chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chills, Cough, Diuretic therapy, Dyspnoea, Electrocardiogram abnormal
Clinical narrative: Narrative: 86 yo male with history of COPD (on 3L home O2), severe pulmonary HTN (type II & III),  HFpEF EF 62%, NYHA Class IV, DM2, HTN, HLD, OSA on home CPAP presented with fever, chills, dyspnea for 5 days. Five days prior to admission, the patient began noticing progressively worsening shortness of breath with associated fever and chills and myalgias. Before the fever, he took two Bumex 2mg PO as he thought he was having a heart failure exacerbation. However, he felt as though he did not improve with diuresis and continued to have progressively worsening SOB. In the ED, patient was afebrile HDS with somewhat soft pressures in 90s systolic up to 113/70s. COVID + despite full vaccination with Pfizer vaccine 1/25/21 and 2/17/2021. Labs were significant for Trop 0.26 which subsequently downtrended to 0.14, BNP 280, Cr 1.1, mag 1.6. WBC 3.85, plt 130s. CXR with mild interstitial pulmonary edema. EKG with NSR, RBBB, LAD, PVCs. The patient was admitted 8/7/21. Procalcitonin within normal limits, repeat CXR notable for pulmonary edema, no concern for superimposed bacterial PNA. Started on standard treatment for COVID: received 10 day course of dexamethasone 6mg daily, 5 day course remdesivir. Per latest evidence, covid patients benefit from full anticoagulation until off O2 or at baseline O2 requirements. Patient started on enoxaparin 40mg SQ BID until back to baseline O2 (3 days), then increased to 70mg SQ BID until hospital discharge. Continued Albuterol MDI q4h prn, Symbicort MDI daily, Tiotropium MDI daily (2.5mcg). D Dimer downtrended to 0.43 (from 0.93) and CRP to 2.9 (from 4.01). At discharge, back to baseline oxygen requirements (on 3L at home), stable for discharge home 8/16/2021.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fibrin D dimer, Hyperhidrosis, Myalgia, Osteoarthritis, Platelet count decreased
Clinical narrative: Narrative: 86 yo male with history of COPD (on 3L home O2), severe pulmonary HTN (type II & III),  HFpEF EF 62%, NYHA Class IV, DM2, HTN, HLD, OSA on home CPAP presented with fever, chills, dyspnea for 5 days. Five days prior to admission, the patient began noticing progressively worsening shortness of breath with associated fever and chills and myalgias. Before the fever, he took two Bumex 2mg PO as he thought he was having a heart failure exacerbation. However, he felt as though he did not improve with diuresis and continued to have progressively worsening SOB. In the ED, patient was afebrile HDS with somewhat soft pressures in 90s systolic up to 113/70s. COVID + despite full vaccination with Pfizer vaccine 1/25/21 and 2/17/2021. Labs were significant for Trop 0.26 which subsequently downtrended to 0.14, BNP 280, Cr 1.1, mag 1.6. WBC 3.85, plt 130s. CXR with mild interstitial pulmonary edema. EKG with NSR, RBBB, LAD, PVCs. The patient was admitted 8/7/21. Procalcitonin within normal limits, repeat CXR notable for pulmonary edema, no concern for superimposed bacterial PNA. Started on standard treatment for COVID: received 10 day course of dexamethasone 6mg daily, 5 day course remdesivir. Per latest evidence, covid patients benefit from full anticoagulation until off O2 or at baseline O2 requirements. Patient started on enoxaparin 40mg SQ BID until back to baseline O2 (3 days), then increased to 70mg SQ BID until hospital discharge. Continued Albuterol MDI q4h prn, Symbicort MDI daily, Tiotropium MDI daily (2.5mcg). D Dimer downtrended to 0.43 (from 0.93) and CRP to 2.9 (from 4.01). At discharge, back to baseline oxygen requirements (on 3L at home), stable for discharge home 8/16/2021.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Procalcitonin normal, Pulmonary congestion, Pulmonary oedema, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Narrative: 86 yo male with history of COPD (on 3L home O2), severe pulmonary HTN (type II & III),  HFpEF EF 62%, NYHA Class IV, DM2, HTN, HLD, OSA on home CPAP presented with fever, chills, dyspnea for 5 days. Five days prior to admission, the patient began noticing progressively worsening shortness of breath with associated fever and chills and myalgias. Before the fever, he took two Bumex 2mg PO as he thought he was having a heart failure exacerbation. However, he felt as though he did not improve with diuresis and continued to have progressively worsening SOB. In the ED, patient was afebrile HDS with somewhat soft pressures in 90s systolic up to 113/70s. COVID + despite full vaccination with Pfizer vaccine 1/25/21 and 2/17/2021. Labs were significant for Trop 0.26 which subsequently downtrended to 0.14, BNP 280, Cr 1.1, mag 1.6. WBC 3.85, plt 130s. CXR with mild interstitial pulmonary edema. EKG with NSR, RBBB, LAD, PVCs. The patient was admitted 8/7/21. Procalcitonin within normal limits, repeat CXR notable for pulmonary edema, no concern for superimposed bacterial PNA. Started on standard treatment for COVID: received 10 day course of dexamethasone 6mg daily, 5 day course remdesivir. Per latest evidence, covid patients benefit from full anticoagulation until off O2 or at baseline O2 requirements. Patient started on enoxaparin 40mg SQ BID until back to baseline O2 (3 days), then increased to 70mg SQ BID until hospital discharge. Continued Albuterol MDI q4h prn, Symbicort MDI daily, Tiotropium MDI daily (2.5mcg). D Dimer downtrended to 0.43 (from 0.93) and CRP to 2.9 (from 4.01). At discharge, back to baseline oxygen requirements (on 3L at home), stable for discharge home 8/16/2021.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Sinus rhythm, Troponin increased, Ventricular extrasystoles, White blood cell count decreased
