chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory disorder, SARS-CoV-2 test positive, Upper-airway cough syndrome
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: MD  Admission Date: 10/21/2022 Discharge Date: 10/23/2022  PRESENTING PROBLEM: Acute respiratory disease due to COVID-19 virus  COVID-19    HOSPITAL COURSE:    Patient is a 84 y.o. male with a prior medical history of chronic kidney disease stage 3, hypertension, hyperlipidemia, coronary artery disease, BPH, coronary artery disease, PVD, PAD, and basal cell carcinoma the skin who presents to the hospital on 10/21/2000 with cough, shortness of breath and fever.  The patient's wife tested COVID positive about 1 week prior.  The patient began having symptom onset on 10/21/2022 and also tested positive for COVID-19.  He noted shortness of breath that was worse with activity.  Nonproductive cough and postnasal drip A fever of 101.1 at home and generalized weakness.   Upon evaluation in emergency department the patient had a CTA of the chest completed which was negative for pulmonary embolism or pneumonia.  He was found to be hypoxic with ambulation and given a dose of Decadron in the emergency department. The patient was admit for can you had observation and IV Decadron.  The patient has remained off of supplemental oxygen since admission to the hospital.  Will discharge home with an additional 3 doses of Decadron to complete a 5 day course.  He was also given Mucinex for expectorant and Claritin to help with post-nasal drip.  Remdesivir was not initiated IV was not persistently hypoxic during stay. PRN Albuterol inhaler provided significant relief for the patient therefore will continue this upon discharge as well.
Age: 73.0
Sex: M
Vaccine: FLU4
Symptoms: Death
Clinical narrative: Resident 10/27/2022
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Cardiac monitoring abnormal, Chest pain, Head titubation, Musculoskeletal stiffness
Clinical narrative: After my 4th vaccine I had noticed my leg would quiver when I was doing physical therapy. I spoke with my neurologist and they stated it may be due to an old injury. I noticed my hand would tremor as well when trying to drink water or coffee, and my neurologist notated that my head was also showing signs of tremors. After dinner in July, my smart watch had alerted me that my heart rate was over 120. I started to then feel a stiff arm and chest pain. I went to the emergency room and they had diagnosed me with a sinus ventral tachycardia. Now I feel fine except the episode has given me anxiety.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Sinus tachycardia, Tremor
Clinical narrative: After my 4th vaccine I had noticed my leg would quiver when I was doing physical therapy. I spoke with my neurologist and they stated it may be due to an old injury. I noticed my hand would tremor as well when trying to drink water or coffee, and my neurologist notated that my head was also showing signs of tremors. After dinner in July, my smart watch had alerted me that my heart rate was over 120. I started to then feel a stiff arm and chest pain. I went to the emergency room and they had diagnosed me with a sinus ventral tachycardia. Now I feel fine except the episode has given me anxiety.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site induration, Injection site rash, Rash erythematous
Clinical narrative: pts mother states she developed a red hard rash the size the palm of her hand around the injection site.
