chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Wheezing
Clinical narrative: She got the vaccine, on Friday she was running a light fever, coughing, tightness in her chest.  Friday she called the clinic and they told her to take cough drops, and OTC medications for the symptoms.  On 1/22/22 she called them again and she was advised to go to the office on 1/24/22 for COVID test, did so and was a 48 test, got the results on 1/26/22 that they were negative.  By then she was not doing good, you had coughing green sputum, running out of her nose like water (green), light fever of 99, trouble breathing with shortness of breath, and went to the ER.  They did a breathing treatment, they gave her a Ventolin inhaler, a steroid shot, they advised her to see her PCP in 7 days.   While in the ER she had a 2nd COVID test that was negative also.  They told her that they did not have the reason for her symptoms, but if they continue to return to the ER or go to the PCP.  Diagnosed with acute bronchial spasm.    She had to go out of town to bury her nephew who was killed.  On 2/2/22 she went to CHC and was given a Z-Pak, and a cough syrup Promethezine DM.  She was afraid that she had gotten COVID as she felt bad.  She saw doctor at the clinic.  This did help her, but she still has wheezing when she takes a deep breath, and still coughing up sputum.
Age: 83.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Event occurred after 3rd vaccine; breakthrough case
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Malaise, Pyrexia, Urticaria
Clinical narrative: aprox 9  hrs post booster (pfizer) pt developed urticarial rash, generally unwell feeling and subjective fever and chills.  Non toxic in appearance. Treated symptomatically with H1/H2 blk, presnisode. Stable for D/C home.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered BUD
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cough, Oropharyngeal pain
Clinical narrative: cough, sore throat
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Chest pain, Computerised tomogram, Dyspnoea, Pneumonia
Clinical narrative: Beginning Saturday January 8 (almost 11 months after my first vaccine), pain developed in my right side chest. Worsened throughout day. Hurt to breathe. Went to ER. Diagnosed with right side pneumonia. Also discovered small pulmonary emboli. ER doc and GP believe this has nothing to do with COVID or vaccines.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary embolism, X-ray
Clinical narrative: Beginning Saturday January 8 (almost 11 months after my first vaccine), pain developed in my right side chest. Worsened throughout day. Hurt to breathe. Went to ER. Diagnosed with right side pneumonia. Also discovered small pulmonary emboli. ER doc and GP believe this has nothing to do with COVID or vaccines.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic spontaneous urticaria, Condition aggravated, Joint swelling, Rash
Clinical narrative: Chronic Spontaneous Urticaria appeared less than a month after my vaccination.  It began very severely, and has gradually gotten better.  The ankle swelling has decreased, and the rash has been controlled by taking Zirtec every 48 hours.
Age: 1.0
Sex: F
Vaccine: MENB, MMR, VARCEL
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: VACCINATION ERROR: MCVB BEXSERO ADMINISTERED BUT  IS  NOT APPROVED VACCINE FOR 1 YEAR OF AGE.  MOTHER INFORMED 3 HOURS LATER AND PATIENT DID NOT HAVE ANY ADVERSE REACTIONS AT THAT TIME BUT MOM WILL BRING PATIENT  TO THE EMERGENCY ROOM AS A PRECAUTIONARY MEASURE.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Patient received Pfizer COVID-19 vaccine which was beyond the manufacturer recommended use time of 31 days at the refrigerated temperature. Organization has been in direct contact with the vaccine manufacturer regarding this issue. Pfizer has data to support the stability of the vaccine up to 45 days at refrigerated temperatures. The vaccine given was within this range which is supported by the above data. No known adverse outcomes.
Age: 14.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary mass
Clinical narrative: She felt a lump in her armpit on the same side as where she had the injection. The injection site and full arm are fine, but there is a lump in her armpit.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Headache, Hyperhidrosis, Syncope, Vomiting
Clinical narrative: Patient called pharmacy around 12 noon on 02/08/2022 and informed that she had adverse effects with her booster Pfizer vaccine around 2am today. she had fainted 2 times, sweating, dizzy, headache and vomiting.  Advising patient to go to emergency department to check up and let her primary care doctor aware of this situation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: C-reactive protein, Cardiac ablation, Cardiac monitoring, Differential white blood cell count, Dizziness
Clinical narrative: Severe SVT (racing heart beat, shortness of breath, light headedness) occurring several times a week to sometimes several times a day resulting in an urgent heart ablation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Echocardiogram, Electrocardiogram, Full blood count, Palpitations
Clinical narrative: Severe SVT (racing heart beat, shortness of breath, light headedness) occurring several times a week to sometimes several times a day resulting in an urgent heart ablation.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Red blood cell sedimentation rate, Supraventricular tachycardia
Clinical narrative: Severe SVT (racing heart beat, shortness of breath, light headedness) occurring several times a week to sometimes several times a day resulting in an urgent heart ablation.
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Breath sounds abnormal, Cardiac monitoring, Cardiovascular evaluation, Chest X-ray normal, Chest pain
Clinical narrative: Pt having chest pains with associated SOB and cough, sore throat, body aches, fever and chills. Diminished breath sounds bilaterally. No consolidation noted on chest xray. Pt admitted for further cardiac monitoring and work up.
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chills, Cough, Dyspnoea, Oropharyngeal pain, Pain
Clinical narrative: Pt having chest pains with associated SOB and cough, sore throat, body aches, fever and chills. Diminished breath sounds bilaterally. No consolidation noted on chest xray. Pt admitted for further cardiac monitoring and work up.