Clinical narrative: Narrative: 86 yo male with history of COPD (on 3L home O2), severe pulmonary HTN (type II & III),  HFpEF EF 62%, NYHA Class IV, DM2, HTN, HLD, OSA on home CPAP presented with fever, chills, dyspnea for 5 days. Five days prior to admission, the patient began noticing progressively worsening shortness of breath with associated fever and chills and myalgias. Before the fever, he took two Bumex 2mg PO as he thought he was having a heart failure exacerbation. However, he felt as though he did not improve with diuresis and continued to have progressively worsening SOB. In the ED, patient was afebrile HDS with somewhat soft pressures in 90s systolic up to 113/70s. COVID + despite full vaccination with Pfizer vaccine 1/25/21 and 2/17/2021. Labs were significant for Trop 0.26 which subsequently downtrended to 0.14, BNP 280, Cr 1.1, mag 1.6. WBC 3.85, plt 130s. CXR with mild interstitial pulmonary edema. EKG with NSR, RBBB, LAD, PVCs. The patient was admitted 8/7/21. Procalcitonin within normal limits, repeat CXR notable for pulmonary edema, no concern for superimposed bacterial PNA. Started on standard treatment for COVID: received 10 day course of dexamethasone 6mg daily, 5 day course remdesivir. Per latest evidence, covid patients benefit from full anticoagulation until off O2 or at baseline O2 requirements. Patient started on enoxaparin 40mg SQ BID until back to baseline O2 (3 days), then increased to 70mg SQ BID until hospital discharge. Continued Albuterol MDI q4h prn, Symbicort MDI daily, Tiotropium MDI daily (2.5mcg). D Dimer downtrended to 0.43 (from 0.93) and CRP to 2.9 (from 4.01). At discharge, back to baseline oxygen requirements (on 3L at home), stable for discharge home 8/16/2021.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Adenovirus test, Anaemia, Angiogram pulmonary abnormal, Blood creatinine increased, Bordetella test negative
Clinical narrative: Narrative:  Admission 09/23/2021, Discharge 09/28/2021. Diagnosis: COVID pneumonia On 9/16/2021, 59 yo male with history of CAD (post PCI 6 months prior to admission), HTN, and Diabetes presented to the Emergency Department with complaints of chills and body aches for 3 days. He tested COVID positive despite being fully vaccinated at the local medical hospital with Pfizer COVID vaccine on 1/13/2021 and 1/26/2021. Since the patient had temp 99.7@ the Emergency Room, HR 101, Vital signs otherwise stable, Patient non-toxic appearing. Good breath sounds, no shortness of breath, the decision was made to administer "mab" as outpatient therapy on 9/18/2021. This was completed as planned. On 9/18/21, he had some mild worsening in his breathing from previously. no chest pain. Vital signs were stable and he was in no distress. On 9/23/21, he returned to the Emergency Department with shortness of breath which seemed to get much worse around 9/21/21. He was unable to walk around his house due to the the SOB and had decreased appetite. He had worsening creatinine from 1.1 on 9/12 to 1.5 today. He was also anemic with hemoglobin of 10, unknown if this was an acute change. WBC was elevated at 11.1. His chest CT showed moderate to severe covid pneumonitis without any signs of PE. Pt is tachypnic at rest but is saturating at 94% on room air. With any movement he becomes more tachypneic and desaturates to 88%, because of this he is now on 2L NC and was admitted to the hospital. He was treated with remdesivir and dexamethasone (described in more detail above) and was discharged on 9/28/21. At the time of discharge, he was on room air at rest, but 2L O2 needed with exertion. Pulmonology providing home oxygen on discharge.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray, Chills, Chlamydia test negative
Clinical narrative: Narrative:  Admission 09/23/2021, Discharge 09/28/2021. Diagnosis: COVID pneumonia On 9/16/2021, 59 yo male with history of CAD (post PCI 6 months prior to admission), HTN, and Diabetes presented to the Emergency Department with complaints of chills and body aches for 3 days. He tested COVID positive despite being fully vaccinated at the local medical hospital with Pfizer COVID vaccine on 1/13/2021 and 1/26/2021. Since the patient had temp 99.7@ the Emergency Room, HR 101, Vital signs otherwise stable, Patient non-toxic appearing. Good breath sounds, no shortness of breath, the decision was made to administer "mab" as outpatient therapy on 9/18/2021. This was completed as planned. On 9/18/21, he had some mild worsening in his breathing from previously. no chest pain. Vital signs were stable and he was in no distress. On 9/23/21, he returned to the Emergency Department with shortness of breath which seemed to get much worse around 9/21/21. He was unable to walk around his house due to the the SOB and had decreased appetite. He had worsening creatinine from 1.1 on 9/12 to 1.5 today. He was also anemic with hemoglobin of 10, unknown if this was an acute change. WBC was elevated at 11.1. His chest CT showed moderate to severe covid pneumonitis without any signs of PE. Pt is tachypnic at rest but is saturating at 94% on room air. With any movement he becomes more tachypneic and desaturates to 88%, because of this he is now on 2L NC and was admitted to the hospital. He was treated with remdesivir and dexamethasone (described in more detail above) and was discharged on 9/28/21. At the time of discharge, he was on room air at rest, but 2L O2 needed with exertion. Pulmonology providing home oxygen on discharge.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram thorax abnormal, Condition aggravated, Coronary artery disease, Coronavirus test negative, Decreased appetite
