chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 28.0
Sex: F
Vaccine: COVID19-2, COVID19-2
Symptoms: Unevaluable event
Clinical narrative: Moderna: If the patient received a bivalent booster dose instead of a monovalent primary series dose, this is considered a lower-than-authorized dose. Repeat the dose with the correct monovalent product immediately (no minimum interval). Some experts suggest delaying the repeat dose for 8 weeks after the invalid dose based on the potential for increased reactogenicity and the rare risk of myocarditis and pericarditis from mRNA COVID-19 vaccine, especially in males ages 12?39 years. Both situations are considered vaccine administration errors; you are required to report COVID-19 vaccine administration errors to the Vaccine Adverse Event Reporting System (VAERS). For more information, see vaccine administration errors and deviations.
Age: 28.0
Sex: F
Vaccine: COVID19-2, COVID19-2
Symptoms: Wrong product administered
Clinical narrative: Moderna: If the patient received a bivalent booster dose instead of a monovalent primary series dose, this is considered a lower-than-authorized dose. Repeat the dose with the correct monovalent product immediately (no minimum interval). Some experts suggest delaying the repeat dose for 8 weeks after the invalid dose based on the potential for increased reactogenicity and the rare risk of myocarditis and pericarditis from mRNA COVID-19 vaccine, especially in males ages 12?39 years. Both situations are considered vaccine administration errors; you are required to report COVID-19 vaccine administration errors to the Vaccine Adverse Event Reporting System (VAERS). For more information, see vaccine administration errors and deviations.
Age: 36.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Injection site pain, Palpitations, Tachycardia
Clinical narrative: Site: Pain at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Tachycardia-Severe, Additional Details: patient went to hospital after vaccine with racing heart, difficulty breathing, was told in ambulance that se has poor vital signs. on 09/16/2022 was complaining of still having continued shortness of breath and using albuterol inhaler. tried to reach on 09/17 to get an update, not able to reach patient.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Error: Wrong Vaccine/Product Administered-
Age: 41.0
Sex: F
Vaccine: TDAP
Symptoms: Injection site pruritus, Pruritus, Rash, Urticaria
Clinical narrative: Site: Itching at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Additional Details: Patient developed rash/hives on one leg about one hour after receiving vaccines. Rash appeared on chest a few hours later. Took Benadryl, and this resolved rash.
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: The Person served did not have a reaction to vaccine given. It was noticed that the vaccine administered was one of the ones considered not usable due to the fact that the temperature was out of range and was stored for 2 months.
Age: 15.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, Dizziness, Hypotension, Nausea, Tinnitus
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Tinnitus-Medium, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Medium
Age: 15.0
Sex: M
Vaccine: COVID19-2
Symptoms: Visual impairment
Clinical narrative: Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Tinnitus-Medium, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Medium
Age: 21.0
Sex: M
Vaccine: COVID19-2
Symptoms: Feeling abnormal, Hypotension, Immediate post-injection reaction, Malaise
Clinical narrative: Systemic: PT COMPLAINT FEELING SICK AND CANNOT CLEARY EXPLAIN WHAT-Medium, Systemic: Hypotension-Medium, Additional Details: IMMEDIATELY AFTER SHOT PT COMPLAINS FEELING WEIRD AND FEELING SICK;PATIENT LIED DOWN STILL FOR FEW MINUTES.STILL TALKING.NO RASH OR ITCHING.BP CHECKED AND WAS LOW WHILE SITTING.PT LAID DOWN AND BP WAS FOUND RETURNING TO 108/68. PT STAYED FOR ALMOST 30 MINUTES.DRANK WATER.PARENTS WERE WITH HIM AND WAS FEELING OK AND LEFT WALKING.DID NOT REPORT ANY DIFFICULTY BREATHING OR DISORIENTATION.OFFERED TO CALL 911.REPORTED WAS SICK LAST TIME GOT THE VACCINE.CALLED AFTER 1HR MOM SAID HE FEELING BETTER.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site bruising, Injection site erythema
Clinical narrative: Site: Bruising at Injection Site-Mild, Site: Redness at Injection Site-Mild
Age: 83.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Injection site bruising, Injection site swelling
Clinical narrative: Site: Bruising at Injection Site-Medium, Site: Swelling at Injection Site-Severe, Systemic: Joint Pain-Severe
Age: 40.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Lymphadenopathy
Clinical narrative: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Rash Generalized-Medium, Systemic: Lymph Node Swelling-Medium
Age: 40.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rash
Clinical narrative: Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Rash Generalized-Medium, Systemic: Lymph Node Swelling-Medium
Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: No adverse reaction occurred. Vaccine was out of the temperature range for approximately 2 months and then was administered yesterday not knowing was one of the out of temperature  range vaccines.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Wrong product administered
Clinical narrative: Error: Wrong Vaccine/Product Administered-
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Fall, SARS-CoV-2 test positive
Clinical narrative: Patient with 3 COVID vaccines who admitted to hospital after fall with COVID detected test.  Provider d/c note:  "77-year-old male with past medical history of hypertension and T2DM who was admitted 09/09 for falls and generalized weakness.  He was found to be COVID-19 positive, but has not required any supplemental O2.  Patient has worked with therapies while hospitalized who have recommended SNF on discharge.  Placement was delayed due to his COVID-19 positive status."
