chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebral atrophy, Chest X-ray abnormal, Chronic respiratory failure, Delirium, Drug screen positive
Clinical narrative: Patient is a 61 y.o. female patient with history of  of COPD. ILD, RA, Anxiety, DDD of L spine, T2DM, HTN, HLD , Chronic pain syndrome presented to Hospital.   Acute delirium from combination of COVID-19 infection and behavioral health issues Suicidal Ideation Extensive psych history, was recently discharged from BH on 2/9 Currently alert and oriented, denies SI/HI CTH No acute findings.  No hemorrhage or mass. Brain atrophy stable.  No hydrocephalus Blood work non revaling, other than positive for COVID19 UA WNL, UDS benzos and opiates positive, TSH 0.28, B-12 742 Consult BH, appreciate assistance Had an episode of attempting to hang herself in her room 2/15 Per BH, palliative care consult recommended and placed. Appreciate assistance BHU OK with discharge once medically cleared and safe discharge plan arranged Palliative and CM helped determine to discharge with return to hospice at home Sister with some concerns prior to discharge, Psych agreed to call her the morning after discharge to discuss her behavioral issues   Nausea/Vomiting Nausea and vomiting still intermittently present, but improved May be secondary to COVID Tolerating PO and ok with discharge Hospice to help manage potential anti-emetics   Chronic hypoxic respiratory failure COVDI19 pneumonia ILD COPD/Asthma CXR Worsening of the mixed interstitial and alveolar opacities in the perihilar regions and lower lungs from the prior study suggesting superimposed edema or pneumonitis on chronic interstitial changes. On chronic 4 L O2 therapy. IV lasix 40 mg one dose, cont po lasix 40mg qd Mucinex, IS/PEP, Check CRP Monitor on continuous pulse ox .  Hold home p.o. prednisone and switch to IV Decadron given elevated CRP Continue breathing treatments and bronchodilator therapy   HTN HLD Resume coreg and lisinopril Resume statin Monitor and adjust BP medication as able   T2DM with hyperglycemia Poorly controled.  A1c 8.8 Lantus and SSI adjusted  Adjust insulin as able.    Chronic leukocytosis Normocytic anemia Likely from steroid, WBC 14, Hg stable at 10.9 monitor
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Leukocytosis, Mental status changes, Nausea, Normocytic anaemia, Opiates positive
Clinical narrative: Patient is a 61 y.o. female patient with history of  of COPD. ILD, RA, Anxiety, DDD of L spine, T2DM, HTN, HLD , Chronic pain syndrome presented to Hospital.   Acute delirium from combination of COVID-19 infection and behavioral health issues Suicidal Ideation Extensive psych history, was recently discharged from BH on 2/9 Currently alert and oriented, denies SI/HI CTH No acute findings.  No hemorrhage or mass. Brain atrophy stable.  No hydrocephalus Blood work non revaling, other than positive for COVID19 UA WNL, UDS benzos and opiates positive, TSH 0.28, B-12 742 Consult BH, appreciate assistance Had an episode of attempting to hang herself in her room 2/15 Per BH, palliative care consult recommended and placed. Appreciate assistance BHU OK with discharge once medically cleared and safe discharge plan arranged Palliative and CM helped determine to discharge with return to hospice at home Sister with some concerns prior to discharge, Psych agreed to call her the morning after discharge to discuss her behavioral issues   Nausea/Vomiting Nausea and vomiting still intermittently present, but improved May be secondary to COVID Tolerating PO and ok with discharge Hospice to help manage potential anti-emetics   Chronic hypoxic respiratory failure COVDI19 pneumonia ILD COPD/Asthma CXR Worsening of the mixed interstitial and alveolar opacities in the perihilar regions and lower lungs from the prior study suggesting superimposed edema or pneumonitis on chronic interstitial changes. On chronic 4 L O2 therapy. IV lasix 40 mg one dose, cont po lasix 40mg qd Mucinex, IS/PEP, Check CRP Monitor on continuous pulse ox .  Hold home p.o. prednisone and switch to IV Decadron given elevated CRP Continue breathing treatments and bronchodilator therapy   HTN HLD Resume coreg and lisinopril Resume statin Monitor and adjust BP medication as able   T2DM with hyperglycemia Poorly controled.  A1c 8.8 Lantus and SSI adjusted  Adjust insulin as able.    Chronic leukocytosis Normocytic anemia Likely from steroid, WBC 14, Hg stable at 10.9 monitor
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Pneumonitis, Pulmonary oedema, Respiratory failure, SARS-CoV-2 test positive, Suicidal ideation
Clinical narrative: Patient is a 61 y.o. female patient with history of  of COPD. ILD, RA, Anxiety, DDD of L spine, T2DM, HTN, HLD , Chronic pain syndrome presented to Hospital.   Acute delirium from combination of COVID-19 infection and behavioral health issues Suicidal Ideation Extensive psych history, was recently discharged from BH on 2/9 Currently alert and oriented, denies SI/HI CTH No acute findings.  No hemorrhage or mass. Brain atrophy stable.  