Clinical narrative: Narrative:  Admission 09/23/2021, Discharge 09/28/2021. Diagnosis: COVID pneumonia On 9/16/2021, 59 yo male with history of CAD (post PCI 6 months prior to admission), HTN, and Diabetes presented to the Emergency Department with complaints of chills and body aches for 3 days. He tested COVID positive despite being fully vaccinated at the local medical hospital with Pfizer COVID vaccine on 1/13/2021 and 1/26/2021. Since the patient had temp 99.7@ the Emergency Room, HR 101, Vital signs otherwise stable, Patient non-toxic appearing. Good breath sounds, no shortness of breath, the decision was made to administer "mab" as outpatient therapy on 9/18/2021. This was completed as planned. On 9/18/21, he had some mild worsening in his breathing from previously. no chest pain. Vital signs were stable and he was in no distress. On 9/23/21, he returned to the Emergency Department with shortness of breath which seemed to get much worse around 9/21/21. He was unable to walk around his house due to the the SOB and had decreased appetite. He had worsening creatinine from 1.1 on 9/12 to 1.5 today. He was also anemic with hemoglobin of 10, unknown if this was an acute change. WBC was elevated at 11.1. His chest CT showed moderate to severe covid pneumonitis without any signs of PE. Pt is tachypnic at rest but is saturating at 94% on room air. With any movement he becomes more tachypneic and desaturates to 88%, because of this he is now on 2L NC and was admitted to the hospital. He was treated with remdesivir and dexamethasone (described in more detail above) and was discharged on 9/28/21. At the time of discharge, he was on room air at rest, but 2L O2 needed with exertion. Pulmonology providing home oxygen on discharge.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Diverticulum gastric, Dyspnoea, Enterovirus test negative, Gait disturbance, Haemoglobin decreased
Clinical narrative: Narrative:  Admission 09/23/2021, Discharge 09/28/2021. Diagnosis: COVID pneumonia On 9/16/2021, 59 yo male with history of CAD (post PCI 6 months prior to admission), HTN, and Diabetes presented to the Emergency Department with complaints of chills and body aches for 3 days. He tested COVID positive despite being fully vaccinated at the local medical hospital with Pfizer COVID vaccine on 1/13/2021 and 1/26/2021. Since the patient had temp 99.7@ the Emergency Room, HR 101, Vital signs otherwise stable, Patient non-toxic appearing. Good breath sounds, no shortness of breath, the decision was made to administer "mab" as outpatient therapy on 9/18/2021. This was completed as planned. On 9/18/21, he had some mild worsening in his breathing from previously. no chest pain. Vital signs were stable and he was in no distress. On 9/23/21, he returned to the Emergency Department with shortness of breath which seemed to get much worse around 9/21/21. He was unable to walk around his house due to the the SOB and had decreased appetite. He had worsening creatinine from 1.1 on 9/12 to 1.5 today. He was also anemic with hemoglobin of 10, unknown if this was an acute change. WBC was elevated at 11.1. His chest CT showed moderate to severe covid pneumonitis without any signs of PE. Pt is tachypnic at rest but is saturating at 94% on room air. With any movement he becomes more tachypneic and desaturates to 88%, because of this he is now on 2L NC and was admitted to the hospital. He was treated with remdesivir and dexamethasone (described in more detail above) and was discharged on 9/28/21. At the time of discharge, he was on room air at rest, but 2L O2 needed with exertion. Pulmonology providing home oxygen on discharge.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test, Left ventricular hypertrophy
Clinical narrative: Narrative:  Admission 09/23/2021, Discharge 09/28/2021. Diagnosis: COVID pneumonia On 9/16/2021, 59 yo male with history of CAD (post PCI 6 months prior to admission), HTN, and Diabetes presented to the Emergency Department with complaints of chills and body aches for 3 days. He tested COVID positive despite being fully vaccinated at the local medical hospital with Pfizer COVID vaccine on 1/13/2021 and 1/26/2021. Since the patient had temp 99.7@ the Emergency Room, HR 101, Vital signs otherwise stable, Patient non-toxic appearing. Good breath sounds, no shortness of breath, the decision was made to administer "mab" as outpatient therapy on 9/18/2021. This was completed as planned. On 9/18/21, he had some mild worsening in his breathing from previously. no chest pain. Vital signs were stable and he was in no distress. On 9/23/21, he returned to the Emergency Department with shortness of breath which seemed to get much worse around 9/21/21. He was unable to walk around his house due to the the SOB and had decreased appetite. He had worsening creatinine from 1.1 on 9/12 to 1.5 today. He was also anemic with hemoglobin of 10, unknown if this was an acute change. WBC was elevated at 11.1. His chest CT showed moderate to severe covid pneumonitis without any signs of PE. Pt is tachypnic at rest but is saturating at 94% on room air. With any movement he becomes more tachypneic and desaturates to 88%, because of this he is now on 2L NC and was admitted to the hospital. He was treated with remdesivir and dexamethasone (described in more detail above) and was discharged on 9/28/21. At the time of discharge, he was on room air at rest, but 2L O2 needed with exertion. Pulmonology providing home oxygen on discharge.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Mycoplasma test negative, Oxygen saturation decreased, Pain, Percutaneous coronary intervention, Respiration abnormal
