 11/11/23 after he was found unresponsive at his TCU. Additionally, he was reported to have recently tested COVID positive.  A repeat COVID PCR test collected in the ED also resulted positive. He was admitted 11/11/23 - 11/16/23 initially for acute on chronic hypoxic and hypercapnic respiratory failure requiring intubation. He was extubated on 11/12/23. Discharge diagnoses included acute on chronic hypoxic and hypercapnic respiratory failure, multifactorial; COPD exacerbation; and COVID-19 infection, among other diagnoses. Of note, the patient has received four doses of the COVID vaccine - the Pfizer monovalent COVID vaccine (given 1/21/21; 2/11/21; and 10/21/21) and the Pfizer Bivalent COVID vaccine (given 10/18/22).
Age: 65.0
Sex: F
Vaccine: COVID19-2
Symptoms: Condition aggravated, Sleep disorder
Clinical narrative: I have had very mild tinnitus for about 20 years. Beginning with my first Pfizer vaccination in March 2021, it has worsened with every shot, especially after the booster I received in October. The ringing is now a persistent eeeeeeeeee sound like a whistle along with pulsatile rhythm. It's finally reached distraction level and I have to sleep with white noise like a fan, even in cold weather when I would normally not do this. I don't know why I even have this as I wasn't exposed to excessive noise and don't listen to loud music. I've been to ENTs and a neurologist, whom I will have to visit again. I'm not sure I'll take another vaccination after this one as if it gets louder I will certainly go mad.
Age: 33.0
Sex: F
Vaccine: RSV
Symptoms: Exposure during pregnancy, Musculoskeletal stiffness, Neck pain
Clinical narrative: 34 weeks pregnant. Neck pain and stiffness on left side, same side as vaccine.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Breast swelling
Clinical narrative: severe breast swelling
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Atelectasis, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: Patient is a 76 years old male patient with history of CVA, hypertension, hyperlipidemia, neuropathy, and GERD who presented to Hospital with worsened right sided weakness.   Sepsis, and Acute Hypoxic Respiratory Failure, due to: COVID 19 Pneumonia Tachycardic and febrile on presentation to ED Some desaturations on RA prompted NC to be placed. Currently on room air since yesterday Personally reviewed chest xray with bibasilar atelectasis UA not suggestive of infection Urine and blood cultures pending COVID positive Discontinue remdesivir, plan to complete 10 days of steroids Patient has been on room air for the last 48 hoursStroke Like Symptoms Past CV Stroke Like Symptoms Past CVA with Right Sided Weakness NSTEMI, likely type 2 Hypertension Hyperlipidemia Has had worsening right sided weakness the last couple days Wife having a hard time assisting with ambulation CT head with evidence of prior infarct, seen on previous MRI, and other chronic changes Suspect symptoms are due to recrudescence in the setting of sepsis from COVID as above Troponin 24, no chest pain, likely type 2 in the setting of COVID. Right hemiparesis as a long-term effect of stroke chronic with acute exacerbation since resolved by neurology Cleared for discharge   Chronic Normocytic Anemia Hemoglobin 11.3 on admission Baseline around 12 No evidence of bleeding Continue to monitor with daily CBC's   Neuropathy Continue home Lyrica   GERD Continue home PPI
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Hemiparesis, Oxygen saturation decreased, Pyrexia, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Patient is a 76 years old male patient with history of CVA, hypertension, hyperlipidemia, neuropathy, and GERD who presented to Hospital with worsened right sided weakness.   Sepsis, and Acute Hypoxic Respiratory Failure, due to: COVID 19 Pneumonia Tachycardic and febrile on presentation to ED Some desaturations on RA prompted NC to be placed. Currently on room air since yesterday Personally reviewed chest xray with bibasilar atelectasis UA not suggestive of infection Urine and blood cultures pending COVID positive Discontinue remdesivir, plan to complete 10 days of steroids Patient has been on room air for the last 48 hoursStroke Like Symptoms Past CV Stroke Like Symptoms Past CVA with Right Sided Weakness NSTEMI, likely type 2 Hypertension Hyperlipidemia Has had worsening right sided weakness the last couple days Wife having a hard time assisting with ambulation CT head with evidence of prior infarct, seen on previous MRI, and other chronic changes Suspect symptoms are due to recrudescence in the setting of sepsis from COVID as above Troponin 24, no chest pain, likely type 2 in the setting of COVID. Right hemiparesis as a long-term effect of stroke chronic with acute exacerbation since resolved by neurology Cleared for discharge   Chronic Normocytic Anemia Hemoglobin 11.3 on admission Baseline around 12 No evidence of bleeding Continue to monitor with daily CBC's   Neuropathy Continue home Lyrica   GERD Continue home PPI