No hydrocephalus Blood work non revaling, other than positive for COVID19 UA WNL, UDS benzos and opiates positive, TSH 0.28, B-12 742 Consult BH, appreciate assistance Had an episode of attempting to hang herself in her room 2/15 Per BH, palliative care consult recommended and placed. Appreciate assistance BHU OK with discharge once medically cleared and safe discharge plan arranged Palliative and CM helped determine to discharge with return to hospice at home Sister with some concerns prior to discharge, Psych agreed to call her the morning after discharge to discuss her behavioral issues   Nausea/Vomiting Nausea and vomiting still intermittently present, but improved May be secondary to COVID Tolerating PO and ok with discharge Hospice to help manage potential anti-emetics   Chronic hypoxic respiratory failure COVDI19 pneumonia ILD COPD/Asthma CXR Worsening of the mixed interstitial and alveolar opacities in the perihilar regions and lower lungs from the prior study suggesting superimposed edema or pneumonitis on chronic interstitial changes. On chronic 4 L O2 therapy. IV lasix 40 mg one dose, cont po lasix 40mg qd Mucinex, IS/PEP, Check CRP Monitor on continuous pulse ox .  Hold home p.o. prednisone and switch to IV Decadron given elevated CRP Continue breathing treatments and bronchodilator therapy   HTN HLD Resume coreg and lisinopril Resume statin Monitor and adjust BP medication as able   T2DM with hyperglycemia Poorly controled.  A1c 8.8 Lantus and SSI adjusted  Adjust insulin as able.    Chronic leukocytosis Normocytic anemia Likely from steroid, WBC 14, Hg stable at 10.9 monitor
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Suicide attempt, Urine analysis normal, Vitamin B12, Vomiting, White blood cell count increased
Clinical narrative: Patient is a 61 y.o. female patient with history of  of COPD. ILD, RA, Anxiety, DDD of L spine, T2DM, HTN, HLD , Chronic pain syndrome presented to Hospital.   Acute delirium from combination of COVID-19 infection and behavioral health issues Suicidal Ideation Extensive psych history, was recently discharged from BH on 2/9 Currently alert and oriented, denies SI/HI CTH No acute findings.  No hemorrhage or mass. Brain atrophy stable.  No hydrocephalus Blood work non revaling, other than positive for COVID19 UA WNL, UDS benzos and opiates positive, TSH 0.28, B-12 742 Consult BH, appreciate assistance Had an episode of attempting to hang herself in her room 2/15 Per BH, palliative care consult recommended and placed. Appreciate assistance BHU OK with discharge once medically cleared and safe discharge plan arranged Palliative and CM helped determine to discharge with return to hospice at home Sister with some concerns prior to discharge, Psych agreed to call her the morning after discharge to discuss her behavioral issues   Nausea/Vomiting Nausea and vomiting still intermittently present, but improved May be secondary to COVID Tolerating PO and ok with discharge Hospice to help manage potential anti-emetics   Chronic hypoxic respiratory failure COVDI19 pneumonia ILD COPD/Asthma CXR Worsening of the mixed interstitial and alveolar opacities in the perihilar regions and lower lungs from the prior study suggesting superimposed edema or pneumonitis on chronic interstitial changes. On chronic 4 L O2 therapy. IV lasix 40 mg one dose, cont po lasix 40mg qd Mucinex, IS/PEP, Check CRP Monitor on continuous pulse ox .  Hold home p.o. prednisone and switch to IV Decadron given elevated CRP Continue breathing treatments and bronchodilator therapy   HTN HLD Resume coreg and lisinopril Resume statin Monitor and adjust BP medication as able   T2DM with hyperglycemia Poorly controled.  A1c 8.8 Lantus and SSI adjusted  Adjust insulin as able.    Chronic leukocytosis Normocytic anemia Likely from steroid, WBC 14, Hg stable at 10.9 monitor
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, Asthenia, Brain natriuretic peptide increased, COVID-19
Clinical narrative: Patient is a 70 y.o. female with a history of Afib,HTN, L MCA stroke s/p NIR for TICI 2c reperfusion, Asthma and morbid obesity who was admitted 2/6/23 for AMS , Seizure and found to have hemorrhagic shock due to GIB and acute respiratory failure requiring intubation. She was just discharged home with HHC after she refused facility and represented RMH 2/13/2023 with  cough and increased SOB. She was found to have positive COVID-19. CTPA without PE, noted b/l GGO. Discharged to home w/ HHC 2/17/23.    1. COVID-19 Pneumonia: Vaccinated.  Test positive 2/13/23. CTPA as above. Of not pt was intubated from 2/6-2/9/23 and weaned to room air prior to discharge. Hypoxia noted and initiated decadron and remdesivir 2/15/23. Improved.  2. Acute Hypoxic Respiratory Failure: due to COVID-19. BNP 7000s. TTE 02/2023 with EF 50-55%. On room air and not overloaded on exam. Given IV Lasix x1. Did not qualify for home O2. Resolved.  3. Generalized weakness: due to recent critical admission and deconditioning. Reportedly pt refused SNF on prior admission and dc with HHC. Therapies followed
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Cough, Dyspnoea, Echocardiogram normal, Endotracheal intubation
Clinical narrative: Patient is a 70 y.o. female with a history of Afib,HTN, L MCA stroke s/p NIR for TICI 2c reperfusion, Asthma and morbid obesity who was admitted 2/6/23 for AMS , Seizure and found to have hemorrhagic shock due to GIB and acute respiratory failure requiring intubation. She was just discharged home with HHC after she refused facility and represented RMH 2/13/2023 with  cough and increased SOB. She was found to have positive COVID-19. CTPA without PE, noted b/l GGO. Discharged to home w/ HHC 2/17/23.    1. COVID-19 Pneumonia: Vaccinated.  Test positive 2/13/23. CTPA as above. Of not pt was intubated from 2/6-2/9/23 and weaned to room air prior to discharge. Hypoxia noted and initiated decadron and remdesivir 2/15/23. Improved.  2. Acute Hypoxic Respiratory Failure: due to COVID-19. BNP 7000s. TTE 02/2023 with EF 50-55%. On room air and not overloaded on exam. Given IV Lasix x1. Did not qualify for home O2. Resolved.  3. Generalized weakness: due to recent critical admission and deconditioning. Reportedly pt refused SNF on prior admission and dc with HHC. Therapies followed