Clinical narrative: Narrative:  Admission 09/23/2021, Discharge 09/28/2021. Diagnosis: COVID pneumonia On 9/16/2021, 59 yo male with history of CAD (post PCI 6 months prior to admission), HTN, and Diabetes presented to the Emergency Department with complaints of chills and body aches for 3 days. He tested COVID positive despite being fully vaccinated at the local medical hospital with Pfizer COVID vaccine on 1/13/2021 and 1/26/2021. Since the patient had temp 99.7@ the Emergency Room, HR 101, Vital signs otherwise stable, Patient non-toxic appearing. Good breath sounds, no shortness of breath, the decision was made to administer "mab" as outpatient therapy on 9/18/2021. This was completed as planned. On 9/18/21, he had some mild worsening in his breathing from previously. no chest pain. Vital signs were stable and he was in no distress. On 9/23/21, he returned to the Emergency Department with shortness of breath which seemed to get much worse around 9/21/21. He was unable to walk around his house due to the the SOB and had decreased appetite. He had worsening creatinine from 1.1 on 9/12 to 1.5 today. He was also anemic with hemoglobin of 10, unknown if this was an acute change. WBC was elevated at 11.1. His chest CT showed moderate to severe covid pneumonitis without any signs of PE. Pt is tachypnic at rest but is saturating at 94% on room air. With any movement he becomes more tachypneic and desaturates to 88%, because of this he is now on 2L NC and was admitted to the hospital. He was treated with remdesivir and dexamethasone (described in more detail above) and was discharged on 9/28/21. At the time of discharge, he was on room air at rest, but 2L O2 needed with exertion. Pulmonology providing home oxygen on discharge.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Tachypnoea, Viral test negative, White blood cell count increased
Clinical narrative: Narrative:  Admission 09/23/2021, Discharge 09/28/2021. Diagnosis: COVID pneumonia On 9/16/2021, 59 yo male with history of CAD (post PCI 6 months prior to admission), HTN, and Diabetes presented to the Emergency Department with complaints of chills and body aches for 3 days. He tested COVID positive despite being fully vaccinated at the local medical hospital with Pfizer COVID vaccine on 1/13/2021 and 1/26/2021. Since the patient had temp 99.7@ the Emergency Room, HR 101, Vital signs otherwise stable, Patient non-toxic appearing. Good breath sounds, no shortness of breath, the decision was made to administer "mab" as outpatient therapy on 9/18/2021. This was completed as planned. On 9/18/21, he had some mild worsening in his breathing from previously. no chest pain. Vital signs were stable and he was in no distress. On 9/23/21, he returned to the Emergency Department with shortness of breath which seemed to get much worse around 9/21/21. He was unable to walk around his house due to the the SOB and had decreased appetite. He had worsening creatinine from 1.1 on 9/12 to 1.5 today. He was also anemic with hemoglobin of 10, unknown if this was an acute change. WBC was elevated at 11.1. His chest CT showed moderate to severe covid pneumonitis without any signs of PE. Pt is tachypnic at rest but is saturating at 94% on room air. With any movement he becomes more tachypneic and desaturates to 88%, because of this he is now on 2L NC and was admitted to the hospital. He was treated with remdesivir and dexamethasone (described in more detail above) and was discharged on 9/28/21. At the time of discharge, he was on room air at rest, but 2L O2 needed with exertion. Pulmonology providing home oxygen on discharge.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Narrative: Breakthrough COVID infection requiring hospitalization
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anaemia, Anticoagulant therapy, Aspartate aminotransferase increased, Blood creatinine increased, Blood gases normal
Clinical narrative: Narrative: Admission Date: Aug 13,2021 Discharge Date: Aug 17,2021 Primary Diagnosis during Admission/Treatment: COVID Pneumonia 82yoM with past medical history of COPD on 2L O2 by NC, non-operative gallstones complicated by recurrent pancreatitis, CKD, HFpEF, AFIB (not on anticoagulation), pulmonary HTN (group II/III), prolonged QTc, hypothyroidism, HTN, HLD, and gout who presents with SOB x 1 day. Notably, patient was admitted in July 2021 for gallstone pancreatitis, and managed non-operatively. On August 13, 2021 he presented with complaints of progressive shortness of breath from baseline 2L O2 requirement. Patient woke up in the morning with increased SOB and was found by EMS to be satting 89% on home 2L O2. He had occasional desaturations while in ED to mid-80s. Patient denies having sick contacts, has "no idea" where he could have come into contact with the virus. Has been fully vaccinated on 1/22/2021 and 2/10/2021 with the Pfizer vaccine. Denies subjective fever, chills, myalgias, CP, palpitations, NVDC, dysuria, productive cough, rashes. In the ED, patient was afebrile, with variable pulse from 70s to 150s, labile BP from 140-70s systolic, and satting high 70s to low 90s on home 2L O2. Labs were significant for anemia to 9, AST slightly elevated to 43, Cr 2.99 (labile creatinine, baseline close to 3), VBG WNL. CXR significant for "Interval increase of hazy bilateral lower lung parenchymal opacities that could represent infection, atelectasis, and/or aspiration." COVID rapid test confirmed + COVID infection. He was given Albuterol neb in ED and was admitted for further mgmt of COVID PNA. During the admission, the patient desaturated requiring 2L by NC with any movement or coughing spell. O2 requirement remained elevated at 3L by NC beyond baseline 2L NC. Pt was placed on Dexamethasone 6mg daily from 8/13-8/22. During hospitalization, the patient was continued on home Spiriva, Albuterol, Budesonide/Formoterol MDIs. Remdesivir was deferred in the setting of chronic kidney disease and Therapeutic AC with enoxaparin was given 1mg/kg twice daily as able to for CrCl>30. He recovered and was discharged on 08/17/2021.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chest pain, Cholelithiasis