Age: 32.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fungal infection, Immune system disorder, Pyrexia
Clinical narrative: Yeast infection developed 3 days after vaccine.  Day of vaccine: fever, immune response.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: asymptomatic
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Chills, Feeling cold, Mobility decreased, Muscular weakness
Clinical narrative: I just realized that I got my shot on the 20th, not the 19th, got my days wrong my bad. about five hours after I got my booster shot, I started having severe muscle pain, especially in my back. as the night progressed, i started to not be able to control my neck muscles to hold my head up, and the pain in my arm was so severe i could not lift it more than 45 degrees. Since about 6:30 pm on the 20th, I have been extremely cold and unable to warm up, accompanied with shivering. On the morning of the 21st, I was throwing up as well.
Age: 19.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Pain in extremity, Vomiting
Clinical narrative: I just realized that I got my shot on the 20th, not the 19th, got my days wrong my bad. about five hours after I got my booster shot, I started having severe muscle pain, especially in my back. as the night progressed, i started to not be able to control my neck muscles to hold my head up, and the pain in my arm was so severe i could not lift it more than 45 degrees. Since about 6:30 pm on the 20th, I have been extremely cold and unable to warm up, accompanied with shivering. On the morning of the 21st, I was throwing up as well.
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypoaesthesia, Vaccine positive rechallenge
Clinical narrative: Left side of my face was numb.  It happened last time as well.   Doctor suggested I should not have a booster in the future.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Blindness, Dry eye, Eye inflammation, Eye pain, Magnetic resonance imaging
Clinical narrative: Developed extreme , incapacitating ocular inflammatory process . Diagnosed with anterior necrotizing scleritis, along with posterior scleritis and concomitant  dry eye...all inflammatory processes of eyes, with no prior history of ocular inflammation. No rheumatologic disease.  Has been extremely resistant to treatment, requiring long term  steroids , Humira weekly. Patient with continual ocular pain, scleral thinning ,  some vision  loss.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Necrotising scleritis, Scleral thinning, Scleritis, Ultrasound eye
Clinical narrative: Developed extreme , incapacitating ocular inflammatory process . Diagnosed with anterior necrotizing scleritis, along with posterior scleritis and concomitant  dry eye...all inflammatory processes of eyes, with no prior history of ocular inflammation. No rheumatologic disease.  Has been extremely resistant to treatment, requiring long term  steroids , Humira weekly. Patient with continual ocular pain, scleral thinning ,  some vision  loss.
Age: 23.0
Sex: M
Vaccine: UNK
Symptoms: Fall, Hyperhidrosis, Syncope
Clinical narrative: Patient experienced a syncopal episode after receiving dose. He fell as he was walking to the observation area . The episode was witnessed .  Patient became diaphoretic.  Recovered uneventfully EMS were on scene . Patient did not require transport to ER.
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pyrexia
Clinical narrative: running fever five days after the vaccination.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Adenocarcinoma, Adhesion, Atrial fibrillation, Biopsy, COVID-19
Clinical narrative: Transfer from Hospital on 8/15 for evaluation following biopsy of pelvic mass for possible ovarian cancer with small bowel obstruction with NG tube. Biopsy returned adenocarcinoma. Repeat CT showed mass with omental caking and extensive adhesions contributing to bowel obstruction and possible aspiration pneumonitis lower lobe. NG in place with NPO status and IV fluids. 8/16 COVID +. Developed tachycardia, leukocytosis pretension and worsenng renal function requiring ICU care. Started on vancomycin and cefepime. Continued metoprolol for a fib. Due to worsening staus and complex medical comorbitities, pallative care was consulted. Patinet requested DNR/DNI and comfort care measures provided.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram abdomen abnormal, Gastrointestinal tube insertion, General physical health deterioration, Intensive care, Leukocytosis
Clinical narrative: Transfer from Hospital on 8/15 for evaluation following biopsy of pelvic mass for possible ovarian cancer with small bowel obstruction with NG tube. Biopsy returned adenocarcinoma. Repeat CT showed mass with omental caking and extensive adhesions contributing to bowel obstruction and possible aspiration pneumonitis lower lobe. NG in place with NPO status and IV fluids. 8/16 COVID +. Developed tachycardia, leukocytosis pretension and worsenng renal function requiring ICU care. Started on vancomycin and cefepime. Continued metoprolol for a fib. Due to worsening staus and complex medical comorbitities, pallative care was consulted. Patinet requested DNR/DNI and comfort care measures provided.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Multimorbidity, Nothing by mouth order, Pelvic mass, Peritoneal disorder, Renal impairment
Clinical narrative: Transfer from Hospital on 8/15 for evaluation following biopsy of pelvic mass for possible ovarian cancer with small bowel obstruction with NG tube. Biopsy returned adenocarcinoma. Repeat CT showed mass with omental caking and extensive adhesions contributing to bowel obstruction and possible aspiration pneumonitis lower lobe. NG in place with NPO status and IV fluids. 8/16 COVID +. Developed tachycardia, leukocytosis pretension and worsenng renal function requiring ICU care. Started on vancomycin and cefepime. Continued metoprolol for a fib. Due to worsening staus and complex medical comorbitities, pallative care was consulted. Patinet requested DNR/DNI and comfort care measures provided.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Small intestinal obstruction, Tachycardia
Clinical narrative: Transfer from Hospital on 8/15 for evaluation following biopsy of pelvic mass for possible ovarian cancer with small bowel obstruction with NG tube. Biopsy returned adenocarcinoma. Repeat CT showed mass with omental caking and extensive adhesions contributing to bowel obstruction and possible aspiration pneumonitis lower lobe. NG in place with NPO status and IV fluids. 8/16 COVID +. Developed tachycardia, leukocytosis pretension and worsenng renal function requiring ICU care. Started on vancomycin and cefepime. Continued metoprolol for a fib. Due to worsening staus and complex medical comorbitities, pallative care was consulted. Patinet requested DNR/DNI and comfort care measures provided.