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pyrexia
Clinical narrative: Pt having chest pains with associated SOB and cough, sore throat, body aches, fever and chills. Diminished breath sounds bilaterally. No consolidation noted on chest xray. Pt admitted for further cardiac monitoring and work up.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Aura, Deafness, Dizziness, Migraine, Pain
Clinical narrative: For 3 days I experiencing fever, aches, and dizziness. Then two days later started having Migraines lasted for two weeks straight. Since then getting visual aura and hearing loss.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: For 3 days I experiencing fever, aches, and dizziness. Then two days later started having Migraines lasted for two weeks straight. Since then getting visual aura and hearing loss.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy, Erythema, Erythema nodosum, Pain, Pruritus
Clinical narrative: red type welts on lower legs. hurt somewhat and itched-clobetasol cream and elevated legs- was biopsied
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: red type welts on lower legs. hurt somewhat and itched-clobetasol cream and elevated legs- was biopsied
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count, Injection site lymphadenopathy, Injection site swelling, Metabolic function test, Pain
Clinical narrative: Fever, tachycardia, hives on face, generalized body aches and pain, swelling and lymphadenopathy at and around injection site
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Tachycardia, Urticaria
Clinical narrative: Fever, tachycardia, hives on face, generalized body aches and pain, swelling and lymphadenopathy at and around injection site
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Positive COVID-19
Age: 15.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Positive for COVID-19.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Event occurred after 2nd vaccine; breakthrough case
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Positive for COVID-19.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Chest discomfort, Cough, Deep vein thrombosis, Dyspnoea
Clinical narrative: Onset of left lower leg cramping and pain on 12/8/21.  Progressive worsening with ambulation.  Onset of expiratory wheezes at rest, intermittently with non-productive cough. 1/22/22: shortness of breath on exertion (while in cold temperatures only) with chest heaviness.  Resolved quickly with rest. 1/29/22: worsening SOB and difficulty breathing with exertion, chest pressure and discomfort.  2/2/22: office appointment with primary care provider.  EKG with abnormal ST segment abnormality.  Transported to ED via EMS.  Labs significant for elevated troponin.  Imaging revealed saddled pulmonary emboli and left femoral DVT. Transferred to hospital for Heparin drip.  Discharged on 2/4/22 for outpatient follow up and management on oral anticoags.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea exertional, Electrocardiogram ST segment abnormal, Laboratory test abnormal, Muscle spasms, Pain
Clinical narrative: Onset of left lower leg cramping and pain on 12/8/21.  Progressive worsening with ambulation.  Onset of expiratory wheezes at rest, intermittently with non-productive cough. 1/22/22: shortness of breath on exertion (while in cold temperatures only) with chest heaviness.  Resolved quickly with rest. 1/29/22: worsening SOB and difficulty breathing with exertion, chest pressure and discomfort.  2/2/22: office appointment with primary care provider.  EKG with abnormal ST segment abnormality.  Transported to ED via EMS.  Labs significant for elevated troponin.  Imaging revealed saddled pulmonary emboli and left femoral DVT. Transferred to hospital for Heparin drip.  Discharged on 2/4/22 for outpatient follow up and management on oral anticoags.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pain in extremity, Pulmonary embolism, Pulmonary imaging procedure abnormal, Troponin increased, Wheezing
Clinical narrative: Onset of left lower leg cramping and pain on 12/8/21.  Progressive worsening with ambulation.  Onset of expiratory wheezes at rest, intermittently with non-productive cough. 1/22/22: shortness of breath on exertion (while in cold temperatures only) with chest heaviness.  Resolved quickly with rest. 1/29/22: worsening SOB and difficulty breathing with exertion, chest pressure and discomfort.  2/2/22: office appointment with primary care provider.  EKG with abnormal ST segment abnormality.  Transported to ED via EMS.  Labs significant for elevated troponin.  Imaging revealed saddled pulmonary emboli and left femoral DVT. Transferred to hospital for Heparin drip.  Discharged on 2/4/22 for outpatient follow up and management on oral anticoags.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Chest discomfort, Deep vein thrombosis, Dyspnoea, Fibrin D dimer
Clinical narrative: Onset of left lower leg cramping and pain on 12/8/21.  Progressive worsening with ambulation.  Onset of expiratory wheezes at rest, intermittently with non-productive cough. 1/22/22: shortness of breath on exertion (while in cold temperatures only) with chest heaviness.  Resolved quickly with rest. 1/29/22: worsening SOB and difficulty breathing with exertion, chest pressure and discomfort.  2/2/22: office appointment with primary care provider.  EKG with abnormal ST segment abnormality.  Transported to ED via EMS.  Labs significant for elevated troponin.  Imaging revealed saddled pulmonary emboli and left femoral DVT. Transferred to hospital for Heparin drip.  Discharged on 2/4/22 for outpatient follow up and management on oral anticoags.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fibrin D dimer increased, Full blood count normal, International normalised ratio normal, Platelet count normal, Prothrombin time normal
Clinical narrative: Onset of left lower leg cramping and pain on 12/8/21.  Progressive worsening with ambulation.  Onset of expiratory wheezes at rest, intermittently with non-productive cough. 1/22/22: shortness of breath on exertion (while in cold temperatures only) with chest heaviness.  Resolved quickly with rest. 1/29/22: worsening SOB and difficulty breathing with exertion, chest pressure and discomfort.  2/2/22: office appointment with primary care provider.  EKG with abnormal ST segment abnormality.  Transported to ED via EMS.  Labs significant for elevated troponin.  Imaging revealed saddled pulmonary emboli and left femoral DVT. Transferred to hospital for Heparin drip.  Discharged on 2/4/22 for outpatient follow up and management on oral anticoags.