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Gastrointestinal haemorrhage, Lung opacity, Mental status changes, Physical deconditioning, SARS-CoV-2 test positive
Clinical narrative: Patient is a 70 y.o. female with a history of Afib,HTN, L MCA stroke s/p NIR for TICI 2c reperfusion, Asthma and morbid obesity who was admitted 2/6/23 for AMS , Seizure and found to have hemorrhagic shock due to GIB and acute respiratory failure requiring intubation. She was just discharged home with HHC after she refused facility and represented RMH 2/13/2023 with  cough and increased SOB. She was found to have positive COVID-19. CTPA without PE, noted b/l GGO. Discharged to home w/ HHC 2/17/23.    1. COVID-19 Pneumonia: Vaccinated.  Test positive 2/13/23. CTPA as above. Of not pt was intubated from 2/6-2/9/23 and weaned to room air prior to discharge. Hypoxia noted and initiated decadron and remdesivir 2/15/23. Improved.  2. Acute Hypoxic Respiratory Failure: due to COVID-19. BNP 7000s. TTE 02/2023 with EF 50-55%. On room air and not overloaded on exam. Given IV Lasix x1. Did not qualify for home O2. Resolved.  3. Generalized weakness: due to recent critical admission and deconditioning. Reportedly pt refused SNF on prior admission and dc with HHC. Therapies followed
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Seizure, Shock haemorrhagic
Clinical narrative: Patient is a 70 y.o. female with a history of Afib,HTN, L MCA stroke s/p NIR for TICI 2c reperfusion, Asthma and morbid obesity who was admitted 2/6/23 for AMS , Seizure and found to have hemorrhagic shock due to GIB and acute respiratory failure requiring intubation. She was just discharged home with HHC after she refused facility and represented RMH 2/13/2023 with  cough and increased SOB. She was found to have positive COVID-19. CTPA without PE, noted b/l GGO. Discharged to home w/ HHC 2/17/23.    1. COVID-19 Pneumonia: Vaccinated.  Test positive 2/13/23. CTPA as above. Of not pt was intubated from 2/6-2/9/23 and weaned to room air prior to discharge. Hypoxia noted and initiated decadron and remdesivir 2/15/23. Improved.  2. Acute Hypoxic Respiratory Failure: due to COVID-19. BNP 7000s. TTE 02/2023 with EF 50-55%. On room air and not overloaded on exam. Given IV Lasix x1. Did not qualify for home O2. Resolved.  3. Generalized weakness: due to recent critical admission and deconditioning. Reportedly pt refused SNF on prior admission and dc with HHC. Therapies followed
Age: 78.0
Sex: M
Vaccine: VARZOS
Symptoms: Headache, Influenza, Muscular weakness, Oropharyngeal pain, Rhinorrhoea
Clinical narrative: The vaccination was received on Sunday, March 19, 2023.  On Tuesday March 21 I started feeling that a flu was coming on.  I had and continue to have a sore throat, runny nose with white sometimes yellow snot, a headache and muscle weakness.  These symptoms still are present today, perhaps worse than prior days. I am not experiencing any fever.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Airway secretion clearance therapy, Alanine aminotransferase increased, Aspartate aminotransferase normal, Blood alkaline phosphatase normal
Clinical narrative: Patient is a 78 y.o. female patient of DO presented with abnormal labs.  Found to have hyperkalemia, tracheitis and Covid.    Tracheitis - resolved Acute on chronic respiratory failure - resolved Covid 19 virus infection - resolved WBC 12.04--10.88 Patient arrived in the ED via EMS on 15 L of blow-by oxygen.  Patient was discharged on 5 L about 10 days ago. Chest x-ray "mild bilateral perihilar airway wall thickening with surrounding streaky opacities" Large amount of thick mucus suctioned from trachea in the ER Inner cannula of trach removed and replaced in the ER Patient was then weaned to room air in the ED Sputum cultures --normal flora Appreciate ID input--Vancomycin d'ced. Completed course of Rocephin Completed course of Remdesivir and Decadron; now out of COVID isolation Appreciate Pulmonology input-- downsized trach to a Shiley 6 Pt doing well on 2L O2 at 100%, can likely wean to room air   Hyperkalemia - resolved Potassium is 6.1 No EKG changes; sinus bradycardia without QT prolongation Etiology unclear; not in renal failure, no inciting medications. May be related to hyperglycemia. Insulin/dextrose/Lasix given in the ER Follow-up potassium improved to 4.4     Transaminitis Elevated alk phos, AST, ALT Has been elevated in the past Avoid hepatotoxic agents Alk phos 120, AST 31, ALT 79 Consider rechecking outpatient  Type 2 diabetes Sliding scale insulin.  Continue Lantus 10 units Continue to monitor BG's and adjust insulin accordingly. Diabetic tube feeds Fair glycemic control   Anoxic brain injury History of CVA Status post tracheostomy Status post PEG placement Nutrition following for tube feeding Respiratory therapy for trach care  Speak valve per speech therapy   History of seizure-like activity Continue Keppra
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium increased, Brain injury, Bronchial wall thickening, COVID-19, Catheter placement