Age: 83.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Acute kidney injury, Asthenia, Bladder catheterisation, Bladder dilatation, Bladder wall calcification
Clinical narrative: Discharge Provider: PRIVATE MD Primary Care Provider at Discharge: PRIVATE DO Admission Date: 10/15/2022 Discharge Date: 10/25/2022  PRESENTING PROBLEM: Dehydration [E86.0] Severe sepsis (HCC) [A41.9, R65.20] Sepsis due to urinary tract infection (HCC) [A41.9, N39.0] Diarrhea, unspecified type [R19.7]  HOSPITAL COURSE: "84-year-old past medical history significant for type 2 diabetes, hypertension, chronic obstructive pulmonary disease, coronary artery disease, hyperlipidemia, history of MI who came to the ER complains of generalized weakness, fatigue.  At baseline patient is oriented x2.  After arrival, patient was found to be tachycardic, lab work showed leukocytosis of 24, AKI.  CT abdomen/pelvis showed distended urinary bladder with tiny calcifications left ureterovesical junction which could reflect a recently passed calculus.  Urine looked infected showing large leukocytes small blood.  Urine culture collected.  He was placed on 2 g Rocephin and given 3 L fluid resuscitation per sepsis protocol and admitted to Medicine.   After admission, patient did improve with IV antibiotics.  AKI quickly resolved.  Urology was consulted for urinary retention which is felt to be acute on chronic, despite treatment with Flomax and Proscar.  Urology recommended placement of Foley, commenting that it should NOT be removed at discharge, as the patient would have difficulty with intermittent straight cathing.  Plan is for the patient to follow up with Urology as an outpatient for definitive plan.  Urine culture finalized as Enterococcus Faecalis.  ID was consulted and IV antibiotics switched to IV ampicillin.  ID recommended treatment with IV ampicillin through 10/21.  Patient was originally seen by PT/OT who recommended discharge to home.  Patient was re-evaluated by therapy on 10/19, and at that time it was felt he would be better suited for discharge to subacute rehab.  Referrals were made by care management, and the patient was set for discharge on 10/21/22 but the patient became hypoxic and was tachypenic and the discharge was cancelled. The patient was found to be COVID positive and he qualified for Dexamethasone and Remdisivir.   Once the patient respiratory status improved, he was discharged to the facility in a stable condition
Age: 83.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Blood urine present, COVID-19, Computerised tomogram abdomen abnormal, Condition aggravated, Culture urine positive
Clinical narrative: Discharge Provider: PRIVATE MD Primary Care Provider at Discharge: PRIVATE DO Admission Date: 10/15/2022 Discharge Date: 10/25/2022  PRESENTING PROBLEM: Dehydration [E86.0] Severe sepsis (HCC) [A41.9, R65.20] Sepsis due to urinary tract infection (HCC) [A41.9, N39.0] Diarrhea, unspecified type [R19.7]  HOSPITAL COURSE: "84-year-old past medical history significant for type 2 diabetes, hypertension, chronic obstructive pulmonary disease, coronary artery disease, hyperlipidemia, history of MI who came to the ER complains of generalized weakness, fatigue.  At baseline patient is oriented x2.  After arrival, patient was found to be tachycardic, lab work showed leukocytosis of 24, AKI.  CT abdomen/pelvis showed distended urinary bladder with tiny calcifications left ureterovesical junction which could reflect a recently passed calculus.  Urine looked infected showing large leukocytes small blood.  Urine culture collected.  He was placed on 2 g Rocephin and given 3 L fluid resuscitation per sepsis protocol and admitted to Medicine.   After admission, patient did improve with IV antibiotics.  AKI quickly resolved.  Urology was consulted for urinary retention which is felt to be acute on chronic, despite treatment with Flomax and Proscar.  Urology recommended placement of Foley, commenting that it should NOT be removed at discharge, as the patient would have difficulty with intermittent straight cathing.  Plan is for the patient to follow up with Urology as an outpatient for definitive plan.  Urine culture finalized as Enterococcus Faecalis.  ID was consulted and IV antibiotics switched to IV ampicillin.  ID recommended treatment with IV ampicillin through 10/21.  Patient was originally seen by PT/OT who recommended discharge to home.  Patient was re-evaluated by therapy on 10/19, and at that time it was felt he would be better suited for discharge to subacute rehab.  Referrals were made by care management, and the patient was set for discharge on 10/21/22 but the patient became hypoxic and was tachypenic and the discharge was cancelled. The patient was found to be COVID positive and he qualified for Dexamethasone and Remdisivir.   Once the patient respiratory status improved, he was discharged to the facility in a stable condition
Age: 83.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Dehydration, Diarrhoea, Enterococcus test positive, Fatigue, Hypoxia
