chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Blood creatinine normal, Blood gases, Blood urea increased, COVID-19
Clinical narrative: Moderna Dose 1 6/4/21 (035C21A) Moderna Dose 2 7/2/21 (NA) COVID Positive 2/5/21 COVID Positive 2/8/21  2/8/22: Patient is a 82 year-old female patient with a past medical history of COPD (on home O2 2L),  presented to hospital with complaints of shortness of breath that progressively became worse with ambulation for the last couple days. Symptoms associated with non-productive cough, sore throat and low grade fever 99F. She was recently seen at urgent care for increased cough and was prescribed antibiotic and steroid. Patient reports that she did not feel improvement in her symptoms. Pt had 2 vaccinations for COVID 19, no booster yet.  On admission to ED pt's BP 141/74, RR 20, HR 97, pulse ox 100% on 2 L nasal cannula. Laboratory findings showed leukocytosis WBC 14.88,  Creatinine 1.09, BUN 30, blood gases with pCO2 57, pro BNP 1480, d-dimer 1.4 . CT chest angiogram negative for PE, show bilateral mild ground-glass opacity, basal consolidation.   Pt was seen and evaluated at bedside. On supplemental oxygen 2L saturating 99%. She denies any chest pain, dizziness or lightheadedness, denies nausea, vomiting, problems with urination no diarrhea.  2/9/22: The patient known to have COPD on 2 L of oxygen at home, diagnosed with COVID-19 infection 5 days ago and her symptoms worse about 7 days ago, she is vaccinated but she did not get her booster, presented with worsen shortness of breath and cough and increased oxygen requirement initially at ED to 4 L, initially had bilateral wheezing and crepitation which improved after IV steroids and antibiotic and schedule nebulizer treatment and inhalers.  Her chest CT angiogram negative for PE.  The patient continue on schedule IV steroid with inhalers and antibiotic with faster than expected improvement in her symptoms and her oxygen requirement back to its baseline 2 L through nasal cannula and no more wheezing or shortness of breath and she has been able to ambulate independently.  Discussed with the patient, will discharge her home on inhaler and prednisone with COVID-19 safe home program.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Crepitations, Dyspnoea, Dyspnoea exertional, Fibrin D dimer
Clinical narrative: Moderna Dose 1 6/4/21 (035C21A) Moderna Dose 2 7/2/21 (NA) COVID Positive 2/5/21 COVID Positive 2/8/21  2/8/22: Patient is a 82 year-old female patient with a past medical history of COPD (on home O2 2L),  presented to hospital with complaints of shortness of breath that progressively became worse with ambulation for the last couple days. Symptoms associated with non-productive cough, sore throat and low grade fever 99F. She was recently seen at urgent care for increased cough and was prescribed antibiotic and steroid. Patient reports that she did not feel improvement in her symptoms. Pt had 2 vaccinations for COVID 19, no booster yet.  On admission to ED pt's BP 141/74, RR 20, HR 97, pulse ox 100% on 2 L nasal cannula. Laboratory findings showed leukocytosis WBC 14.88,  Creatinine 1.09, BUN 30, blood gases with pCO2 57, pro BNP 1480, d-dimer 1.4 . CT chest angiogram negative for PE, show bilateral mild ground-glass opacity, basal consolidation.   Pt was seen and evaluated at bedside. On supplemental oxygen 2L saturating 99%. She denies any chest pain, dizziness or lightheadedness, denies nausea, vomiting, problems with urination no diarrhea.  2/9/22: The patient known to have COPD on 2 L of oxygen at home, diagnosed with COVID-19 infection 5 days ago and her symptoms worse about 7 days ago, she is vaccinated but she did not get her booster, presented with worsen shortness of breath and cough and increased oxygen requirement initially at ED to 4 L, initially had bilateral wheezing and crepitation which improved after IV steroids and antibiotic and schedule nebulizer treatment and inhalers.  Her chest CT angiogram negative for PE.  The patient continue on schedule IV steroid with inhalers and antibiotic with faster than expected improvement in her symptoms and her oxygen requirement back to its baseline 2 L through nasal cannula and no more wheezing or shortness of breath and she has been able to ambulate independently.  Discussed with the patient, will discharge her home on inhaler and prednisone with COVID-19 safe home program.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Leukocytosis, Lung consolidation, Lung opacity, Oropharyngeal pain, PCO2 increased
