chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 51.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Transaminases, Transaminases increased, Vaccination failure, Ventricular extrasystoles, Vomiting
Clinical narrative: J&J Dose 6/2/21 (lot not listed in database) COVID Positive 8/29/21  8/29/21: Pt is a 51 year old male who presented to ED with a chief complaint of vomiting. He has a past medical history of BPH, hypertension, type 2 diabetes mellitus, and GERD. Pt started feeling unwell on Tuesday of last week. He had fever, dizziness, body aches, headache and vomiting. He has had persistent vomiting since Tuesday. He has chronic bilateral lower extremities wounds, he is being seen by wound care. He was seen by urgent care with concerns for cellulitis and placed on cipro. He symptoms have worsened and he has developed severe shortness of breath, worse on exertion, and a dry cough. He has developed some nausea with diarrhea. He does wear a BIPAP at home. He is not on any diuretics. He believes he might have been told in the past he has congestive heart failure but is unsure. He has been full Covid-19 vaccinated.  On arrival to ED patient was febrile 101.3, tachycardic 113 hypotensive 99/66.  Laboratory findings were significant for hyponatremia 126. Hyperkalemia 5.4. Hyperglycemia 422. AKI BUN 27 and creatinine 2.84. Transaminitis 51. Anemia HGB 11.3. Chest x-ray showed CHF, superimposed pneumonia is not excluded. IV Levaquin was initiated in ED.  IV hydration NS 0.9% 1 L bolus given in ED.  9/22/21: Pt is a 51-year-old male with PMHx significant for HTN, T2DM, GERD, BPH and morbid obesity who was admitted on 8/29/2021 for acute hypoxic respiratory failure due to COVID PNA.  Patient was intubated on 08/30/2021.  He is s/p remdesivir, Actemra, dexamethasone, Rocephin, azithromycin, ceftazidime, vancomycin and Zosyn. He was diuresed with Lasix.  He remained on mechanical ventilation throughout hospitalization.  Patient was removed from precautions on 09/17/2021 and tracheostomy and PEG tube were placed at that time.  He was weaned from his paralytic on 09/18/2021.  He continues on Lovenox 40 mg subQ daily for VTE prophylaxis.  Patient with multifocal ventricular ectopy while hospitalized.  Cardiology was consulted.  Suspected etiology 2/2 COVID myocarditis. Patient unable to tolerate beta-blockers.  Magnesium levels and potassium levels were optimized.  Patient continues on tube feeds via PEG tube.  He has history of T2DM and was on GlucoStabilizer protocol but eventually transitioned to Lantus 35U BID with correctional dose insulin.  Patient with oral candidal lesions on 09/22/2021.  Started on nystatin oral solution 4 times daily for 7 days.  Patient was accepted by (privacy) and discharged to local HCF.
Age: 24.0
Sex: F
Vaccine: YF
Symptoms: Erythema, Pruritus, Swelling
Clinical narrative: Itchy, Raised reddened area 3 cm x 2.5 cm .
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Lymphadenopathy
Clinical narrative: Swollen lymph nodes (bilaterally) with significant swelling on the left side.  This was a more severe reaction than the one I received after my first dose. Onset was immediate and swelling was worse.  I do still have some sensitivity with palpation in the area of my left neck where the swelling was the worst.
Age: 72.0
Sex: F
Vaccine: UNK, UNK
Symptoms: Adverse reaction, Dupuytren's contracture, Extremity contracture, Manipulation, Pain in extremity
Clinical narrative: On June 29, 2021, I was treated for Dupytren's Contracture with XIFLEX and the next day, with the manipulation.  My left index finger was the digit treated.  My hand started to swell and the pain was unbearable.  I couldn't take pain medication.  It made mr throw up.  Extra Strength Tylenol did not help ease the pain.  I went back in 28 days and received a shot of Cortisone for pain and swelling.  The pain eased up in three days.  My feeling is that the vaccine, perhaps affected the XIFLEX? Two months had not passed since receiving the second dose of the vaccine.  I have AB- BLOOD TYPE.  Perhaps this, this blood type, also has a play in the reaction?  I'm still dealing with the Dupyren's Contracture.  After the XIFLEX injection, I developed trigger finger in the middle finger.  I'm told that rarely, very rarely do people have a reaction as the one I have.   AB- BLOOD TYPE, plus getting the XIFLEX too soon after getting the second dose of the vaccine, could have resulted in my adverse reaction?? I just wanted to alert you to this.
