chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Metabolic function test, Pyrexia, SARS-CoV-2 test positive, Type 2 diabetes mellitus
Clinical narrative: Patient currently admitted at (5) days inpatient starting on 11/21/2021. Patient is a 79 y.o. male who presents today with weakness and diarrhea. The patient has a history of renal transplant, diabetes, CKD 3, HTN, HLD, COPD. The patient speaks another language and his son at bedside assists with translation. The patient is fully vaccinated for COVID and he was getting his booster shot on 11/18. Later that day he developed symptoms of fatigue and weakness. He then developed diarrhea and abdominal pain, fever and cough. He has some shortness of breath with activity. He came to the ER for evaluation.    In the ER the patient was COVID positive. He was found to be hypoxic requiring 2L NC. His CXR was negative for any acute abnormalities. He had labs showing AKI and hypokalemia. He was given decadron and potassium supplement. The hospitalist team was contacted for admission and further management.   ASSESSMENT / PLAN: * Acute hypoxemic respiratory failure Assessment & Plan Secondary to COVID, no infiltrates noted on CXR at this time Symptom onset: 11/18 Isolation: Severe Respiratory, if improved/afebrile antipyretics consider deescalation on 12/8 due to immune compromised status  Vaccination Status: Fully vaccinated, got his booster shot on the day of symptom onset  Continue supplemental O2, Titrate/wean to maintain SpO2>92% Continue Dexamethasone 1/10 Continue Remdesivir 1/5 Encourage Self Prone, IS, deep breathing and ambulation as tolerated  Symptomatic Treatment: Anti Tussives, Anti Emetics, Analgesics VTE PPx: Lovenox 40mg SQ q24 Daily CBC, CMP, CRP, D-Dimer Monitor I/O, daily weight, creatinine Maintain net neutral to negative fluid balance q24 Code Status: Full      AKI (acute kidney injury) Assessment & Plan Likely due to dehydration with poor PO intake and diarrhea  History of renal transplant Monitor renal function closely  Hold home lasix and lisinopril    COVID-19 virus infection Assessment & Plan Tested positive 11/21 Fully vaccinated, got booster the same day as symptom onset See plan above    COPD (chronic obstructive pulmonary disease) Assessment & Plan Continue inhalers  No wheezing on exam   Chronic kidney disease (CKD), stage III (moderate) Assessment & Plan Now with AKI Continue to monitor renal function closely    Dyslipidemia Assessment & Plan Continue statin    HTN (hypertension) Assessment & Plan BP stable Continue home metoprolol and hydralazine, hold home lisinopril and lasix with AKI   History of renal transplant Assessment & Plan Continue home tacrolimus, mycophenolate  Renal function worse than baseline, monitor closely    Type 2 diabetes mellitus  Assessment & Plan Last A1c 7.2, repeat pending Transition home levemir to lantus  Monitor blood sugars and adjust insulin as needed, anticipate hyperglycemia with steroid use
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary system X-ray
Clinical narrative: Patient currently admitted at (5) days inpatient starting on 11/21/2021. Patient is a 79 y.o. male who presents today with weakness and diarrhea. The patient has a history of renal transplant, diabetes, CKD 3, HTN, HLD, COPD. The patient speaks another language and his son at bedside assists with translation. The patient is fully vaccinated for COVID and he was getting his booster shot on 11/18. Later that day he developed symptoms of fatigue and weakness. He then developed diarrhea and abdominal pain, fever and cough. He has some shortness of breath with activity. He came to the ER for evaluation.    In the ER the patient was COVID positive. He was found to be hypoxic requiring 2L NC. His CXR was negative for any acute abnormalities. He had labs showing AKI and hypokalemia. He was given decadron and potassium supplement. The hospitalist team was contacted for admission and further management.   ASSESSMENT / PLAN: * Acute hypoxemic respiratory failure Assessment & Plan Secondary to COVID, no infiltrates noted on CXR at this time Symptom onset: 11/18 Isolation: Severe Respiratory, if improved/afebrile antipyretics consider deescalation on 12/8 due to immune compromised status  Vaccination Status: Fully vaccinated, got his booster shot on the day of symptom onset  Continue supplemental O2, Titrate/wean to maintain SpO2>92% Continue Dexamethasone 1/10 Continue Remdesivir 1/5 Encourage Self Prone, IS, deep breathing and ambulation as tolerated  Symptomatic Treatment: Anti Tussives, Anti Emetics, Analgesics VTE PPx: Lovenox 40mg SQ q24 Daily CBC, CMP, CRP, D-Dimer Monitor I/O, daily weight, creatinine Maintain net neutral to negative fluid balance q24 Code Status: Full      AKI (acute kidney injury) Assessment & Plan Likely due to dehydration with poor PO intake and diarrhea  History of renal transplant Monitor renal function closely  Hold home lasix and lisinopril    COVID-19 virus infection Assessment & Plan Tested positive 11/21 Fully vaccinated, got booster the same day as symptom onset See plan above    COPD (chronic obstructive pulmonary disease) Assessment & Plan Continue inhalers  No wheezing on exam   Chronic kidney disease (CKD), stage III (moderate) Assessment & Plan Now with AKI Continue to monitor renal function closely    Dyslipidemia Assessment & Plan Continue statin    HTN (hypertension) Assessment & Plan BP stable Continue home metoprolol and hydralazine, hold home lisinopril and lasix with AKI   History of renal transplant Assessment & Plan Continue home tacrolimus, mycophenolate  Renal function worse than baseline, monitor closely    Type 2 diabetes mellitus  Assessment & Plan Last A1c 7.2, repeat pending Transition home levemir to lantus  Monitor blood sugars and adjust insulin as needed, anticipate hyperglycemia with steroid use
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Headache, Muscular weakness
Clinical narrative: Headache, weak muscles, fatigue.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood culture negative, Blood gases, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient currently admitted at (3) days inpatient stay starting at 11/23/2021. PT 56 y.o. male  who presents to hospital with shortness of breath.  Patient is presently vaccinated against COVID in May of this year.  He states approximately 2-3 days ago he began having worsening cough shortness of breath and fatigue.  Denies any GI complaints.  He has been using his oxygen around the clock; normally only uses 3 L at night.  Because of worsening shortness of breath he presented to the emergency department for evaluation.  Oxygen saturations on room air were in the 70s.  He is currently saturating 94% with 4 L of oxygen.  Chest x-ray showed bilateral infiltrates and COVID testing was positive.  He had significant wheezing; he did get steroids but did not get bronchodilators.  D-dimer was negative.  Because of his worsening hypoxemia and respiratory distress he was referred to the hospital for further evaluation and care.   Acute respiratory failure with hypoxia Assessment & Plan Patient uses 3 L of oxygen at nighttime only Concurrently saturating 94% on 4 L Plan incentive spirometry, flutter, proning as tolerated Check blood gases to rule out hypercapnia   COPD with acute exacerbation Assessment & Plan Patient with history of severe disease based on PFTs Uses trilogy at home Suspect exacerbation worsened due to underlying COVID Aggressive respiratory hygiene steroids and bronchodilators Strongly encouraged smoking cessation   * Pneumonia due to COVID-19 virus Assessment & Plan Patient with symptom onset 11/21 Worsening shortness of breath cough and hypoxia Chest x-ray showing bilateral infiltrates Vaccinated in April and May of 2021 COVID positive 11/23 Plan admission, steroids, remdesivir, and aggressive supportive respiratory care   Hypertension Assessment & Plan Blood pressure is currently stable     Obesity Assessment & Plan Body mass index 47.6
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Patient currently admitted at (3) days inpatient stay starting at 11/23/2021. PT 56 y.o. male  who presents to hospital with shortness of breath.  Patient is presently vaccinated against COVID in May of this year.  He states approximately 2-3 days ago he began having worsening cough shortness of breath and fatigue.  Denies any GI complaints.  He has been using his oxygen around the clock; normally only uses 3 L at night.  Because of worsening shortness of breath he presented to the emergency department for evaluation.  Oxygen saturations on room air were in the 70s.  He is currently saturating 94% with 4 L of oxygen.  Chest x-ray showed bilateral infiltrates and COVID testing was positive.  He had significant wheezing; he did get steroids but did not get bronchodilators.  D-dimer was negative.  Because of his worsening hypoxemia and respiratory distress he was referred to the hospital for further evaluation and care.   Acute respiratory failure with hypoxia Assessment & Plan Patient uses 3 L of oxygen at nighttime only Concurrently saturating 94% on 4 L Plan incentive spirometry, flutter, proning as tolerated Check blood gases to rule out hypercapnia   COPD with acute exacerbation Assessment & Plan Patient with history of severe disease based on PFTs Uses trilogy at home Suspect exacerbation worsened due to underlying COVID Aggressive respiratory hygiene steroids and bronchodilators Strongly encouraged smoking cessation   * Pneumonia due to COVID-19 virus Assessment & Plan Patient with symptom onset 11/21 Worsening shortness of breath cough and hypoxia Chest x-ray showing bilateral infiltrates Vaccinated in April and May of 2021 COVID positive 11/23 Plan admission, steroids, remdesivir, and aggressive supportive respiratory care   Hypertension Assessment & Plan Blood pressure is currently stable     Obesity Assessment & Plan Body mass index 47.6