Clinical narrative: Narrative: Admission Date: Aug 13,2021 Discharge Date: Aug 17,2021 Primary Diagnosis during Admission/Treatment: COVID Pneumonia 82yoM with past medical history of COPD on 2L O2 by NC, non-operative gallstones complicated by recurrent pancreatitis, CKD, HFpEF, AFIB (not on anticoagulation), pulmonary HTN (group II/III), prolonged QTc, hypothyroidism, HTN, HLD, and gout who presents with SOB x 1 day. Notably, patient was admitted in July 2021 for gallstone pancreatitis, and managed non-operatively. On August 13, 2021 he presented with complaints of progressive shortness of breath from baseline 2L O2 requirement. Patient woke up in the morning with increased SOB and was found by EMS to be satting 89% on home 2L O2. He had occasional desaturations while in ED to mid-80s. Patient denies having sick contacts, has "no idea" where he could have come into contact with the virus. Has been fully vaccinated on 1/22/2021 and 2/10/2021 with the Pfizer vaccine. Denies subjective fever, chills, myalgias, CP, palpitations, NVDC, dysuria, productive cough, rashes. In the ED, patient was afebrile, with variable pulse from 70s to 150s, labile BP from 140-70s systolic, and satting high 70s to low 90s on home 2L O2. Labs were significant for anemia to 9, AST slightly elevated to 43, Cr 2.99 (labile creatinine, baseline close to 3), VBG WNL. CXR significant for "Interval increase of hazy bilateral lower lung parenchymal opacities that could represent infection, atelectasis, and/or aspiration." COVID rapid test confirmed + COVID infection. He was given Albuterol neb in ED and was admitted for further mgmt of COVID PNA. During the admission, the patient desaturated requiring 2L by NC with any movement or coughing spell. O2 requirement remained elevated at 3L by NC beyond baseline 2L NC. Pt was placed on Dexamethasone 6mg daily from 8/13-8/22. During hospitalization, the patient was continued on home Spiriva, Albuterol, Budesonide/Formoterol MDIs. Remdesivir was deferred in the setting of chronic kidney disease and Therapeutic AC with enoxaparin was given 1mg/kg twice daily as able to for CrCl>30. He recovered and was discharged on 08/17/2021.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Cough, Creatinine renal clearance, Dyspnoea, Laboratory test abnormal
Clinical narrative: Narrative: Admission Date: Aug 13,2021 Discharge Date: Aug 17,2021 Primary Diagnosis during Admission/Treatment: COVID Pneumonia 82yoM with past medical history of COPD on 2L O2 by NC, non-operative gallstones complicated by recurrent pancreatitis, CKD, HFpEF, AFIB (not on anticoagulation), pulmonary HTN (group II/III), prolonged QTc, hypothyroidism, HTN, HLD, and gout who presents with SOB x 1 day. Notably, patient was admitted in July 2021 for gallstone pancreatitis, and managed non-operatively. On August 13, 2021 he presented with complaints of progressive shortness of breath from baseline 2L O2 requirement. Patient woke up in the morning with increased SOB and was found by EMS to be satting 89% on home 2L O2. He had occasional desaturations while in ED to mid-80s. Patient denies having sick contacts, has "no idea" where he could have come into contact with the virus. Has been fully vaccinated on 1/22/2021 and 2/10/2021 with the Pfizer vaccine. Denies subjective fever, chills, myalgias, CP, palpitations, NVDC, dysuria, productive cough, rashes. In the ED, patient was afebrile, with variable pulse from 70s to 150s, labile BP from 140-70s systolic, and satting high 70s to low 90s on home 2L O2. Labs were significant for anemia to 9, AST slightly elevated to 43, Cr 2.99 (labile creatinine, baseline close to 3), VBG WNL. CXR significant for "Interval increase of hazy bilateral lower lung parenchymal opacities that could represent infection, atelectasis, and/or aspiration." COVID rapid test confirmed + COVID infection. He was given Albuterol neb in ED and was admitted for further mgmt of COVID PNA. During the admission, the patient desaturated requiring 2L by NC with any movement or coughing spell. O2 requirement remained elevated at 3L by NC beyond baseline 2L NC. Pt was placed on Dexamethasone 6mg daily from 8/13-8/22. During hospitalization, the patient was continued on home Spiriva, Albuterol, Budesonide/Formoterol MDIs. Remdesivir was deferred in the setting of chronic kidney disease and Therapeutic AC with enoxaparin was given 1mg/kg twice daily as able to for CrCl>30. He recovered and was discharged on 08/17/2021.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Oxygen saturation decreased, Pancreatitis, Pleural calcification, SARS-CoV-2 test positive
Clinical narrative: Narrative: Admission Date: Aug 13,2021 Discharge Date: Aug 17,2021 Primary Diagnosis during Admission/Treatment: COVID Pneumonia 82yoM with past medical history of COPD on 2L O2 by NC, non-operative gallstones complicated by recurrent pancreatitis, CKD, HFpEF, AFIB (not on anticoagulation), pulmonary HTN (group II/III), prolonged QTc, hypothyroidism, HTN, HLD, and gout who presents with SOB x 1 day. Notably, patient was admitted in July 2021 for gallstone pancreatitis, and managed non-operatively. On August 13, 2021 he presented with complaints of progressive shortness of breath from baseline 2L O2 requirement. Patient woke up in the morning with increased SOB and was found by EMS to be satting 89% on home 2L O2. He had occasional desaturations while in ED to mid-80s. Patient denies having sick contacts, has "no idea" where he could have come into contact with the virus. Has been fully vaccinated on 1/22/2021 and 2/10/2021 with the Pfizer vaccine. Denies subjective fever, chills, myalgias, CP, palpitations, NVDC, dysuria, productive cough, rashes. In the ED, patient was afebrile, with variable pulse from 70s to 150s, labile BP from 140-70s systolic, and satting high 70s to low 90s on home 2L O2. Labs were significant for anemia to 9, AST slightly elevated to 43, Cr 2.99 (labile creatinine, baseline close to 3), VBG WNL. CXR significant for "Interval increase of hazy bilateral lower lung parenchymal opacities that could represent infection, atelectasis, and/or aspiration." COVID rapid test confirmed + COVID infection. He was given Albuterol neb in ED and was admitted for further mgmt of COVID PNA. During the admission, the patient desaturated requiring 2L by NC with any movement or coughing spell. O2 requirement remained elevated at 3L by NC beyond baseline 2L NC. Pt was placed on Dexamethasone 6mg daily from 8/13-8/22. During hospitalization, the patient was continued on home Spiriva, Albuterol, Budesonide/Formoterol MDIs. Remdesivir was deferred in the setting of chronic kidney disease and Therapeutic AC with enoxaparin was given 1mg/kg twice daily as able to for CrCl>30. He recovered and was discharged on 08/17/2021.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Wheezing