Age: 72.0
Sex: F
Vaccine: UNK, UNK
Symptoms: Peripheral swelling, Trigger finger
Clinical narrative: On June 29, 2021, I was treated for Dupytren's Contracture with XIFLEX and the next day, with the manipulation.  My left index finger was the digit treated.  My hand started to swell and the pain was unbearable.  I couldn't take pain medication.  It made mr throw up.  Extra Strength Tylenol did not help ease the pain.  I went back in 28 days and received a shot of Cortisone for pain and swelling.  The pain eased up in three days.  My feeling is that the vaccine, perhaps affected the XIFLEX? Two months had not passed since receiving the second dose of the vaccine.  I have AB- BLOOD TYPE.  Perhaps this, this blood type, also has a play in the reaction?  I'm still dealing with the Dupyren's Contracture.  After the XIFLEX injection, I developed trigger finger in the middle finger.  I'm told that rarely, very rarely do people have a reaction as the one I have.   AB- BLOOD TYPE, plus getting the XIFLEX too soon after getting the second dose of the vaccine, could have resulted in my adverse reaction?? I just wanted to alert you to this.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: BREAKTHROUGH COVID 19 INFECTION (MILD TO MOD)
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Rash, Skin warm
Clinical narrative: Extreme redness, spots, arm warm to touch
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Aortic valve replacement, Aortic valve stenosis, Blood test normal, Breast pain, Cardiac monitoring
Clinical narrative: Chest pain which continued to worsen as time progressed, heart palpitations, left arm and neck pain, fatigue, sweating of hands/feet, clamminess, shortness of breath, left breast pain, easily over exerted.  Visited primary care on 10/13/21 diagnosed with rib inflammation and new heart murmur was discovered. (Heart murmur was a new finding, have been to primary care doctor for many years and played sports many years / physicals; heart murmur was never diagnosed/heard). EKG done in the primary care office was normal. Was prescribed naproxen sodium.  Symptoms got rapidly worse (thought I was having a heart attack) so went to the ER on 10/14/21. EKG/ chest x-ray and blood work done was normal. Was admitted to hospital after heart rate jumped to 140-150 by just standing, also admitting doctor was concerned of heart murmur. Echo performed inpatient on 10/15/21 showed severe aortic valve stenosis.  Chest MRI done 10/16/21. Carotid artery ultrasound done 10/16/21. Heart catheterization procedure done 10/18/21. Open heart surgery done 10/20/21 to replace aortic valve with mechanical valve.  Discharged from hospital on 10/26/21.
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cardiac murmur, Cardiac operation, Catheterisation cardiac, Chest X-ray normal, Chest pain
Clinical narrative: Chest pain which continued to worsen as time progressed, heart palpitations, left arm and neck pain, fatigue, sweating of hands/feet, clamminess, shortness of breath, left breast pain, easily over exerted.  Visited primary care on 10/13/21 diagnosed with rib inflammation and new heart murmur was discovered. (Heart murmur was a new finding, have been to primary care doctor for many years and played sports many years / physicals; heart murmur was never diagnosed/heard). EKG done in the primary care office was normal. Was prescribed naproxen sodium.  Symptoms got rapidly worse (thought I was having a heart attack) so went to the ER on 10/14/21. EKG/ chest x-ray and blood work done was normal. Was admitted to hospital after heart rate jumped to 140-150 by just standing, also admitting doctor was concerned of heart murmur. Echo performed inpatient on 10/15/21 showed severe aortic valve stenosis.  Chest MRI done 10/16/21. Carotid artery ultrasound done 10/16/21. Heart catheterization procedure done 10/18/21. Open heart surgery done 10/20/21 to replace aortic valve with mechanical valve.  Discharged from hospital on 10/26/21.
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cold sweat, Dyspnoea, Echocardiogram abnormal, Electrocardiogram normal, Fatigue
Clinical narrative: Chest pain which continued to worsen as time progressed, heart palpitations, left arm and neck pain, fatigue, sweating of hands/feet, clamminess, shortness of breath, left breast pain, easily over exerted.  Visited primary care on 10/13/21 diagnosed with rib inflammation and new heart murmur was discovered. (Heart murmur was a new finding, have been to primary care doctor for many years and played sports many years / physicals; heart murmur was never diagnosed/heard). EKG done in the primary care office was normal. Was prescribed naproxen sodium.  Symptoms got rapidly worse (thought I was having a heart attack) so went to the ER on 10/14/21. EKG/ chest x-ray and blood work done was normal. Was admitted to hospital after heart rate jumped to 140-150 by just standing, also admitting doctor was concerned of heart murmur. Echo performed inpatient on 10/15/21 showed severe aortic valve stenosis.  Chest MRI done 10/16/21. Carotid artery ultrasound done 10/16/21. Heart catheterization procedure done 10/18/21. Open heart surgery done 10/20/21 to replace aortic valve with mechanical valve.  Discharged from hospital on 10/26/21.
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Heart rate increased, Hyperhidrosis, Inflammation, Magnetic resonance imaging thoracic, Neck pain
Clinical narrative: Chest pain which continued to worsen as time progressed, heart palpitations, left arm and neck pain, fatigue, sweating of hands/feet, clamminess, shortness of breath, left breast pain, easily over exerted.  Visited primary care on 10/13/21 diagnosed with rib inflammation and new heart murmur was discovered. (Heart murmur was a new finding, have been to primary care doctor for many years and played sports many years / physicals; heart murmur was never diagnosed/heard). EKG done in the primary care office was normal. Was prescribed naproxen sodium.  Symptoms got rapidly worse (thought I was having a heart attack) so went to the ER on 10/14/21. EKG/ chest x-ray and blood work done was normal. Was admitted to hospital after heart rate jumped to 140-150 by just standing, also admitting doctor was concerned of heart murmur. Echo performed inpatient on 10/15/21 showed severe aortic valve stenosis.  Chest MRI done 10/16/21. Carotid artery ultrasound done 10/16/21. Heart catheterization procedure done 10/18/21. Open heart surgery done 10/20/21 to replace aortic valve with mechanical valve.  Discharged from hospital on 10/26/21.