Age: 66.0
Sex: F
Vaccine: COVID19-2
Symptoms: Urticaria
Clinical narrative: Woke up this morning with hives, will take benadryl and apply calamine as needed
Age: 35.0
Sex: M
Vaccine: FLUC4
Symptoms: Blood pressure increased, Chest discomfort, Dyspnoea, Flushing, Hyperhidrosis
Clinical narrative: Chest tightness, trouble breathing, tunnel vision, flushing, sweating, elevated blood pressure all happened and resolved within 15 minutes. General malaise persisted about 4 hours post injection.
Age: 35.0
Sex: M
Vaccine: FLUC4
Symptoms: Malaise, Tunnel vision
Clinical narrative: Chest tightness, trouble breathing, tunnel vision, flushing, sweating, elevated blood pressure all happened and resolved within 15 minutes. General malaise persisted about 4 hours post injection.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Bronchitis, COVID-19, COVID-19 pneumonia
Clinical narrative: Discharge Date: Sep 17, 2022 Discharge Provider: MD Primary Care Provider:  MD  Admission Date: 9/15/2022  PRESENTING PROBLEM: Respiratory insufficiency   HOSPITAL COURSE: 79-year-old male with past medical history significant for chronic obstructive pulmonary disease, chronic arthritis, hypertension, history of stroke, BPH and GERD.  Presented to emergency department on 09/15 with generalized malaise, headaches, shortness of breath and cough.  He had been feeling symptoms since 09/04 and has a positive for COVID-19 on 09/07.  He was recently given a short course of prednisone but did not improve so presented emergency department.  He is found to be hemodynamically stable placed on 2 L of nasal cannula.  Labs appeared relatively stable.  CTA thorax was negative for pulmonary embolus but did show ground-glass opacities favoring multifocal pneumonia, findings of bronchitis and emphysema.  He is started on increased dose of steroids, DuoNebs and admitted to Medicine Service for further management.   As far as acute hypoxic respiratory failure, this is likely secondary to COVID-19 pneumonia as well as a mild chronic obstructive pulmonary disease flare.  This was treated with DuoNebs, Symbicort, azithromycin and steroids. Procalcitonin and Influenza PCR were negative. Patient was on 2-3 L nasal cannula. He is subjectively feeling better. He had stable oxygen requirement of 2-3L for 48 hours. Patient was discharged home on home oxygen. He will continue to monitor his O2 sats at home and present back for re-evaluation if he develops increasing oxygen requirement and symptoms. He will finish 2 more days of azithromycin and finish a prednisone taper
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dyspnoea, Headache
Clinical narrative: Discharge Date: Sep 17, 2022 Discharge Provider: MD Primary Care Provider:  MD  Admission Date: 9/15/2022  PRESENTING PROBLEM: Respiratory insufficiency   HOSPITAL COURSE: 79-year-old male with past medical history significant for chronic obstructive pulmonary disease, chronic arthritis, hypertension, history of stroke, BPH and GERD.  Presented to emergency department on 09/15 with generalized malaise, headaches, shortness of breath and cough.  He had been feeling symptoms since 09/04 and has a positive for COVID-19 on 09/07.  He was recently given a short course of prednisone but did not improve so presented emergency department.  He is found to be hemodynamically stable placed on 2 L of nasal cannula.  Labs appeared relatively stable.  CTA thorax was negative for pulmonary embolus but did show ground-glass opacities favoring multifocal pneumonia, findings of bronchitis and emphysema.  He is started on increased dose of steroids, DuoNebs and admitted to Medicine Service for further management.   As far as acute hypoxic respiratory failure, this is likely secondary to COVID-19 pneumonia as well as a mild chronic obstructive pulmonary disease flare.  This was treated with DuoNebs, Symbicort, azithromycin and steroids. Procalcitonin and Influenza PCR were negative. Patient was on 2-3 L nasal cannula. He is subjectively feeling better. He had stable oxygen requirement of 2-3L for 48 hours. Patient was discharged home on home oxygen. He will continue to monitor his O2 sats at home and present back for re-evaluation if he develops increasing oxygen requirement and symptoms. He will finish 2 more days of azithromycin and finish a prednisone taper
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Influenza virus test negative, Lung opacity, Malaise, Pneumonia, Procalcitonin normal
Clinical narrative: Discharge Date: Sep 17, 2022 Discharge Provider: MD Primary Care Provider:  MD  Admission Date: 9/15/2022  PRESENTING PROBLEM: Respiratory insufficiency   HOSPITAL COURSE: 79-year-old male with past medical history significant for chronic obstructive pulmonary disease, chronic arthritis, hypertension, history of stroke, BPH and GERD.  Presented to emergency department on 09/15 with generalized malaise, headaches, shortness of breath and cough.  He had been feeling symptoms since 09/04 and has a positive for COVID-19 on 09/07.  He was recently given a short course of prednisone but did not improve so presented emergency department.  He is found to be hemodynamically stable placed on 2 L of nasal cannula.  Labs appeared relatively stable.  CTA thorax was negative for pulmonary embolus but did show ground-glass opacities favoring multifocal pneumonia, findings of bronchitis and emphysema.  He is started on increased dose of steroids, DuoNebs and admitted to Medicine Service for further management.   As far as acute hypoxic respiratory failure, this is likely secondary to COVID-19 pneumonia as well as a mild chronic obstructive pulmonary disease flare.  This was treated with DuoNebs, Symbicort, azithromycin and steroids. Procalcitonin and Influenza PCR were negative. Patient was on 2-3 L nasal cannula. He is subjectively feeling better. He had stable oxygen requirement of 2-3L for 48 hours. Patient was discharged home on home oxygen. He will continue to monitor his O2 sats at home and present back for re-evaluation if he develops increasing oxygen requirement and symptoms. He will finish 2 more days of azithromycin and finish a prednisone taper