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pulmonary embolism, Ultrasound Doppler abnormal
Clinical narrative: Onset of left lower leg cramping and pain on 12/8/21.  Progressive worsening with ambulation.  Onset of expiratory wheezes at rest, intermittently with non-productive cough. 1/22/22: shortness of breath on exertion (while in cold temperatures only) with chest heaviness.  Resolved quickly with rest. 1/29/22: worsening SOB and difficulty breathing with exertion, chest pressure and discomfort.  2/2/22: office appointment with primary care provider.  EKG with abnormal ST segment abnormality.  Transported to ED via EMS.  Labs significant for elevated troponin.  Imaging revealed saddled pulmonary emboli and left femoral DVT. Transferred to hospital for Heparin drip.  Discharged on 2/4/22 for outpatient follow up and management on oral anticoags.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Allergy test, Immediate post-injection reaction, Impaired driving ability, Injection site rash, Joint stiffness
Clinical narrative: On 12/14, developed a rash all over body.  Very itchy, resulting in waking up from itchiness and inability to go ablout day due to intensity. Few but scattered hives. No other changes to environment but recent covid booster.  Developed stiffness and pain in multiple hand joints, difficulty moving hands such that driving was difficult and unable to fasten a button  Unable to be still due to intensity of itching.    Saw PCP on 12/15, she  stated urticaria and dermatographia, prescribed:  medrol dose pack, famotidine, zyrtec BID, benadryl, singulair. Symptoms improved but persisted and continue to date of this report.  Saw the doctor with ASAP Allergy mid-January, she performed lab testing and changed up meds. She did not think it was from the vaccine as "I think that would have been gone by now."  Symptoms are gradually improving with time, but still occur daily.  Immediately after booster, had a wide, horizontal  rash on arm for 2 days, approximately 2-3  inches below injection site.     After first covid shot on the same arm, had possible undiagnosed covid arm, as I did not seek any medical treatment:  reddened, slightly inflamed, hot to touch area approximately size of my palm, starting  3-4 days after shot, diminishing after several days, then returned for a couple of weeks.  Second shot was to right arm and no cutaneous effects.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test, Loss of personal independence in daily activities, Mechanical urticaria, Mobility decreased, Rash
Clinical narrative: On 12/14, developed a rash all over body.  Very itchy, resulting in waking up from itchiness and inability to go ablout day due to intensity. Few but scattered hives. No other changes to environment but recent covid booster.  Developed stiffness and pain in multiple hand joints, difficulty moving hands such that driving was difficult and unable to fasten a button  Unable to be still due to intensity of itching.    Saw PCP on 12/15, she  stated urticaria and dermatographia, prescribed:  medrol dose pack, famotidine, zyrtec BID, benadryl, singulair. Symptoms improved but persisted and continue to date of this report.  Saw the doctor with ASAP Allergy mid-January, she performed lab testing and changed up meds. She did not think it was from the vaccine as "I think that would have been gone by now."  Symptoms are gradually improving with time, but still occur daily.  Immediately after booster, had a wide, horizontal  rash on arm for 2 days, approximately 2-3  inches below injection site.     After first covid shot on the same arm, had possible undiagnosed covid arm, as I did not seek any medical treatment:  reddened, slightly inflamed, hot to touch area approximately size of my palm, starting  3-4 days after shot, diminishing after several days, then returned for a couple of weeks.  Second shot was to right arm and no cutaneous effects.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Rash pruritic, Sleep disorder, Urticaria
Clinical narrative: On 12/14, developed a rash all over body.  Very itchy, resulting in waking up from itchiness and inability to go ablout day due to intensity. Few but scattered hives. No other changes to environment but recent covid booster.  Developed stiffness and pain in multiple hand joints, difficulty moving hands such that driving was difficult and unable to fasten a button  Unable to be still due to intensity of itching.    Saw PCP on 12/15, she  stated urticaria and dermatographia, prescribed:  medrol dose pack, famotidine, zyrtec BID, benadryl, singulair. Symptoms improved but persisted and continue to date of this report.  Saw the doctor with ASAP Allergy mid-January, she performed lab testing and changed up meds. She did not think it was from the vaccine as "I think that would have been gone by now."  Symptoms are gradually improving with time, but still occur daily.  Immediately after booster, had a wide, horizontal  rash on arm for 2 days, approximately 2-3  inches below injection site.     After first covid shot on the same arm, had possible undiagnosed covid arm, as I did not seek any medical treatment:  reddened, slightly inflamed, hot to touch area approximately size of my palm, starting  3-4 days after shot, diminishing after several days, then returned for a couple of weeks.  Second shot was to right arm and no cutaneous effects.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Dyspnoea, Fatigue
Clinical narrative: After getting covid I had ringing in the ears, fatigued, shortness of breath, and sinus congestion. I also lost my sense of smell and taste. When I went to the doctor he prescribed me Decadron for 9 days. I also had the monoclonal antibody infusion on 11/11/2021. I still have the ringing in my ears since having covid.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sinus congestion, Tinnitus
Clinical narrative: After getting covid I had ringing in the ears, fatigued, shortness of breath, and sinus congestion. I also lost my sense of smell and taste. When I went to the doctor he prescribed me Decadron for 9 days. I also had the monoclonal antibody infusion on 11/11/2021. I still have the ringing in my ears since having covid.