Clinical narrative: Patient is a 78 y.o. female patient of DO presented with abnormal labs.  Found to have hyperkalemia, tracheitis and Covid.    Tracheitis - resolved Acute on chronic respiratory failure - resolved Covid 19 virus infection - resolved WBC 12.04--10.88 Patient arrived in the ED via EMS on 15 L of blow-by oxygen.  Patient was discharged on 5 L about 10 days ago. Chest x-ray "mild bilateral perihilar airway wall thickening with surrounding streaky opacities" Large amount of thick mucus suctioned from trachea in the ER Inner cannula of trach removed and replaced in the ER Patient was then weaned to room air in the ED Sputum cultures --normal flora Appreciate ID input--Vancomycin d'ced. Completed course of Rocephin Completed course of Remdesivir and Decadron; now out of COVID isolation Appreciate Pulmonology input-- downsized trach to a Shiley 6 Pt doing well on 2L O2 at 100%, can likely wean to room air   Hyperkalemia - resolved Potassium is 6.1 No EKG changes; sinus bradycardia without QT prolongation Etiology unclear; not in renal failure, no inciting medications. May be related to hyperglycemia. Insulin/dextrose/Lasix given in the ER Follow-up potassium improved to 4.4     Transaminitis Elevated alk phos, AST, ALT Has been elevated in the past Avoid hepatotoxic agents Alk phos 120, AST 31, ALT 79 Consider rechecking outpatient  Type 2 diabetes Sliding scale insulin.  Continue Lantus 10 units Continue to monitor BG's and adjust insulin accordingly. Diabetic tube feeds Fair glycemic control   Anoxic brain injury History of CVA Status post tracheostomy Status post PEG placement Nutrition following for tube feeding Respiratory therapy for trach care  Speak valve per speech therapy   History of seizure-like activity Continue Keppra
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Electrocardiogram abnormal, Enteral nutrition, Hyperglycaemia, Hyperkalaemia
Clinical narrative: Patient is a 78 y.o. female patient of DO presented with abnormal labs.  Found to have hyperkalemia, tracheitis and Covid.    Tracheitis - resolved Acute on chronic respiratory failure - resolved Covid 19 virus infection - resolved WBC 12.04--10.88 Patient arrived in the ED via EMS on 15 L of blow-by oxygen.  Patient was discharged on 5 L about 10 days ago. Chest x-ray "mild bilateral perihilar airway wall thickening with surrounding streaky opacities" Large amount of thick mucus suctioned from trachea in the ER Inner cannula of trach removed and replaced in the ER Patient was then weaned to room air in the ED Sputum cultures --normal flora Appreciate ID input--Vancomycin d'ced. Completed course of Rocephin Completed course of Remdesivir and Decadron; now out of COVID isolation Appreciate Pulmonology input-- downsized trach to a Shiley 6 Pt doing well on 2L O2 at 100%, can likely wean to room air   Hyperkalemia - resolved Potassium is 6.1 No EKG changes; sinus bradycardia without QT prolongation Etiology unclear; not in renal failure, no inciting medications. May be related to hyperglycemia. Insulin/dextrose/Lasix given in the ER Follow-up potassium improved to 4.4     Transaminitis Elevated alk phos, AST, ALT Has been elevated in the past Avoid hepatotoxic agents Alk phos 120, AST 31, ALT 79 Consider rechecking outpatient  Type 2 diabetes Sliding scale insulin.  Continue Lantus 10 units Continue to monitor BG's and adjust insulin accordingly. Diabetic tube feeds Fair glycemic control   Anoxic brain injury History of CVA Status post tracheostomy Status post PEG placement Nutrition following for tube feeding Respiratory therapy for trach care  Speak valve per speech therapy   History of seizure-like activity Continue Keppra
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Hypertransaminasaemia, Insulin therapy, Laboratory test abnormal, Lung opacity, Sinus bradycardia
Clinical narrative: Patient is a 78 y.o. female patient of DO presented with abnormal labs.  Found to have hyperkalemia, tracheitis and Covid.    Tracheitis - resolved Acute on chronic respiratory failure - resolved Covid 19 virus infection - resolved WBC 12.04--10.88 Patient arrived in the ED via EMS on 15 L of blow-by oxygen.  Patient was discharged on 5 L about 10 days ago. Chest x-ray "mild bilateral perihilar airway wall thickening with surrounding streaky opacities" Large amount of thick mucus suctioned from trachea in the ER Inner cannula of trach removed and replaced in the ER Patient was then weaned to room air in the ED Sputum cultures --normal flora Appreciate ID input--Vancomycin d'ced. Completed course of Rocephin Completed course of Remdesivir and Decadron; now out of COVID isolation Appreciate Pulmonology input-- downsized trach to a Shiley 6 Pt doing well on 2L O2 at 100%, can likely wean to room air   Hyperkalemia - resolved Potassium is 6.1 No EKG changes; sinus bradycardia without QT prolongation Etiology unclear; not in renal failure, no inciting medications. May be related to hyperglycemia. Insulin/dextrose/Lasix given in the ER Follow-up potassium improved to 4.4     Transaminitis Elevated alk phos, AST, ALT Has been elevated in the past Avoid hepatotoxic agents Alk phos 120, AST 31, ALT 79 Consider rechecking outpatient  Type 2 diabetes Sliding scale insulin.  Continue Lantus 10 units Continue to monitor BG's and adjust insulin accordingly. Diabetic tube feeds Fair glycemic control   Anoxic brain injury History of CVA Status post tracheostomy Status post PEG placement Nutrition following for tube feeding Respiratory therapy for trach care  Speak valve per speech therapy   History of seizure-like activity Continue Keppra