Clinical narrative: Moderna Dose 1 6/4/21 (035C21A) Moderna Dose 2 7/2/21 (NA) COVID Positive 2/5/21 COVID Positive 2/8/21  2/8/22: Patient is a 82 year-old female patient with a past medical history of COPD (on home O2 2L),  presented to hospital with complaints of shortness of breath that progressively became worse with ambulation for the last couple days. Symptoms associated with non-productive cough, sore throat and low grade fever 99F. She was recently seen at urgent care for increased cough and was prescribed antibiotic and steroid. Patient reports that she did not feel improvement in her symptoms. Pt had 2 vaccinations for COVID 19, no booster yet.  On admission to ED pt's BP 141/74, RR 20, HR 97, pulse ox 100% on 2 L nasal cannula. Laboratory findings showed leukocytosis WBC 14.88,  Creatinine 1.09, BUN 30, blood gases with pCO2 57, pro BNP 1480, d-dimer 1.4 . CT chest angiogram negative for PE, show bilateral mild ground-glass opacity, basal consolidation.   Pt was seen and evaluated at bedside. On supplemental oxygen 2L saturating 99%. She denies any chest pain, dizziness or lightheadedness, denies nausea, vomiting, problems with urination no diarrhea.  2/9/22: The patient known to have COPD on 2 L of oxygen at home, diagnosed with COVID-19 infection 5 days ago and her symptoms worse about 7 days ago, she is vaccinated but she did not get her booster, presented with worsen shortness of breath and cough and increased oxygen requirement initially at ED to 4 L, initially had bilateral wheezing and crepitation which improved after IV steroids and antibiotic and schedule nebulizer treatment and inhalers.  Her chest CT angiogram negative for PE.  The patient continue on schedule IV steroid with inhalers and antibiotic with faster than expected improvement in her symptoms and her oxygen requirement back to its baseline 2 L through nasal cannula and no more wheezing or shortness of breath and she has been able to ambulate independently.  Discussed with the patient, will discharge her home on inhaler and prednisone with COVID-19 safe home program.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Prohormone brain natriuretic peptide increased, Pyrexia, SARS-CoV-2 test positive, Wheezing, White blood cell count increased
Clinical narrative: Moderna Dose 1 6/4/21 (035C21A) Moderna Dose 2 7/2/21 (NA) COVID Positive 2/5/21 COVID Positive 2/8/21  2/8/22: Patient is a 82 year-old female patient with a past medical history of COPD (on home O2 2L),  presented to hospital with complaints of shortness of breath that progressively became worse with ambulation for the last couple days. Symptoms associated with non-productive cough, sore throat and low grade fever 99F. She was recently seen at urgent care for increased cough and was prescribed antibiotic and steroid. Patient reports that she did not feel improvement in her symptoms. Pt had 2 vaccinations for COVID 19, no booster yet.  On admission to ED pt's BP 141/74, RR 20, HR 97, pulse ox 100% on 2 L nasal cannula. Laboratory findings showed leukocytosis WBC 14.88,  Creatinine 1.09, BUN 30, blood gases with pCO2 57, pro BNP 1480, d-dimer 1.4 . CT chest angiogram negative for PE, show bilateral mild ground-glass opacity, basal consolidation.   Pt was seen and evaluated at bedside. On supplemental oxygen 2L saturating 99%. She denies any chest pain, dizziness or lightheadedness, denies nausea, vomiting, problems with urination no diarrhea.  2/9/22: The patient known to have COPD on 2 L of oxygen at home, diagnosed with COVID-19 infection 5 days ago and her symptoms worse about 7 days ago, she is vaccinated but she did not get her booster, presented with worsen shortness of breath and cough and increased oxygen requirement initially at ED to 4 L, initially had bilateral wheezing and crepitation which improved after IV steroids and antibiotic and schedule nebulizer treatment and inhalers.  Her chest CT angiogram negative for PE.  The patient continue on schedule IV steroid with inhalers and antibiotic with faster than expected improvement in her symptoms and her oxygen requirement back to its baseline 2 L through nasal cannula and no more wheezing or shortness of breath and she has been able to ambulate independently.  Discussed with the patient, will discharge her home on inhaler and prednisone with COVID-19 safe home program.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond use date.