Clinical narrative: Discharge Provider: PRIVATE MD Primary Care Provider at Discharge: PRIVATE DO Admission Date: 10/15/2022 Discharge Date: 10/25/2022  PRESENTING PROBLEM: Dehydration [E86.0] Severe sepsis (HCC) [A41.9, R65.20] Sepsis due to urinary tract infection (HCC) [A41.9, N39.0] Diarrhea, unspecified type [R19.7]  HOSPITAL COURSE: "84-year-old past medical history significant for type 2 diabetes, hypertension, chronic obstructive pulmonary disease, coronary artery disease, hyperlipidemia, history of MI who came to the ER complains of generalized weakness, fatigue.  At baseline patient is oriented x2.  After arrival, patient was found to be tachycardic, lab work showed leukocytosis of 24, AKI.  CT abdomen/pelvis showed distended urinary bladder with tiny calcifications left ureterovesical junction which could reflect a recently passed calculus.  Urine looked infected showing large leukocytes small blood.  Urine culture collected.  He was placed on 2 g Rocephin and given 3 L fluid resuscitation per sepsis protocol and admitted to Medicine.   After admission, patient did improve with IV antibiotics.  AKI quickly resolved.  Urology was consulted for urinary retention which is felt to be acute on chronic, despite treatment with Flomax and Proscar.  Urology recommended placement of Foley, commenting that it should NOT be removed at discharge, as the patient would have difficulty with intermittent straight cathing.  Plan is for the patient to follow up with Urology as an outpatient for definitive plan.  Urine culture finalized as Enterococcus Faecalis.  ID was consulted and IV antibiotics switched to IV ampicillin.  ID recommended treatment with IV ampicillin through 10/21.  Patient was originally seen by PT/OT who recommended discharge to home.  Patient was re-evaluated by therapy on 10/19, and at that time it was felt he would be better suited for discharge to subacute rehab.  Referrals were made by care management, and the patient was set for discharge on 10/21/22 but the patient became hypoxic and was tachypenic and the discharge was cancelled. The patient was found to be COVID positive and he qualified for Dexamethasone and Remdisivir.   Once the patient respiratory status improved, he was discharged to the facility in a stable condition
Age: 83.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Laboratory test abnormal, Leukocytosis, Respiratory disorder, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Discharge Provider: PRIVATE MD Primary Care Provider at Discharge: PRIVATE DO Admission Date: 10/15/2022 Discharge Date: 10/25/2022  PRESENTING PROBLEM: Dehydration [E86.0] Severe sepsis (HCC) [A41.9, R65.20] Sepsis due to urinary tract infection (HCC) [A41.9, N39.0] Diarrhea, unspecified type [R19.7]  HOSPITAL COURSE: "84-year-old past medical history significant for type 2 diabetes, hypertension, chronic obstructive pulmonary disease, coronary artery disease, hyperlipidemia, history of MI who came to the ER complains of generalized weakness, fatigue.  At baseline patient is oriented x2.  After arrival, patient was found to be tachycardic, lab work showed leukocytosis of 24, AKI.  CT abdomen/pelvis showed distended urinary bladder with tiny calcifications left ureterovesical junction which could reflect a recently passed calculus.  Urine looked infected showing large leukocytes small blood.  Urine culture collected.  He was placed on 2 g Rocephin and given 3 L fluid resuscitation per sepsis protocol and admitted to Medicine.   After admission, patient did improve with IV antibiotics.  AKI quickly resolved.  Urology was consulted for urinary retention which is felt to be acute on chronic, despite treatment with Flomax and Proscar.  Urology recommended placement of Foley, commenting that it should NOT be removed at discharge, as the patient would have difficulty with intermittent straight cathing.  Plan is for the patient to follow up with Urology as an outpatient for definitive plan.  Urine culture finalized as Enterococcus Faecalis.  ID was consulted and IV antibiotics switched to IV ampicillin.  ID recommended treatment with IV ampicillin through 10/21.  Patient was originally seen by PT/OT who recommended discharge to home.  Patient was re-evaluated by therapy on 10/19, and at that time it was felt he would be better suited for discharge to subacute rehab.  Referrals were made by care management, and the patient was set for discharge on 10/21/22 but the patient became hypoxic and was tachypenic and the discharge was cancelled. The patient was found to be COVID positive and he qualified for Dexamethasone and Remdisivir.   Once the patient respiratory status improved, he was discharged to the facility in a stable condition
Age: 83.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Tachycardia, Tachypnoea, Urinary retention, Urinary tract infection, Urine analysis abnormal
