chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Decreased appetite, Depressed mood, Depression, Dysphagia, Facetectomy
Clinical narrative: 71y.o. male with multiple medical problems including BPH, chronic LBP with LLE radicular pain, DMII and PPN who was admitted to the hospital on 9/5/2022 for N/V and abdominal pain. Upon admission, lexiscan MPI showed a reversible perfusion defect. Cardiovascular surgery was consulted and performed CABG x3 on 9/13. Pts hospital course has been c/b acute hypoxic respiratory failure, post-op acute blood loss anemia, dysphagia and right forearm cellulitis with completion of abx courses. Corpak was pulled on 9/21 by the pt. SLP is following and have the pt on mechanical soft diet with thickened liquids. Psych was consulted for depression and started the pt on Wellbutrin. Pt with recent hx of (7/27/2022) lumbar laminectomy with medial facetectomy and foraminotomy with fusion at L4-5 on  by Dr., post-op course complicated by lethargy and confusion. Patient with unwitnessed fall with RRT activated on 9/26- no head trauma and no head CT required. He was transferred to the med ward for a dx of COVID with fever and anorexia.  He was treated with remdesivir - he did not have hypoxia. He had quite some anorexia and asthenia and some depressed mood.  He has been recovering and is now showing signs of resolution of these problems and we anticipated return to HCF, but he was denied by insurance, including a peer to peer.  Evaluation on Day of Discharge: Last night he had nausea and vomiting and could not eat dinner. Also did not eat lunch. This morning he felt good and ate the entire BKF. He has had multiple stools (constipation was an issue in the past days and received plenty of stool softners) - stool sfotners will be held now. Suspect component of gastroparesis - this should improve as he becomes more active.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Fall, Feeding disorder, Foraminotomy, Impaired gastric emptying, Lethargy
Clinical narrative: 71y.o. male with multiple medical problems including BPH, chronic LBP with LLE radicular pain, DMII and PPN who was admitted to the hospital on 9/5/2022 for N/V and abdominal pain. Upon admission, lexiscan MPI showed a reversible perfusion defect. Cardiovascular surgery was consulted and performed CABG x3 on 9/13. Pts hospital course has been c/b acute hypoxic respiratory failure, post-op acute blood loss anemia, dysphagia and right forearm cellulitis with completion of abx courses. Corpak was pulled on 9/21 by the pt. SLP is following and have the pt on mechanical soft diet with thickened liquids. Psych was consulted for depression and started the pt on Wellbutrin. Pt with recent hx of (7/27/2022) lumbar laminectomy with medial facetectomy and foraminotomy with fusion at L4-5 on  by Dr., post-op course complicated by lethargy and confusion. Patient with unwitnessed fall with RRT activated on 9/26- no head trauma and no head CT required. He was transferred to the med ward for a dx of COVID with fever and anorexia.  He was treated with remdesivir - he did not have hypoxia. He had quite some anorexia and asthenia and some depressed mood.  He has been recovering and is now showing signs of resolution of these problems and we anticipated return to HCF, but he was denied by insurance, including a peer to peer.  Evaluation on Day of Discharge: Last night he had nausea and vomiting and could not eat dinner. Also did not eat lunch. This morning he felt good and ate the entire BKF. He has had multiple stools (constipation was an issue in the past days and received plenty of stool softners) - stool sfotners will be held now. Suspect component of gastroparesis - this should improve as he becomes more active.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Medical diet, Nausea, Pyrexia, SARS-CoV-2 test positive, Scan myocardial perfusion abnormal
Clinical narrative: 71y.o. male with multiple medical problems including BPH, chronic LBP with LLE radicular pain, DMII and PPN who was admitted to the hospital on 9/5/2022 for N/V and abdominal pain. Upon admission, lexiscan MPI showed a reversible perfusion defect. Cardiovascular surgery was consulted and performed CABG x3 on 9/13. Pts hospital course has been c/b acute hypoxic respiratory failure, post-op acute blood loss anemia, dysphagia and right forearm cellulitis with completion of abx courses. Corpak was pulled on 9/21 by the pt. SLP is following and have the pt on mechanical soft diet with thickened liquids. Psych was consulted for depression and started the pt on Wellbutrin. Pt with recent hx of (7/27/2022) lumbar laminectomy with medial facetectomy and foraminotomy with fusion at L4-5 on  by Dr., post-op course complicated by lethargy and confusion. Patient with unwitnessed fall with RRT activated on 9/26- no head trauma and no head CT required. He was transferred to the med ward for a dx of COVID with fever and anorexia.  He was treated with remdesivir - he did not have hypoxia. He had quite some anorexia and asthenia and some depressed mood.  He has been recovering and is now showing signs of resolution of these problems and we anticipated return to HCF, but he was denied by insurance, including a peer to peer.  Evaluation on Day of Discharge: Last night he had nausea and vomiting and could not eat dinner. Also did not eat lunch. This morning he felt good and ate the entire BKF. He has had multiple stools (constipation was an issue in the past days and received plenty of stool softners) - stool sfotners will be held now. Suspect component of gastroparesis - this should improve as he becomes more active.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Spinal fusion surgery, Spinal laminectomy, Vomiting
Clinical narrative: 71y.o. male with multiple medical problems including BPH, chronic LBP with LLE radicular pain, DMII and PPN who was admitted to the hospital on 9/5/2022 for N/V and abdominal pain. Upon admission, lexiscan MPI showed a reversible perfusion defect. Cardiovascular surgery was consulted and performed CABG x3 on 9/13. Pts hospital course has been c/b acute hypoxic respiratory failure, post-op acute blood loss anemia, dysphagia and right forearm cellulitis with completion of abx courses. Corpak was pulled on 9/21 by the pt. SLP is following and have the pt on mechanical soft diet with thickened liquids. Psych was consulted for depression and started the pt on Wellbutrin. Pt with recent hx of (7/27/2022) lumbar laminectomy with medial facetectomy and foraminotomy with fusion at L4-5 on  by Dr., post-op course complicated by lethargy and confusion. Patient with unwitnessed fall with RRT activated on 9/26- no head trauma and no head CT required. He was transferred to the med ward for a dx of COVID with fever and anorexia.  He was treated with remdesivir - he did not have hypoxia. He had quite some anorexia and asthenia and some depressed mood.  He has been recovering and is now showing signs of resolution of these problems and we anticipated return to HCF, but he was denied by insurance, including a peer to peer.  Evaluation on Day of Discharge: Last night he had nausea and vomiting and could not eat dinner. Also did not eat lunch. This morning he felt good and ate the entire BKF. He has had multiple stools (constipation was an issue in the past days and received plenty of stool softners) - stool sfotners will be held now. Suspect component of gastroparesis - this should improve as he becomes more active.