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Sputum culture, Tracheal disorder, Tracheitis, Tracheostomy malfunction, Type 2 diabetes mellitus
Clinical narrative: Patient is a 78 y.o. female patient of DO presented with abnormal labs.  Found to have hyperkalemia, tracheitis and Covid.    Tracheitis - resolved Acute on chronic respiratory failure - resolved Covid 19 virus infection - resolved WBC 12.04--10.88 Patient arrived in the ED via EMS on 15 L of blow-by oxygen.  Patient was discharged on 5 L about 10 days ago. Chest x-ray "mild bilateral perihilar airway wall thickening with surrounding streaky opacities" Large amount of thick mucus suctioned from trachea in the ER Inner cannula of trach removed and replaced in the ER Patient was then weaned to room air in the ED Sputum cultures --normal flora Appreciate ID input--Vancomycin d'ced. Completed course of Rocephin Completed course of Remdesivir and Decadron; now out of COVID isolation Appreciate Pulmonology input-- downsized trach to a Shiley 6 Pt doing well on 2L O2 at 100%, can likely wean to room air   Hyperkalemia - resolved Potassium is 6.1 No EKG changes; sinus bradycardia without QT prolongation Etiology unclear; not in renal failure, no inciting medications. May be related to hyperglycemia. Insulin/dextrose/Lasix given in the ER Follow-up potassium improved to 4.4     Transaminitis Elevated alk phos, AST, ALT Has been elevated in the past Avoid hepatotoxic agents Alk phos 120, AST 31, ALT 79 Consider rechecking outpatient  Type 2 diabetes Sliding scale insulin.  Continue Lantus 10 units Continue to monitor BG's and adjust insulin accordingly. Diabetic tube feeds Fair glycemic control   Anoxic brain injury History of CVA Status post tracheostomy Status post PEG placement Nutrition following for tube feeding Respiratory therapy for trach care  Speak valve per speech therapy   History of seizure-like activity Continue Keppra
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: White blood cell count increased
Clinical narrative: Patient is a 78 y.o. female patient of DO presented with abnormal labs.  Found to have hyperkalemia, tracheitis and Covid.    Tracheitis - resolved Acute on chronic respiratory failure - resolved Covid 19 virus infection - resolved WBC 12.04--10.88 Patient arrived in the ED via EMS on 15 L of blow-by oxygen.  Patient was discharged on 5 L about 10 days ago. Chest x-ray "mild bilateral perihilar airway wall thickening with surrounding streaky opacities" Large amount of thick mucus suctioned from trachea in the ER Inner cannula of trach removed and replaced in the ER Patient was then weaned to room air in the ED Sputum cultures --normal flora Appreciate ID input--Vancomycin d'ced. Completed course of Rocephin Completed course of Remdesivir and Decadron; now out of COVID isolation Appreciate Pulmonology input-- downsized trach to a Shiley 6 Pt doing well on 2L O2 at 100%, can likely wean to room air   Hyperkalemia - resolved Potassium is 6.1 No EKG changes; sinus bradycardia without QT prolongation Etiology unclear; not in renal failure, no inciting medications. May be related to hyperglycemia. Insulin/dextrose/Lasix given in the ER Follow-up potassium improved to 4.4     Transaminitis Elevated alk phos, AST, ALT Has been elevated in the past Avoid hepatotoxic agents Alk phos 120, AST 31, ALT 79 Consider rechecking outpatient  Type 2 diabetes Sliding scale insulin.  Continue Lantus 10 units Continue to monitor BG's and adjust insulin accordingly. Diabetic tube feeds Fair glycemic control   Anoxic brain injury History of CVA Status post tracheostomy Status post PEG placement Nutrition following for tube feeding Respiratory therapy for trach care  Speak valve per speech therapy   History of seizure-like activity Continue Keppra
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Erythema, Fatigue, Headache, Injection site erythema
Clinical narrative: Patient developed a firm large nodule with redness, pain at the injection site.  Subsequently developed red spots on the inner arm as well as swollen lymph nodes in the left axilla.  Also experienced high fever, headaches, chills, fatigue and an inability to place arm next to her side.  Symptoms are better at day five, but not completely resolved.  Her mammogram was recommended to be rescheduled given her symptoms.
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site induration, Injection site nodule, Injection site pain, Lymphadenopathy, Mobility decreased
Clinical narrative: Patient developed a firm large nodule with redness, pain at the injection site.  Subsequently developed red spots on the inner arm as well as swollen lymph nodes in the left axilla.  Also experienced high fever, headaches, chills, fatigue and an inability to place arm next to her side.  Symptoms are better at day five, but not completely resolved.  Her mammogram was recommended to be rescheduled given her symptoms.
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Pyrexia
Clinical narrative: Patient developed a firm large nodule with redness, pain at the injection site.  Subsequently developed red spots on the inner arm as well as swollen lymph nodes in the left axilla.  Also experienced high fever, headaches, chills, fatigue and an inability to place arm next to her side.  Symptoms are better at day five, but not completely resolved.  Her mammogram was recommended to be rescheduled given her symptoms.