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pain in extremity, Palpitations, Ultrasound Doppler
Clinical narrative: Chest pain which continued to worsen as time progressed, heart palpitations, left arm and neck pain, fatigue, sweating of hands/feet, clamminess, shortness of breath, left breast pain, easily over exerted.  Visited primary care on 10/13/21 diagnosed with rib inflammation and new heart murmur was discovered. (Heart murmur was a new finding, have been to primary care doctor for many years and played sports many years / physicals; heart murmur was never diagnosed/heard). EKG done in the primary care office was normal. Was prescribed naproxen sodium.  Symptoms got rapidly worse (thought I was having a heart attack) so went to the ER on 10/14/21. EKG/ chest x-ray and blood work done was normal. Was admitted to hospital after heart rate jumped to 140-150 by just standing, also admitting doctor was concerned of heart murmur. Echo performed inpatient on 10/15/21 showed severe aortic valve stenosis.  Chest MRI done 10/16/21. Carotid artery ultrasound done 10/16/21. Heart catheterization procedure done 10/18/21. Open heart surgery done 10/20/21 to replace aortic valve with mechanical valve.  Discharged from hospital on 10/26/21.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Aphasia, Blood creatinine, Blood glucose normal, Blood potassium increased, Blood urea increased
Clinical narrative: Pfizer Dose 1 3/9/21 (EN6199) Pfizer Dose 2 4/8/21 (ER8737) COVID Positive 8/23/21 COVID Negative 9/6/21  9/6/21: Patient is a 73-year-old female who presents to the ED today for altered mental status, high blood pressure and headache.  Patient states her headache started approximately 7 hours prior to arrival.  Patient states she was also having trouble finding words.  Per patient's daughter she was significantly more confused than earlier in the day.  Patient currently has COVID pneumonia, and missed dialysis on Saturday.  Patient has a past medical history significant for ESRD on hemodialysis Tuesday Thursday Saturday, hyperlipidemia, hypertension, CHF, sleep apnea, hyperparathyroidism, anemia, leukopenia, vitamin B12 deficiency.   Upon arrival to ED patient was given azithromycin and Rocephin for community-acquired pneumonia.  Patient also had a chest x-ray that revealed bilateral pneumonia that has progressed since 08/23/2021.  Head CT was performed due to trouble finding words, confusion and showed no new intracranial hemorrhage or other acute findings.  Patient's laboratory findings were significant for WBC 4.46, HGB 10.5, HCT 32.7%, glucose 112, BUN 59, creatinine 10.62, potassium 6.2.  Patient was given 1 time dose of Kayexalate.  Dr. consulted in the ED and recommended dialysis treatment in the morning.   Patient was seen and examined in the ED, patient is sitting comfortably in bed.  Patient is confused, but answering questions.  Patient states she continues to have a headache that she states is all over.  She describes the pain as aching.   Patient also complains that she overall does not feel well.  Patient denies any chest pain, or shortness of breath at this time.  9/13/21: This 73-year-old female with history of end-stage renal disease, along with breast cancer and left arm lymphedema was having dialysis. She has been sick during dialysis days recently.  Blood pressure has been noted to be low and some bradycardia.  Review of her home medicines is somewhat unclear, but it looks like she has had both carvedilol and labetalol filled recently, is taking both of these twice a day, even on dialysis days. We tried to decrease the carvedilol on dialysis days, stop the labetalol and add Norvasc.  She tolerated the most recent hemodialysis. She has developed left arm swelling, pain; has an ultrasound showing a superficial phlebitis of the cephalic vein with no signs of deep vein involvement. We discussed blood thinners, but will not treat superficial phlebitis unless symptoms get worse, suggesting it is going into a deep vein thrombosis.  She will use warm compresses when she gets home.  She is seen the day of discharge, doing quite well.  She is afebrile.  Oxygenation 97% on room air. Blood pressure is 155/83.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Bradycardia, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Computerised tomogram head normal
Clinical narrative: Pfizer Dose 1 3/9/21 (EN6199) Pfizer Dose 2 4/8/21 (ER8737) COVID Positive 8/23/21 COVID Negative 9/6/21  9/6/21: Patient is a 73-year-old female who presents to the ED today for altered mental status, high blood pressure and headache.  Patient states her headache started approximately 7 hours prior to arrival.  Patient states she was also having trouble finding words.  Per patient's daughter she was significantly more confused than earlier in the day.  Patient currently has COVID pneumonia, and missed dialysis on Saturday.  Patient has a past medical history significant for ESRD on hemodialysis Tuesday Thursday Saturday, hyperlipidemia, hypertension, CHF, sleep apnea, hyperparathyroidism, anemia, leukopenia, vitamin B12 deficiency.   Upon arrival to ED patient was given azithromycin and Rocephin for community-acquired pneumonia.  Patient also had a chest x-ray that revealed bilateral pneumonia that has progressed since 08/23/2021.  Head CT was performed due to trouble finding words, confusion and showed no new intracranial hemorrhage or other acute findings.  Patient's laboratory findings were significant for WBC 4.46, HGB 10.5, HCT 32.7%, glucose 112, BUN 59, creatinine 10.62, potassium 6.2.  Patient was given 1 time dose of Kayexalate.  Dr. consulted in the ED and recommended dialysis treatment in the morning.   Patient was seen and examined in the ED, patient is sitting comfortably in bed.  Patient is confused, but answering questions.  Patient states she continues to have a headache that she states is all over.  She describes the pain as aching.   Patient also complains that she overall does not feel well.  Patient denies any chest pain, or shortness of breath at this time.  9/13/21: This 73-year-old female with history of end-stage renal disease, along with breast cancer and left arm lymphedema was having dialysis. She has been sick during dialysis days recently.  