Clinical narrative: Discharge Provider: PRIVATE MD Primary Care Provider at Discharge: PRIVATE DO Admission Date: 10/15/2022 Discharge Date: 10/25/2022  PRESENTING PROBLEM: Dehydration [E86.0] Severe sepsis (HCC) [A41.9, R65.20] Sepsis due to urinary tract infection (HCC) [A41.9, N39.0] Diarrhea, unspecified type [R19.7]  HOSPITAL COURSE: "84-year-old past medical history significant for type 2 diabetes, hypertension, chronic obstructive pulmonary disease, coronary artery disease, hyperlipidemia, history of MI who came to the ER complains of generalized weakness, fatigue.  At baseline patient is oriented x2.  After arrival, patient was found to be tachycardic, lab work showed leukocytosis of 24, AKI.  CT abdomen/pelvis showed distended urinary bladder with tiny calcifications left ureterovesical junction which could reflect a recently passed calculus.  Urine looked infected showing large leukocytes small blood.  Urine culture collected.  He was placed on 2 g Rocephin and given 3 L fluid resuscitation per sepsis protocol and admitted to Medicine.   After admission, patient did improve with IV antibiotics.  AKI quickly resolved.  Urology was consulted for urinary retention which is felt to be acute on chronic, despite treatment with Flomax and Proscar.  Urology recommended placement of Foley, commenting that it should NOT be removed at discharge, as the patient would have difficulty with intermittent straight cathing.  Plan is for the patient to follow up with Urology as an outpatient for definitive plan.  Urine culture finalized as Enterococcus Faecalis.  ID was consulted and IV antibiotics switched to IV ampicillin.  ID recommended treatment with IV ampicillin through 10/21.  Patient was originally seen by PT/OT who recommended discharge to home.  Patient was re-evaluated by therapy on 10/19, and at that time it was felt he would be better suited for discharge to subacute rehab.  Referrals were made by care management, and the patient was set for discharge on 10/21/22 but the patient became hypoxic and was tachypenic and the discharge was cancelled. The patient was found to be COVID positive and he qualified for Dexamethasone and Remdisivir.   Once the patient respiratory status improved, he was discharged to the facility in a stable condition
Age: 83.0
Sex: M
Vaccine: COVID19, FLU4
Symptoms: Urine leukocyte esterase positive, White blood cell count increased
Clinical narrative: Discharge Provider: PRIVATE MD Primary Care Provider at Discharge: PRIVATE DO Admission Date: 10/15/2022 Discharge Date: 10/25/2022  PRESENTING PROBLEM: Dehydration [E86.0] Severe sepsis (HCC) [A41.9, R65.20] Sepsis due to urinary tract infection (HCC) [A41.9, N39.0] Diarrhea, unspecified type [R19.7]  HOSPITAL COURSE: "84-year-old past medical history significant for type 2 diabetes, hypertension, chronic obstructive pulmonary disease, coronary artery disease, hyperlipidemia, history of MI who came to the ER complains of generalized weakness, fatigue.  At baseline patient is oriented x2.  After arrival, patient was found to be tachycardic, lab work showed leukocytosis of 24, AKI.  CT abdomen/pelvis showed distended urinary bladder with tiny calcifications left ureterovesical junction which could reflect a recently passed calculus.  Urine looked infected showing large leukocytes small blood.  Urine culture collected.  He was placed on 2 g Rocephin and given 3 L fluid resuscitation per sepsis protocol and admitted to Medicine.   After admission, patient did improve with IV antibiotics.  AKI quickly resolved.  Urology was consulted for urinary retention which is felt to be acute on chronic, despite treatment with Flomax and Proscar.  Urology recommended placement of Foley, commenting that it should NOT be removed at discharge, as the patient would have difficulty with intermittent straight cathing.  Plan is for the patient to follow up with Urology as an outpatient for definitive plan.  Urine culture finalized as Enterococcus Faecalis.  ID was consulted and IV antibiotics switched to IV ampicillin.  ID recommended treatment with IV ampicillin through 10/21.  Patient was originally seen by PT/OT who recommended discharge to home.  Patient was re-evaluated by therapy on 10/19, and at that time it was felt he would be better suited for discharge to subacute rehab.  Referrals were made by care management, and the patient was set for discharge on 10/21/22 but the patient became hypoxic and was tachypenic and the discharge was cancelled. The patient was found to be COVID positive and he qualified for Dexamethasone and Remdisivir.   Once the patient respiratory status improved, he was discharged to the facility in a stable condition
Age: 62.0
Sex: F
Vaccine: FLU4
Symptoms: Incorrect dose administered, No adverse event, Product administered to patient of inappropriate age
Clinical narrative: NO ADVERSE EVENT REPORTED- BUT PATIENT RECIEVED A HIGH DOSE VACCINE AND IS ONLY 62
Age: 59.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Cough, Myalgia, Oropharyngeal pain, Respiratory tract congestion
Clinical narrative: I had congestion, a slight sore throat that lasted 12 hours. I actually felt worse on the PAXLOVID, I started having muscle aches and a horrible taste in my mouth. I had a slight cough.