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Discharge Date: Sep 17, 2022 Discharge Provider: MD Primary Care Provider:  MD  Admission Date: 9/15/2022  PRESENTING PROBLEM: Respiratory insufficiency   HOSPITAL COURSE: 79-year-old male with past medical history significant for chronic obstructive pulmonary disease, chronic arthritis, hypertension, history of stroke, BPH and GERD.  Presented to emergency department on 09/15 with generalized malaise, headaches, shortness of breath and cough.  He had been feeling symptoms since 09/04 and has a positive for COVID-19 on 09/07.  He was recently given a short course of prednisone but did not improve so presented emergency department.  He is found to be hemodynamically stable placed on 2 L of nasal cannula.  Labs appeared relatively stable.  CTA thorax was negative for pulmonary embolus but did show ground-glass opacities favoring multifocal pneumonia, findings of bronchitis and emphysema.  He is started on increased dose of steroids, DuoNebs and admitted to Medicine Service for further management.   As far as acute hypoxic respiratory failure, this is likely secondary to COVID-19 pneumonia as well as a mild chronic obstructive pulmonary disease flare.  This was treated with DuoNebs, Symbicort, azithromycin and steroids. Procalcitonin and Influenza PCR were negative. Patient was on 2-3 L nasal cannula. He is subjectively feeling better. He had stable oxygen requirement of 2-3L for 48 hours. Patient was discharged home on home oxygen. He will continue to monitor his O2 sats at home and present back for re-evaluation if he develops increasing oxygen requirement and symptoms. He will finish 2 more days of azithromycin and finish a prednisone taper
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Asthenia, Blood potassium decreased, Blood sodium decreased
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: NP  Admission Date: 9/15/2022 Discharge Date: 9/18/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pulmonary embolism associated with COVID-19 [U07.1, I26.99]   HOSPITAL COURSE: Patient is a 70 y.o. female who presented with a history of GERD, GI bleed, common murmur.  Over the past day or 2 patient has had increased weakness and fell on Wednesday.  Patient waited until Thursday to come to the emergency department when she noticed her blood pressures were low.  EMS was called and noted patient to be hypotensive provided 1 L saline.  Upon arrival to the emergency department chest x-ray, x-ray of the spine were all negative acute process.  Lab work showed potassium level of 3.2, sodium level 128 BNP 337.  Initial troponin 24 with a repeat of 21 a delta of -3.  WBC 3.11.  COVID-19 PCR did detect virus.  D-dimer was 1710. UA was negative for infection and occult blood stool was negative.  EKG showed normal sinus rhythm  with possible atrial enlargement.  CTA thorax was ordered due to elevated D-dimer.  Imaging showed right lower lobe subsegmental pulmonary embolism.  No findings of right heart strain.  Patient was then started on heparin infusion.  Hospitalist services was contacted and accepted patient treatment of pulmonary embolism in the presence of COVID-19.   The patient was transitioned to Xarelto without issue, and the cost was verified as affordable with patient. The patient otherwise remained stable on room air, with a cough as her only bothersome symptom.  Echo was completed showing an EF of 75%, grade 1 diastolic dysfunction, mild LVH, severely increased left atrial volume, and moderate mitral stenosis. She was noted to be hypertensive while inpatient and blood pressure medications were titrated to achieve better control. She is recommended to have a sleep study outpatient.   PT and OT recommended SAR stay for further strengthening. The patient was concerned about finances and was only agreeable to placement. This was not possible due to covid status. She elected to go home with home health care, and services were arranged.  She was explicitly that she is at high risk of self harm is she continues to have multiple falls while on Xarelto. This did not persuade her; she expressed understanding of the risks, and knowledge of when she should seek medical care. She was discharge home in stable condition with HHC services, xarelto and blood pressure medications sent to desired pharmacy. She is recommended to follow up with her PCP for further management of PE, referral for sleep study, hypertension, and other chronic conditions. A BMP was ordered for 2 weeks as lisinopril was increased and hydrochlorothiazide were added, to check for electrolyte abnormalities.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, Chest X-ray abnormal, Cough, Diastolic dysfunction