Age: 42.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Asthma, Dizziness, Fatigue, Headache
Clinical narrative: Within 3-4 minutes, room spinning, dizzy, nauseated, bad headache, joint pain, body ache, fever, sweating, shaking, asthma, nausea, exhaustion. Took albuterol inhaler, called Dr, said to rest, drink fluids, so went home, rested. Took 5 days to a week to recover.
Age: 42.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hyperhidrosis, Nausea, Pain, Pyrexia, Tremor
Clinical narrative: Within 3-4 minutes, room spinning, dizzy, nauseated, bad headache, joint pain, body ache, fever, sweating, shaking, asthma, nausea, exhaustion. Took albuterol inhaler, called Dr, said to rest, drink fluids, so went home, rested. Took 5 days to a week to recover.
Age: 42.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Vertigo
Clinical narrative: Within 3-4 minutes, room spinning, dizzy, nauseated, bad headache, joint pain, body ache, fever, sweating, shaking, asthma, nausea, exhaustion. Took albuterol inhaler, called Dr, said to rest, drink fluids, so went home, rested. Took 5 days to a week to recover.
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Injection site erythema, Injection site pain, Nausea, Pyrexia
Clinical narrative: Severe sleepiness, nausea, fever, chills, red lines appearing at site of injection, soreness and pain at sight of injection
Age: 52.0
Sex: F
Vaccine: VARZOS
Symptoms: Somnolence
Clinical narrative: Severe sleepiness, nausea, fever, chills, red lines appearing at site of injection, soreness and pain at sight of injection
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Injection site pain, Product administration error
Clinical narrative: Vaccine administering error: At our COVID vaccination clinic, patient was accidentally given Moderna COVID vaccine (18 and up) 0.3 ml instead of 0.25ml as the 2nd COVID vaccine booster.  Patient was contacted the same day and notified this vaccine administering error. Then patient was contacted again the next day to follow up. Patient did not have any other signs or symptoms except pain in the injection site.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Product administration error
Clinical narrative: Admin error.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, COVID-19, Cardiac arrest, Computerised tomogram head normal, Computerised tomogram spine
Clinical narrative: pt brought to the ED on 5/26/22 after a fall; left hip fractured; CT of head and C-spine without acute abnormalities; A fib with RVR; pt found to be positive for COVID; c/o cough and scratchy throat x 2 wks; O2 supplementation; dexamethasone; ORIF; suffered cardiac arrest the following day and never regained ROSC after 2nd arrest
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Fall, Hip fracture, Open reduction of fracture, SARS-CoV-2 test positive
Clinical narrative: pt brought to the ED on 5/26/22 after a fall; left hip fractured; CT of head and C-spine without acute abnormalities; A fib with RVR; pt found to be positive for COVID; c/o cough and scratchy throat x 2 wks; O2 supplementation; dexamethasone; ORIF; suffered cardiac arrest the following day and never regained ROSC after 2nd arrest
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Throat irritation
Clinical narrative: pt brought to the ED on 5/26/22 after a fall; left hip fractured; CT of head and C-spine without acute abnormalities; A fib with RVR; pt found to be positive for COVID; c/o cough and scratchy throat x 2 wks; O2 supplementation; dexamethasone; ORIF; suffered cardiac arrest the following day and never regained ROSC after 2nd arrest
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Product administration error
Clinical narrative: admin error
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Pt to ED 1/1 for sudden onset of shortness of breath. Pt COVID+ 1/1, on 2L NC, oral Decadron ordered. 1/2 pt is A&Ox4 with clear speech. Respirations are regular and unlabored, skin is warm and dry. Plan of care discussed, patient verbalized understanding. Pt on room air, verbalized improvement in breathing.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Scab
Clinical narrative: I got up the next morning and notice white spots on right side of forehead, eyelid and over brow. It also feels like scalp and puse bumps are on my scalp.  After about 4 days, it began to heal and scab up.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Product administration error
Clinical narrative: admin error
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Delivery, Exposure during pregnancy
Clinical narrative: Patient received COVID Pfizer vaccines during pregnancy (03/05/2021, 03/26/2021 and 10/05/2021). She delivered a baby girl on 10/29/2021 at approximately 38 weeks gestation. Baby was diagnosed with a Hemangioma on right upper arm above elbow, dxd by pediatrician on 12/17/21. All three in same location, size is 2 mL, 5 mL, 10 mL. Per mob ped said it will decrease with time, should resolve by age 6. No attribution specified.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Adenovirus test, Atelectasis, Blood immunoglobulin G, Bordetella test negative
