chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Abdominal pain, COVID-19, Computerised tomogram thorax abnormal, Drug intolerance, Intermenstrual bleeding
Clinical narrative: 50 year old female with PMH of fibroids and ovarian cyst who presented to hospital with subacute abdominal pain. Patient still has menstrual periods every 28 days and has noted some mild inter-menstrual spotting over the past year- she has never been pregnant, has no known STI history, and is not currently sexually active. There is no known family history of breast or gynecologic malignancy. Patient will follow up with gynecologic oncology as an outpatient for further discussion of treatment. She did not tolerate Dilaudid or Tramadol due to nausea and dizziness and has an allergy to the Norco, so she was switched to Percocet. IR was consulted for biopsy of pleural nodules noted on chest CT, but determined they we not accessible due to size, and patient is encouraged to have the nodules surveyed with serial imaging at 3 month intervals. Patient had a mild fever to 100.2 without leukocytosis, we held Percocet and gave Tylenol, which resolved the episode. She is to follow up with gynecologic oncology within 1 week of discharge. Patient was medically stable for discharge with pain and anti-nausea medication.
Age: 49.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Pulmonary mass, SARS-CoV-2 test positive
Clinical narrative: 50 year old female with PMH of fibroids and ovarian cyst who presented to hospital with subacute abdominal pain. Patient still has menstrual periods every 28 days and has noted some mild inter-menstrual spotting over the past year- she has never been pregnant, has no known STI history, and is not currently sexually active. There is no known family history of breast or gynecologic malignancy. Patient will follow up with gynecologic oncology as an outpatient for further discussion of treatment. She did not tolerate Dilaudid or Tramadol due to nausea and dizziness and has an allergy to the Norco, so she was switched to Percocet. IR was consulted for biopsy of pleural nodules noted on chest CT, but determined they we not accessible due to size, and patient is encouraged to have the nodules surveyed with serial imaging at 3 month intervals. Patient had a mild fever to 100.2 without leukocytosis, we held Percocet and gave Tylenol, which resolved the episode. She is to follow up with gynecologic oncology within 1 week of discharge. Patient was medically stable for discharge with pain and anti-nausea medication.
Age: 5.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Aspartate aminotransferase increased, Blood creatine phosphokinase increased, Blood electrolytes normal, C-reactive protein increased, COVID-19
Clinical narrative: 6 year old female with PMH of asthma who presented to the ED 8/14 due to fever, sore throat, cough, congestion for 4 days. Day prior patient had been refusing to walk due to calf pain. Upon presentation to the ED vital signs were stable, patient was complaining of painful ambulation. Labs were ordered. No leukocytosis or anemia noted, slight AST elevation. No electrolyte abnormalities. ESR was WNL, slightly elevated CRP at 9.9. COVID-19 positive with elevated CK at 633. Patient was given fluids, steroids, and breathing treatment. Toradol for calf pain. Admitted to the floor for further management. Patient did well overnight. Medically stable for discharge.
Age: 5.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cough, Gait disturbance, Oropharyngeal pain, Pain, Pain in extremity
Clinical narrative: 6 year old female with PMH of asthma who presented to the ED 8/14 due to fever, sore throat, cough, congestion for 4 days. Day prior patient had been refusing to walk due to calf pain. Upon presentation to the ED vital signs were stable, patient was complaining of painful ambulation. Labs were ordered. No leukocytosis or anemia noted, slight AST elevation. No electrolyte abnormalities. ESR was WNL, slightly elevated CRP at 9.9. COVID-19 positive with elevated CK at 633. Patient was given fluids, steroids, and breathing treatment. Toradol for calf pain. Admitted to the floor for further management. Patient did well overnight. Medically stable for discharge.