Age: 59.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: SARS-CoV-2 test positive, Taste disorder
Clinical narrative: I had congestion, a slight sore throat that lasted 12 hours. I actually felt worse on the PAXLOVID, I started having muscle aches and a horrible taste in my mouth. I had a slight cough.
Age: 92.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered, No adverse event
Clinical narrative: NO ADVERSE EVENT REPORTED- PATIENT RECIEVED 2 DOSES OF THE HIGH DOSE VACCINE- ONE IN SEPT, ONE IN OCT
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Anaemia, Appetite disorder, Blood bilirubin increased, Blood creatinine increased
Clinical narrative: Primary Care Physician at Discharge: DO Hematologist/Oncologist: Dr.  Admission Date: 10/21/2022 Discharge Date: 10/22/2022 Patient's Discharge Disposition:  Home in stable condition.  PRESENTING PROBLEM: Acute renal failure (HCC)    ADMISSION DIAGNOSES: AKI Hyperbilirubinemia Anemia Metastatic breast cancer History of renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma   DISCHARGE DIAGNOSES: Failure to thrive COVID-19 AKI Hyperbilirubinemia Anemia Metastatic breast cancer Renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma    Hospital course: This is a 61-year-old female with a past medical history as listed above who presented as a direct admission following an appointment in our office where she was found to be mildly hypotensive with an elevated creatinine and bilirubin.  The patient was admitted for further evaluation and management.  The patient received IV fluids at the office and on admission.  She had a summary that was positive for COVID.  She was started on remdesivir but did not complete the course prior to discharge.  The patient was informed about paxlovid and the side effects but she declined further treatment.  She also received a unit of blood.  Her AKI improved with the fluids.  Her hyperbilirubinemia was improving by time of discharge.  The patient reported improvement in her sore throat and felt like her appetite returned to normal.  She felt much stronger and like her normal self.   The patient was eating and ambulating at the time of discharge.  Discharge medications and follow-up as listed below.  Answered all questions in the patient was comfortable with the discharge plan.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Breast cancer metastatic, COVID-19, Condition aggravated, Cough, Diarrhoea
Clinical narrative: Primary Care Physician at Discharge: DO Hematologist/Oncologist: Dr.  Admission Date: 10/21/2022 Discharge Date: 10/22/2022 Patient's Discharge Disposition:  Home in stable condition.  PRESENTING PROBLEM: Acute renal failure (HCC)    ADMISSION DIAGNOSES: AKI Hyperbilirubinemia Anemia Metastatic breast cancer History of renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma   DISCHARGE DIAGNOSES: Failure to thrive COVID-19 AKI Hyperbilirubinemia Anemia Metastatic breast cancer Renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma    Hospital course: This is a 61-year-old female with a past medical history as listed above who presented as a direct admission following an appointment in our office where she was found to be mildly hypotensive with an elevated creatinine and bilirubin.  The patient was admitted for further evaluation and management.  The patient received IV fluids at the office and on admission.  She had a summary that was positive for COVID.  She was started on remdesivir but did not complete the course prior to discharge.  The patient was informed about paxlovid and the side effects but she declined further treatment.  She also received a unit of blood.  Her AKI improved with the fluids.  Her hyperbilirubinemia was improving by time of discharge.  The patient reported improvement in her sore throat and felt like her appetite returned to normal.  She felt much stronger and like her normal self.   The patient was eating and ambulating at the time of discharge.  Discharge medications and follow-up as listed below.  Answered all questions in the patient was comfortable with the discharge plan.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Dyslipidaemia, Failure to thrive, Hyperbilirubinaemia, Hypertension, Hypotension