Age: 19.0
Sex: M
Vaccine: HEP
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: 19 year old given Engerix-B for 20 years and above
Age: 79.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Event occurred after 2nd vaccine; breakthrough case
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: Patient experienced syncope within 48 hours after COVID-19 vaccination.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: Head to toe rash
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Positive COVID-19
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Blood creatinine increased, Blood glucose increased, COVID-19, Chest X-ray abnormal
Clinical narrative: Came into the ER on 2/2 C/O generalized malaise and weakness. Tested positive for covid on 1/24. O2 sat 100%. WBC 14.5. Chest xray worrisome for pneumonia. Creatinine 4.1. Gluc 223. Treating with IV steroids, IV antibiotics, oxygen support by nasal cannula to maintain sat 94%. Started on fluid hydration D/T pt being dedydrated. Creatinine on 2/3 3.5. On discharge creatinine was 2.2. Changed to PO antibiotics and steroids on discharge and follow up with nephrology
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dehydration, Malaise, SARS-CoV-2 test positive, White blood cell count increased
Clinical narrative: Came into the ER on 2/2 C/O generalized malaise and weakness. Tested positive for covid on 1/24. O2 sat 100%. WBC 14.5. Chest xray worrisome for pneumonia. Creatinine 4.1. Gluc 223. Treating with IV steroids, IV antibiotics, oxygen support by nasal cannula to maintain sat 94%. Started on fluid hydration D/T pt being dedydrated. Creatinine on 2/3 3.5. On discharge creatinine was 2.2. Changed to PO antibiotics and steroids on discharge and follow up with nephrology
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide increased, Cardiac failure congestive, Chest X-ray abnormal, Condition aggravated, Cough
Clinical narrative: Worsening SOB, cough and wheezing with history of COPD. Pt having fatigue, palpitations and leg swelling. Chest Xray suggestive of mild fluid overload/CHF, BNP 894.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Fatigue, Hypervolaemia, Palpitations, Peripheral swelling
Clinical narrative: Worsening SOB, cough and wheezing with history of COPD. Pt having fatigue, palpitations and leg swelling. Chest Xray suggestive of mild fluid overload/CHF, BNP 894.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Wheezing
Clinical narrative: Worsening SOB, cough and wheezing with history of COPD. Pt having fatigue, palpitations and leg swelling. Chest Xray suggestive of mild fluid overload/CHF, BNP 894.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Blood thyroid stimulating hormone, Differential white blood cell count, Full blood count, Laboratory test, Rash pruritic
Clinical narrative: Frequent itchy rash that spontaneously pops up on different parts of my body. Comes and goes. Started 10 days after booster. I thought through and through if I started anything new, ate anything new, tried any new creams or lotions and I have not. I get relief with taking Zyrtec. But when I do not take Zyrtec it comes back within a day or so. I saw my family doctor 2/7/22. She ordered bloodwork and advised me to take Zyrtec every day for the next two or three weeks. Then stop it and we will see if rash comes back.
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Event occurred after 2nd vaccine; breakthrough case
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Occupational exposure to SARS-CoV-2, SARS-CoV-2 test positive
Clinical narrative: Occupational exposure to COVID-19. Developed symptoms on 1/12/2022. Tested positive on 1/15/2022 via rapid and PCR tests.
Age: 35.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Positive COVID-19
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Carotid artery stenosis, Cerebrovascular accident, Heparin-induced thrombocytopenia test, Platelet count decreased, Thrombosis with thrombocytopenia syndrome
Clinical narrative: vaccine-induced immune thrombotic thrombocytopenia (VITT) ~2w post J&J vaccine -admitted for left ICA occlusion (large stroke) and also had thrombocytopenia (platelet 73) -SRA (+) which confirmed VITT
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Parents lied about age of child in order for her to be vaccinated. They gave the date of date, she would have been under the age of 12 at that time.  She was given the Pfizer 12+ dose.  Child is now under service and returned for the seconded dose. That is when we were informed of the incorrect information given previously. Child was vaccinated with the Pfizer 5-11 dose on 2/7/2022.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Positive COVID-19
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Patient came to the clinic for the administration of her 2nd dose of Moderna vaccine. The nurse administered a lower-than authorized dose (volume) of the correct formulation (0.25 ml) instead of the full dose (0.5ml). After noticing the patient was oriented and as directed by CDC administration error guidelines, the dose was repeated immediately in the contralateral arm.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Feeling abnormal, Myalgia, Rash, Scar
Clinical narrative: Five days after vaccine felt terrible, got rash on chin, scar on chin. Two weeks of sore muscles and tiredness.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Urticaria
Clinical narrative: patient was vaccinated at ~9:50 am. Daughter decided to give patient an ibuprofen "just in case she had side effects" around 12:30-1:00. Shortly thereafter, patient started to itch on scalp and palms of hands and "a couple" of hives noted on back. patient was advised to take a benadryl. Daughter reports that one hour later, patient is symptom free. Advised to call pcp to report this, as patient may be allergic to the ibuprofen. Patient does not usually take ibuprofen.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Positive COVID-19
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Dermatitis contact, Pruritus
Clinical narrative: Contact dermatitis manifested in identical area as contact dermatitis, which was a reaction to the back brace post-surgically following lumbar fusion. At about the same time, I developed acute itchiness primarily on neck. I continued to have severe itching. Per dermatologist, in her clinical experience, skin rashes are more common than reported from COVID-19 vaccines.  My rash resolved by the time of my appointment with her.
Age: 14.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Positive COVID-19
Age: 23.0
Sex: F
Vaccine: TDAP
Symptoms: Immediate post-injection reaction, Injection site pain, Magnetic resonance imaging, Pain in extremity
Clinical narrative: Right shoulder pain and soreness. Started immediately but attributed to Tdap causing a sore arm but after 2 weeks is progressing down right arm and persisting pains.