Clinical narrative: Narrative: Admission Date: Aug 13,2021 Discharge Date: Aug 17,2021 Primary Diagnosis during Admission/Treatment: COVID Pneumonia 82yoM with past medical history of COPD on 2L O2 by NC, non-operative gallstones complicated by recurrent pancreatitis, CKD, HFpEF, AFIB (not on anticoagulation), pulmonary HTN (group II/III), prolonged QTc, hypothyroidism, HTN, HLD, and gout who presents with SOB x 1 day. Notably, patient was admitted in July 2021 for gallstone pancreatitis, and managed non-operatively. On August 13, 2021 he presented with complaints of progressive shortness of breath from baseline 2L O2 requirement. Patient woke up in the morning with increased SOB and was found by EMS to be satting 89% on home 2L O2. He had occasional desaturations while in ED to mid-80s. Patient denies having sick contacts, has "no idea" where he could have come into contact with the virus. Has been fully vaccinated on 1/22/2021 and 2/10/2021 with the Pfizer vaccine. Denies subjective fever, chills, myalgias, CP, palpitations, NVDC, dysuria, productive cough, rashes. In the ED, patient was afebrile, with variable pulse from 70s to 150s, labile BP from 140-70s systolic, and satting high 70s to low 90s on home 2L O2. Labs were significant for anemia to 9, AST slightly elevated to 43, Cr 2.99 (labile creatinine, baseline close to 3), VBG WNL. CXR significant for "Interval increase of hazy bilateral lower lung parenchymal opacities that could represent infection, atelectasis, and/or aspiration." COVID rapid test confirmed + COVID infection. He was given Albuterol neb in ED and was admitted for further mgmt of COVID PNA. During the admission, the patient desaturated requiring 2L by NC with any movement or coughing spell. O2 requirement remained elevated at 3L by NC beyond baseline 2L NC. Pt was placed on Dexamethasone 6mg daily from 8/13-8/22. During hospitalization, the patient was continued on home Spiriva, Albuterol, Budesonide/Formoterol MDIs. Remdesivir was deferred in the setting of chronic kidney disease and Therapeutic AC with enoxaparin was given 1mg/kg twice daily as able to for CrCl>30. He recovered and was discharged on 08/17/2021.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccine breakthrough infection
Clinical narrative: Narrative: Breakthrough COVID infection requiring hospitalization
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Computerised tomogram thorax abnormal
Clinical narrative: Narrative: 67 y/o female with paroxysmal Afib who experienced syncope at home, fell and hit her head. she tested + for COVID w/o symptoms. +CT findings for pneumonia-mild. No arrythmia while in ED; however, findings concerning for arrythmia induced syncope. Assessment: Syncope COVID PNA Afib Patient had mild symptoms of achinness x1 week but no other covid symptoms. CTA chest consistent with mild pneumonia. Stayed in hospital for syncope workup, discharged home after 24 hours.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Fall, Head injury, Pain, SARS-CoV-2 test positive
Clinical narrative: Narrative: 67 y/o female with paroxysmal Afib who experienced syncope at home, fell and hit her head. she tested + for COVID w/o symptoms. +CT findings for pneumonia-mild. No arrythmia while in ED; however, findings concerning for arrythmia induced syncope. Assessment: Syncope COVID PNA Afib Patient had mild symptoms of achinness x1 week but no other covid symptoms. CTA chest consistent with mild pneumonia. Stayed in hospital for syncope workup, discharged home after 24 hours.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: Narrative: 67 y/o female with paroxysmal Afib who experienced syncope at home, fell and hit her head. she tested + for COVID w/o symptoms. +CT findings for pneumonia-mild. No arrythmia while in ED; however, findings concerning for arrythmia induced syncope. Assessment: Syncope COVID PNA Afib Patient had mild symptoms of achinness x1 week but no other covid symptoms. CTA chest consistent with mild pneumonia. Stayed in hospital for syncope workup, discharged home after 24 hours.
Age: 36.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood homocysteine increased, COVID-19, Chest X-ray normal, Cough, Fatigue
Clinical narrative: Narrative: COVID infection following COVID vaccine series 03/09, Pfizer, dose #1 03/31, Pfizer, dose #2 08/24 HOMOCYSTEINE: 16.4 08/31 pt admit to ED cc: malaise dx: COVID 19 LOS: 1 day 08/31 CXR impression: Support devices: None identified Mediastinum: Normal cardiac size. No central pulmonary vascular enlargement. Lungs and pleura: No dense consolidation or pleural effusion is identified Bones: Within normal limits 08/31 COVID swab, result: detected 08/31 COVID-19 ANTIGEN: not detected 08/31 SARS-COV-2 Variant Sequencing result: pending 08/31 pt cc: cough, fatigue, headache, myalgias, rhinorrhea, exposure: unknown
Age: 36.0
Sex: M
Vaccine: COVID19-2
Symptoms: Headache, Malaise, Myalgia, Rhinorrhoea, SARS-CoV-2 test
Clinical narrative: Narrative: COVID infection following COVID vaccine series 03/09, Pfizer, dose #1 03/31, Pfizer, dose #2 08/24 HOMOCYSTEINE: 16.4 08/31 pt admit to ED cc: malaise dx: COVID 19 LOS: 1 day 08/31 CXR impression: Support devices: None identified Mediastinum: Normal cardiac size. No central pulmonary vascular enlargement. Lungs and pleura: No dense consolidation or pleural effusion is identified Bones: Within normal limits 08/31 COVID swab, result: detected 08/31 COVID-19 ANTIGEN: not detected 08/31 SARS-COV-2 Variant Sequencing result: pending 08/31 pt cc: cough, fatigue, headache, myalgias, rhinorrhea, exposure: unknown