Age: 5.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pyrexia, Red blood cell sedimentation rate normal, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: 6 year old female with PMH of asthma who presented to the ED 8/14 due to fever, sore throat, cough, congestion for 4 days. Day prior patient had been refusing to walk due to calf pain. Upon presentation to the ED vital signs were stable, patient was complaining of painful ambulation. Labs were ordered. No leukocytosis or anemia noted, slight AST elevation. No electrolyte abnormalities. ESR was WNL, slightly elevated CRP at 9.9. COVID-19 positive with elevated CK at 633. Patient was given fluids, steroids, and breathing treatment. Toradol for calf pain. Admitted to the floor for further management. Patient did well overnight. Medically stable for discharge.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Confusional state, Hepatic cirrhosis, SARS-CoV-2 test positive
Clinical narrative: 61y.o. male who presents for the above issues. Patient is confused during exam with poor recall. Had recent admission for confusion related to covid-19 in setting of cirrhosis. He was managed supportively. He is stable for discharge to SAR with close outpatient follow-up. Discussed management plan with patient at bedside and wife over phone.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: ADMINISTERED EXPIRED VACCINE.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, COVID-19, Condition aggravated, Diabetes mellitus, Diabetes mellitus inadequate control
Clinical narrative: HISTORY AND COURSE IN THE HOSPITAL:   1. Acute on chronic hypoxic respiratory failure. The patient is a 71-year-old female with past medical history of chronic respiratory failure, on home O2, comes in with history of increasing shortness of breath. She was found to be COVID positive, ID and Pulmonary was consulted. She was started on Decadron 6 mg daily, IV remdesivir, breathing treatments. She was also found to be fluid overloaded.  She was started on IV Lasix 40 mg b.i.d. with treatment, she noted marked improvement.  Shortness of breath improved.  She completed 5 days of remdesivir and also 6 days of Decadron and 4 days of Prednisone, and oxygen saturation was back to baseline. She has been advised to be compliant with Bumex at home, and to weigh herself every day and if she gains 3 pounds to take extra dose of Bumex.  Once she was symptomatically better, she has been sent home with home care and home O2.  2. Iron deficiency anemia and stool occult blood positive .Hematology and GI was consulted. She was given IV iron and because of her multiple comorbidities and COVID, she has been advised to follow up with GI as an outpatient for EGD and colonoscopy when she is out of isolation for  COVID.  3. Diabetes mellitus with uncontrolled blood sugar. She was on Lantus insulin, Lispro with meals and SSI .improved once the steroids were tapered.  4. Critical illness myopathy.  PT/OT was consulted. They felt she can go home with home care. I recommended her going to subacute rehab, but the patient refused and prefers to go home. I have also advised her that if she finds it difficult to go to the primary care physician. I have given her a name of a primary care physician who can come to her house. She has been advised to follow up with the primary care physician in one week and Pulmonologist as needed and GI in 2 to 3 weeks.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Dyspnoea, Hypervolaemia, Intensive care unit acquired weakness, Iron deficiency anaemia, Multimorbidity
Clinical narrative: HISTORY AND COURSE IN THE HOSPITAL:   1. Acute on chronic hypoxic respiratory failure. The patient is a 71-year-old female with past medical history of chronic respiratory failure, on home O2, comes in with history of increasing shortness of breath. She was found to be COVID positive, ID and Pulmonary was consulted. She was started on Decadron 6 mg daily, IV remdesivir, breathing treatments. She was also found to be fluid overloaded.  She was started on IV Lasix 40 mg b.i.d. with treatment, she noted marked improvement.  Shortness of breath improved.  She completed 5 days of remdesivir and also 6 days of Decadron and 4 days of Prednisone, and oxygen saturation was back to baseline. She has been advised to be compliant with Bumex at home, and to weigh herself every day and if she gains 3 pounds to take extra dose of Bumex.  Once she was symptomatically better, she has been sent home with home care and home O2.  2. Iron deficiency anemia and stool occult blood positive .Hematology and GI was consulted. She was given IV iron and because of her multiple comorbidities and COVID, she has been advised to follow up with GI as an outpatient for EGD and colonoscopy when she is out of isolation for  COVID.  3. Diabetes mellitus with uncontrolled blood sugar. She was on Lantus insulin, Lispro with meals and SSI .improved once the steroids were tapered.  4. Critical illness myopathy.  PT/OT was consulted. They felt she can go home with home care. I recommended her going to subacute rehab, but the patient refused and prefers to go home. I have also advised her that if she finds it difficult to go to the primary care physician. I have given her a name of a primary care physician who can come to her house. She has been advised to follow up with the primary care physician in one week and Pulmonologist as needed and GI in 2 to 3 weeks.