Age: 61.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Event occurred after third vaccine; breakthrough case
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Anticoagulant therapy, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal
Clinical narrative: 12/6/2021 - presents to ED SOB/chest pain/severe dyspnea. Patient is on dialysis 3xs/wk but missed 1 day. Temp 98.6, HR 108, R 20, BP  215/122, SPO2 92%. D dimer 469. Sepsis/Covid pneumonia and need for urgent dialysis. Covid+ on admit. Patient dialyzed in ED. Following this, RA sat 99%, BP 212/112. Reglan, Tylenol, and Clonidine given - BP improved. Casirivimab/imdevimab given. CXR neg for PE.Prepared for discharge with Covid at home.  12/7- Subsequently presents chest pain/SOB to ED. T-101.5,R-22,HR-149, BP-188/126, O2 94% RA. Admit to ICU acute RF due to Covid. CXR shows groundglass bil pneumonia. Started ceftriaxone, azithromycin, heparin. Decadron continued. Not a candidate for Baricitinib/Remdesivir.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea, Fibrin D dimer increased, Intensive care, Lung opacity
Clinical narrative: 12/6/2021 - presents to ED SOB/chest pain/severe dyspnea. Patient is on dialysis 3xs/wk but missed 1 day. Temp 98.6, HR 108, R 20, BP  215/122, SPO2 92%. D dimer 469. Sepsis/Covid pneumonia and need for urgent dialysis. Covid+ on admit. Patient dialyzed in ED. Following this, RA sat 99%, BP 212/112. Reglan, Tylenol, and Clonidine given - BP improved. Casirivimab/imdevimab given. CXR neg for PE.Prepared for discharge with Covid at home.  12/7- Subsequently presents chest pain/SOB to ED. T-101.5,R-22,HR-149, BP-188/126, O2 94% RA. Admit to ICU acute RF due to Covid. CXR shows groundglass bil pneumonia. Started ceftriaxone, azithromycin, heparin. Decadron continued. Not a candidate for Baricitinib/Remdesivir.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sepsis, Treatment noncompliance
Clinical narrative: 12/6/2021 - presents to ED SOB/chest pain/severe dyspnea. Patient is on dialysis 3xs/wk but missed 1 day. Temp 98.6, HR 108, R 20, BP  215/122, SPO2 92%. D dimer 469. Sepsis/Covid pneumonia and need for urgent dialysis. Covid+ on admit. Patient dialyzed in ED. Following this, RA sat 99%, BP 212/112. Reglan, Tylenol, and Clonidine given - BP improved. Casirivimab/imdevimab given. CXR neg for PE.Prepared for discharge with Covid at home.  12/7- Subsequently presents chest pain/SOB to ED. T-101.5,R-22,HR-149, BP-188/126, O2 94% RA. Admit to ICU acute RF due to Covid. CXR shows groundglass bil pneumonia. Started ceftriaxone, azithromycin, heparin. Decadron continued. Not a candidate for Baricitinib/Remdesivir.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Alanine aminotransferase increased, Anticoagulant therapy, Aphasia
Clinical narrative: 12/9/21:  Patient admitted post fall and left sided weakness.  Found to have left cerebellar infarct and left intertrochanteric femur fracture.  Covid negative on admission and no symptoms. 12/10/21:  OR for nailing of femur fracture 12/11/21:  developed aphasia and aspiration PNA 12/13-12/17:  in and out of afib with RVR treated with IV Cardizem.  Continues to have no Covid symptoms.  NPO due to aspiration risk.  For PEG tube.  Improving lung imaging post IV abx for aspiration PNA.  On 2L via NC sat >97%. 12/22/21:  Symptomatic bradycardia events.  Need for pacemacker 12/24/21:  GI bleed with transfusion needed.  Continues to have no Covid symptoms.  2L NC sat >95%.  Ferritin 235 WBC 20.8 12/27/21:  Continued leukocytosis WBC 18.2, GFR 34.  Increased resp. rate 26-32, increased oxygen need 4L NC to sat >92%.  Temp 98.6 F.  Tested Covid positive and concerns for aspiration.  CXR shows increased pulmonary infiltrates bilaterally with small left pleural effusion.  Started IV Remdesivir, decadron, flagyl, cefepime, and vitamin cocktail. 12/28/21:  Concern for PE, unable to do VQ scan due to AKI and allergies.  Started on heparin gtt.  GFR 30, temp 99.5 F, AST 39 ALT 32.  Remdesivir stopped.  Started on renal dose baricitinib.  RR 30-32 sat >92% on 5L NC. 12/29/21: @0540 patient becoming unresponsive with desaturation.  On NRBM sat 80% RR varied from 12 to 40.  Rapid response called.  ABG on NRBM 6.992 CO2 >100 unobtainable BE or HCO3.  Rhonchi and rales throughout bilateral lungs with weak inspiratory effort in acute hypercapnic/hypoxic respiratory failure.  Patient intubated and placed on Bilevel 28/20 PS 20 FiO2 100%.  CXR shows increased bilateral atelectasis and infiltrates.  GFR 29 Temp 100.0F. BP 82/41 started on Levophed.  Two hour post intubation ABG 7.298/54.6/236/26.7/-0.2. 12/30/21:  Off Levophed and sedation, minimal response to painful stimuli.  Afebrile, breathing only with vent, Bilevel 28/8 PS 20 RR 18 FiO2 45% sat 97%.  WBC 13.4, Ferritin 108, GFR 23, Ddimer 2576, AST 71, ALT 50. 12/31/21:   GFR 18 continues to be minimal nonpurposeful movement to painful stimuli off sedation.  Sputum cx negative.  End of life family meeting decide to make comfort care.  @2020 terminal extubation with rapid decline and expiration.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Aspartate aminotransferase increased, Atelectasis, Atrial fibrillation, Blood gases, Bradycardia