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cardiomegaly, Chlamydia test negative, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Enterovirus test negative, Full blood count, Haemoglobin normal, Hilar lymphadenopathy
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Human metapneumovirus test, Human rhinovirus test, Infectious pleural effusion, Influenza A virus test negative, Influenza B virus test
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza virus test negative, Laboratory test abnormal, Legionella test, Liver disorder, Lung abscess
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Lung consolidation, Malaise, Metabolic function test, Mycoplasma test negative, Oesophageal disorder
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Oesophageal oedema, Overgrowth fungal, Pain, Platelet count increased, Pleural effusion
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Pleurisy, Pneumonia, Pulmonary fibrosis, Respiratory syncytial virus test negative, Respiratory tract congestion
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Scan with contrast abnormal, Sputum culture positive, Staphylococcus test negative, Streptococcus test negative
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound chest, White blood cell count increased
Clinical narrative: Patient is a 60 y.o. female with PMH sifnificant for DM-2, fibromyalgia and OSA who presented with left upper quadrant abdominal pain and increased cough.  The patient was diagnosed with COVID on home test on 05/20/2022. The patient did have cough, malaise and body aches for 3 weeks and then her symptoms improved.  Her cough started again 5 days prior to admission. CT abdomen and pelvis showed left basilar pneumonia with small abscess. Lower esophagus slightly patulous with fluid.  Greater than expected prominence of intrahepatic bile ducts with out convincing evidence of gallstones or more distal common bile duct dilation Right middle lobe 6 mm nodule.  CMP was unremarkable. CBC with WBC 12.8 hemoglobin 13.1 platelets 488. CT chest with IV contrast showed extensive multifocal consolidation bilaterally concerning for pneumonia. 16 mm left lower lobe collection concerning for abscess.  Necrotic malignancy cannot be entirely excluded.  Small left pleural effusion bilateral hilar lymphadenopathy.  Patulous esophagus.  Patient was given azithromycin, Rocephin and vancomycin and transferred to Hospital for further evaluation and management.   At the Hospital, the patient was given IV Zosyn, vancomycin and azithromycin for pneumonia.  Pulmonology was consulted and they recommend to continue IV antibiotics. MRSA screen was negative. IV vancomycin was stopped on 6/17/22. She was continued on zosyn as a single agent from 6/15 to 6/20, Pulmonary recommended another 4 weeks off Augmentin 8 incentive 5 mg orally 2 times a day.  Her sputum grew yeast which pulmonary thought was a contaminant.   She was noted to have an elevated gamma gap. A select workup for myeloma and with quanitative IgGs was perfomed to evaluate further and will need to be followed up as outpatient. The pulmonologist recommended an x-ray chest with PCP in 1 week to again evaluate for effusion, if present it will need to be tapped.  Otherwise the patient can undergo noncontrast CT of the chest through PCP in 2-3 months to ensure a 16 mm fluid collection is resolved with treatment.  The patient was recommended to stop smoking, counseling was done, nicotine patch were prescribed at the time of discharge. The patient did not require oxygen at the time of discharge did very well and was subsequently discharged home.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cough, Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: Patient seen in the emergency department on 5/28 for testicular pain and was admitted for scrotal cellulitis. During admission, also endorsed sore throat and cough, ultimately tested positive for Covid-19 via PCR on 5/29. Was placed on 4-5L supplemental O2 and eventually weaned to room air on 6/2, diagnosed with pneumonia due to Covid-19. Discharged on 6/3. This meets criteria for vaccine breakthrough case review.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Scrotal cellulitis, Testicular pain
Clinical narrative: Patient seen in the emergency department on 5/28 for testicular pain and was admitted for scrotal cellulitis. During admission, also endorsed sore throat and cough, ultimately tested positive for Covid-19 via PCR on 5/29. Was placed on 4-5L supplemental O2 and eventually weaned to room air on 6/2, diagnosed with pneumonia due to Covid-19. Discharged on 6/3. This meets criteria for vaccine breakthrough case review.