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Fibrin D dimer normal, Hypoxia, Lung infiltration, Lung opacity
Clinical narrative: Patient currently admitted at (3) days inpatient stay starting at 11/23/2021. PT 56 y.o. male  who presents to hospital with shortness of breath.  Patient is presently vaccinated against COVID in May of this year.  He states approximately 2-3 days ago he began having worsening cough shortness of breath and fatigue.  Denies any GI complaints.  He has been using his oxygen around the clock; normally only uses 3 L at night.  Because of worsening shortness of breath he presented to the emergency department for evaluation.  Oxygen saturations on room air were in the 70s.  He is currently saturating 94% with 4 L of oxygen.  Chest x-ray showed bilateral infiltrates and COVID testing was positive.  He had significant wheezing; he did get steroids but did not get bronchodilators.  D-dimer was negative.  Because of his worsening hypoxemia and respiratory distress he was referred to the hospital for further evaluation and care.   Acute respiratory failure with hypoxia Assessment & Plan Patient uses 3 L of oxygen at nighttime only Concurrently saturating 94% on 4 L Plan incentive spirometry, flutter, proning as tolerated Check blood gases to rule out hypercapnia   COPD with acute exacerbation Assessment & Plan Patient with history of severe disease based on PFTs Uses trilogy at home Suspect exacerbation worsened due to underlying COVID Aggressive respiratory hygiene steroids and bronchodilators Strongly encouraged smoking cessation   * Pneumonia due to COVID-19 virus Assessment & Plan Patient with symptom onset 11/21 Worsening shortness of breath cough and hypoxia Chest x-ray showing bilateral infiltrates Vaccinated in April and May of 2021 COVID positive 11/23 Plan admission, steroids, remdesivir, and aggressive supportive respiratory care   Hypertension Assessment & Plan Blood pressure is currently stable     Obesity Assessment & Plan Body mass index 47.6
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory distress, SARS-CoV-2 test positive, Spirometry, Wheezing
Clinical narrative: Patient currently admitted at (3) days inpatient stay starting at 11/23/2021. PT 56 y.o. male  who presents to hospital with shortness of breath.  Patient is presently vaccinated against COVID in May of this year.  He states approximately 2-3 days ago he began having worsening cough shortness of breath and fatigue.  Denies any GI complaints.  He has been using his oxygen around the clock; normally only uses 3 L at night.  Because of worsening shortness of breath he presented to the emergency department for evaluation.  Oxygen saturations on room air were in the 70s.  He is currently saturating 94% with 4 L of oxygen.  Chest x-ray showed bilateral infiltrates and COVID testing was positive.  He had significant wheezing; he did get steroids but did not get bronchodilators.  D-dimer was negative.  Because of his worsening hypoxemia and respiratory distress he was referred to the hospital for further evaluation and care.   Acute respiratory failure with hypoxia Assessment & Plan Patient uses 3 L of oxygen at nighttime only Concurrently saturating 94% on 4 L Plan incentive spirometry, flutter, proning as tolerated Check blood gases to rule out hypercapnia   COPD with acute exacerbation Assessment & Plan Patient with history of severe disease based on PFTs Uses trilogy at home Suspect exacerbation worsened due to underlying COVID Aggressive respiratory hygiene steroids and bronchodilators Strongly encouraged smoking cessation   * Pneumonia due to COVID-19 virus Assessment & Plan Patient with symptom onset 11/21 Worsening shortness of breath cough and hypoxia Chest x-ray showing bilateral infiltrates Vaccinated in April and May of 2021 COVID positive 11/23 Plan admission, steroids, remdesivir, and aggressive supportive respiratory care   Hypertension Assessment & Plan Blood pressure is currently stable     Obesity Assessment & Plan Body mass index 47.6
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19 pneumonia, Cough, Decreased appetite, Dyspnoea, Exposure to SARS-CoV-2
Clinical narrative: Pt with a history of CAD/MI s/p stent and OSA on CPAP was exposed to COVID at church.  His complaints are fatigue, dry cough, shortness of breath, and lack of appetite.  Pt admitted for COVID-19 infection with pneumonia.