Age: 37.0
Sex: F
Vaccine: UNK
Symptoms: Feeling hot, Pain in extremity, Rash, Rash erythematous
Clinical narrative: left arm remains hot and painful with heat from shower or upon exasperation. there is visible rash with exertio (small red dots) which stops above the elbow.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Atrial fibrillation, COVID-19, Condition aggravated, Culture urine positive
Clinical narrative: Patient is 79 years old with past medical history of heart failure, hyperlipidemia, atrial fibrillation, hypertension, hypothyroidism presented to the hospital with a chief complaint of fatigue and weakness associated with fever.  Patient was found to have COVID infection.  Patient has history of developmental delay and he is wheelchair-bound.  When seen, patient resting in bed comfortably.  I was unable to obtain any further history from the patient at this time.  Patient does not know where he is at.  Appears to be that is his baseline mentation. otherwise patient has no chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea, constipation, difficulty urination, dysuria.  Comfortable with no acute distress at this time when seen.   Clinical Summary   Patient was admitted to the medical surgical unit due to generalized weakness, COVID +, and UTI.  It was reported that the patient had a fall from his wheel chair at his home.  Patient has chronic indwelling Foley catheter but urinalysis was obtained and culture has resulted with Pseudomonas.  He was treated with IV cefepime which was de-escalated to Cipro to complete 7-day course.  He was also found COVID-positive, but did not have oxygen requirements.  He was evaluated by respiratory therapy on day of discharge and did not require supplemental oxygen.  He was discharged with prescription for course of Paxlovid.  His POA was instructed to hold Lipitor until completion of Paxlovid.  Discussed risk benefits and alternative with POA. Patient has numerous scrotal, peri rectum, and buttocks wounds. He was evaluated by wound care with wounds addressed. May continue to follow with wound care. Instructions for daily cleaning and barrier cream recommended.   Discharge diagnosis COVID infection Urinary tract infection Atrial fibrillation Hypertension Hypothyroidism Hyperlipidemia History of developmental delay
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Disorientation, Fall, Fatigue, Hyperlipidaemia, Hypertension
Clinical narrative: Patient is 79 years old with past medical history of heart failure, hyperlipidemia, atrial fibrillation, hypertension, hypothyroidism presented to the hospital with a chief complaint of fatigue and weakness associated with fever.  Patient was found to have COVID infection.  Patient has history of developmental delay and he is wheelchair-bound.  When seen, patient resting in bed comfortably.  I was unable to obtain any further history from the patient at this time.  Patient does not know where he is at.  Appears to be that is his baseline mentation. otherwise patient has no chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea, constipation, difficulty urination, dysuria.  Comfortable with no acute distress at this time when seen.   Clinical Summary   Patient was admitted to the medical surgical unit due to generalized weakness, COVID +, and UTI.  It was reported that the patient had a fall from his wheel chair at his home.  Patient has chronic indwelling Foley catheter but urinalysis was obtained and culture has resulted with Pseudomonas.  He was treated with IV cefepime which was de-escalated to Cipro to complete 7-day course.  He was also found COVID-positive, but did not have oxygen requirements.  He was evaluated by respiratory therapy on day of discharge and did not require supplemental oxygen.  He was discharged with prescription for course of Paxlovid.  His POA was instructed to hold Lipitor until completion of Paxlovid.  Discussed risk benefits and alternative with POA. Patient has numerous scrotal, peri rectum, and buttocks wounds. He was evaluated by wound care with wounds addressed. May continue to follow with wound care. Instructions for daily cleaning and barrier cream recommended.   Discharge diagnosis COVID infection Urinary tract infection Atrial fibrillation Hypertension Hypothyroidism Hyperlipidemia History of developmental delay
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Hypothyroidism, Pseudomonas test positive, Pyrexia, SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: Patient is 79 years old with past medical history of heart failure, hyperlipidemia, atrial fibrillation, hypertension, hypothyroidism presented to the hospital with a chief complaint of fatigue and weakness associated with fever.  Patient was found to have COVID infection.  Patient has history of developmental delay and he is wheelchair-bound.  When seen, patient resting in bed comfortably.  I was unable to obtain any further history from the patient at this time.  Patient does not know where he is at.  Appears to be that is his baseline mentation. otherwise patient has no chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea, constipation, difficulty urination, dysuria.  Comfortable with no acute distress at this time when seen.   Clinical Summary   Patient was admitted to the medical surgical unit due to generalized weakness, COVID +, and UTI.  It was reported that the patient had a fall from his wheel chair at his home.  Patient has chronic indwelling Foley catheter but urinalysis was obtained and culture has resulted with Pseudomonas.  He was treated with IV cefepime which was de-escalated to Cipro to complete 7-day course.  He was also found COVID-positive, but did not have oxygen requirements.  He was evaluated by respiratory therapy on day of discharge and did not require supplemental oxygen.  He was discharged with prescription for course of Paxlovid.  His POA was instructed to hold Lipitor until completion of Paxlovid.  Discussed risk benefits and alternative with POA. Patient has numerous scrotal, peri rectum, and buttocks wounds. He was evaluated by wound care with wounds addressed. May continue to follow with wound care. Instructions for daily cleaning and barrier cream recommended.   Discharge diagnosis COVID infection Urinary tract infection Atrial fibrillation Hypertension Hypothyroidism Hyperlipidemia History of developmental delay
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Urine analysis abnormal, Wound