Blood pressure has been noted to be low and some bradycardia.  Review of her home medicines is somewhat unclear, but it looks like she has had both carvedilol and labetalol filled recently, is taking both of these twice a day, even on dialysis days. We tried to decrease the carvedilol on dialysis days, stop the labetalol and add Norvasc.  She tolerated the most recent hemodialysis. She has developed left arm swelling, pain; has an ultrasound showing a superficial phlebitis of the cephalic vein with no signs of deep vein involvement. We discussed blood thinners, but will not treat superficial phlebitis unless symptoms get worse, suggesting it is going into a deep vein thrombosis.  She will use warm compresses when she gets home.  She is seen the day of discharge, doing quite well.  She is afebrile.  Oxygenation 97% on room air. Blood pressure is 155/83.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Haematocrit decreased, Haemoglobin decreased, Headache, Hypertension
Clinical narrative: Pfizer Dose 1 3/9/21 (EN6199) Pfizer Dose 2 4/8/21 (ER8737) COVID Positive 8/23/21 COVID Negative 9/6/21  9/6/21: Patient is a 73-year-old female who presents to the ED today for altered mental status, high blood pressure and headache.  Patient states her headache started approximately 7 hours prior to arrival.  Patient states she was also having trouble finding words.  Per patient's daughter she was significantly more confused than earlier in the day.  Patient currently has COVID pneumonia, and missed dialysis on Saturday.  Patient has a past medical history significant for ESRD on hemodialysis Tuesday Thursday Saturday, hyperlipidemia, hypertension, CHF, sleep apnea, hyperparathyroidism, anemia, leukopenia, vitamin B12 deficiency.   Upon arrival to ED patient was given azithromycin and Rocephin for community-acquired pneumonia.  Patient also had a chest x-ray that revealed bilateral pneumonia that has progressed since 08/23/2021.  Head CT was performed due to trouble finding words, confusion and showed no new intracranial hemorrhage or other acute findings.  Patient's laboratory findings were significant for WBC 4.46, HGB 10.5, HCT 32.7%, glucose 112, BUN 59, creatinine 10.62, potassium 6.2.  Patient was given 1 time dose of Kayexalate.  Dr. consulted in the ED and recommended dialysis treatment in the morning.   Patient was seen and examined in the ED, patient is sitting comfortably in bed.  Patient is confused, but answering questions.  Patient states she continues to have a headache that she states is all over.  She describes the pain as aching.   Patient also complains that she overall does not feel well.  Patient denies any chest pain, or shortness of breath at this time.  9/13/21: This 73-year-old female with history of end-stage renal disease, along with breast cancer and left arm lymphedema was having dialysis. She has been sick during dialysis days recently.  Blood pressure has been noted to be low and some bradycardia.  Review of her home medicines is somewhat unclear, but it looks like she has had both carvedilol and labetalol filled recently, is taking both of these twice a day, even on dialysis days. We tried to decrease the carvedilol on dialysis days, stop the labetalol and add Norvasc.  She tolerated the most recent hemodialysis. She has developed left arm swelling, pain; has an ultrasound showing a superficial phlebitis of the cephalic vein with no signs of deep vein involvement. We discussed blood thinners, but will not treat superficial phlebitis unless symptoms get worse, suggesting it is going into a deep vein thrombosis.  She will use warm compresses when she gets home.  She is seen the day of discharge, doing quite well.  She is afebrile.  Oxygenation 97% on room air. Blood pressure is 155/83.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Hypotension, Laboratory test, Malaise, Mental status changes, Pain in extremity
Clinical narrative: Pfizer Dose 1 3/9/21 (EN6199) Pfizer Dose 2 4/8/21 (ER8737) COVID Positive 8/23/21 COVID Negative 9/6/21  9/6/21: Patient is a 73-year-old female who presents to the ED today for altered mental status, high blood pressure and headache.  Patient states her headache started approximately 7 hours prior to arrival.  Patient states she was also having trouble finding words.  Per patient's daughter she was significantly more confused than earlier in the day.  Patient currently has COVID pneumonia, and missed dialysis on Saturday.  Patient has a past medical history significant for ESRD on hemodialysis Tuesday Thursday Saturday, hyperlipidemia, hypertension, CHF, sleep apnea, hyperparathyroidism, anemia, leukopenia, vitamin B12 deficiency.   Upon arrival to ED patient was given azithromycin and Rocephin for community-acquired pneumonia.  Patient also had a chest x-ray that revealed bilateral pneumonia that has progressed since 08/23/2021.  Head CT was performed due to trouble finding words, confusion and showed no new intracranial hemorrhage or other acute findings.  Patient's laboratory findings were significant for WBC 4.46, HGB 10.5, HCT 32.7%, glucose 112, BUN 59, creatinine 10.62, potassium 6.2.  Patient was given 1 time dose of Kayexalate.  Dr. consulted in the ED and recommended dialysis treatment in the morning.   Patient was seen and examined in the ED, patient is sitting comfortably in bed.  Patient is confused, but answering questions.  Patient states she continues to have a headache that she states is all over.  She describes the pain as aching.   Patient also complains that she overall does not feel well.  Patient denies any chest pain, or shortness of breath at this time.  9/13/21: This 73-year-old female with history of end-stage renal disease, along with breast cancer and left arm lymphedema was having dialysis. She has been sick during dialysis days recently.  Blood pressure has been noted to be low and some bradycardia.  Review of her home medicines is somewhat unclear, but it looks like she has had both carvedilol and labetalol filled recently, is taking both of these twice a day, even on dialysis days. We tried to decrease the carvedilol on dialysis days, stop the labetalol and add Norvasc.  She tolerated the most recent hemodialysis. She has developed left arm swelling, pain; has an ultrasound showing a superficial phlebitis of the cephalic vein with no signs of deep vein involvement. We discussed blood thinners, but will not treat superficial phlebitis unless symptoms get worse, suggesting it is going into a deep vein thrombosis.  She will use warm compresses when she gets home.  She is seen the day of discharge, doing quite well.  She is afebrile.  Oxygenation 97% on room air. Blood pressure is 155/83.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Peripheral swelling, Phlebitis superficial, Pneumonia, SARS-CoV-2 test positive, Ultrasound Doppler abnormal