Age: 70.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Occult blood positive, Respiratory failure, SARS-CoV-2 test positive, Type 1 diabetes mellitus
Clinical narrative: HISTORY AND COURSE IN THE HOSPITAL:   1. Acute on chronic hypoxic respiratory failure. The patient is a 71-year-old female with past medical history of chronic respiratory failure, on home O2, comes in with history of increasing shortness of breath. She was found to be COVID positive, ID and Pulmonary was consulted. She was started on Decadron 6 mg daily, IV remdesivir, breathing treatments. She was also found to be fluid overloaded.  She was started on IV Lasix 40 mg b.i.d. with treatment, she noted marked improvement.  Shortness of breath improved.  She completed 5 days of remdesivir and also 6 days of Decadron and 4 days of Prednisone, and oxygen saturation was back to baseline. She has been advised to be compliant with Bumex at home, and to weigh herself every day and if she gains 3 pounds to take extra dose of Bumex.  Once she was symptomatically better, she has been sent home with home care and home O2.  2. Iron deficiency anemia and stool occult blood positive .Hematology and GI was consulted. She was given IV iron and because of her multiple comorbidities and COVID, she has been advised to follow up with GI as an outpatient for EGD and colonoscopy when she is out of isolation for  COVID.  3. Diabetes mellitus with uncontrolled blood sugar. She was on Lantus insulin, Lispro with meals and SSI .improved once the steroids were tapered.  4. Critical illness myopathy.  PT/OT was consulted. They felt she can go home with home care. I recommended her going to subacute rehab, but the patient refused and prefers to go home. I have also advised her that if she finds it difficult to go to the primary care physician. I have given her a name of a primary care physician who can come to her house. She has been advised to follow up with the primary care physician in one week and Pulmonologist as needed and GI in 2 to 3 weeks.
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dizziness, Feeling of despair, Gait disturbance, Hypotension
Clinical narrative: 75y.o. female who presents to hospital 8/15 presents with a c/o of dizziness. Pt states she was standing at the kitchen sink and suddenly got dizzy. Then she went to go sit on the toilet and still felt dizzy and then went to lay down using her walker and could "barely make it." Pt lives with her daughter. Pt's daughter states she felt like her mother was despondent - however she could answer the questions she was asking her. The daughter called EMS and pt was found to be hypotensive 79/37, given IVF bolus. During EMS ride, daughter states the pt had an unresponsive episode. Has hx of vertigo, although this episode felt different. Pt states her symptoms lasted about 1 hour. Pt states she was covid+ 2 weeks ago and her PCP
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Unresponsive to stimuli, Walking aid user
Clinical narrative: 75y.o. female who presents to hospital 8/15 presents with a c/o of dizziness. Pt states she was standing at the kitchen sink and suddenly got dizzy. Then she went to go sit on the toilet and still felt dizzy and then went to lay down using her walker and could "barely make it." Pt lives with her daughter. Pt's daughter states she felt like her mother was despondent - however she could answer the questions she was asking her. The daughter called EMS and pt was found to be hypotensive 79/37, given IVF bolus. During EMS ride, daughter states the pt had an unresponsive episode. Has hx of vertigo, although this episode felt different. Pt states her symptoms lasted about 1 hour. Pt states she was covid+ 2 weeks ago and her PCP
Age: 91.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Bundle branch block right, COVID-19, Cerebellar infarction, Computerised tomogram head abnormal, Electrocardiogram QT prolonged
Clinical narrative: The patient has a history of multivessel CAD s/p CABG, HFrEF, PE on apixaban, AAA s/p repair 2017, TIA, vascular dementia who presented to WBH on 8/15/2022 for left sided weakness.  Per chart review, the patient was noted to have sudden onset left sided weakness on 8/14/22 around 2300. Last seen at his baseline around 1900.  There is mention of seizure once EMS was called, but there is no description of what happened. Patient was hemodynamically stable, afebrile, on room air upon presentation to ED. EKG showed QTC prolongation at 527 with incomplete right bundle branch block and accelerated junctional rhythm.  His CT of the head showed a 5.2 x 2.2 cm right pericallosal white matter mass along with adjacent masses in both cerebral hemispheres involving the body of the corpus callosum.  There is also mention of remote infarcts of the cerebellum, left temporal occipital, right parietal, left frontal regions.  He was started on Decadron and given 1 g of IV Keppra and started on 500 mg IV Keppra twice daily.  Neurosurgery evaluated the patient and MRI of the brain plus minus gad was ordered. Patient is terminally ill with a life expectancy of six months or less if the illness runs its normal course with a diagnosis of brain mass.