Age: 36.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test negative, SARS-CoV-2 test positive
Clinical narrative: Narrative: COVID infection following COVID vaccine series 03/09, Pfizer, dose #1 03/31, Pfizer, dose #2 08/24 HOMOCYSTEINE: 16.4 08/31 pt admit to ED cc: malaise dx: COVID 19 LOS: 1 day 08/31 CXR impression: Support devices: None identified Mediastinum: Normal cardiac size. No central pulmonary vascular enlargement. Lungs and pleura: No dense consolidation or pleural effusion is identified Bones: Within normal limits 08/31 COVID swab, result: detected 08/31 COVID-19 ANTIGEN: not detected 08/31 SARS-COV-2 Variant Sequencing result: pending 08/31 pt cc: cough, fatigue, headache, myalgias, rhinorrhea, exposure: unknown
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Diarrhoea
Clinical narrative: Narrative: Patient tested positive for breakthrough COVID infection (8/10/21) via out-patient test. No details on initial symptoms documented. Patient presented to ER on 8/17/21 with intractable nausea, vomiting, diarrhea ongoing for the past 2 weeks. Since COVID dx, unable to keep any of his food or medications down. Reports fever, chills, cough productive of sputum, body aches, fatigue, and loss of taste and smell. Has a history of CLL (s/p Bendamustine and Rituximab 4 years ago) currently on oral ibrutinib therapy. Given age, medical history, persistent symptoms, patient was admitted. Treated with IV Remdesivir 08/17 - 08/21 (x 3 days) and dexamethasone 08/17 - 8/26 (x 10 day course). Supportive treatment with ascorbic acid, zinc sulfate, benzonatate, acetaminophen, albuterol inhaler and supplemental O2. Discharged on 8/20/21 with dexamethasone for 7 more days
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Nausea, Pain, Productive cough, Pyrexia
Clinical narrative: Narrative: Patient tested positive for breakthrough COVID infection (8/10/21) via out-patient test. No details on initial symptoms documented. Patient presented to ER on 8/17/21 with intractable nausea, vomiting, diarrhea ongoing for the past 2 weeks. Since COVID dx, unable to keep any of his food or medications down. Reports fever, chills, cough productive of sputum, body aches, fatigue, and loss of taste and smell. Has a history of CLL (s/p Bendamustine and Rituximab 4 years ago) currently on oral ibrutinib therapy. Given age, medical history, persistent symptoms, patient was admitted. Treated with IV Remdesivir 08/17 - 08/21 (x 3 days) and dexamethasone 08/17 - 8/26 (x 10 day course). Supportive treatment with ascorbic acid, zinc sulfate, benzonatate, acetaminophen, albuterol inhaler and supplemental O2. Discharged on 8/20/21 with dexamethasone for 7 more days
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting
Clinical narrative: Narrative: Patient tested positive for breakthrough COVID infection (8/10/21) via out-patient test. No details on initial symptoms documented. Patient presented to ER on 8/17/21 with intractable nausea, vomiting, diarrhea ongoing for the past 2 weeks. Since COVID dx, unable to keep any of his food or medications down. Reports fever, chills, cough productive of sputum, body aches, fatigue, and loss of taste and smell. Has a history of CLL (s/p Bendamustine and Rituximab 4 years ago) currently on oral ibrutinib therapy. Given age, medical history, persistent symptoms, patient was admitted. Treated with IV Remdesivir 08/17 - 08/21 (x 3 days) and dexamethasone 08/17 - 8/26 (x 10 day course). Supportive treatment with ascorbic acid, zinc sulfate, benzonatate, acetaminophen, albuterol inhaler and supplemental O2. Discharged on 8/20/21 with dexamethasone for 7 more days
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Blood creatinine normal, Blood gases, Blood potassium normal, Blood sodium normal
Clinical narrative: Narrative:  77 yo M with a PMH of HLD, OA, erectile dysfunction who presented to the ED on 8/11/2021 complaining of progressively worsening fatigue. Patient states he felt "drowsy" and fatigued for the past one and a half week which urged him to visit the ED today. Also states he had decreased appetite. Denied SOB, chest pain, cough, nausea or vomiting. Upon presentation to the ED, T 97.5, P 72, BP 159/85, sating 84% on RA, 96% on 2L NC. Labs significant for WBC 8.33, Na 139, K 4.2, sCr 0.85, Hb 13.1, COVID positive despite 2 Pfizer vaccinations on 1/27/2021 and 2/18/2021, D-Dimer 2.46, trop neg, BNP <100. VBG 7.44/37.7/17. CXR with patchy and "groundglass" bilateral mid and lower lung opacification, in the setting of underlying emphysema. Due to concerns for underlying COVID pneumonia, patient was admitted. Patient was started on dexamethasone, remdesivir and oxygen supplementation. Therapeutic dose of enoxaparin was also added. During the course of his hospitalization, his b/l crackles and clinical trajectory improved. Walk test on 8/15 showed resting sat on RA 91% and requirement of 5L NC to maintain sat>88% with amputation. Patient completed course of remdesivir. On 8/16 patient was able to be discharged to home with oxygen (5L), rest of dexamethasone course, and with quarantine instructions.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide normal, COVID-19, Chest X-ray abnormal, Chest pain, Decreased appetite