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure immeasurable, Computerised tomogram head, Drooling, Facial paralysis, Hypopnoea
Clinical narrative: At 1155AM resident was in dinging room in wheelchair. The resident "slumped over" in her wheelchair with "blank stare and pupils dilated, right side of mouth dropped open and drooling," resident did not respond to verbal or painful stimuli, respirations rapid and shallow, VS: temp97.3 forehead scan, pulse with machine 94 respiration 30, 02 Sat 90% room air, machine will not give BP reading, attempted manual BP and unable to hear any beats, res taken to ER via W/C with 2 staff assist ER Course: Evaluated in ER-
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: Mydriasis, Respiratory rate increased, Staring, Syncope, Unresponsive to stimuli
Clinical narrative: At 1155AM resident was in dinging room in wheelchair. The resident "slumped over" in her wheelchair with "blank stare and pupils dilated, right side of mouth dropped open and drooling," resident did not respond to verbal or painful stimuli, respirations rapid and shallow, VS: temp97.3 forehead scan, pulse with machine 94 respiration 30, 02 Sat 90% room air, machine will not give BP reading, attempted manual BP and unable to hear any beats, res taken to ER via W/C with 2 staff assist ER Course: Evaluated in ER-
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, COVID-19, Cough, Dyspnoea, Dyspnoea exertional
Clinical narrative: Moderna Dose 1 3/24/21 (016B21A) Moderna Dose 2 4/21/21 (048B21A) Moderna Dose 3 1/7/22 (lot NA) COVID Positive 2/25/22  2/25/22: A 59-year-old gentleman presented to Hospital as a transfer from ED with a history of persistent cough and shortness of breath for a week.  The patient reports increasing shortness of breath with activities.  He has completed a course of Z-Pak and steroid. However, the symptoms have not improved.  He denies fever. He denies chest pain, though he has pain on the rib related to cough.  The patient reports that he was vaccinated x2 with Moderna and has received his boost for COVID.  3/2/22: P.o. Levaquin course for 10 days per ID  Nebulizer treatments  P.o. prednisone course  P.o. Eliquis  P.o. amiodarone  Breo Ellipta  Metoprolol tartrate 50 mg b.i.d.  Follow-up with ID in 4 weeks  Follow-up with EP Cardiology as outpatient in 1-2 weeks  Follow-up with PCP in 3-5 days  Hemodynamically stable for discharge  Will discharge home  Patient agrees with plan of care
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Musculoskeletal chest pain, SARS-CoV-2 test positive
Clinical narrative: Moderna Dose 1 3/24/21 (016B21A) Moderna Dose 2 4/21/21 (048B21A) Moderna Dose 3 1/7/22 (lot NA) COVID Positive 2/25/22  2/25/22: A 59-year-old gentleman presented to Hospital as a transfer from ED with a history of persistent cough and shortness of breath for a week.  The patient reports increasing shortness of breath with activities.  He has completed a course of Z-Pak and steroid. However, the symptoms have not improved.  He denies fever. He denies chest pain, though he has pain on the rib related to cough.  The patient reports that he was vaccinated x2 with Moderna and has received his boost for COVID.  3/2/22: P.o. Levaquin course for 10 days per ID  Nebulizer treatments  P.o. prednisone course  P.o. Eliquis  P.o. amiodarone  Breo Ellipta  Metoprolol tartrate 50 mg b.i.d.  Follow-up with ID in 4 weeks  Follow-up with EP Cardiology as outpatient in 1-2 weeks  Follow-up with PCP in 3-5 days  Hemodynamically stable for discharge  Will discharge home  Patient agrees with plan of care
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation
Clinical narrative: burning sensation in both feet