Age: 81.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Pneumonia
Clinical narrative: Pt with a history of CAD/MI s/p stent and OSA on CPAP was exposed to COVID at church.  His complaints are fatigue, dry cough, shortness of breath, and lack of appetite.  Pt admitted for COVID-19 infection with pneumonia.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Decreased appetite, Pain, Pyrexia
Clinical narrative: Elevated temp (fever) along with body aches, pains and decreased appetite.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Herpes zoster, Oral herpes
Clinical narrative: Fever blisters, Shingles, AFIB event.  I took valtrex for the fever blisters which also kept the shingles from spreading.  The AFIB was on the Saturday evening after the shot on Monday.  I went to the emergency room where it was controlled by medication.  This was the first heart event in my lifetime.  I spent the next months doing tests and seeing a cardiologist.  I have not had another event since the week of the vaccine.  I am to see my cardiologist one a year as followup.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Fatigue, Injection site pain
Clinical narrative: Soreness at injection site, tiredness next day, pain in knee joints on 3rd day
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19 pneumonia, Chills, Chronic obstructive pulmonary disease, Dyspnoea
Clinical narrative: Pt complains of shortness of breath worse than baseline with fever and chills.  Pt admitted for acute on chronic hypoxic respiratory failure secondary to COVID-19 pneumonia and acute COPD exacerbation.
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoxia, Pyrexia
Clinical narrative: Pt complains of shortness of breath worse than baseline with fever and chills.  Pt admitted for acute on chronic hypoxic respiratory failure secondary to COVID-19 pneumonia and acute COPD exacerbation.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Injection site pain, Lymph node pain, Neck pain
Clinical narrative: Severe pain in my neck going down through my shoulder and around my right arm at the injection site.  Pain started on November 21 and has continued through and is still current now.  I have tried treating with over the counter medication, Aleve, and prescription muscle relaxer (Flexeril) and have not been able to find any relief.  I have also experienced pain in my lymph node in my right arm pit of the injection site.  This pain has subsided.  I did not experience any of these side effects with the Pfizer vaccination.  This was the booster shot.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Erythema, Pain in extremity, Peripheral swelling
Clinical narrative: Patient called pharmacy on Friday morning . He stated that his whole arm is red , swollen and hurts him. It started Tuesday and continued till Friday morning. Patient states he is stable and concerned about his arm.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Fatigue, Injection site pain
Clinical narrative: Extreme tiredness, joint pain & pain at the injection site.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Acidosis, Bacterial test negative, Blood creatinine abnormal, Blood culture negative, Blood gases abnormal
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cardiomegaly, Central venous catheterisation, Chest X-ray abnormal
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram head normal, Condition aggravated, Dyspnoea, Echocardiogram, Ejection fraction normal
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Endotracheal intubation, Fibrin D dimer increased, Gastrointestinal tube insertion, Gram stain positive
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hypoxia, Ill-defined disorder, Intensive care, Lethargy
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Lung infiltration, Lung opacity, Mechanical ventilation, Oliguria, Positive airway pressure therapy