Clinical narrative: Patient is 79 years old with past medical history of heart failure, hyperlipidemia, atrial fibrillation, hypertension, hypothyroidism presented to the hospital with a chief complaint of fatigue and weakness associated with fever.  Patient was found to have COVID infection.  Patient has history of developmental delay and he is wheelchair-bound.  When seen, patient resting in bed comfortably.  I was unable to obtain any further history from the patient at this time.  Patient does not know where he is at.  Appears to be that is his baseline mentation. otherwise patient has no chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea, constipation, difficulty urination, dysuria.  Comfortable with no acute distress at this time when seen.   Clinical Summary   Patient was admitted to the medical surgical unit due to generalized weakness, COVID +, and UTI.  It was reported that the patient had a fall from his wheel chair at his home.  Patient has chronic indwelling Foley catheter but urinalysis was obtained and culture has resulted with Pseudomonas.  He was treated with IV cefepime which was de-escalated to Cipro to complete 7-day course.  He was also found COVID-positive, but did not have oxygen requirements.  He was evaluated by respiratory therapy on day of discharge and did not require supplemental oxygen.  He was discharged with prescription for course of Paxlovid.  His POA was instructed to hold Lipitor until completion of Paxlovid.  Discussed risk benefits and alternative with POA. Patient has numerous scrotal, peri rectum, and buttocks wounds. He was evaluated by wound care with wounds addressed. May continue to follow with wound care. Instructions for daily cleaning and barrier cream recommended.   Discharge diagnosis COVID infection Urinary tract infection Atrial fibrillation Hypertension Hypothyroidism Hyperlipidemia History of developmental delay
Age: 56.0
Sex: F
Vaccine: FLU4, VARZOS
Symptoms: Erythema, Local reaction
Clinical narrative: PATIENT HAD A LOCALIZED REACTION - REDNESS
Age: 87.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abdominal pain, Asthenia, COVID-19, Chest X-ray normal, Chills
Clinical narrative: Report on admission: Patient is a 87 y.o. female presenting from home with c/o She is a 87 y.o. female who presents with a chief complaint of Shortness of Breath and Cough.  Patient states her symptoms started 1 day ago.  Reports generalized fatigue and feeling "like I have the flu."  Reports shortness of breath with lying supine and with exertion.  Patient does not wear home oxygen.  Reports chills and possible fever, did not take her temperature at home.  Also states she has a cough that is intermittent and occasionally productive.  Reports rhinorrhea and occasional sneezing, denies sore throat, sinus pressure, or ear pain.  Reports decreased appetite since yesterday, but can tolerate p.o. intake.  Reports nausea and generalized abdominal pain. Denies vomiting, diarrhea, or urinary symptoms.  Reports headache that started yesterday that is constant in nature and described as dull or aching.  Denies chest pain, visual changes, neck pain/stiffness, or known sick contacts.  Patient has not taken anything prior to arrival for her symptoms.      Hospital course as below.  Patient improved with medical treatment.  Patient will need to be evaluated outpatient for underlying cognitive dysfunction.  Patient discharged in stable condition.   . COVID, +2/16: -Chest x-ray nonacute -DC Decadron in setting of worsening delirium -Home Eliquis DVT prophylaxis -No hypoxia, no indication for remdesivir at this time  2.  Generalized weakness: -PT/OT -Social work for discharge needs  3.  Delirium: -Psychiatry consulted -Delirium precautions -Evaluate for underlying neurocognitive disorder outpatient  4.  Chronic hyponatremia: -Follows with nephrology outpatient -Continue home sodium tablets  5.  Other chronic medical conditions: Arthritis, hyperlipidemia, hypertension, history of DVT
Age: 87.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cognitive disorder, Cough, Decreased appetite, Delirium, Dyspnoea
Clinical narrative: Report on admission: Patient is a 87 y.o. female presenting from home with c/o She is a 87 y.o. female who presents with a chief complaint of Shortness of Breath and Cough.  Patient states her symptoms started 1 day ago.  Reports generalized fatigue and feeling "like I have the flu."  Reports shortness of breath with lying supine and with exertion.  Patient does not wear home oxygen.  Reports chills and possible fever, did not take her temperature at home.  Also states she has a cough that is intermittent and occasionally productive.  Reports rhinorrhea and occasional sneezing, denies sore throat, sinus pressure, or ear pain.  Reports decreased appetite since yesterday, but can tolerate p.o. intake.  Reports nausea and generalized abdominal pain. Denies vomiting, diarrhea, or urinary symptoms.  Reports headache that started yesterday that is constant in nature and described as dull or aching.  Denies chest pain, visual changes, neck pain/stiffness, or known sick contacts.  Patient has not taken anything prior to arrival for her symptoms.      Hospital course as below.  Patient improved with medical treatment.  Patient will need to be evaluated outpatient for underlying cognitive dysfunction.  Patient discharged in stable condition.   . COVID, +2/16: -Chest x-ray nonacute -DC Decadron in setting of worsening delirium -Home Eliquis DVT prophylaxis -No hypoxia, no indication for remdesivir at this time  2.  Generalized weakness: -PT/OT -Social work for discharge needs  3.  Delirium: -Psychiatry consulted -Delirium precautions -Evaluate for underlying neurocognitive disorder outpatient  4.  Chronic hyponatremia: -Follows with nephrology outpatient -Continue home sodium tablets  5.  Other chronic medical conditions: Arthritis, hyperlipidemia, hypertension, history of DVT
Age: 87.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea at rest, Dyspnoea exertional, Fatigue, Headache, Influenza like illness