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Aortic valve incompetence, Aortic valve sclerosis, Atelectasis, Brain natriuretic peptide increased, COVID-19
Clinical narrative: The patient is a 67 y.o. with past and current medical history of ICM EF 15-20% chronic systolic heart failure, CAD with hx of anterior STEMI in 2016 with PCI LAD, with 70-80% RCA not intervened at the time, EF25% at that time. He has followed with Cardiology but was referred to another healthcare facility Feb 2022.    He presented to the ED 6/15 with edema, dyspnea, orthopnea, and PND for 1-2 weeks prior to admission. He had admitted weight gain about 20-25 lbs. In the ED, CXR with pulmonary congestion, BNP 5k. He was admitted to care service for diuresis. An echo was updated on admit that showed severely dilated LV with EF 15%. He was diuresed aggressively with a lasix drip. He threatened to leave AMA multiple times, but ended up staying, lasix gtt transitioned to PO torsemide 40mg bid. His fluid status and symptoms greatly improved with aggressive diuresis.   GDMT; his coreg was cotninued. Lisinopril was continued but later held and transitioned to entresto on discharge. He reported a hx of dizziness with aldactone but this was trailed while inpatient and tolerated well. SGLT2i cost was prohibitive, therefore not prescribed.    Patient reported that his wife recently testes positive for COVID, he took a home test and was positive, PCR was positive on admit 6/16. Internal medicine was consulted to help treat COVID. He was hypoxic, unclear how much was from COVID vs fluid overload. He was treated with remdesivir x5 doses. He was offered decadron but declined due to possible edema side effects.    He qualified for home oxygen, especially required it at night, he initially refused home O2 due to the copay, but later okay with a lower copay and was delivered oxygen tanks.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Cardiomegaly, Chest X-ray abnormal, Dyspnoea, Dyspnoea paroxysmal nocturnal
Clinical narrative: The patient is a 67 y.o. with past and current medical history of ICM EF 15-20% chronic systolic heart failure, CAD with hx of anterior STEMI in 2016 with PCI LAD, with 70-80% RCA not intervened at the time, EF25% at that time. He has followed with Cardiology but was referred to another healthcare facility Feb 2022.    He presented to the ED 6/15 with edema, dyspnea, orthopnea, and PND for 1-2 weeks prior to admission. He had admitted weight gain about 20-25 lbs. In the ED, CXR with pulmonary congestion, BNP 5k. He was admitted to care service for diuresis. An echo was updated on admit that showed severely dilated LV with EF 15%. He was diuresed aggressively with a lasix drip. He threatened to leave AMA multiple times, but ended up staying, lasix gtt transitioned to PO torsemide 40mg bid. His fluid status and symptoms greatly improved with aggressive diuresis.   GDMT; his coreg was cotninued. Lisinopril was continued but later held and transitioned to entresto on discharge. He reported a hx of dizziness with aldactone but this was trailed while inpatient and tolerated well. SGLT2i cost was prohibitive, therefore not prescribed.    Patient reported that his wife recently testes positive for COVID, he took a home test and was positive, PCR was positive on admit 6/16. Internal medicine was consulted to help treat COVID. He was hypoxic, unclear how much was from COVID vs fluid overload. He was treated with remdesivir x5 doses. He was offered decadron but declined due to possible edema side effects.    He qualified for home oxygen, especially required it at night, he initially refused home O2 due to the copay, but later okay with a lower copay and was delivered oxygen tanks.