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary vasculitis, Renal failure, Right ventricular systolic pressure, SARS-CoV-2 test positive, Serology normal
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Shock, Sinus tachycardia, Sputum culture, Tricuspid valve incompetence, Ultrasound Doppler normal
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection, Urine analysis abnormal, pH body fluid abnormal
Clinical narrative: Patient currently inpatient at (7) days starting at 11/19/2021. Patient is a 71 y.o. female past medical history chronic obstructive pulmonary disease, hypertension, MVP, obesity class 3, prior PE and 2010 who presents today with shortness of breath.   Patient intubated and sedated upon initial evaluation history obtained from emergency department note and discussion with NOK.  Patient's son reports symptom onset Monday/Tuesday (11/15 or 11/16) with severe headache different than usual headache. She had no symptoms of shortness of breath. She was evaluated in Hospital ER and had a negative CT head and serum studies. She was placed on Carbamazepine and discharged home. She developed shortness of breath and lethargy over past few days. Son reports patient used nebulizer treatments at home give history of COPD. EMS was called and noted patient hypoxic and placed on CPAP with improvement of O2 sats to 80%.   In the Emergency Department, patient arrived on NIPPV which was started in route by EMS. COVID-19 PCR positive, initial ABG with acidemia. ED physician had discussion of with patient's son who was agreeable with patient being intubated.  Electrocardiogram with sinus tachycardia no acute ischemic changes. Patient was intubated and placed on propofol drip. CVC was placed.  Chest x-ray with bilateral infiltrates suggestive COVID-19 and adequate RIJ CVC placement.  Serum studies with renal failure.  She was administered IV fluid resuscitation.  Emergency department physician discussed with MICU who advised further fluid resuscitation as well as lactic acid evaluation but there were no indications for transfer at that time.  UA with evidence of urinary tract infection was started on IV antibiotics. Admitted initially at another facility but given oliguria and worsening pH, transferred for possible CRRT.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Cheilitis, Inflammation, Lip swelling, Swelling face
Clinical narrative: inflammation/swelling starting in lips and expanding to cheek/chin on right side of face for 48 hours.   zyrtec 10mg and 25mg benadryl and 3 advils only mildly improved symptoms
Age: 6.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Patient was to be administered 0.2 mL of pediatric formulation, however, was given 0.2 mL of adult formulation. This is an overdose equivalent to 20 mcg of COVID vaccination. Patient's mother was contacted and informed of the risk and to closely monitor. Per CDC guidance, patient is to continue 2nd dose as scheduled. Attempted to follow-up call but did not get an answer.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: COVID BREAKTHROUGH
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site cellulitis
Clinical narrative: cellulitis at injection site doctor prescribed Cephalexin
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Tinnitus bilateral ears, constant ringing, higher pitched in right ear. Saw PCP, Dentist, ENT, Audiologist all tes
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: COVID BREAKTHROUGH CASE
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product administration error
Clinical narrative: Reporting is for a vaccine medication administration error where an adult patient was administered the Pfizer-BioTech Vaccine 5-11 years formulation(orange cap), resulting in a lower than authorized dose for a booster. There is  currently no symptoms or adverse event. Patient has been called and correct age appropriate dose of vaccine has been administered  as per CDC and vaccine manufacturer guidelines.