Clinical narrative: Pfizer Dose 1 3/9/21 (EN6199) Pfizer Dose 2 4/8/21 (ER8737) COVID Positive 8/23/21 COVID Negative 9/6/21  9/6/21: Patient is a 73-year-old female who presents to the ED today for altered mental status, high blood pressure and headache.  Patient states her headache started approximately 7 hours prior to arrival.  Patient states she was also having trouble finding words.  Per patient's daughter she was significantly more confused than earlier in the day.  Patient currently has COVID pneumonia, and missed dialysis on Saturday.  Patient has a past medical history significant for ESRD on hemodialysis Tuesday Thursday Saturday, hyperlipidemia, hypertension, CHF, sleep apnea, hyperparathyroidism, anemia, leukopenia, vitamin B12 deficiency.   Upon arrival to ED patient was given azithromycin and Rocephin for community-acquired pneumonia.  Patient also had a chest x-ray that revealed bilateral pneumonia that has progressed since 08/23/2021.  Head CT was performed due to trouble finding words, confusion and showed no new intracranial hemorrhage or other acute findings.  Patient's laboratory findings were significant for WBC 4.46, HGB 10.5, HCT 32.7%, glucose 112, BUN 59, creatinine 10.62, potassium 6.2.  Patient was given 1 time dose of Kayexalate.  Dr. consulted in the ED and recommended dialysis treatment in the morning.   Patient was seen and examined in the ED, patient is sitting comfortably in bed.  Patient is confused, but answering questions.  Patient states she continues to have a headache that she states is all over.  She describes the pain as aching.   Patient also complains that she overall does not feel well.  Patient denies any chest pain, or shortness of breath at this time.  9/13/21: This 73-year-old female with history of end-stage renal disease, along with breast cancer and left arm lymphedema was having dialysis. She has been sick during dialysis days recently.  Blood pressure has been noted to be low and some bradycardia.  Review of her home medicines is somewhat unclear, but it looks like she has had both carvedilol and labetalol filled recently, is taking both of these twice a day, even on dialysis days. We tried to decrease the carvedilol on dialysis days, stop the labetalol and add Norvasc.  She tolerated the most recent hemodialysis. She has developed left arm swelling, pain; has an ultrasound showing a superficial phlebitis of the cephalic vein with no signs of deep vein involvement. We discussed blood thinners, but will not treat superficial phlebitis unless symptoms get worse, suggesting it is going into a deep vein thrombosis.  She will use warm compresses when she gets home.  She is seen the day of discharge, doing quite well.  She is afebrile.  Oxygenation 97% on room air. Blood pressure is 155/83.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: White blood cell count decreased
Clinical narrative: Pfizer Dose 1 3/9/21 (EN6199) Pfizer Dose 2 4/8/21 (ER8737) COVID Positive 8/23/21 COVID Negative 9/6/21  9/6/21: Patient is a 73-year-old female who presents to the ED today for altered mental status, high blood pressure and headache.  Patient states her headache started approximately 7 hours prior to arrival.  Patient states she was also having trouble finding words.  Per patient's daughter she was significantly more confused than earlier in the day.  Patient currently has COVID pneumonia, and missed dialysis on Saturday.  Patient has a past medical history significant for ESRD on hemodialysis Tuesday Thursday Saturday, hyperlipidemia, hypertension, CHF, sleep apnea, hyperparathyroidism, anemia, leukopenia, vitamin B12 deficiency.   Upon arrival to ED patient was given azithromycin and Rocephin for community-acquired pneumonia.  Patient also had a chest x-ray that revealed bilateral pneumonia that has progressed since 08/23/2021.  Head CT was performed due to trouble finding words, confusion and showed no new intracranial hemorrhage or other acute findings.  Patient's laboratory findings were significant for WBC 4.46, HGB 10.5, HCT 32.7%, glucose 112, BUN 59, creatinine 10.62, potassium 6.2.  Patient was given 1 time dose of Kayexalate.  Dr. consulted in the ED and recommended dialysis treatment in the morning.   Patient was seen and examined in the ED, patient is sitting comfortably in bed.  Patient is confused, but answering questions.  Patient states she continues to have a headache that she states is all over.  She describes the pain as aching.   Patient also complains that she overall does not feel well.  Patient denies any chest pain, or shortness of breath at this time.  9/13/21: This 73-year-old female with history of end-stage renal disease, along with breast cancer and left arm lymphedema was having dialysis. She has been sick during dialysis days recently.  Blood pressure has been noted to be low and some bradycardia.  Review of her home medicines is somewhat unclear, but it looks like she has had both carvedilol and labetalol filled recently, is taking both of these twice a day, even on dialysis days. We tried to decrease the carvedilol on dialysis days, stop the labetalol and add Norvasc.  She tolerated the most recent hemodialysis. She has developed left arm swelling, pain; has an ultrasound showing a superficial phlebitis of the cephalic vein with no signs of deep vein involvement. We discussed blood thinners, but will not treat superficial phlebitis unless symptoms get worse, suggesting it is going into a deep vein thrombosis.  She will use warm compresses when she gets home.  She is seen the day of discharge, doing quite well.  She is afebrile.  Oxygenation 97% on room air. Blood pressure is 155/83.