Clinical narrative: 12/9/21:  Patient admitted post fall and left sided weakness.  Found to have left cerebellar infarct and left intertrochanteric femur fracture.  Covid negative on admission and no symptoms. 12/10/21:  OR for nailing of femur fracture 12/11/21:  developed aphasia and aspiration PNA 12/13-12/17:  in and out of afib with RVR treated with IV Cardizem.  Continues to have no Covid symptoms.  NPO due to aspiration risk.  For PEG tube.  Improving lung imaging post IV abx for aspiration PNA.  On 2L via NC sat >97%. 12/22/21:  Symptomatic bradycardia events.  Need for pacemacker 12/24/21:  GI bleed with transfusion needed.  Continues to have no Covid symptoms.  2L NC sat >95%.  Ferritin 235 WBC 20.8 12/27/21:  Continued leukocytosis WBC 18.2, GFR 34.  Increased resp. rate 26-32, increased oxygen need 4L NC to sat >92%.  Temp 98.6 F.  Tested Covid positive and concerns for aspiration.  CXR shows increased pulmonary infiltrates bilaterally with small left pleural effusion.  Started IV Remdesivir, decadron, flagyl, cefepime, and vitamin cocktail. 12/28/21:  Concern for PE, unable to do VQ scan due to AKI and allergies.  Started on heparin gtt.  GFR 30, temp 99.5 F, AST 39 ALT 32.  Remdesivir stopped.  Started on renal dose baricitinib.  RR 30-32 sat >92% on 5L NC. 12/29/21: @0540 patient becoming unresponsive with desaturation.  On NRBM sat 80% RR varied from 12 to 40.  Rapid response called.  ABG on NRBM 6.992 CO2 >100 unobtainable BE or HCO3.  Rhonchi and rales throughout bilateral lungs with weak inspiratory effort in acute hypercapnic/hypoxic respiratory failure.  Patient intubated and placed on Bilevel 28/20 PS 20 FiO2 100%.  CXR shows increased bilateral atelectasis and infiltrates.  GFR 29 Temp 100.0F. BP 82/41 started on Levophed.  Two hour post intubation ABG 7.298/54.6/236/26.7/-0.2. 12/30/21:  Off Levophed and sedation, minimal response to painful stimuli.  Afebrile, breathing only with vent, Bilevel 28/8 PS 20 RR 18 FiO2 45% sat 97%.  WBC 13.4, Ferritin 108, GFR 23, Ddimer 2576, AST 71, ALT 50. 12/31/21:   GFR 18 continues to be minimal nonpurposeful movement to painful stimuli off sedation.  Sputum cx negative.  End of life family meeting decide to make comfort care.  @2020 terminal extubation with rapid decline and expiration.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cardiac pacemaker insertion, Cerebellar infarction, Chest X-ray abnormal, Death
Clinical narrative: 12/9/21:  Patient admitted post fall and left sided weakness.  Found to have left cerebellar infarct and left intertrochanteric femur fracture.  Covid negative on admission and no symptoms. 12/10/21:  OR for nailing of femur fracture 12/11/21:  developed aphasia and aspiration PNA 12/13-12/17:  in and out of afib with RVR treated with IV Cardizem.  Continues to have no Covid symptoms.  NPO due to aspiration risk.  For PEG tube.  Improving lung imaging post IV abx for aspiration PNA.  On 2L via NC sat >97%. 12/22/21:  Symptomatic bradycardia events.  Need for pacemacker 12/24/21:  GI bleed with transfusion needed.  Continues to have no Covid symptoms.  2L NC sat >95%.  Ferritin 235 WBC 20.8 12/27/21:  Continued leukocytosis WBC 18.2, GFR 34.  Increased resp. rate 26-32, increased oxygen need 4L NC to sat >92%.  Temp 98.6 F.  Tested Covid positive and concerns for aspiration.  CXR shows increased pulmonary infiltrates bilaterally with small left pleural effusion.  Started IV Remdesivir, decadron, flagyl, cefepime, and vitamin cocktail. 12/28/21:  Concern for PE, unable to do VQ scan due to AKI and allergies.  Started on heparin gtt.  GFR 30, temp 99.5 F, AST 39 ALT 32.  Remdesivir stopped.  Started on renal dose baricitinib.  RR 30-32 sat >92% on 5L NC. 12/29/21: @0540 patient becoming unresponsive with desaturation.  On NRBM sat 80% RR varied from 12 to 40.  Rapid response called.  ABG on NRBM 6.992 CO2 >100 unobtainable BE or HCO3.  Rhonchi and rales throughout bilateral lungs with weak inspiratory effort in acute hypercapnic/hypoxic respiratory failure.  Patient intubated and placed on Bilevel 28/20 PS 20 FiO2 100%.  CXR shows increased bilateral atelectasis and infiltrates.  GFR 29 Temp 100.0F. BP 82/41 started on Levophed.  Two hour post intubation ABG 7.298/54.6/236/26.7/-0.2. 12/30/21:  Off Levophed and sedation, minimal response to painful stimuli.  Afebrile, breathing only with vent, Bilevel 28/8 PS 20 RR 18 FiO2 45% sat 97%.  WBC 13.4, Ferritin 108, GFR 23, Ddimer 2576, AST 71, ALT 50. 12/31/21:   GFR 18 continues to be minimal nonpurposeful movement to painful stimuli off sedation.  Sputum cx negative.  End of life family meeting decide to make comfort care.  @2020 terminal extubation with rapid decline and expiration.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Endotracheal intubation, Fall, Femur fracture, Fibrin D dimer increased, Gastrointestinal haemorrhage