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy
Clinical narrative: Swelling left armpit
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Ageusia, Angiogram pulmonary abnormal, Blood culture negative, Blood lactic acid
Clinical narrative: Patient currently admitted at (6) days starting 11/20/2021. Patient is a 61 y.o. male who presents today with progressive shortness of breath. Began last Thursday with fatigue, cough, exertional dyspnea, and malaise. Progressed to significant shortness of breath with diarrhea for last 3 days and poor PO intake due to loss of taste. Patient has been trying to drink gatorade and eat small amounts of crackers or toast when he can but it has been challenging. He tested his oxygen saturation at home (wife works in hospice) the last few days and he was in the 80's and decided to come in. Heis vaccinated except for his booster shot, but knew he had covid19 after he was helping customers in the sporting goods store he works at who were coughing without masks around him and sounded sick. Admits some blood tinged sputum from cough 2 days prior, and watery stools. He denies chest pain, vomiting, blood in urine/stool, abdominal pain, swelling/pain in legs or extremities.    ED course: On arrival he was hypoxic at 57% and tachypneic, normotensive, aox3, breath sounds clear. He was placed on NRB which improved his saturations to around 90, and subsequently switched to HFNC 60L at FiO2 of 100% which brought his saturations up to 90's. Cultures and labs were drawn, Covid test was obtained and positive. ECG showed NSR with isolated t-wave inversion in lead 3. CXR showed extensive bilateral lung infiltrates. WBC normal, no fever. Lactate was elevated to 2.1. Procal mildly elevated. He received Decadron 6mg IV and was admitted to general floors with acute hypoxic respiratory failure secondary to covid19 pneumonia.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cardiomegaly, Chest X-ray abnormal, Cough
Clinical narrative: Patient currently admitted at (6) days starting 11/20/2021. Patient is a 61 y.o. male who presents today with progressive shortness of breath. Began last Thursday with fatigue, cough, exertional dyspnea, and malaise. Progressed to significant shortness of breath with diarrhea for last 3 days and poor PO intake due to loss of taste. Patient has been trying to drink gatorade and eat small amounts of crackers or toast when he can but it has been challenging. He tested his oxygen saturation at home (wife works in hospice) the last few days and he was in the 80's and decided to come in. Heis vaccinated except for his booster shot, but knew he had covid19 after he was helping customers in the sporting goods store he works at who were coughing without masks around him and sounded sick. Admits some blood tinged sputum from cough 2 days prior, and watery stools. He denies chest pain, vomiting, blood in urine/stool, abdominal pain, swelling/pain in legs or extremities.    ED course: On arrival he was hypoxic at 57% and tachypneic, normotensive, aox3, breath sounds clear. He was placed on NRB which improved his saturations to around 90, and subsequently switched to HFNC 60L at FiO2 of 100% which brought his saturations up to 90's. Cultures and labs were drawn, Covid test was obtained and positive. ECG showed NSR with isolated t-wave inversion in lead 3. CXR showed extensive bilateral lung infiltrates. WBC normal, no fever. Lactate was elevated to 2.1. Procal mildly elevated. He received Decadron 6mg IV and was admitted to general floors with acute hypoxic respiratory failure secondary to covid19 pneumonia.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Culture, Diarrhoea, Dyspnoea, Dyspnoea exertional, Electrocardiogram T wave inversion
Clinical narrative: Patient currently admitted at (6) days starting 11/20/2021. Patient is a 61 y.o. male who presents today with progressive shortness of breath. Began last Thursday with fatigue, cough, exertional dyspnea, and malaise. Progressed to significant shortness of breath with diarrhea for last 3 days and poor PO intake due to loss of taste. Patient has been trying to drink gatorade and eat small amounts of crackers or toast when he can but it has been challenging. He tested his oxygen saturation at home (wife works in hospice) the last few days and he was in the 80's and decided to come in. Heis vaccinated except for his booster shot, but knew he had covid19 after he was helping customers in the sporting goods store he works at who were coughing without masks around him and sounded sick. Admits some blood tinged sputum from cough 2 days prior, and watery stools. He denies chest pain, vomiting, blood in urine/stool, abdominal pain, swelling/pain in legs or extremities.    ED course: On arrival he was hypoxic at 57% and tachypneic, normotensive, aox3, breath sounds clear. He was placed on NRB which improved his saturations to around 90, and subsequently switched to HFNC 60L at FiO2 of 100% which brought his saturations up to 90's. Cultures and labs were drawn, Covid test was obtained and positive. ECG showed NSR with isolated t-wave inversion in lead 3. CXR showed extensive bilateral lung infiltrates. WBC normal, no fever. Lactate was elevated to 2.1. Procal mildly elevated. He received Decadron 6mg IV and was admitted to general floors with acute hypoxic respiratory failure secondary to covid19 pneumonia.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Fibrin D dimer increased, Goitre, Haemoptysis, Hypophagia