Age: 67.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Computerised tomogram abnormal, Oesophageal disorder, Oesophagogastroduodenoscopy abnormal, SARS-CoV-2 test, Tumour necrosis
Clinical narrative: Patient is a 68y.o.male h/o lung CA 2020 s/p resection, chemo and RT who was sent to HCF by Rad Onc after routine CT yesterday showed possible esophageal perforation. Seen by Thoracic Surg and underwent EGD that showed fibrinous material/ necrotic tumor in that area but no signs of perforation. He is recommended to continue with full liquid diet until f/u in 2 weeks. EGD to be repeated.
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Blood sodium decreased, Body height decreased, COVID-19, Chest X-ray normal
Clinical narrative: 94-year-old man with past medical history of HTN, CKD, HLD,  spinal stenosis and sacroiliac joint disease who came to the hospital due to fatigue, decreased appetite, weakness, dizziness and falling at home.  Fell in the shower. To be COVID-positive upon presentation, chest x-ray was reviewed and is not concerning for COVID-pneumonia, on room air.  Sodium of 133, hemoglobin of 9.4, troponin is negative.  Head CT was done due to the fall and was negative for acute event.  Lumbosacral x-ray with stable anterior wedging with vertebral body height loss at T12 and L1, approximately 50% loss at each level.  Oriented x2.  Daughter reported mild confusion. Received 2 doses of Pfizer vaccine in 2021.  Started on IV fluids,
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram head normal, Confusional state, Decreased appetite, Dizziness, Fall
Clinical narrative: 94-year-old man with past medical history of HTN, CKD, HLD,  spinal stenosis and sacroiliac joint disease who came to the hospital due to fatigue, decreased appetite, weakness, dizziness and falling at home.  Fell in the shower. To be COVID-positive upon presentation, chest x-ray was reviewed and is not concerning for COVID-pneumonia, on room air.  Sodium of 133, hemoglobin of 9.4, troponin is negative.  Head CT was done due to the fall and was negative for acute event.  Lumbosacral x-ray with stable anterior wedging with vertebral body height loss at T12 and L1, approximately 50% loss at each level.  Oriented x2.  Daughter reported mild confusion. Received 2 doses of Pfizer vaccine in 2021.  Started on IV fluids,
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Haemoglobin decreased, Mental status changes, SARS-CoV-2 test positive, Spinal X-ray abnormal
Clinical narrative: 94-year-old man with past medical history of HTN, CKD, HLD,  spinal stenosis and sacroiliac joint disease who came to the hospital due to fatigue, decreased appetite, weakness, dizziness and falling at home.  Fell in the shower. To be COVID-positive upon presentation, chest x-ray was reviewed and is not concerning for COVID-pneumonia, on room air.  Sodium of 133, hemoglobin of 9.4, troponin is negative.  Head CT was done due to the fall and was negative for acute event.  Lumbosacral x-ray with stable anterior wedging with vertebral body height loss at T12 and L1, approximately 50% loss at each level.  Oriented x2.  Daughter reported mild confusion. Received 2 doses of Pfizer vaccine in 2021.  Started on IV fluids,
Age: 92.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Troponin normal, Vertebral wedging
Clinical narrative: 94-year-old man with past medical history of HTN, CKD, HLD,  spinal stenosis and sacroiliac joint disease who came to the hospital due to fatigue, decreased appetite, weakness, dizziness and falling at home.  Fell in the shower. To be COVID-positive upon presentation, chest x-ray was reviewed and is not concerning for COVID-pneumonia, on room air.  Sodium of 133, hemoglobin of 9.4, troponin is negative.  Head CT was done due to the fall and was negative for acute event.  Lumbosacral x-ray with stable anterior wedging with vertebral body height loss at T12 and L1, approximately 50% loss at each level.  Oriented x2.  Daughter reported mild confusion. Received 2 doses of Pfizer vaccine in 2021.  Started on IV fluids,
Age: 23.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Depression, Dissociative disorder, SARS-CoV-2 test
Clinical narrative: 25-year-old who lives with her partner and her roommate and who presented with disassociative phenomena and depression.