Age: 0.17
Sex: F
Vaccine: RV5
Symptoms: Lethargy
Clinical narrative: Patient became very lethargic right after giving the oral vaccine on 10-27-2021 @ 9:00am - EMS called - patient started acting more normal upon the arrival of  EMS. Parents decided to watch patient at home and will call EMS if any changes.
Age: 19.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Fatigue, Nausea, Vomiting
Clinical narrative: 1 day after receiving the vaccine patient has generalized abdominal pain/cramping and n/v and fatigue
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Blood test, Chest pain, Dizziness, Dysmenorrhoea
Clinical narrative: severe trembling for 48 hours from being cold, 12 hours of vomiting, muscle aches, severe joint pain which I still have 6 months later, numbness in right arm from shoulder to wrist with shooting pain at times.  extremely lethargic.   Chest pains on a daily basis with some dizziness on and off. Menstrual cycle has completely been out of whack with severe cramping at times. All the above have been on going since my second dosage.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram, Feeling cold, Hypoaesthesia, Lethargy, Menstrual disorder
Clinical narrative: severe trembling for 48 hours from being cold, 12 hours of vomiting, muscle aches, severe joint pain which I still have 6 months later, numbness in right arm from shoulder to wrist with shooting pain at times.  extremely lethargic.   Chest pains on a daily basis with some dizziness on and off. Menstrual cycle has completely been out of whack with severe cramping at times. All the above have been on going since my second dosage.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Pain, Physical examination, Tremor, Vomiting
Clinical narrative: severe trembling for 48 hours from being cold, 12 hours of vomiting, muscle aches, severe joint pain which I still have 6 months later, numbness in right arm from shoulder to wrist with shooting pain at times.  extremely lethargic.   Chest pains on a daily basis with some dizziness on and off. Menstrual cycle has completely been out of whack with severe cramping at times. All the above have been on going since my second dosage.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chest pain, Decreased appetite, Fatigue, Injection site pain
Clinical narrative: The day following the vaccine, my arm was very tender at the injection site and I started feeling like I was getting sick.  The second day after the injection, I continued to feel like I was getting sick (sore throat, congestion, and fatigue).  I remembered dreaming that night, while sleeping, that my heart was racing (I'd never had a dream like that before and didn't think much of it).  By the fourth day following, I felt like I was having a severe panic attack as my heart was racing, my chest hurt, I was on the verge of crying all day, and there was no way to resolve any of it.  On the fifth day, my heart has continued to race (140 bpm on average), my chest continues to hurt, my lungs hurt, my stomach hurts, and I have no appetite.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Oropharyngeal pain, Palpitations, Panic attack, Pulmonary pain
Clinical narrative: The day following the vaccine, my arm was very tender at the injection site and I started feeling like I was getting sick.  The second day after the injection, I continued to feel like I was getting sick (sore throat, congestion, and fatigue).  I remembered dreaming that night, while sleeping, that my heart was racing (I'd never had a dream like that before and didn't think much of it).  By the fourth day following, I felt like I was having a severe panic attack as my heart was racing, my chest hurt, I was on the verge of crying all day, and there was no way to resolve any of it.  On the fifth day, my heart has continued to race (140 bpm on average), my chest continues to hurt, my lungs hurt, my stomach hurts, and I have no appetite.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract congestion
Clinical narrative: The day following the vaccine, my arm was very tender at the injection site and I started feeling like I was getting sick.  The second day after the injection, I continued to feel like I was getting sick (sore throat, congestion, and fatigue).  I remembered dreaming that night, while sleeping, that my heart was racing (I'd never had a dream like that before and didn't think much of it).  By the fourth day following, I felt like I was having a severe panic attack as my heart was racing, my chest hurt, I was on the verge of crying all day, and there was no way to resolve any of it.  On the fifth day, my heart has continued to race (140 bpm on average), my chest continues to hurt, my lungs hurt, my stomach hurts, and I have no appetite.