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: NP  Admission Date: 9/15/2022 Discharge Date: 9/18/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pulmonary embolism associated with COVID-19 [U07.1, I26.99]   HOSPITAL COURSE: Patient is a 70 y.o. female who presented with a history of GERD, GI bleed, common murmur.  Over the past day or 2 patient has had increased weakness and fell on Wednesday.  Patient waited until Thursday to come to the emergency department when she noticed her blood pressures were low.  EMS was called and noted patient to be hypotensive provided 1 L saline.  Upon arrival to the emergency department chest x-ray, x-ray of the spine were all negative acute process.  Lab work showed potassium level of 3.2, sodium level 128 BNP 337.  Initial troponin 24 with a repeat of 21 a delta of -3.  WBC 3.11.  COVID-19 PCR did detect virus.  D-dimer was 1710. UA was negative for infection and occult blood stool was negative.  EKG showed normal sinus rhythm  with possible atrial enlargement.  CTA thorax was ordered due to elevated D-dimer.  Imaging showed right lower lobe subsegmental pulmonary embolism.  No findings of right heart strain.  Patient was then started on heparin infusion.  Hospitalist services was contacted and accepted patient treatment of pulmonary embolism in the presence of COVID-19.   The patient was transitioned to Xarelto without issue, and the cost was verified as affordable with patient. The patient otherwise remained stable on room air, with a cough as her only bothersome symptom.  Echo was completed showing an EF of 75%, grade 1 diastolic dysfunction, mild LVH, severely increased left atrial volume, and moderate mitral stenosis. She was noted to be hypertensive while inpatient and blood pressure medications were titrated to achieve better control. She is recommended to have a sleep study outpatient.   PT and OT recommended SAR stay for further strengthening. The patient was concerned about finances and was only agreeable to placement. This was not possible due to covid status. She elected to go home with home health care, and services were arranged.  She was explicitly that she is at high risk of self harm is she continues to have multiple falls while on Xarelto. This did not persuade her; she expressed understanding of the risks, and knowledge of when she should seek medical care. She was discharge home in stable condition with HHC services, xarelto and blood pressure medications sent to desired pharmacy. She is recommended to follow up with her PCP for further management of PE, referral for sleep study, hypertension, and other chronic conditions. A BMP was ordered for 2 weeks as lisinopril was increased and hydrochlorothiazide were added, to check for electrolyte abnormalities.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Ejection fraction normal, Electrocardiogram abnormal, Fall, Fibrin D dimer increased
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: NP  Admission Date: 9/15/2022 Discharge Date: 9/18/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pulmonary embolism associated with COVID-19 [U07.1, I26.99]   HOSPITAL COURSE: Patient is a 70 y.o. female who presented with a history of GERD, GI bleed, common murmur.  Over the past day or 2 patient has had increased weakness and fell on Wednesday.  Patient waited until Thursday to come to the emergency department when she noticed her blood pressures were low.  EMS was called and noted patient to be hypotensive provided 1 L saline.  Upon arrival to the emergency department chest x-ray, x-ray of the spine were all negative acute process.  Lab work showed potassium level of 3.2, sodium level 128 BNP 337.  Initial troponin 24 with a repeat of 21 a delta of -3.  WBC 3.11.  COVID-19 PCR did detect virus.  D-dimer was 1710. UA was negative for infection and occult blood stool was negative.  EKG showed normal sinus rhythm  with possible atrial enlargement.  CTA thorax was ordered due to elevated D-dimer.  Imaging showed right lower lobe subsegmental pulmonary embolism.  No findings of right heart strain.  Patient was then started on heparin infusion.  Hospitalist services was contacted and accepted patient treatment of pulmonary embolism in the presence of COVID-19.   The patient was transitioned to Xarelto without issue, and the cost was verified as affordable with patient. The patient otherwise remained stable on room air, with a cough as her only bothersome symptom.  Echo was completed showing an EF of 75%, grade 1 diastolic dysfunction, mild LVH, severely increased left atrial volume, and moderate mitral stenosis. She was noted to be hypertensive while inpatient and blood pressure medications were titrated to achieve better control. She is recommended to have a sleep study outpatient.   PT and OT recommended SAR stay for further strengthening. The patient was concerned about finances and was only agreeable to placement. This was not possible due to covid status. She elected to go home with home health care, and services were arranged.  She was explicitly that she is at high risk of self harm is she continues to have multiple falls while on Xarelto. This did not persuade her; she expressed understanding of the risks, and knowledge of when she should seek medical care. She was discharge home in stable condition with HHC services, xarelto and blood pressure medications sent to desired pharmacy. She is recommended to follow up with her PCP for further management of PE, referral for sleep study, hypertension, and other chronic conditions. A BMP was ordered for 2 weeks as lisinopril was increased and hydrochlorothiazide were added, to check for electrolyte abnormalities.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertension, Hypotension, Laboratory test abnormal, Left atrial volume increased, Left ventricular hypertrophy