Age: 77.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Adult failure to thrive, Bronchitis, COVID-19, Confusional state
Clinical narrative: Patient is a 78-year-old gentleman with prior history of dementia, stroke, debility chronically, who presented from the nursing care facility with reports of acute mental status changes and fever.  See admission note for full details on his presentation.  He was found to be positive for COVID-19 and was treated with stress dose of his prednisone and fluids for acute kidney injury.  In 24 hours of hydration and steroid dose, his mental status returned to baseline.  He unfortunately was depressed and had some confusion and was failure to thrive here in the hospital, refusing medications on a regular basis and taking a p.o. poorly.  The family elected not to do a remdesivir, so he was just treated conservatively for the COVID-19.  His O2 sats remained stable.  Had just very mild bronchitis but was stable on 2 L O2, which is similar to his previous baseline.  The patient remained resistant to taking his medication and family was concerned about his continued decline.  They wish to have a rasp for a hospice evaluation and consultation.  They elected for home hospice care with more palliative care approach going forward.
Age: 77.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Depression, Hypophagia, Mental status changes, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Patient is a 78-year-old gentleman with prior history of dementia, stroke, debility chronically, who presented from the nursing care facility with reports of acute mental status changes and fever.  See admission note for full details on his presentation.  He was found to be positive for COVID-19 and was treated with stress dose of his prednisone and fluids for acute kidney injury.  In 24 hours of hydration and steroid dose, his mental status returned to baseline.  He unfortunately was depressed and had some confusion and was failure to thrive here in the hospital, refusing medications on a regular basis and taking a p.o. poorly.  The family elected not to do a remdesivir, so he was just treated conservatively for the COVID-19.  His O2 sats remained stable.  Had just very mild bronchitis but was stable on 2 L O2, which is similar to his previous baseline.  The patient remained resistant to taking his medication and family was concerned about his continued decline.  They wish to have a rasp for a hospice evaluation and consultation.  They elected for home hospice care with more palliative care approach going forward.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, Blood urea increased, Bronchitis, COVID-19
Clinical narrative: The patient is a 76-year-old female. She was admitted because of shortness of breath, difficulty breathing, wheezing, and a lot of cough and yellow phlegm.  She was found to be COVID positive.  She was given Remdesivir, IV steroids, nebulizer treatment and oxygen.  She was seen by the lung specialist and the Pulmonary doctor. The acute respiratory infection of COVID got better, but she developed what appeared to be acute exacerbation of COPD and bronchitis for which she was given IV steroids, nebulizer, oxygen treatment, and bronchodilators by nebulizer machine, slowly improved with that regard.  Her BUN and creatinine went up.  She developed acute renal failure.  She was given hydration, sodium bicarbonate. For her diabetes and her cardiac problem, she was given Jardiance. She was slow to improve, but with physical therapy and occupational therapy and also the Physical Medicine and Rehab doctor felt that she was better suited for nursing home rather than inpatient rehab.  The patient did improve slowly gradually.  She was able to function somewhat.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dyspnoea, Loss of personal independence in daily activities
Clinical narrative: The patient is a 76-year-old female. She was admitted because of shortness of breath, difficulty breathing, wheezing, and a lot of cough and yellow phlegm.  She was found to be COVID positive.  She was given Remdesivir, IV steroids, nebulizer treatment and oxygen.  She was seen by the lung specialist and the Pulmonary doctor. The acute respiratory infection of COVID got better, but she developed what appeared to be acute exacerbation of COPD and bronchitis for which she was given IV steroids, nebulizer, oxygen treatment, and bronchodilators by nebulizer machine, slowly improved with that regard.  Her BUN and creatinine went up.  She developed acute renal failure.  She was given hydration, sodium bicarbonate. For her diabetes and her cardiac problem, she was given Jardiance. She was slow to improve, but with physical therapy and occupational therapy and also the Physical Medicine and Rehab doctor felt that she was better suited for nursing home rather than inpatient rehab.  The patient did improve slowly gradually.  She was able to function somewhat.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Sputum discoloured, Wheezing
Clinical narrative: The patient is a 76-year-old female. She was admitted because of shortness of breath, difficulty breathing, wheezing, and a lot of cough and yellow phlegm.  She was found to be COVID positive.  She was given Remdesivir, IV steroids, nebulizer treatment and oxygen.  She was seen by the lung specialist and the Pulmonary doctor. The acute respiratory infection of COVID got better, but she developed what appeared to be acute exacerbation of COPD and bronchitis for which she was given IV steroids, nebulizer, oxygen treatment, and bronchodilators by nebulizer machine, slowly improved with that regard.  Her BUN and creatinine went up.  She developed acute renal failure.  She was given hydration, sodium bicarbonate. For her diabetes and her cardiac problem, she was given Jardiance. She was slow to improve, but with physical therapy and occupational therapy and also the Physical Medicine and Rehab doctor felt that she was better suited for nursing home rather than inpatient rehab.  The patient did improve slowly gradually.  She was able to function somewhat.
Age: 30.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Caesarean section, Delivery, Maternal exposure before pregnancy, SARS-CoV-2 test
Clinical narrative: 31y.o. G4P3013 presents for routine postpartum incision check. She delivered via primary cesarean section for non-reassuring fetal heart tones with intraoperative findings concerning for placental abruption. Postpartum course has been uncomplicated. She denies fever, chills, nausea or vomiting and pain at incision site is well controlled. Baby doing well. Patient denies headache, visual disturbances, chest pain, shortness of breath, RUQ/epigastric pain. Is not currently taking her blood pressures at home but is agreeable to doing so.