Clinical narrative: Report on admission: Patient is a 87 y.o. female presenting from home with c/o She is a 87 y.o. female who presents with a chief complaint of Shortness of Breath and Cough.  Patient states her symptoms started 1 day ago.  Reports generalized fatigue and feeling "like I have the flu."  Reports shortness of breath with lying supine and with exertion.  Patient does not wear home oxygen.  Reports chills and possible fever, did not take her temperature at home.  Also states she has a cough that is intermittent and occasionally productive.  Reports rhinorrhea and occasional sneezing, denies sore throat, sinus pressure, or ear pain.  Reports decreased appetite since yesterday, but can tolerate p.o. intake.  Reports nausea and generalized abdominal pain. Denies vomiting, diarrhea, or urinary symptoms.  Reports headache that started yesterday that is constant in nature and described as dull or aching.  Denies chest pain, visual changes, neck pain/stiffness, or known sick contacts.  Patient has not taken anything prior to arrival for her symptoms.      Hospital course as below.  Patient improved with medical treatment.  Patient will need to be evaluated outpatient for underlying cognitive dysfunction.  Patient discharged in stable condition.   . COVID, +2/16: -Chest x-ray nonacute -DC Decadron in setting of worsening delirium -Home Eliquis DVT prophylaxis -No hypoxia, no indication for remdesivir at this time  2.  Generalized weakness: -PT/OT -Social work for discharge needs  3.  Delirium: -Psychiatry consulted -Delirium precautions -Evaluate for underlying neurocognitive disorder outpatient  4.  Chronic hyponatremia: -Follows with nephrology outpatient -Continue home sodium tablets  5.  Other chronic medical conditions: Arthritis, hyperlipidemia, hypertension, history of DVT
Age: 87.0
Sex: F
Vaccine: COVID19-2
Symptoms: Nausea, Productive cough, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
Clinical narrative: Report on admission: Patient is a 87 y.o. female presenting from home with c/o She is a 87 y.o. female who presents with a chief complaint of Shortness of Breath and Cough.  Patient states her symptoms started 1 day ago.  Reports generalized fatigue and feeling "like I have the flu."  Reports shortness of breath with lying supine and with exertion.  Patient does not wear home oxygen.  Reports chills and possible fever, did not take her temperature at home.  Also states she has a cough that is intermittent and occasionally productive.  Reports rhinorrhea and occasional sneezing, denies sore throat, sinus pressure, or ear pain.  Reports decreased appetite since yesterday, but can tolerate p.o. intake.  Reports nausea and generalized abdominal pain. Denies vomiting, diarrhea, or urinary symptoms.  Reports headache that started yesterday that is constant in nature and described as dull or aching.  Denies chest pain, visual changes, neck pain/stiffness, or known sick contacts.  Patient has not taken anything prior to arrival for her symptoms.      Hospital course as below.  Patient improved with medical treatment.  Patient will need to be evaluated outpatient for underlying cognitive dysfunction.  Patient discharged in stable condition.   . COVID, +2/16: -Chest x-ray nonacute -DC Decadron in setting of worsening delirium -Home Eliquis DVT prophylaxis -No hypoxia, no indication for remdesivir at this time  2.  Generalized weakness: -PT/OT -Social work for discharge needs  3.  Delirium: -Psychiatry consulted -Delirium precautions -Evaluate for underlying neurocognitive disorder outpatient  4.  Chronic hyponatremia: -Follows with nephrology outpatient -Continue home sodium tablets  5.  Other chronic medical conditions: Arthritis, hyperlipidemia, hypertension, history of DVT
Age: 19.0
Sex: F
Vaccine: MNQ
Symptoms: Wrong product administered
Clinical narrative: Patient was administered Menveo instead of Men B.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: On 3/17/23 client was given a first dose of Moderna 12+ monovalent vaccine, which expired on 3/12/23. Per CDC guidance Moderna was contacted. Moderna conducted stability testing on lot #071B22A and found that the vaccine was stable at time of administration an repeat vaccination was not required.
Age: 41.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: I did not have an adverse reaction to the vaccine. My throat was really sore, and I went to the clinic. I tasted positive for COVID-19 in 12/2022. I was given the prescription PAXLOVID and I tolerated it without any complications.
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Vaccine administered to patient on 11/10/2022. It was identified in the days following the administration that the BUD out of the freezer for this vaccine was 10/18/2022. Patient lost to follow up. Manufacturer expiration date = 11/30/2022.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Ageusia, Anosmia, COVID-19, Fatigue, Malaise
Clinical narrative: I started feeling lousy, had a lot of congestion and fatigue. I lost my sense of taste and smell, I took an at home test on 31DEC2022 and it was positive. I contacted my doctor and they prescribed PAXLOVID. I started feeling better about 3 days after and retested and it was negative.
Age: 61.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: I started feeling lousy, had a lot of congestion and fatigue. I lost my sense of taste and smell, I took an at home test on 31DEC2022 and it was positive. I contacted my doctor and they prescribed PAXLOVID. I started feeling better about 3 days after and retested and it was negative.
Age: 42.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Cough, Epistaxis, Influenza virus test negative, Nasopharyngitis, Respiratory syncytial virus test negative
Clinical narrative: Around December 9, I began having cold symptoms. Symptoms did not improve and I began having nose bleeds when I would cough. I went to urgent care and was diagnosed with a sinus infection. I was prescribed amoxicillin and told to switch to Claritin from Zyrtec. Completed course of Amoxicillin and symptoms improved during treatment but returned much worse when antibiotic was completed. Returned to a different urgent care clinic and was tested for Flu, RSV, and COVID-19, all were negative. They stated that the sinus infection was still present and was prescribed  augmentin,  sudafed  , and nasal rinse with saline.  After completing augmentin I continued with sudafed  and nasal rinse due to residual congestion. Congestion cleared up around the end of January.
Age: 42.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Respiratory tract congestion, SARS-CoV-2 test negative, Sinusitis
Clinical narrative: Around December 9, I began having cold symptoms. Symptoms did not improve and I began having nose bleeds when I would cough. I went to urgent care and was diagnosed with a sinus infection. I was prescribed amoxicillin and told to switch to Claritin from Zyrtec. Completed course of Amoxicillin and symptoms improved during treatment but returned much worse when antibiotic was completed. Returned to a different urgent care clinic and was tested for Flu, RSV, and COVID-19, all were negative. They stated that the sinus infection was still present and was prescribed  augmentin,  sudafed  , and nasal rinse with saline.  After completing augmentin I continued with sudafed  and nasal rinse due to residual congestion. Congestion cleared up around the end of January.