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: NP  Admission Date: 9/15/2022 Discharge Date: 9/18/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pulmonary embolism associated with COVID-19 [U07.1, I26.99]   HOSPITAL COURSE: Patient is a 70 y.o. female who presented with a history of GERD, GI bleed, common murmur.  Over the past day or 2 patient has had increased weakness and fell on Wednesday.  Patient waited until Thursday to come to the emergency department when she noticed her blood pressures were low.  EMS was called and noted patient to be hypotensive provided 1 L saline.  Upon arrival to the emergency department chest x-ray, x-ray of the spine were all negative acute process.  Lab work showed potassium level of 3.2, sodium level 128 BNP 337.  Initial troponin 24 with a repeat of 21 a delta of -3.  WBC 3.11.  COVID-19 PCR did detect virus.  D-dimer was 1710. UA was negative for infection and occult blood stool was negative.  EKG showed normal sinus rhythm  with possible atrial enlargement.  CTA thorax was ordered due to elevated D-dimer.  Imaging showed right lower lobe subsegmental pulmonary embolism.  No findings of right heart strain.  Patient was then started on heparin infusion.  Hospitalist services was contacted and accepted patient treatment of pulmonary embolism in the presence of COVID-19.   The patient was transitioned to Xarelto without issue, and the cost was verified as affordable with patient. The patient otherwise remained stable on room air, with a cough as her only bothersome symptom.  Echo was completed showing an EF of 75%, grade 1 diastolic dysfunction, mild LVH, severely increased left atrial volume, and moderate mitral stenosis. She was noted to be hypertensive while inpatient and blood pressure medications were titrated to achieve better control. She is recommended to have a sleep study outpatient.   PT and OT recommended SAR stay for further strengthening. The patient was concerned about finances and was only agreeable to placement. This was not possible due to covid status. She elected to go home with home health care, and services were arranged.  She was explicitly that she is at high risk of self harm is she continues to have multiple falls while on Xarelto. This did not persuade her; she expressed understanding of the risks, and knowledge of when she should seek medical care. She was discharge home in stable condition with HHC services, xarelto and blood pressure medications sent to desired pharmacy. She is recommended to follow up with her PCP for further management of PE, referral for sleep study, hypertension, and other chronic conditions. A BMP was ordered for 2 weeks as lisinopril was increased and hydrochlorothiazide were added, to check for electrolyte abnormalities.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Mitral valve stenosis, Occult blood negative, Pulmonary embolism, SARS-CoV-2 test positive, Spinal X-ray normal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: NP  Admission Date: 9/15/2022 Discharge Date: 9/18/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pulmonary embolism associated with COVID-19 [U07.1, I26.99]   HOSPITAL COURSE: Patient is a 70 y.o. female who presented with a history of GERD, GI bleed, common murmur.  Over the past day or 2 patient has had increased weakness and fell on Wednesday.  Patient waited until Thursday to come to the emergency department when she noticed her blood pressures were low.  EMS was called and noted patient to be hypotensive provided 1 L saline.  Upon arrival to the emergency department chest x-ray, x-ray of the spine were all negative acute process.  Lab work showed potassium level of 3.2, sodium level 128 BNP 337.  Initial troponin 24 with a repeat of 21 a delta of -3.  WBC 3.11.  COVID-19 PCR did detect virus.  D-dimer was 1710. UA was negative for infection and occult blood stool was negative.  EKG showed normal sinus rhythm  with possible atrial enlargement.  CTA thorax was ordered due to elevated D-dimer.  Imaging showed right lower lobe subsegmental pulmonary embolism.  No findings of right heart strain.  Patient was then started on heparin infusion.  Hospitalist services was contacted and accepted patient treatment of pulmonary embolism in the presence of COVID-19.   The patient was transitioned to Xarelto without issue, and the cost was verified as affordable with patient. The patient otherwise remained stable on room air, with a cough as her only bothersome symptom.  Echo was completed showing an EF of 75%, grade 1 diastolic dysfunction, mild LVH, severely increased left atrial volume, and moderate mitral stenosis. She was noted to be hypertensive while inpatient and blood pressure medications were titrated to achieve better control. She is recommended to have a sleep study outpatient.   PT and OT recommended SAR stay for further strengthening. The patient was concerned about finances and was only agreeable to placement. This was not possible due to covid status. She elected to go home with home health care, and services were arranged.  She was explicitly that she is at high risk of self harm is she continues to have multiple falls while on Xarelto. This did not persuade her; she expressed understanding of the risks, and knowledge of when she should seek medical care. She was discharge home in stable condition with HHC services, xarelto and blood pressure medications sent to desired pharmacy. She is recommended to follow up with her PCP for further management of PE, referral for sleep study, hypertension, and other chronic conditions. A BMP was ordered for 2 weeks as lisinopril was increased and hydrochlorothiazide were added, to check for electrolyte abnormalities.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin increased, Urine analysis normal, White blood cell count decreased