Clinical narrative: Patient currently admitted at (6) days starting 11/20/2021. Patient is a 61 y.o. male who presents today with progressive shortness of breath. Began last Thursday with fatigue, cough, exertional dyspnea, and malaise. Progressed to significant shortness of breath with diarrhea for last 3 days and poor PO intake due to loss of taste. Patient has been trying to drink gatorade and eat small amounts of crackers or toast when he can but it has been challenging. He tested his oxygen saturation at home (wife works in hospice) the last few days and he was in the 80's and decided to come in. Heis vaccinated except for his booster shot, but knew he had covid19 after he was helping customers in the sporting goods store he works at who were coughing without masks around him and sounded sick. Admits some blood tinged sputum from cough 2 days prior, and watery stools. He denies chest pain, vomiting, blood in urine/stool, abdominal pain, swelling/pain in legs or extremities.    ED course: On arrival he was hypoxic at 57% and tachypneic, normotensive, aox3, breath sounds clear. He was placed on NRB which improved his saturations to around 90, and subsequently switched to HFNC 60L at FiO2 of 100% which brought his saturations up to 90's. Cultures and labs were drawn, Covid test was obtained and positive. ECG showed NSR with isolated t-wave inversion in lead 3. CXR showed extensive bilateral lung infiltrates. WBC normal, no fever. Lactate was elevated to 2.1. Procal mildly elevated. He received Decadron 6mg IV and was admitted to general floors with acute hypoxic respiratory failure secondary to covid19 pneumonia.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Intervertebral disc degeneration, Laboratory test, Lung disorder, Lung infiltration
Clinical narrative: Patient currently admitted at (6) days starting 11/20/2021. Patient is a 61 y.o. male who presents today with progressive shortness of breath. Began last Thursday with fatigue, cough, exertional dyspnea, and malaise. Progressed to significant shortness of breath with diarrhea for last 3 days and poor PO intake due to loss of taste. Patient has been trying to drink gatorade and eat small amounts of crackers or toast when he can but it has been challenging. He tested his oxygen saturation at home (wife works in hospice) the last few days and he was in the 80's and decided to come in. Heis vaccinated except for his booster shot, but knew he had covid19 after he was helping customers in the sporting goods store he works at who were coughing without masks around him and sounded sick. Admits some blood tinged sputum from cough 2 days prior, and watery stools. He denies chest pain, vomiting, blood in urine/stool, abdominal pain, swelling/pain in legs or extremities.    ED course: On arrival he was hypoxic at 57% and tachypneic, normotensive, aox3, breath sounds clear. He was placed on NRB which improved his saturations to around 90, and subsequently switched to HFNC 60L at FiO2 of 100% which brought his saturations up to 90's. Cultures and labs were drawn, Covid test was obtained and positive. ECG showed NSR with isolated t-wave inversion in lead 3. CXR showed extensive bilateral lung infiltrates. WBC normal, no fever. Lactate was elevated to 2.1. Procal mildly elevated. He received Decadron 6mg IV and was admitted to general floors with acute hypoxic respiratory failure secondary to covid19 pneumonia.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Lymphadenopathy mediastinal, Malaise, Pain in extremity, Pneumonia
Clinical narrative: Patient currently admitted at (6) days starting 11/20/2021. Patient is a 61 y.o. male who presents today with progressive shortness of breath. Began last Thursday with fatigue, cough, exertional dyspnea, and malaise. Progressed to significant shortness of breath with diarrhea for last 3 days and poor PO intake due to loss of taste. Patient has been trying to drink gatorade and eat small amounts of crackers or toast when he can but it has been challenging. He tested his oxygen saturation at home (wife works in hospice) the last few days and he was in the 80's and decided to come in. Heis vaccinated except for his booster shot, but knew he had covid19 after he was helping customers in the sporting goods store he works at who were coughing without masks around him and sounded sick. Admits some blood tinged sputum from cough 2 days prior, and watery stools. He denies chest pain, vomiting, blood in urine/stool, abdominal pain, swelling/pain in legs or extremities.    ED course: On arrival he was hypoxic at 57% and tachypneic, normotensive, aox3, breath sounds clear. He was placed on NRB which improved his saturations to around 90, and subsequently switched to HFNC 60L at FiO2 of 100% which brought his saturations up to 90's. Cultures and labs were drawn, Covid test was obtained and positive. ECG showed NSR with isolated t-wave inversion in lead 3. CXR showed extensive bilateral lung infiltrates. WBC normal, no fever. Lactate was elevated to 2.1. Procal mildly elevated. He received Decadron 6mg IV and was admitted to general floors with acute hypoxic respiratory failure secondary to covid19 pneumonia.