Clinical narrative: 12/9/21:  Patient admitted post fall and left sided weakness.  Found to have left cerebellar infarct and left intertrochanteric femur fracture.  Covid negative on admission and no symptoms. 12/10/21:  OR for nailing of femur fracture 12/11/21:  developed aphasia and aspiration PNA 12/13-12/17:  in and out of afib with RVR treated with IV Cardizem.  Continues to have no Covid symptoms.  NPO due to aspiration risk.  For PEG tube.  Improving lung imaging post IV abx for aspiration PNA.  On 2L via NC sat >97%. 12/22/21:  Symptomatic bradycardia events.  Need for pacemacker 12/24/21:  GI bleed with transfusion needed.  Continues to have no Covid symptoms.  2L NC sat >95%.  Ferritin 235 WBC 20.8 12/27/21:  Continued leukocytosis WBC 18.2, GFR 34.  Increased resp. rate 26-32, increased oxygen need 4L NC to sat >92%.  Temp 98.6 F.  Tested Covid positive and concerns for aspiration.  CXR shows increased pulmonary infiltrates bilaterally with small left pleural effusion.  Started IV Remdesivir, decadron, flagyl, cefepime, and vitamin cocktail. 12/28/21:  Concern for PE, unable to do VQ scan due to AKI and allergies.  Started on heparin gtt.  GFR 30, temp 99.5 F, AST 39 ALT 32.  Remdesivir stopped.  Started on renal dose baricitinib.  RR 30-32 sat >92% on 5L NC. 12/29/21: @0540 patient becoming unresponsive with desaturation.  On NRBM sat 80% RR varied from 12 to 40.  Rapid response called.  ABG on NRBM 6.992 CO2 >100 unobtainable BE or HCO3.  Rhonchi and rales throughout bilateral lungs with weak inspiratory effort in acute hypercapnic/hypoxic respiratory failure.  Patient intubated and placed on Bilevel 28/20 PS 20 FiO2 100%.  CXR shows increased bilateral atelectasis and infiltrates.  GFR 29 Temp 100.0F. BP 82/41 started on Levophed.  Two hour post intubation ABG 7.298/54.6/236/26.7/-0.2. 12/30/21:  Off Levophed and sedation, minimal response to painful stimuli.  Afebrile, breathing only with vent, Bilevel 28/8 PS 20 RR 18 FiO2 45% sat 97%.  WBC 13.4, Ferritin 108, GFR 23, Ddimer 2576, AST 71, ALT 50. 12/31/21:   GFR 18 continues to be minimal nonpurposeful movement to painful stimuli off sedation.  Sputum cx negative.  End of life family meeting decide to make comfort care.  @2020 terminal extubation with rapid decline and expiration.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Gastrostomy, Glomerular filtration rate decreased, Hemiparesis, Intramedullary rod insertion, Leukocytosis
Clinical narrative: 12/9/21:  Patient admitted post fall and left sided weakness.  Found to have left cerebellar infarct and left intertrochanteric femur fracture.  Covid negative on admission and no symptoms. 12/10/21:  OR for nailing of femur fracture 12/11/21:  developed aphasia and aspiration PNA 12/13-12/17:  in and out of afib with RVR treated with IV Cardizem.  Continues to have no Covid symptoms.  NPO due to aspiration risk.  For PEG tube.  Improving lung imaging post IV abx for aspiration PNA.  On 2L via NC sat >97%. 12/22/21:  Symptomatic bradycardia events.  Need for pacemacker 12/24/21:  GI bleed with transfusion needed.  Continues to have no Covid symptoms.  2L NC sat >95%.  Ferritin 235 WBC 20.8 12/27/21:  Continued leukocytosis WBC 18.2, GFR 34.  Increased resp. rate 26-32, increased oxygen need 4L NC to sat >92%.  Temp 98.6 F.  Tested Covid positive and concerns for aspiration.  CXR shows increased pulmonary infiltrates bilaterally with small left pleural effusion.  Started IV Remdesivir, decadron, flagyl, cefepime, and vitamin cocktail. 12/28/21:  Concern for PE, unable to do VQ scan due to AKI and allergies.  Started on heparin gtt.  GFR 30, temp 99.5 F, AST 39 ALT 32.  Remdesivir stopped.  Started on renal dose baricitinib.  RR 30-32 sat >92% on 5L NC. 12/29/21: @0540 patient becoming unresponsive with desaturation.  On NRBM sat 80% RR varied from 12 to 40.  Rapid response called.  ABG on NRBM 6.992 CO2 >100 unobtainable BE or HCO3.  Rhonchi and rales throughout bilateral lungs with weak inspiratory effort in acute hypercapnic/hypoxic respiratory failure.  Patient intubated and placed on Bilevel 28/20 PS 20 FiO2 100%.  CXR shows increased bilateral atelectasis and infiltrates.  GFR 29 Temp 100.0F. BP 82/41 started on Levophed.  Two hour post intubation ABG 7.298/54.6/236/26.7/-0.2. 12/30/21:  Off Levophed and sedation, minimal response to painful stimuli.  Afebrile, breathing only with vent, Bilevel 28/8 PS 20 RR 18 FiO2 45% sat 97%.  WBC 13.4, Ferritin 108, GFR 23, Ddimer 2576, AST 71, ALT 50. 12/31/21:   GFR 18 continues to be minimal nonpurposeful movement to painful stimuli off sedation.  Sputum cx negative.  End of life family meeting decide to make comfort care.  @2020 terminal extubation with rapid decline and expiration.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Lung infiltration, Mechanical ventilation, Oxygen saturation decreased, Pleural effusion, Pneumonia aspiration