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: NP  Admission Date: 9/15/2022 Discharge Date: 9/18/2022  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pulmonary embolism associated with COVID-19 [U07.1, I26.99]   HOSPITAL COURSE: Patient is a 70 y.o. female who presented with a history of GERD, GI bleed, common murmur.  Over the past day or 2 patient has had increased weakness and fell on Wednesday.  Patient waited until Thursday to come to the emergency department when she noticed her blood pressures were low.  EMS was called and noted patient to be hypotensive provided 1 L saline.  Upon arrival to the emergency department chest x-ray, x-ray of the spine were all negative acute process.  Lab work showed potassium level of 3.2, sodium level 128 BNP 337.  Initial troponin 24 with a repeat of 21 a delta of -3.  WBC 3.11.  COVID-19 PCR did detect virus.  D-dimer was 1710. UA was negative for infection and occult blood stool was negative.  EKG showed normal sinus rhythm  with possible atrial enlargement.  CTA thorax was ordered due to elevated D-dimer.  Imaging showed right lower lobe subsegmental pulmonary embolism.  No findings of right heart strain.  Patient was then started on heparin infusion.  Hospitalist services was contacted and accepted patient treatment of pulmonary embolism in the presence of COVID-19.   The patient was transitioned to Xarelto without issue, and the cost was verified as affordable with patient. The patient otherwise remained stable on room air, with a cough as her only bothersome symptom.  Echo was completed showing an EF of 75%, grade 1 diastolic dysfunction, mild LVH, severely increased left atrial volume, and moderate mitral stenosis. She was noted to be hypertensive while inpatient and blood pressure medications were titrated to achieve better control. She is recommended to have a sleep study outpatient.   PT and OT recommended SAR stay for further strengthening. The patient was concerned about finances and was only agreeable to placement. This was not possible due to covid status. She elected to go home with home health care, and services were arranged.  She was explicitly that she is at high risk of self harm is she continues to have multiple falls while on Xarelto. This did not persuade her; she expressed understanding of the risks, and knowledge of when she should seek medical care. She was discharge home in stable condition with HHC services, xarelto and blood pressure medications sent to desired pharmacy. She is recommended to follow up with her PCP for further management of PE, referral for sleep study, hypertension, and other chronic conditions. A BMP was ordered for 2 weeks as lisinopril was increased and hydrochlorothiazide were added, to check for electrolyte abnormalities.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against, then tested positive for COVID-19.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 1/5/21, 1/26/21, 10/22/21. Positive on 9/21/22
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Inappropriate schedule of product administration, SARS-CoV-2 test positive
Clinical narrative: Pfizer 9/15/21, 10/13/21. Positive on 9/20/22.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against, then tested positive for COVID-19.
Age: 42.0
Sex: M
Vaccine: COVID19-2
Symptoms: Inappropriate schedule of product administration
Clinical narrative: Pt received bivalent booster dose 6 weeks after last COVID vaccine.  Per pt report, had been over one year since last COVID vaccine.  Registry unavailable at time of vaccination because it was administered at an outreach event.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chills, Computerised tomogram head normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 9/12/2022 Discharge Date: Sep 14, 2022  PRESENTING PROBLEM: Acute metabolic and toxic Encephalopathy [G93.40] (POA)__Resolved  Pneumonia of right lower lobe due to infectious organism (Community acquired pneumonia of right lower lobe of lung [J18.9]) COVID-19 PNA (POA) Abnormal LFTs     HOSPITAL COURSE: The patient is a 65 y.o. female with past medical history significant for anxiety, depression, hypothyroidism who presents with complaint of confusion and making  nonsensical statements to family.  Patient tested positive for COVID-19 2 days prior to admission.  she has had fevers, chills, nausea, headache, neck pain, shortness of breath, fatigue prior to presentation.  CT Head was negative. CXR with right lung base consolidation. She underwent LP in the ED which was negative with 2 nucleated WBCs. She was placed on Rocephin and Zpak for CAP in the setting of COVID-19 pneumonia. Her confusion was thought to be multifactorial due to acute metabolic/toxic encephalopathy due to COVID-19 + CAP + Polypharmacy from recent initiation of Trazodone and Neurontin. MRI brain was negative for stroke or acute brain pathology.  She improved with supportive measures and was discharged in stable condition.  Cultures remains negative. She was transitioned to Ceftin+Zpak x 5 days for CAP.   She also has generalized myalgia with mildly elevated LFTs which could be 2/2 COVID infection but pt opted to hold her Crestor as she was just started on it a week ago and is concerned it may the cause of her myalgia and abnormal LFTs. She will have a follow up LFTs in one week with PCP and discuss resumption of Crestor or using an alternative Lipid agent.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Culture negative, Dyspnoea, Fatigue, Headache