Age: 25.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Asthma, COVID-19 pneumonia, Chest discomfort, Condition aggravated
Clinical narrative: 26y.o. female with past medical history WPW s/p ablation 2015, hydrocephalus s/p multiple shunts (VTI now lumboperitoneal), seizure disorder, severe persistent asthma without history of intubation, functional stridor, COVID infection in January 2022 presenting for shortness of breath. She had history of admission earlier in the month for asthma exacerbation at which point she was admitted to the hospital and received IV steroids. She improved and was discharged home on steroid taper which she did complete. The last couple days prior to this presentation, she has been feeling more short of breath. Yesterday she was helping her parents move when she began to feel short of breath with wheezing, hoarseness, some chest tightness. She used nebulizer, oral steroid, Benadryl without improvement and decided to seek attention. Plan of Care for: Acute hypoxic respiratory failure secondary to COVID-19 pneumonia + asthma exacerbation ?Scheduled Breathing tx Q.4hrs  ? IV steroids Decadron &  per pulmonology's note from 9/29 "Recommend decreasing steroids from decadron 6mg IV qd to Prednisone 30mg PO qd to complete 5 days"  ? Lovenox
Age: 25.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dysphonia, Dyspnoea, SARS-CoV-2 test positive, Wheezing
Clinical narrative: 26y.o. female with past medical history WPW s/p ablation 2015, hydrocephalus s/p multiple shunts (VTI now lumboperitoneal), seizure disorder, severe persistent asthma without history of intubation, functional stridor, COVID infection in January 2022 presenting for shortness of breath. She had history of admission earlier in the month for asthma exacerbation at which point she was admitted to the hospital and received IV steroids. She improved and was discharged home on steroid taper which she did complete. The last couple days prior to this presentation, she has been feeling more short of breath. Yesterday she was helping her parents move when she began to feel short of breath with wheezing, hoarseness, some chest tightness. She used nebulizer, oral steroid, Benadryl without improvement and decided to seek attention. Plan of Care for: Acute hypoxic respiratory failure secondary to COVID-19 pneumonia + asthma exacerbation ?Scheduled Breathing tx Q.4hrs  ? IV steroids Decadron &  per pulmonology's note from 9/29 "Recommend decreasing steroids from decadron 6mg IV qd to Prednisone 30mg PO qd to complete 5 days"  ? Lovenox
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Delivery, Maternal exposure before pregnancy, SARS-CoV-2 test positive, Spontaneous rupture of membranes
Clinical narrative: OB Delivery Note:  Labor Events  Preterm labor?: No Antenatal steroids: None Antibiotics received during labor?: No Rupture of Membranes Baby:
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered, No adverse event
Clinical narrative: PT RECEIVED MONOVALENT INSTEAD OF BIVALENT, NO ADVERSE EVENTS AT ALL. PT WILL GET VACCINATED WITH BIVALENT IN 8 WEEKS.
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Asymptomatic COVID-19, Bladder catheterisation, Renal impairment, SARS-CoV-2 test positive
Clinical narrative: 76 year old male with chronic bladder outlet obstruction, HTN, BPH, presented to ER with AKI. Found to have suspected UTI as wll as COVID +. Admitted to hospital medicine. Urology, nephro, ID (Infectious diseases) consulted. ID recommended no treatment of COVID as he was relatively asymptomatic. Completed short course IV rocephin. Entresto was held on admission. Renal function improved. nephro cleared him to resume entresto at dc. Urology placed foley cath and recommended he keep this in til he follows up with them in clinic. He worked with PTOT (Physical Therapy & Occupational Therapy). Plan home w home care at dc. To return to ER should admission symptoms reoccur. Cleared for dc home on 10/4. To follow up with pcp and all consultants at dc. Discharged home in stable
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Urinary tract infection
Clinical narrative: 76 year old male with chronic bladder outlet obstruction, HTN, BPH, presented to ER with AKI. Found to have suspected UTI as wll as COVID +. Admitted to hospital medicine. Urology, nephro, ID (Infectious diseases) consulted. ID recommended no treatment of COVID as he was relatively asymptomatic. Completed short course IV rocephin. Entresto was held on admission. Renal function improved. nephro cleared him to resume entresto at dc. Urology placed foley cath and recommended he keep this in til he follows up with them in clinic. He worked with PTOT (Physical Therapy & Occupational Therapy). Plan home w home care at dc. To return to ER should admission symptoms reoccur. Cleared for dc home on 10/4. To follow up with pcp and all consultants at dc. Discharged home in stable
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Anticoagulant therapy, COVID-19, Cardiac murmur, Chest X-ray abnormal
Clinical narrative: 76y.o. male with a PMH significant for CKD stage V s/p kidney transplant in 2020 on prograf and cellcept, OSA on CPAP since July 2022, CAD s/p triple stent placement in 2022, HTN, and HLD who presented to facility on 9/28/2022 with a chief complaint of cough and fever. Patient's symptoms of non-productive cough and fever started one month ago at which point he was covid19 +. Pt found to be leukopenic, hyponatremic, and  with chest xray showing RLL opacity suspicious for pneumonia. CT chest: Extensive polycystic changes of the visualized native kidneys. Bilateral groundglass airspace opacities, greatest in the right lower lobe. These findings can be see with of atypical pneumonia such as Covid. Patient was treated for CAP pneumonia with ceftriaxone and azithromycin. He was transitioned to levoquin for a total of 7 days. Transplant team worked incoordination with IM team to treat and evaluate patient. Patient was initially hyponatremic, which improved with fluid restriction and liberalization of salt intake. Patient developed AKI, that was monitored by transplant team; improved with some IVF. Patient also provided 1x Granix for leukopenia; which improved immediately. Patient to follow up with transplant team on discharge with labwork. Patient provided albuterol inhaler, breo, and zyrtec to help alleviate symptoms with close follow up with PCP as patient does not need extended course of these medications. Patient also underwent 2d echo as murmur noted; showed persistent mild AS. Patient to continue follow up with cardiology.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Computerised tomogram thorax abnormal, Congenital cystic kidney disease, Cough, Echocardiogram abnormal, Fluid intake restriction