Clinical narrative: Narrative:  77 yo M with a PMH of HLD, OA, erectile dysfunction who presented to the ED on 8/11/2021 complaining of progressively worsening fatigue. Patient states he felt "drowsy" and fatigued for the past one and a half week which urged him to visit the ED today. Also states he had decreased appetite. Denied SOB, chest pain, cough, nausea or vomiting. Upon presentation to the ED, T 97.5, P 72, BP 159/85, sating 84% on RA, 96% on 2L NC. Labs significant for WBC 8.33, Na 139, K 4.2, sCr 0.85, Hb 13.1, COVID positive despite 2 Pfizer vaccinations on 1/27/2021 and 2/18/2021, D-Dimer 2.46, trop neg, BNP <100. VBG 7.44/37.7/17. CXR with patchy and "groundglass" bilateral mid and lower lung opacification, in the setting of underlying emphysema. Due to concerns for underlying COVID pneumonia, patient was admitted. Patient was started on dexamethasone, remdesivir and oxygen supplementation. Therapeutic dose of enoxaparin was also added. During the course of his hospitalization, his b/l crackles and clinical trajectory improved. Walk test on 8/15 showed resting sat on RA 91% and requirement of 5L NC to maintain sat>88% with amputation. Patient completed course of remdesivir. On 8/16 patient was able to be discharged to home with oxygen (5L), rest of dexamethasone course, and with quarantine instructions.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Emphysema, Fatigue, Fibrin D dimer, Haemoglobin decreased
Clinical narrative: Narrative:  77 yo M with a PMH of HLD, OA, erectile dysfunction who presented to the ED on 8/11/2021 complaining of progressively worsening fatigue. Patient states he felt "drowsy" and fatigued for the past one and a half week which urged him to visit the ED today. Also states he had decreased appetite. Denied SOB, chest pain, cough, nausea or vomiting. Upon presentation to the ED, T 97.5, P 72, BP 159/85, sating 84% on RA, 96% on 2L NC. Labs significant for WBC 8.33, Na 139, K 4.2, sCr 0.85, Hb 13.1, COVID positive despite 2 Pfizer vaccinations on 1/27/2021 and 2/18/2021, D-Dimer 2.46, trop neg, BNP <100. VBG 7.44/37.7/17. CXR with patchy and "groundglass" bilateral mid and lower lung opacification, in the setting of underlying emphysema. Due to concerns for underlying COVID pneumonia, patient was admitted. Patient was started on dexamethasone, remdesivir and oxygen supplementation. Therapeutic dose of enoxaparin was also added. During the course of his hospitalization, his b/l crackles and clinical trajectory improved. Walk test on 8/15 showed resting sat on RA 91% and requirement of 5L NC to maintain sat>88% with amputation. Patient completed course of remdesivir. On 8/16 patient was able to be discharged to home with oxygen (5L), rest of dexamethasone course, and with quarantine instructions.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Rales, SARS-CoV-2 test positive, Somnolence, Troponin normal
Clinical narrative: Narrative:  77 yo M with a PMH of HLD, OA, erectile dysfunction who presented to the ED on 8/11/2021 complaining of progressively worsening fatigue. Patient states he felt "drowsy" and fatigued for the past one and a half week which urged him to visit the ED today. Also states he had decreased appetite. Denied SOB, chest pain, cough, nausea or vomiting. Upon presentation to the ED, T 97.5, P 72, BP 159/85, sating 84% on RA, 96% on 2L NC. Labs significant for WBC 8.33, Na 139, K 4.2, sCr 0.85, Hb 13.1, COVID positive despite 2 Pfizer vaccinations on 1/27/2021 and 2/18/2021, D-Dimer 2.46, trop neg, BNP <100. VBG 7.44/37.7/17. CXR with patchy and "groundglass" bilateral mid and lower lung opacification, in the setting of underlying emphysema. Due to concerns for underlying COVID pneumonia, patient was admitted. Patient was started on dexamethasone, remdesivir and oxygen supplementation. Therapeutic dose of enoxaparin was also added. During the course of his hospitalization, his b/l crackles and clinical trajectory improved. Walk test on 8/15 showed resting sat on RA 91% and requirement of 5L NC to maintain sat>88% with amputation. Patient completed course of remdesivir. On 8/16 patient was able to be discharged to home with oxygen (5L), rest of dexamethasone course, and with quarantine instructions.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Walking distance test, White blood cell count normal
Clinical narrative: Narrative:  77 yo M with a PMH of HLD, OA, erectile dysfunction who presented to the ED on 8/11/2021 complaining of progressively worsening fatigue. Patient states he felt "drowsy" and fatigued for the past one and a half week which urged him to visit the ED today. Also states he had decreased appetite. Denied SOB, chest pain, cough, nausea or vomiting. Upon presentation to the ED, T 97.5, P 72, BP 159/85, sating 84% on RA, 96% on 2L NC. Labs significant for WBC 8.33, Na 139, K 4.2, sCr 0.85, Hb 13.1, COVID positive despite 2 Pfizer vaccinations on 1/27/2021 and 2/18/2021, D-Dimer 2.46, trop neg, BNP <100. VBG 7.44/37.7/17. CXR with patchy and "groundglass" bilateral mid and lower lung opacification, in the setting of underlying emphysema. Due to concerns for underlying COVID pneumonia, patient was admitted. Patient was started on dexamethasone, remdesivir and oxygen supplementation. Therapeutic dose of enoxaparin was also added. During the course of his hospitalization, his b/l crackles and clinical trajectory improved. Walk test on 8/15 showed resting sat on RA 91% and requirement of 5L NC to maintain sat>88% with amputation. Patient completed course of remdesivir. On 8/16 patient was able to be discharged to home with oxygen (5L), rest of dexamethasone course, and with quarantine instructions.
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, COVID-19, COVID-19 pneumonia, Chills, Cough
Clinical narrative: Narrative: Presented to ER on 8/1/21 with low blood pressure concerns over 48 hours. Reported warmth and chills. Fever confirmed in ER. Noted patient was in in ER 3x earlier that week for other concerns not related to COVID infection. Dx with COVID Pneumonia. Admitted as in-patient and symptoms evolved to include fatigue, weakness, SOB, chest congestion, and cough. Treated with IV Remdesivir (08/02 - 08/06) and IV Dexamethasone 6 mg IV x 1 dose then po daily to complete 10 day course. Supportive care included ascorbic acid, zinc ,benzonatate, albuterol and supplemental O2. Discharged 8/6 with oral dexamethasone (tx end date: 8/2/21). Co-morbid conditions include HTN, BPH, T2DM,psoriasis (on apremilast), hx non-small cell lung cancer s/p chemo + radiation, gout, hyperlipidemia, obesity, non-obstructive renal calculi (right hydronephrosis s/p ureteral stent)