Age: 74.0
Sex: F
Vaccine: FLUA4, FLUA4
Symptoms: Arthralgia, Gait inability, Immunisation reaction, Joint swelling, Synovial cyst
Clinical narrative: within 20 hours developed pain in left knee which increased in severity with swelling to the point I could not walk spoke to pharmacist who thought this was a reaction to the high dose flue vaccine, spoke to my orthopedic surgeon who also felt this was a reaction to the high dose flu vaccine
Age: 74.0
Sex: F
Vaccine: FLUA4, FLUA4
Symptoms: X-ray limb abnormal
Clinical narrative: within 20 hours developed pain in left knee which increased in severity with swelling to the point I could not walk spoke to pharmacist who thought this was a reaction to the high dose flue vaccine, spoke to my orthopedic surgeon who also felt this was a reaction to the high dose flu vaccine
Age: 74.0
Sex: F
Vaccine: FLUA4, FLUA4
Symptoms: Arthralgia, Synovial cyst
Clinical narrative: within 20 hours developed pain in left knee which increased in severity with swelling to the point I could not walk spoke to pharmacist who thought this was a reaction to the high dose flue vaccine, spoke to my orthopedic surgeon who also felt this was a reaction to the high dose flu vaccine
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Atrial fibrillation, Cardiac ablation, Echocardiogram, Gastrooesophageal reflux disease
Clinical narrative: At first, I had abdominal pain quite a bit. I went to the PCP at the beginning of May and was prescribed medicine for GERD; It started to work, but then the pain kept coming back. My PCP ordered a sonogram on my abdomen, and they didn't see any gall stones or anything, so she referred me to an enterologist around June 30th. I went to the enterologist and was ordered to have a scope done. I went to have a scope done, and was getting prepped to have the procedure, and the anesthesiologist noticed I was in AFIB. My heartrate would go up to 149, come down and go back up. The doctor canceled the procedure and sent me to my doctor and a cardiologist. I was diagnosed with atrial fibrillation. I was put in the hospital to be monitored and nothing happened at that time. So, I was sent to the hospital, and they did test to try and figure out what was going on.  I was told I needed to have an ablation done; I had an ablation done on 10/5/21.  I am currently taking medication for this issue, and I had a clean bill of health prior to this. I also had an echocardiogram before and after the ablation and it was normal.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound scan normal
Clinical narrative: At first, I had abdominal pain quite a bit. I went to the PCP at the beginning of May and was prescribed medicine for GERD; It started to work, but then the pain kept coming back. My PCP ordered a sonogram on my abdomen, and they didn't see any gall stones or anything, so she referred me to an enterologist around June 30th. I went to the enterologist and was ordered to have a scope done. I went to have a scope done, and was getting prepped to have the procedure, and the anesthesiologist noticed I was in AFIB. My heartrate would go up to 149, come down and go back up. The doctor canceled the procedure and sent me to my doctor and a cardiologist. I was diagnosed with atrial fibrillation. I was put in the hospital to be monitored and nothing happened at that time. So, I was sent to the hospital, and they did test to try and figure out what was going on.  I was told I needed to have an ablation done; I had an ablation done on 10/5/21.  I am currently taking medication for this issue, and I had a clean bill of health prior to this. I also had an echocardiogram before and after the ablation and it was normal.
Age: 27.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt had a positive covid test.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus
Clinical narrative: Patient complained of itchiness around B/L arm and chest and stated he has history of itchiness and takes Benadryl at home. Patient is allergic to Xolair and other environmental facts which results in itchiness. On thorough assessment no difficulty breathing, swelling of throat and lips noted. Vital signs initiated.  Benadryl 25 mg PO given. After few minutes patient stated his itchiness subsided and was ready to leave observation area. Thorough assessment and last set of vital signs taken. Patient left observation are in stable condition.
Age: 94.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt had a positive covid test
Sex: U
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Pain
Clinical narrative: Chills, aches all over including joints starting at 3am on 10/26 No treatment  Symptoms gone by morning of 10/27
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain upper, Malaise, Paraesthesia, Pruritus, Skin tightness
Clinical narrative: Covid Vaccine administered. Patient monitored for 30 minutes d/t reaction. Within minutes of receiving the injection, patient started to itch on his arms and it spread to legs. No visible rash. Minutes later patient complained of stomach pain and vomited and felt generally unwell. Patient then reported facial "tightness" and tingling. Reported no issues with breathing or airway. Called ER 2 at this point and he was assessed by the ER team.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Covid Vaccine administered. Patient monitored for 30 minutes d/t reaction. Within minutes of receiving the injection, patient started to itch on his arms and it spread to legs. No visible rash. Minutes later patient complained of stomach pain and vomited and felt generally unwell. Patient then reported facial "tightness" and tingling. Reported no issues with breathing or airway. Called ER 2 at this point and he was assessed by the ER team.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Cholelithiasis, Computerised tomogram abdomen abnormal, Defaecation urgency, Duodenal ulcer, Duodenitis