Clinical narrative: 76y.o. male with a PMH significant for CKD stage V s/p kidney transplant in 2020 on prograf and cellcept, OSA on CPAP since July 2022, CAD s/p triple stent placement in 2022, HTN, and HLD who presented to facility on 9/28/2022 with a chief complaint of cough and fever. Patient's symptoms of non-productive cough and fever started one month ago at which point he was covid19 +. Pt found to be leukopenic, hyponatremic, and  with chest xray showing RLL opacity suspicious for pneumonia. CT chest: Extensive polycystic changes of the visualized native kidneys. Bilateral groundglass airspace opacities, greatest in the right lower lobe. These findings can be see with of atypical pneumonia such as Covid. Patient was treated for CAP pneumonia with ceftriaxone and azithromycin. He was transitioned to levoquin for a total of 7 days. Transplant team worked incoordination with IM team to treat and evaluate patient. Patient was initially hyponatremic, which improved with fluid restriction and liberalization of salt intake. Patient developed AKI, that was monitored by transplant team; improved with some IVF. Patient also provided 1x Granix for leukopenia; which improved immediately. Patient to follow up with transplant team on discharge with labwork. Patient provided albuterol inhaler, breo, and zyrtec to help alleviate symptoms with close follow up with PCP as patient does not need extended course of these medications. Patient also underwent 2d echo as murmur noted; showed persistent mild AS. Patient to continue follow up with cardiology.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hyponatraemia, Leukopenia, Lung opacity, Pneumonia, Pyrexia
Clinical narrative: 76y.o. male with a PMH significant for CKD stage V s/p kidney transplant in 2020 on prograf and cellcept, OSA on CPAP since July 2022, CAD s/p triple stent placement in 2022, HTN, and HLD who presented to facility on 9/28/2022 with a chief complaint of cough and fever. Patient's symptoms of non-productive cough and fever started one month ago at which point he was covid19 +. Pt found to be leukopenic, hyponatremic, and  with chest xray showing RLL opacity suspicious for pneumonia. CT chest: Extensive polycystic changes of the visualized native kidneys. Bilateral groundglass airspace opacities, greatest in the right lower lobe. These findings can be see with of atypical pneumonia such as Covid. Patient was treated for CAP pneumonia with ceftriaxone and azithromycin. He was transitioned to levoquin for a total of 7 days. Transplant team worked incoordination with IM team to treat and evaluate patient. Patient was initially hyponatremic, which improved with fluid restriction and liberalization of salt intake. Patient developed AKI, that was monitored by transplant team; improved with some IVF. Patient also provided 1x Granix for leukopenia; which improved immediately. Patient to follow up with transplant team on discharge with labwork. Patient provided albuterol inhaler, breo, and zyrtec to help alleviate symptoms with close follow up with PCP as patient does not need extended course of these medications. Patient also underwent 2d echo as murmur noted; showed persistent mild AS. Patient to continue follow up with cardiology.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 76y.o. male with a PMH significant for CKD stage V s/p kidney transplant in 2020 on prograf and cellcept, OSA on CPAP since July 2022, CAD s/p triple stent placement in 2022, HTN, and HLD who presented to facility on 9/28/2022 with a chief complaint of cough and fever. Patient's symptoms of non-productive cough and fever started one month ago at which point he was covid19 +. Pt found to be leukopenic, hyponatremic, and  with chest xray showing RLL opacity suspicious for pneumonia. CT chest: Extensive polycystic changes of the visualized native kidneys. Bilateral groundglass airspace opacities, greatest in the right lower lobe. These findings can be see with of atypical pneumonia such as Covid. Patient was treated for CAP pneumonia with ceftriaxone and azithromycin. He was transitioned to levoquin for a total of 7 days. Transplant team worked incoordination with IM team to treat and evaluate patient. Patient was initially hyponatremic, which improved with fluid restriction and liberalization of salt intake. Patient developed AKI, that was monitored by transplant team; improved with some IVF. Patient also provided 1x Granix for leukopenia; which improved immediately. Patient to follow up with transplant team on discharge with labwork. Patient provided albuterol inhaler, breo, and zyrtec to help alleviate symptoms with close follow up with PCP as patient does not need extended course of these medications. Patient also underwent 2d echo as murmur noted; showed persistent mild AS. Patient to continue follow up with cardiology.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Constipation, Culture, Faecal disimpaction, Hydronephrosis
Clinical narrative: 84 yo F was admitted to hospital with concern re uti and was found to have significant b/l hydronephrosis and constipation. She had stent placement and disimpaction in OR per urology and improved. She was treated for abx per cultures and doing well. D/w daughter and concerned re iron supp causing bad constipation and is stopped and discussed to get iron infusion setup as outpt. She was discharged back to assisted living facility with hhc in stable condition.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Stent placement
Clinical narrative: 84 yo F was admitted to hospital with concern re uti and was found to have significant b/l hydronephrosis and constipation. She had stent placement and disimpaction in OR per urology and improved. She was treated for abx per cultures and doing well. D/w daughter and concerned re iron supp causing bad constipation and is stopped and discussed to get iron infusion setup as outpt. She was discharged back to assisted living facility with hhc in stable condition.