Clinical narrative: Primary Care Physician at Discharge: DO Hematologist/Oncologist: Dr.  Admission Date: 10/21/2022 Discharge Date: 10/22/2022 Patient's Discharge Disposition:  Home in stable condition.  PRESENTING PROBLEM: Acute renal failure (HCC)    ADMISSION DIAGNOSES: AKI Hyperbilirubinemia Anemia Metastatic breast cancer History of renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma   DISCHARGE DIAGNOSES: Failure to thrive COVID-19 AKI Hyperbilirubinemia Anemia Metastatic breast cancer Renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma    Hospital course: This is a 61-year-old female with a past medical history as listed above who presented as a direct admission following an appointment in our office where she was found to be mildly hypotensive with an elevated creatinine and bilirubin.  The patient was admitted for further evaluation and management.  The patient received IV fluids at the office and on admission.  She had a summary that was positive for COVID.  She was started on remdesivir but did not complete the course prior to discharge.  The patient was informed about paxlovid and the side effects but she declined further treatment.  She also received a unit of blood.  Her AKI improved with the fluids.  Her hyperbilirubinemia was improving by time of discharge.  The patient reported improvement in her sore throat and felt like her appetite returned to normal.  She felt much stronger and like her normal self.   The patient was eating and ambulating at the time of discharge.  Discharge medications and follow-up as listed below.  Answered all questions in the patient was comfortable with the discharge plan.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Nephrolithiasis, Oropharyngeal pain, Pulmonary mass, SARS-CoV-2 test positive, Transfusion
Clinical narrative: Primary Care Physician at Discharge: DO Hematologist/Oncologist: Dr.  Admission Date: 10/21/2022 Discharge Date: 10/22/2022 Patient's Discharge Disposition:  Home in stable condition.  PRESENTING PROBLEM: Acute renal failure (HCC)    ADMISSION DIAGNOSES: AKI Hyperbilirubinemia Anemia Metastatic breast cancer History of renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma   DISCHARGE DIAGNOSES: Failure to thrive COVID-19 AKI Hyperbilirubinemia Anemia Metastatic breast cancer Renal lithiasis Diarrhea Sore throat Mild cough Hypertension Dyslipidemia History of endometrial carcinoma    Hospital course: This is a 61-year-old female with a past medical history as listed above who presented as a direct admission following an appointment in our office where she was found to be mildly hypotensive with an elevated creatinine and bilirubin.  The patient was admitted for further evaluation and management.  The patient received IV fluids at the office and on admission.  She had a summary that was positive for COVID.  She was started on remdesivir but did not complete the course prior to discharge.  The patient was informed about paxlovid and the side effects but she declined further treatment.  She also received a unit of blood.  Her AKI improved with the fluids.  Her hyperbilirubinemia was improving by time of discharge.  The patient reported improvement in her sore throat and felt like her appetite returned to normal.  She felt much stronger and like her normal self.   The patient was eating and ambulating at the time of discharge.  Discharge medications and follow-up as listed below.  Answered all questions in the patient was comfortable with the discharge plan.