Clinical narrative: 12/9/21:  Patient admitted post fall and left sided weakness.  Found to have left cerebellar infarct and left intertrochanteric femur fracture.  Covid negative on admission and no symptoms. 12/10/21:  OR for nailing of femur fracture 12/11/21:  developed aphasia and aspiration PNA 12/13-12/17:  in and out of afib with RVR treated with IV Cardizem.  Continues to have no Covid symptoms.  NPO due to aspiration risk.  For PEG tube.  Improving lung imaging post IV abx for aspiration PNA.  On 2L via NC sat >97%. 12/22/21:  Symptomatic bradycardia events.  Need for pacemacker 12/24/21:  GI bleed with transfusion needed.  Continues to have no Covid symptoms.  2L NC sat >95%.  Ferritin 235 WBC 20.8 12/27/21:  Continued leukocytosis WBC 18.2, GFR 34.  Increased resp. rate 26-32, increased oxygen need 4L NC to sat >92%.  Temp 98.6 F.  Tested Covid positive and concerns for aspiration.  CXR shows increased pulmonary infiltrates bilaterally with small left pleural effusion.  Started IV Remdesivir, decadron, flagyl, cefepime, and vitamin cocktail. 12/28/21:  Concern for PE, unable to do VQ scan due to AKI and allergies.  Started on heparin gtt.  GFR 30, temp 99.5 F, AST 39 ALT 32.  Remdesivir stopped.  Started on renal dose baricitinib.  RR 30-32 sat >92% on 5L NC. 12/29/21: @0540 patient becoming unresponsive with desaturation.  On NRBM sat 80% RR varied from 12 to 40.  Rapid response called.  ABG on NRBM 6.992 CO2 >100 unobtainable BE or HCO3.  Rhonchi and rales throughout bilateral lungs with weak inspiratory effort in acute hypercapnic/hypoxic respiratory failure.  Patient intubated and placed on Bilevel 28/20 PS 20 FiO2 100%.  CXR shows increased bilateral atelectasis and infiltrates.  GFR 29 Temp 100.0F. BP 82/41 started on Levophed.  Two hour post intubation ABG 7.298/54.6/236/26.7/-0.2. 12/30/21:  Off Levophed and sedation, minimal response to painful stimuli.  Afebrile, breathing only with vent, Bilevel 28/8 PS 20 RR 18 FiO2 45% sat 97%.  WBC 13.4, Ferritin 108, GFR 23, Ddimer 2576, AST 71, ALT 50. 12/31/21:   GFR 18 continues to be minimal nonpurposeful movement to painful stimuli off sedation.  Sputum cx negative.  End of life family meeting decide to make comfort care.  @2020 terminal extubation with rapid decline and expiration.
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Rales, Red blood cell nucleated morphology, Respiratory failure, Respiratory rate increased, Rhonchi
Clinical narrative: 12/9/21:  Patient admitted post fall and left sided weakness.  Found to have left cerebellar infarct and left intertrochanteric femur fracture.  Covid negative on admission and no symptoms. 12/10/21:  OR for nailing of femur fracture 12/11/21:  developed aphasia and aspiration PNA 12/13-12/17:  in and out of afib with RVR treated with IV Cardizem.  Continues to have no Covid symptoms.  NPO due to aspiration risk.  For PEG tube.  Improving lung imaging post IV abx for aspiration PNA.  On 2L via NC sat >97%. 12/22/21:  Symptomatic bradycardia events.  Need for pacemacker 12/24/21:  GI bleed with transfusion needed.  Continues to have no Covid symptoms.  2L NC sat >95%.  Ferritin 235 WBC 20.8 12/27/21:  Continued leukocytosis WBC 18.2, GFR 34.  Increased resp. rate 26-32, increased oxygen need 4L NC to sat >92%.  Temp 98.6 F.  Tested Covid positive and concerns for aspiration.  CXR shows increased pulmonary infiltrates bilaterally with small left pleural effusion.  Started IV Remdesivir, decadron, flagyl, cefepime, and vitamin cocktail. 12/28/21:  Concern for PE, unable to do VQ scan due to AKI and allergies.  Started on heparin gtt.  GFR 30, temp 99.5 F, AST 39 ALT 32.  Remdesivir stopped.  Started on renal dose baricitinib.  RR 30-32 sat >92% on 5L NC. 12/29/21: @0540 patient becoming unresponsive with desaturation.  On NRBM sat 80% RR varied from 12 to 40.  Rapid response called.  ABG on NRBM 6.992 CO2 >100 unobtainable BE or HCO3.  Rhonchi and rales throughout bilateral lungs with weak inspiratory effort in acute hypercapnic/hypoxic respiratory failure.  Patient intubated and placed on Bilevel 28/20 PS 20 FiO2 100%.  CXR shows increased bilateral atelectasis and infiltrates.  GFR 29 Temp 100.0F. BP 82/41 started on Levophed.  Two hour post intubation ABG 7.298/54.6/236/26.7/-0.2. 12/30/21:  Off Levophed and sedation, minimal response to painful stimuli.  Afebrile, breathing only with vent, Bilevel 28/8 PS 20 RR 18 FiO2 45% sat 97%.  WBC 13.4, Ferritin 108, GFR 23, Ddimer 2576, AST 71, ALT 50. 12/31/21:   GFR 18 continues to be minimal nonpurposeful movement to painful stimuli off sedation.  Sputum cx negative.  End of life family meeting decide to make comfort care.  @2020 terminal extubation with rapid decline and expiration.