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Aspiration pleural cavity, Atelectasis, Bradycardia, Bronchoscopy
Clinical narrative: 74-year-old woman with a past medical history significant for breast CA 2010 status post RT and lumpectomy, dyspnea with associated weight loss and fatigue for the last 6 to 8 months, and hypertension who presented to the hospital for an outpatient bronchoscopy with EBUS.  She underwent HRCT outpatient was found to have a large right pleural effusion and underwent thoracentesis on 9/16/2022 which revealed lymphocytic with negative cytology.  The CT also revealed pulmonary nodules with right middle lobe atelectasis mediastinal lymphadenopathy requiring her to be scheduled for the EBUS bronchoscopy today.  Prior to the bronchoscopy the patient was reportedly in her normal state of health.  She denies shortness of breath was any different from her typical shortness of breath for the past 6 months.  She also denied chest pain, fever, chills, abdominal pain, nausea or vomiting.  She denies recent travel or sick contacts.  She has never required home oxygen.  She reports no history of lung disease ( other than recurrent pleural effusions recently) or cardiac disease.  She has never smoked tobacco and only drinks alcohol socially.  Post bronchoscopy today the patient experienced episode of bradycardia with heart rates in the 20s to 30s, atropine was given and the patient also received 4-5 chest compressions by anesthesia.  She was reportedly hypoventilating throughout the procedure with low tidal volumes.  The patient was also initially difficult to arouse postprocedure but she did became more alert and was able to be extubated and transitioned to supplemental oxygen via nasal cannula.  Given the above scenario the patient was admitted to internal medicine for ongoing monitoring. COVID-19 positive.  Medical team consulted, discussed with them.  Patient is agreeable and wishes to start remdesivir if appropriate per recommendations.  Decadron ordered by pulmonary medicine.  Will monitor LFTs and HR. Discussed with medical team, plan to stop Remdesivir and isolation precautions as COVID-19 positivity is likely related to old infection.   Elevated D-dimer in the setting of recent procedure, and chest compressions.  Bilateral lower extremity venous duplex is ordered showing chronic DVT.  VQ scan abnormal.  Patient will need anticoagulation for at least 3 months and prefers to be on Eliquis despite the high cost does not want to be on Coumadin.  Patient understands that she needs to follow-up with cardiology and her primary care provider for ongoing medication refills past the first 30 days.
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Deep vein thrombosis, Endobronchial ultrasound, Fibrin D dimer increased
Clinical narrative: 74-year-old woman with a past medical history significant for breast CA 2010 status post RT and lumpectomy, dyspnea with associated weight loss and fatigue for the last 6 to 8 months, and hypertension who presented to the hospital for an outpatient bronchoscopy with EBUS.  She underwent HRCT outpatient was found to have a large right pleural effusion and underwent thoracentesis on 9/16/2022 which revealed lymphocytic with negative cytology.  The CT also revealed pulmonary nodules with right middle lobe atelectasis mediastinal lymphadenopathy requiring her to be scheduled for the EBUS bronchoscopy today.  Prior to the bronchoscopy the patient was reportedly in her normal state of health.  She denies shortness of breath was any different from her typical shortness of breath for the past 6 months.  She also denied chest pain, fever, chills, abdominal pain, nausea or vomiting.  She denies recent travel or sick contacts.  She has never required home oxygen.  She reports no history of lung disease ( other than recurrent pleural effusions recently) or cardiac disease.  She has never smoked tobacco and only drinks alcohol socially.  Post bronchoscopy today the patient experienced episode of bradycardia with heart rates in the 20s to 30s, atropine was given and the patient also received 4-5 chest compressions by anesthesia.  She was reportedly hypoventilating throughout the procedure with low tidal volumes.  The patient was also initially difficult to arouse postprocedure but she did became more alert and was able to be extubated and transitioned to supplemental oxygen via nasal cannula.  Given the above scenario the patient was admitted to internal medicine for ongoing monitoring. COVID-19 positive.  Medical team consulted, discussed with them.  Patient is agreeable and wishes to start remdesivir if appropriate per recommendations.  Decadron ordered by pulmonary medicine.  Will monitor LFTs and HR. Discussed with medical team, plan to stop Remdesivir and isolation precautions as COVID-19 positivity is likely related to old infection.   Elevated D-dimer in the setting of recent procedure, and chest compressions.  Bilateral lower extremity venous duplex is ordered showing chronic DVT.  VQ scan abnormal.  Patient will need anticoagulation for at least 3 months and prefers to be on Eliquis despite the high cost does not want to be on Coumadin.  Patient understands that she needs to follow-up with cardiology and her primary care provider for ongoing medication refills past the first 30 days.