Age: 91.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hemiparesis, Intracranial mass, Nodal rhythm, SARS-CoV-2 test positive, Seizure
Clinical narrative: The patient has a history of multivessel CAD s/p CABG, HFrEF, PE on apixaban, AAA s/p repair 2017, TIA, vascular dementia who presented to WBH on 8/15/2022 for left sided weakness.  Per chart review, the patient was noted to have sudden onset left sided weakness on 8/14/22 around 2300. Last seen at his baseline around 1900.  There is mention of seizure once EMS was called, but there is no description of what happened. Patient was hemodynamically stable, afebrile, on room air upon presentation to ED. EKG showed QTC prolongation at 527 with incomplete right bundle branch block and accelerated junctional rhythm.  His CT of the head showed a 5.2 x 2.2 cm right pericallosal white matter mass along with adjacent masses in both cerebral hemispheres involving the body of the corpus callosum.  There is also mention of remote infarcts of the cerebellum, left temporal occipital, right parietal, left frontal regions.  He was started on Decadron and given 1 g of IV Keppra and started on 500 mg IV Keppra twice daily.  Neurosurgery evaluated the patient and MRI of the brain plus minus gad was ordered. Patient is terminally ill with a life expectancy of six months or less if the illness runs its normal course with a diagnosis of brain mass.
Age: 91.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: White matter lesion
Clinical narrative: The patient has a history of multivessel CAD s/p CABG, HFrEF, PE on apixaban, AAA s/p repair 2017, TIA, vascular dementia who presented to WBH on 8/15/2022 for left sided weakness.  Per chart review, the patient was noted to have sudden onset left sided weakness on 8/14/22 around 2300. Last seen at his baseline around 1900.  There is mention of seizure once EMS was called, but there is no description of what happened. Patient was hemodynamically stable, afebrile, on room air upon presentation to ED. EKG showed QTC prolongation at 527 with incomplete right bundle branch block and accelerated junctional rhythm.  His CT of the head showed a 5.2 x 2.2 cm right pericallosal white matter mass along with adjacent masses in both cerebral hemispheres involving the body of the corpus callosum.  There is also mention of remote infarcts of the cerebellum, left temporal occipital, right parietal, left frontal regions.  He was started on Decadron and given 1 g of IV Keppra and started on 500 mg IV Keppra twice daily.  Neurosurgery evaluated the patient and MRI of the brain plus minus gad was ordered. Patient is terminally ill with a life expectancy of six months or less if the illness runs its normal course with a diagnosis of brain mass.
Age: 50.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Catheterisation cardiac normal, Chest pain, Coronary artery disease, Diarrhoea
Clinical narrative: 52-year-old female presents with chest pain and episodes of palpitations feeling lightheaded which she describes as dizzy and feeling visual spots. Patient has been lightheaded with standing more recently. She was working here in the food service area when she began to feel the symptoms and came to the emergency department for evaluation. Patient has been seen in urgent care last week and placed on Augmentin for sinus infection. She has had diarrhea since being placed on the Augmentin recently. She had an echo with some wall motion abnormalities, albeit smaller are, in the septum. Due to this and risk factors, she was advised to have an ischemic eval - due to COVID precautions and inability to get her HR to a target for a CTA, she had a cardiac cath with essentially normal coronaries (one report did mention "nonobstructive CAD" but the cath report does not mention lesions or stenosis). She will follow with cardiology.
Age: 50.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Dizziness, Echocardiogram abnormal, Malaise, Palpitations, SARS-CoV-2 test positive
Clinical narrative: 52-year-old female presents with chest pain and episodes of palpitations feeling lightheaded which she describes as dizzy and feeling visual spots. Patient has been lightheaded with standing more recently. She was working here in the food service area when she began to feel the symptoms and came to the emergency department for evaluation. Patient has been seen in urgent care last week and placed on Augmentin for sinus infection. She has had diarrhea since being placed on the Augmentin recently. She had an echo with some wall motion abnormalities, albeit smaller are, in the septum. Due to this and risk factors, she was advised to have an ischemic eval - due to COVID precautions and inability to get her HR to a target for a CTA, she had a cardiac cath with essentially normal coronaries (one report did mention "nonobstructive CAD" but the cath report does not mention lesions or stenosis). She will follow with cardiology.