Clinical narrative: Moderna Dose 1 3/25/21 (017B21A) Moderna Dose ? 3/30/21 (probably mistakenly recorded by human error) Moderna Dose 2 4/23/21 (006C21A) Presented to ED and transferred 9/30/21 COVID Positive 10/1/21  10/1/21:A 76-year-old male past medical history significant for diverticulosis status post bowel resection, essential hypertension, GERD, type 2 diabetes mellitus,  presented to Emergency Room after s/p fall and bloody bowl movement of 1 day.  Patient endorses that she was going to the bathroom when walker "went ahead "of her and fell to the ground.  She was unable to get up and laid on the ground for 2 hours until EMS arrival .  While laying on the ground  patient had the urge to defecate and  had bowel movement.  Per EMS and patient there was dark tarry stool mixed with blood.  Patient denied any abdominal pain nausea or vomiting. Patient denied any previous melena or hematemesis   Patient was diagnosed with COVID-19 infection on 09/29/2021 and got plasma infusion to days back.  Patient was also vaccinated with modern a COVID-19 vaccine in July 9 to August  .   Patient had colonoscopy in 2018 and per patient had removal of polyps.  Patient also had bowel resection surgery in 2011 for diverticulosis  In the emergency room  lab was significant for low sodium of 129, elevated blood glucose of 297 with BUN/creatinine ratio of 36. Hemoglobin was 11.9.  COVID-19 done on 09/27/2021 was positive.  CT abdomen and pelvis with IV contrast showed duodenitis, possibly related to peptic ulcer disease.  No perforation; cholelithiasis without evidence of acute cholecystitis.  Patient was started with Protonix drip by the referring physician   10/3/21: 76-year-old female with a history of HTN, T2 dm, GERD and the bowel resection for diverticulosis admitted for episode of probable syncope and melena stools.  She has a chronic headache for which she takes NSAIDs regularly. At the emergency room the vital signs were normal.  The hemoglobin was 11.9 grams/dL.  Routine COVID 19 screen came back positive but patient has no respiratory symptoms and she is fully vaccinated against COVID 19. She was diagnosed with likely upper GI bleed was admitted to hospital.  Later that night she had upper GI endoscopy and it revealed a medium-sized hiatal hernia, diffuse gastritis, clean based pre-pyloric ulcer, multiple large distal duodenal bulb ulcer.  Patient required placement of a hemoclip for a visible ulcer in the duodenal bulb with successful hemostasis.  Back to the medical ward she has been doing fine and hemoglobin fairly stable.  She has been on pantoprazole infusion since admission.  On re-evaluation this morning she feels fine was able to eat solid meal without any complaint.  The repeat hemoglobin this morning is 9.5 grams/dL which is stable.  She will be discharged home and will continue with oral pantoprazole 40 mg b.i.d. until re-evaluated by the gastroenterologist. Gastric/Duodenal biopsy for Helicobacter pylori is pending and hopefully will be available when she follows up with the GI specialist.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Dysstasia, Endoscopy gastrointestinal abnormal, Essential hypertension, Fall, Gastric ulcer
Clinical narrative: Moderna Dose 1 3/25/21 (017B21A) Moderna Dose ? 3/30/21 (probably mistakenly recorded by human error) Moderna Dose 2 4/23/21 (006C21A) Presented to ED and transferred 9/30/21 COVID Positive 10/1/21  10/1/21:A 76-year-old male past medical history significant for diverticulosis status post bowel resection, essential hypertension, GERD, type 2 diabetes mellitus,  presented to Emergency Room after s/p fall and bloody bowl movement of 1 day.  Patient endorses that she was going to the bathroom when walker "went ahead "of her and fell to the ground.  She was unable to get up and laid on the ground for 2 hours until EMS arrival .  While laying on the ground  patient had the urge to defecate and  had bowel movement.  Per EMS and patient there was dark tarry stool mixed with blood.  Patient denied any abdominal pain nausea or vomiting. Patient denied any previous melena or hematemesis   Patient was diagnosed with COVID-19 infection on 09/29/2021 and got plasma infusion to days back.  Patient was also vaccinated with modern a COVID-19 vaccine in July 9 to August  .   Patient had colonoscopy in 2018 and per patient had removal of polyps.  Patient also had bowel resection surgery in 2011 for diverticulosis  In the emergency room  lab was significant for low sodium of 129, elevated blood glucose of 297 with BUN/creatinine ratio of 36. Hemoglobin was 11.9.  COVID-19 done on 09/27/2021 was positive.  CT abdomen and pelvis with IV contrast showed duodenitis, possibly related to peptic ulcer disease.  No perforation; cholelithiasis without evidence of acute cholecystitis.  Patient was started with Protonix drip by the referring physician   10/3/21: 76-year-old female with a history of HTN, T2 dm, GERD and the bowel resection for diverticulosis admitted for episode of probable syncope and melena stools.  She has a chronic headache for which she takes NSAIDs regularly. At the emergency room the vital signs were normal.  The hemoglobin was 11.9 grams/dL.  Routine COVID 19 screen came back positive but patient has no respiratory symptoms and she is fully vaccinated against COVID 19. She was diagnosed with likely upper GI bleed was admitted to hospital.  Later that night she had upper GI endoscopy and it revealed a medium-sized hiatal hernia, diffuse gastritis, clean based pre-pyloric ulcer, multiple large distal duodenal bulb ulcer.  Patient required placement of a hemoclip for a visible ulcer in the duodenal bulb with successful hemostasis.  Back to the medical ward she has been doing fine and hemoglobin fairly stable.  She has been on pantoprazole infusion since admission.  On re-evaluation this morning she feels fine was able to eat solid meal without any complaint.  The repeat hemoglobin this morning is 9.5 grams/dL which is stable.  She will be discharged home and will continue with oral pantoprazole 40 mg b.i.d. until re-evaluated by the gastroenterologist. Gastric/Duodenal biopsy for Helicobacter pylori is pending and hopefully will be available when she follows up with the GI specialist.