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: High-resolution computerised tomogram of lung, Hypoventilation, Lymphadenopathy mediastinal, Lymphocyte count, Pleural effusion
Clinical narrative: 74-year-old woman with a past medical history significant for breast CA 2010 status post RT and lumpectomy, dyspnea with associated weight loss and fatigue for the last 6 to 8 months, and hypertension who presented to the hospital for an outpatient bronchoscopy with EBUS.  She underwent HRCT outpatient was found to have a large right pleural effusion and underwent thoracentesis on 9/16/2022 which revealed lymphocytic with negative cytology.  The CT also revealed pulmonary nodules with right middle lobe atelectasis mediastinal lymphadenopathy requiring her to be scheduled for the EBUS bronchoscopy today.  Prior to the bronchoscopy the patient was reportedly in her normal state of health.  She denies shortness of breath was any different from her typical shortness of breath for the past 6 months.  She also denied chest pain, fever, chills, abdominal pain, nausea or vomiting.  She denies recent travel or sick contacts.  She has never required home oxygen.  She reports no history of lung disease ( other than recurrent pleural effusions recently) or cardiac disease.  She has never smoked tobacco and only drinks alcohol socially.  Post bronchoscopy today the patient experienced episode of bradycardia with heart rates in the 20s to 30s, atropine was given and the patient also received 4-5 chest compressions by anesthesia.  She was reportedly hypoventilating throughout the procedure with low tidal volumes.  The patient was also initially difficult to arouse postprocedure but she did became more alert and was able to be extubated and transitioned to supplemental oxygen via nasal cannula.  Given the above scenario the patient was admitted to internal medicine for ongoing monitoring. COVID-19 positive.  Medical team consulted, discussed with them.  Patient is agreeable and wishes to start remdesivir if appropriate per recommendations.  Decadron ordered by pulmonary medicine.  Will monitor LFTs and HR. Discussed with medical team, plan to stop Remdesivir and isolation precautions as COVID-19 positivity is likely related to old infection.   Elevated D-dimer in the setting of recent procedure, and chest compressions.  Bilateral lower extremity venous duplex is ordered showing chronic DVT.  VQ scan abnormal.  Patient will need anticoagulation for at least 3 months and prefers to be on Eliquis despite the high cost does not want to be on Coumadin.  Patient understands that she needs to follow-up with cardiology and her primary care provider for ongoing medication refills past the first 30 days.
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pulmonary mass, Resuscitation, SARS-CoV-2 test positive, Tidal volume decreased, Ultrasound Doppler abnormal
Clinical narrative: 74-year-old woman with a past medical history significant for breast CA 2010 status post RT and lumpectomy, dyspnea with associated weight loss and fatigue for the last 6 to 8 months, and hypertension who presented to the hospital for an outpatient bronchoscopy with EBUS.  She underwent HRCT outpatient was found to have a large right pleural effusion and underwent thoracentesis on 9/16/2022 which revealed lymphocytic with negative cytology.  The CT also revealed pulmonary nodules with right middle lobe atelectasis mediastinal lymphadenopathy requiring her to be scheduled for the EBUS bronchoscopy today.  Prior to the bronchoscopy the patient was reportedly in her normal state of health.  She denies shortness of breath was any different from her typical shortness of breath for the past 6 months.  She also denied chest pain, fever, chills, abdominal pain, nausea or vomiting.  She denies recent travel or sick contacts.  She has never required home oxygen.  She reports no history of lung disease ( other than recurrent pleural effusions recently) or cardiac disease.  She has never smoked tobacco and only drinks alcohol socially.  Post bronchoscopy today the patient experienced episode of bradycardia with heart rates in the 20s to 30s, atropine was given and the patient also received 4-5 chest compressions by anesthesia.  She was reportedly hypoventilating throughout the procedure with low tidal volumes.  The patient was also initially difficult to arouse postprocedure but she did became more alert and was able to be extubated and transitioned to supplemental oxygen via nasal cannula.  Given the above scenario the patient was admitted to internal medicine for ongoing monitoring. COVID-19 positive.  Medical team consulted, discussed with them.  Patient is agreeable and wishes to start remdesivir if appropriate per recommendations.  Decadron ordered by pulmonary medicine.  Will monitor LFTs and HR. Discussed with medical team, plan to stop Remdesivir and isolation precautions as COVID-19 positivity is likely related to old infection.   Elevated D-dimer in the setting of recent procedure, and chest compressions.  Bilateral lower extremity venous duplex is ordered showing chronic DVT.  VQ scan abnormal.  Patient will need anticoagulation for at least 3 months and prefers to be on Eliquis despite the high cost does not want to be on Coumadin.  Patient understands that she needs to follow-up with cardiology and her primary care provider for ongoing medication refills past the first 30 days.