Age: 50.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Sinusitis, Visual impairment
Clinical narrative: 52-year-old female presents with chest pain and episodes of palpitations feeling lightheaded which she describes as dizzy and feeling visual spots. Patient has been lightheaded with standing more recently. She was working here in the food service area when she began to feel the symptoms and came to the emergency department for evaluation. Patient has been seen in urgent care last week and placed on Augmentin for sinus infection. She has had diarrhea since being placed on the Augmentin recently. She had an echo with some wall motion abnormalities, albeit smaller are, in the septum. Due to this and risk factors, she was advised to have an ischemic eval - due to COVID precautions and inability to get her HR to a target for a CTA, she had a cardiac cath with essentially normal coronaries (one report did mention "nonobstructive CAD" but the cath report does not mention lesions or stenosis). She will follow with cardiology.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Computerised tomogram abdomen abnormal, Constipation, Enema administration, Faecal disimpaction
Clinical narrative: 81y.o. male past medical history of HLD, HTN presenting with constipation and rectal bleeding. Patient stated that he was constipated for the last 5 days and had tried OTC fiber that did not work well for him then he tried 2 fleet enemas together at the same time and felt sudden pain in his bottom but could not get his stool out. He reports that sometimes he tries to manually disimpact at times and it helps. This has been a chronic problem for him and he does admit to unhealthy diet including potato chips. In the ER, initial chemistry panel was unremarkable however CBC showed leukocytosis and low RBC count and H&H at 12.7/37.7 with normal MCV. Platelets are slightly decreased at 141. Patient was found to be COVID-positive. CT abdomen/pelvis with IV contrast showed inflammatory changes of the rectum likely proctitis. No immediate plans for inpatient endoscopic intervention, we do recommend following up outpatient for discussing possible flex sigmoidoscopy vs colonoscopy for further evaluation of his abnormal CT findings.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Full blood count abnormal, Gastrointestinal motility disorder, Haematocrit decreased, Haemoglobin decreased, Laboratory test normal
Clinical narrative: 81y.o. male past medical history of HLD, HTN presenting with constipation and rectal bleeding. Patient stated that he was constipated for the last 5 days and had tried OTC fiber that did not work well for him then he tried 2 fleet enemas together at the same time and felt sudden pain in his bottom but could not get his stool out. He reports that sometimes he tries to manually disimpact at times and it helps. This has been a chronic problem for him and he does admit to unhealthy diet including potato chips. In the ER, initial chemistry panel was unremarkable however CBC showed leukocytosis and low RBC count and H&H at 12.7/37.7 with normal MCV. Platelets are slightly decreased at 141. Patient was found to be COVID-positive. CT abdomen/pelvis with IV contrast showed inflammatory changes of the rectum likely proctitis. No immediate plans for inpatient endoscopic intervention, we do recommend following up outpatient for discussing possible flex sigmoidoscopy vs colonoscopy for further evaluation of his abnormal CT findings.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Leukocytosis, Mean cell volume normal, Platelet count decreased, Proctalgia, Proctitis
Clinical narrative: 81y.o. male past medical history of HLD, HTN presenting with constipation and rectal bleeding. Patient stated that he was constipated for the last 5 days and had tried OTC fiber that did not work well for him then he tried 2 fleet enemas together at the same time and felt sudden pain in his bottom but could not get his stool out. He reports that sometimes he tries to manually disimpact at times and it helps. This has been a chronic problem for him and he does admit to unhealthy diet including potato chips. In the ER, initial chemistry panel was unremarkable however CBC showed leukocytosis and low RBC count and H&H at 12.7/37.7 with normal MCV. Platelets are slightly decreased at 141. Patient was found to be COVID-positive. CT abdomen/pelvis with IV contrast showed inflammatory changes of the rectum likely proctitis. No immediate plans for inpatient endoscopic intervention, we do recommend following up outpatient for discussing possible flex sigmoidoscopy vs colonoscopy for further evaluation of his abnormal CT findings.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Rectal haemorrhage, Red blood cell count decreased, SARS-CoV-2 test positive, Scan with contrast abnormal, Unhealthy diet