Age: 26.0
Sex: F
Vaccine: FLU4
Symptoms: Injection site erythema, Vaccination site swelling, Vaccination site vesicles
Clinical narrative: Redness, swelling, and blisters around the vaccination site.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Cardiac monitoring, Chills, Electrocardiogram abnormal, Palpitations
Clinical narrative: I had the vaccine around 1:30PM around 2:30PM I started to have my heart pounding and I have a smart watch and I did an EKG with that. I called my doctor, and he said yes, I am in a-fib, and I went to the emergency room locally. When I got there it had resolved itself. They put me on a monitor. Yesterday I had chills, fever like I did with the other vaccines. Today I am fine. I am going to wear the heart monitor for 14 days and see a cardiologist.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia
Clinical narrative: I had the vaccine around 1:30PM around 2:30PM I started to have my heart pounding and I have a smart watch and I did an EKG with that. I called my doctor, and he said yes, I am in a-fib, and I went to the emergency room locally. When I got there it had resolved itself. They put me on a monitor. Yesterday I had chills, fever like I did with the other vaccines. Today I am fine. I am going to wear the heart monitor for 14 days and see a cardiologist.
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Abdominal pain upper, Arthralgia, Asthenia, Atrioventricular block first degree, Blindness
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Blood glucose increased, Bundle branch block left, COVID-19, Chest X-ray normal, Chest pain
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Cough, Electrocardiogram abnormal, Fatigue, Glycosylated haemoglobin normal, Loss of personal independence in daily activities
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Oedema peripheral, Oxygen saturation decreased, SARS-CoV-2 test positive, Scan myocardial perfusion, Tachypnoea
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Troponin increased, Ultrasound Doppler normal
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Abdominal pain upper, Anticoagulant therapy, Arthralgia, Asthenia, Atrioventricular block first degree
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)
Age: 94.0
Sex: M
Vaccine: COVID19-2, COVID19-2
Symptoms: Blindness, Blood creatinine increased, Blood glucose increased, Bundle branch block left, COVID-19
Clinical narrative: Discharge Provider: MD Primary Care Provider at Discharge: DO    Admission Date: 10/20/2022 Discharge Date: 10/22/2022  Condition on discharge: Improved  Patient is a 94 y.o. male with medical history significant for coronary artery disease status post PTCA of RCA (2000) with occlusion of RCA '06, ICM status post dual-chamber ICD placement '06, hypertension, dyslipidemia, type 2 diabetes mellitus not insulin dependent, CKD stage IIIB.  Presents to ER for fatigue, weakness, worsening cough, COVID-19 infection. States he was at baseline health until about 4-5 days ago, developed dry cough and fatigue that has been worsening since then.  Did a home COVID-19 test which was positive.  May have been exposed to family members at a gathering about a week ago. Notes he received his 2nd COVID-19 booster on 10/04 with no immediate side effects.  Additionally, has been having intermittent sharp lower chest pain vs upper abdominal pain, unable to state where pain is coming from, does feel different from his normal anginal pain and is not associated with exertion, comes and goes at any time.  Most recently had the pain Thursday afternoon for several minutes before spontaneously resolving.  Also notes worsening lower extremity edema from baseline as well as some pain behind his right knee which he attributes to a prior knee replacement.  Says his wife of 74 years passed away last year and he currently lives with his daughter.  Mostly independent with ADLs however he is becoming more limited recently due to loss of his eyesight.                 In ER, mildly tachypneic, did briefly desaturate to 88% on room air while ambulating, however never placed on supplemental oxygen. EKG sinus rhythm with first-degree AV block, LBBB which is known, no acute ischemic changes when compared to EKG image from 09/02/2022.  Initial troponin 95-- >120 ---- > 185 -- > 285.  Blood glucose 222.  Labs otherwise stable.  Repeat COVID-19 PCR positive.  CXR with no acute process.  Given ASA 325mg in ER.  He was admitted for observation. Cardiology consulted, and were not concerned with mild chronic troponin elevation, also with CKD III. Chest pain resolved, no further testing recommended. Continue home meds.  Due to COVID-19 and risk for DVT/PE he had negative Doppler US of legs and NM perfusion only study. He never required O2, so was not give Decadron.Continue Mucinex, albuterol inhaler p.r.n.                     DM Type II, well controlled with last Hgb. A1c 6.3 in September, continue home meds. Seen by PT/OT and recommended to discharge home with assist, with home health, PT (resume home health PT)