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Ventilation/perfusion scan abnormal
Clinical narrative: 74-year-old woman with a past medical history significant for breast CA 2010 status post RT and lumpectomy, dyspnea with associated weight loss and fatigue for the last 6 to 8 months, and hypertension who presented to the hospital for an outpatient bronchoscopy with EBUS.  She underwent HRCT outpatient was found to have a large right pleural effusion and underwent thoracentesis on 9/16/2022 which revealed lymphocytic with negative cytology.  The CT also revealed pulmonary nodules with right middle lobe atelectasis mediastinal lymphadenopathy requiring her to be scheduled for the EBUS bronchoscopy today.  Prior to the bronchoscopy the patient was reportedly in her normal state of health.  She denies shortness of breath was any different from her typical shortness of breath for the past 6 months.  She also denied chest pain, fever, chills, abdominal pain, nausea or vomiting.  She denies recent travel or sick contacts.  She has never required home oxygen.  She reports no history of lung disease ( other than recurrent pleural effusions recently) or cardiac disease.  She has never smoked tobacco and only drinks alcohol socially.  Post bronchoscopy today the patient experienced episode of bradycardia with heart rates in the 20s to 30s, atropine was given and the patient also received 4-5 chest compressions by anesthesia.  She was reportedly hypoventilating throughout the procedure with low tidal volumes.  The patient was also initially difficult to arouse postprocedure but she did became more alert and was able to be extubated and transitioned to supplemental oxygen via nasal cannula.  Given the above scenario the patient was admitted to internal medicine for ongoing monitoring. COVID-19 positive.  Medical team consulted, discussed with them.  Patient is agreeable and wishes to start remdesivir if appropriate per recommendations.  Decadron ordered by pulmonary medicine.  Will monitor LFTs and HR. Discussed with medical team, plan to stop Remdesivir and isolation precautions as COVID-19 positivity is likely related to old infection.   Elevated D-dimer in the setting of recent procedure, and chest compressions.  Bilateral lower extremity venous duplex is ordered showing chronic DVT.  VQ scan abnormal.  Patient will need anticoagulation for at least 3 months and prefers to be on Eliquis despite the high cost does not want to be on Coumadin.  Patient understands that she needs to follow-up with cardiology and her primary care provider for ongoing medication refills past the first 30 days.
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Asthenia, Beta haemolytic streptococcal infection, Blood creatinine increased, Blood magnesium normal, Blood potassium normal
Clinical narrative: Pt is a 94 yo female w/ hx of HTN, HLD, AAA, CKD, DM, neuropathy, ILD, spinal stenosis, TIA who presented to ED secondary to weakness. Over the past week, pt w/ weakness, fatigue. She tested positive for COVID on 9/25. She had progressive sx, poor PO intake, cough, She was brought to ED for further care as she lives alone. Upon arrival to ED, BP 150/53, HR 62, afebrile, no hypoxia, no leukocytosis, Hgb 10.7, plts 218. Na 136, K 4.4, Cr 1.37. MG 1.7. Repeat UA concerning for UTI. +COVID. CXR w/ similar interstitial opacities. Pt given IVFs. Abx initiated for UTI. Pt admitted for further care. Stable on RA, afebrile. ID consulted. Cont 5 day course of paxlovid. Urine cx w/ strep agalactiae. Was on  Rocephin, transitioned to Keflex BID to complete 7 days total. Procal WNL. Nephro followed, renal function improved w/ IVFs. PT/OT rec home w/ therapies, physical assist. Pt stable for Dc home w/ home therapies.
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Blood sodium normal, COVID-19, Chest X-ray abnormal, Cough, Culture urine positive
Clinical narrative: Pt is a 94 yo female w/ hx of HTN, HLD, AAA, CKD, DM, neuropathy, ILD, spinal stenosis, TIA who presented to ED secondary to weakness. Over the past week, pt w/ weakness, fatigue. She tested positive for COVID on 9/25. She had progressive sx, poor PO intake, cough, She was brought to ED for further care as she lives alone. Upon arrival to ED, BP 150/53, HR 62, afebrile, no hypoxia, no leukocytosis, Hgb 10.7, plts 218. Na 136, K 4.4, Cr 1.37. MG 1.7. Repeat UA concerning for UTI. +COVID. CXR w/ similar interstitial opacities. Pt given IVFs. Abx initiated for UTI. Pt admitted for further care. Stable on RA, afebrile. ID consulted. Cont 5 day course of paxlovid. Urine cx w/ strep agalactiae. Was on  Rocephin, transitioned to Keflex BID to complete 7 days total. Procal WNL. Nephro followed, renal function improved w/ IVFs. PT/OT rec home w/ therapies, physical assist. Pt stable for Dc home w/ home therapies.
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Fatigue, Haemoglobin decreased, Hypophagia, Lung opacity, Platelet count normal
Clinical narrative: Pt is a 94 yo female w/ hx of HTN, HLD, AAA, CKD, DM, neuropathy, ILD, spinal stenosis, TIA who presented to ED secondary to weakness. Over the past week, pt w/ weakness, fatigue. She tested positive for COVID on 9/25. She had progressive sx, poor PO intake, cough, She was brought to ED for further care as she lives alone. Upon arrival to ED, BP 150/53, HR 62, afebrile, no hypoxia, no leukocytosis, Hgb 10.7, plts 218. Na 136, K 4.4, Cr 1.37. MG 1.7. Repeat UA concerning for UTI. +COVID. CXR w/ similar interstitial opacities. Pt given IVFs. Abx initiated for UTI. Pt admitted for further care. Stable on RA, afebrile. ID consulted. Cont 5 day course of paxlovid. Urine cx w/ strep agalactiae. Was on  Rocephin, transitioned to Keflex BID to complete 7 days total. Procal WNL. Nephro followed, renal function improved w/ IVFs. PT/OT rec home w/ therapies, physical assist. Pt stable for Dc home w/ home therapies.