Clinical narrative: 81y.o. male past medical history of HLD, HTN presenting with constipation and rectal bleeding. Patient stated that he was constipated for the last 5 days and had tried OTC fiber that did not work well for him then he tried 2 fleet enemas together at the same time and felt sudden pain in his bottom but could not get his stool out. He reports that sometimes he tries to manually disimpact at times and it helps. This has been a chronic problem for him and he does admit to unhealthy diet including potato chips. In the ER, initial chemistry panel was unremarkable however CBC showed leukocytosis and low RBC count and H&H at 12.7/37.7 with normal MCV. Platelets are slightly decreased at 141. Patient was found to be COVID-positive. CT abdomen/pelvis with IV contrast showed inflammatory changes of the rectum likely proctitis. No immediate plans for inpatient endoscopic intervention, we do recommend following up outpatient for discussing possible flex sigmoidoscopy vs colonoscopy for further evaluation of his abnormal CT findings.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest discomfort, Dyspnoea, Inflammatory marker test, Malaise
Clinical narrative: 58y.o. female developed symptoms 3 days prior to presentation, felt unwell, developed chest pressure, fever, congestion, runny nose, body aches, productive cough, shortness of breath, mild palpitations. Initial home covid test was negative. Then repeated 2 days later, showed positive.  Vaccinated and boosted. Last in July 2022.   Covid 19. Patient was at high risk due to immunosuppressants post renal transplant and diabetes. She was stable, no hypoxia. Inflammatory markers were monitored. She was started Remdesivir for 3 days. All other medical issues were managed as prior to hospital stay.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Pain, Palpitations, Productive cough, Pyrexia, Respiratory tract congestion
Clinical narrative: 58y.o. female developed symptoms 3 days prior to presentation, felt unwell, developed chest pressure, fever, congestion, runny nose, body aches, productive cough, shortness of breath, mild palpitations. Initial home covid test was negative. Then repeated 2 days later, showed positive.  Vaccinated and boosted. Last in July 2022.   Covid 19. Patient was at high risk due to immunosuppressants post renal transplant and diabetes. She was stable, no hypoxia. Inflammatory markers were monitored. She was started Remdesivir for 3 days. All other medical issues were managed as prior to hospital stay.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: 58y.o. female developed symptoms 3 days prior to presentation, felt unwell, developed chest pressure, fever, congestion, runny nose, body aches, productive cough, shortness of breath, mild palpitations. Initial home covid test was negative. Then repeated 2 days later, showed positive.  Vaccinated and boosted. Last in July 2022.   Covid 19. Patient was at high risk due to immunosuppressants post renal transplant and diabetes. She was stable, no hypoxia. Inflammatory markers were monitored. She was started Remdesivir for 3 days. All other medical issues were managed as prior to hospital stay.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Delivery, Labour stimulation, Maternal exposure before pregnancy, Pregnancy
Clinical narrative: 33y.o. G6P2032 at 39w2d by L=8w5d who presents with cc of passing blood clots since her membrane sweep. SVD 8/17 baby. Pt satisfied from care measures provided.  Vss, ambulating and voiding without difficulty, fundus firm, scant lochia, tolerating regular diet, declining pain meds. Prescriptions given. Discharge instructions discussed/signed and all questions answered. Mom in walking out for discharge.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Thrombosis
Clinical narrative: 33y.o. G6P2032 at 39w2d by L=8w5d who presents with cc of passing blood clots since her membrane sweep. SVD 8/17 baby. Pt satisfied from care measures provided.  Vss, ambulating and voiding without difficulty, fundus firm, scant lochia, tolerating regular diet, declining pain meds. Prescriptions given. Discharge instructions discussed/signed and all questions answered. Mom in walking out for discharge.