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 9/12/2022 Discharge Date: Sep 14, 2022  PRESENTING PROBLEM: Acute metabolic and toxic Encephalopathy [G93.40] (POA)__Resolved  Pneumonia of right lower lobe due to infectious organism (Community acquired pneumonia of right lower lobe of lung [J18.9]) COVID-19 PNA (POA) Abnormal LFTs     HOSPITAL COURSE: The patient is a 65 y.o. female with past medical history significant for anxiety, depression, hypothyroidism who presents with complaint of confusion and making  nonsensical statements to family.  Patient tested positive for COVID-19 2 days prior to admission.  she has had fevers, chills, nausea, headache, neck pain, shortness of breath, fatigue prior to presentation.  CT Head was negative. CXR with right lung base consolidation. She underwent LP in the ED which was negative with 2 nucleated WBCs. She was placed on Rocephin and Zpak for CAP in the setting of COVID-19 pneumonia. Her confusion was thought to be multifactorial due to acute metabolic/toxic encephalopathy due to COVID-19 + CAP + Polypharmacy from recent initiation of Trazodone and Neurontin. MRI brain was negative for stroke or acute brain pathology.  She improved with supportive measures and was discharged in stable condition.  Cultures remains negative. She was transitioned to Ceftin+Zpak x 5 days for CAP.   She also has generalized myalgia with mildly elevated LFTs which could be 2/2 COVID infection but pt opted to hold her Crestor as she was just started on it a week ago and is concerned it may the cause of her myalgia and abnormal LFTs. She will have a follow up LFTs in one week with PCP and discuss resumption of Crestor or using an alternative Lipid agent.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Liver function test abnormal, Liver function test increased, Lumbar puncture normal, Lung consolidation, Magnetic resonance imaging head normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 9/12/2022 Discharge Date: Sep 14, 2022  PRESENTING PROBLEM: Acute metabolic and toxic Encephalopathy [G93.40] (POA)__Resolved  Pneumonia of right lower lobe due to infectious organism (Community acquired pneumonia of right lower lobe of lung [J18.9]) COVID-19 PNA (POA) Abnormal LFTs     HOSPITAL COURSE: The patient is a 65 y.o. female with past medical history significant for anxiety, depression, hypothyroidism who presents with complaint of confusion and making  nonsensical statements to family.  Patient tested positive for COVID-19 2 days prior to admission.  she has had fevers, chills, nausea, headache, neck pain, shortness of breath, fatigue prior to presentation.  CT Head was negative. CXR with right lung base consolidation. She underwent LP in the ED which was negative with 2 nucleated WBCs. She was placed on Rocephin and Zpak for CAP in the setting of COVID-19 pneumonia. Her confusion was thought to be multifactorial due to acute metabolic/toxic encephalopathy due to COVID-19 + CAP + Polypharmacy from recent initiation of Trazodone and Neurontin. MRI brain was negative for stroke or acute brain pathology.  She improved with supportive measures and was discharged in stable condition.  Cultures remains negative. She was transitioned to Ceftin+Zpak x 5 days for CAP.   She also has generalized myalgia with mildly elevated LFTs which could be 2/2 COVID infection but pt opted to hold her Crestor as she was just started on it a week ago and is concerned it may the cause of her myalgia and abnormal LFTs. She will have a follow up LFTs in one week with PCP and discuss resumption of Crestor or using an alternative Lipid agent.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Nausea, Neck pain, Pneumonia, Pyrexia
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 9/12/2022 Discharge Date: Sep 14, 2022  PRESENTING PROBLEM: Acute metabolic and toxic Encephalopathy [G93.40] (POA)__Resolved  Pneumonia of right lower lobe due to infectious organism (Community acquired pneumonia of right lower lobe of lung [J18.9]) COVID-19 PNA (POA) Abnormal LFTs     HOSPITAL COURSE: The patient is a 65 y.o. female with past medical history significant for anxiety, depression, hypothyroidism who presents with complaint of confusion and making  nonsensical statements to family.  Patient tested positive for COVID-19 2 days prior to admission.  she has had fevers, chills, nausea, headache, neck pain, shortness of breath, fatigue prior to presentation.  CT Head was negative. CXR with right lung base consolidation. She underwent LP in the ED which was negative with 2 nucleated WBCs. She was placed on Rocephin and Zpak for CAP in the setting of COVID-19 pneumonia. Her confusion was thought to be multifactorial due to acute metabolic/toxic encephalopathy due to COVID-19 + CAP + Polypharmacy from recent initiation of Trazodone and Neurontin. MRI brain was negative for stroke or acute brain pathology.  She improved with supportive measures and was discharged in stable condition.  Cultures remains negative. She was transitioned to Ceftin+Zpak x 5 days for CAP.   She also has generalized myalgia with mildly elevated LFTs which could be 2/2 COVID infection but pt opted to hold her Crestor as she was just started on it a week ago and is concerned it may the cause of her myalgia and abnormal LFTs. She will have a follow up LFTs in one week with PCP and discuss resumption of Crestor or using an alternative Lipid agent.