Age: 29.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Delivery, Exposure during pregnancy, SARS-CoV-2 test positive
Clinical narrative: NSVD baby
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Cellulitis, Fall, Fibula fracture
Clinical narrative: 88y.o. female with pmh of basilar artery stenosis, CAD, HTN, hypothyroidism, HLD, ILD on 3L home O2, BL knee OA, and seizure d/o admitted to the hospital on 8/23/2022 for LLE pain and weakness.  Patient recently admitted 8/18-8/22 after fall with LLE pain and facial cellulitis and was dx with COVID 19, imaging LLE negative at that time.  Imaging 8/23 in the ED showed L fibular fx. Ortho evaluated and recommend CAM boot with NWB LLE. Admission complicated by hyponatremia. She is stable for discharge to SAR. Discussed management plan with patient at bedside and daughter over phone. She will follow with her primary doctor and surgeon after discharge.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hyponatraemia, Imaging procedure, Pain in extremity, SARS-CoV-2 test positive
Clinical narrative: 88y.o. female with pmh of basilar artery stenosis, CAD, HTN, hypothyroidism, HLD, ILD on 3L home O2, BL knee OA, and seizure d/o admitted to the hospital on 8/23/2022 for LLE pain and weakness.  Patient recently admitted 8/18-8/22 after fall with LLE pain and facial cellulitis and was dx with COVID 19, imaging LLE negative at that time.  Imaging 8/23 in the ED showed L fibular fx. Ortho evaluated and recommend CAM boot with NWB LLE. Admission complicated by hyponatremia. She is stable for discharge to SAR. Discussed management plan with patient at bedside and daughter over phone. She will follow with her primary doctor and surgeon after discharge.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Atrial fibrillation, COVID-19, Chest pain, Electrocardiogram abnormal
Clinical narrative: 70-year-old male with history of CAD, afib, 3v CABG admitted with symptoms of diaphoresis and chest pain/palpitations. In ED, symptoms improved. Troponins elevated. COVID-19 testing positive. Patient noted to be tachycardic; therefore treated with IV diltiazem for rate control and initiated IV heparin per protocol. ECG for atrial fibrillation with RVR. Educated his son on home care and services available. His son provided choice; patient did not have any preference. Agreeable to services.
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Hyperhidrosis, Palpitations, SARS-CoV-2 test positive, Tachycardia, Troponin increased
Clinical narrative: 70-year-old male with history of CAD, afib, 3v CABG admitted with symptoms of diaphoresis and chest pain/palpitations. In ED, symptoms improved. Troponins elevated. COVID-19 testing positive. Patient noted to be tachycardic; therefore treated with IV diltiazem for rate control and initiated IV heparin per protocol. ECG for atrial fibrillation with RVR. Educated his son on home care and services available. His son provided choice; patient did not have any preference. Agreeable to services.
Age: 43.0
Sex: M
Vaccine: COVID19-2
Symptoms: Vertigo
Clinical narrative: Acute vertigo
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute respiratory failure, Anticoagulant therapy, Arterial thrombosis, Atrial fibrillation, COVID-19 pneumonia
Clinical narrative: 66 y/o F with PMH significant for severe COPD, pulmonary HTN, a-fib, pancreatic ca s/p Whipple, and dementia, who was initially admitted to the ICU for acute on chronic hypoxic respiratory failure from COVID-19 PNA requiring HFNC/NRB. Pt was treated with remdesivir and soul-medrol for her COVID-19 PNA. Her hospitalization was otherwise significant for a-fib with rvr, LLE DVT, and a new dx of chronic thrombus in the RLL artery . Pt was treated with anticoagulation with IV heparin. She was ultimately transferred out of the ICU after goals of care were addressed and her code status was changed to DNR/DNI. ICU consultation was requested by the primary team on 9/2 for escalating FiO2 requirements on HFNC. No dyspnea.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Deep vein thrombosis, Intensive care, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: 66 y/o F with PMH significant for severe COPD, pulmonary HTN, a-fib, pancreatic ca s/p Whipple, and dementia, who was initially admitted to the ICU for acute on chronic hypoxic respiratory failure from COVID-19 PNA requiring HFNC/NRB. Pt was treated with remdesivir and soul-medrol for her COVID-19 PNA. Her hospitalization was otherwise significant for a-fib with rvr, LLE DVT, and a new dx of chronic thrombus in the RLL artery . Pt was treated with anticoagulation with IV heparin. She was ultimately transferred out of the ICU after goals of care were addressed and her code status was changed to DNR/DNI. ICU consultation was requested by the primary team on 9/2 for escalating FiO2 requirements on HFNC. No dyspnea.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Anticoagulant therapy, Blood electrolytes, COVID-19, Cardiac telemetry
Clinical narrative: 79y.o. male with past medical history of COPD, hypertension, Mobitz type I AV block, pulmonary nodules, COVID-19 February 2022 who presented to Hospital for shortness of breath that was worsening over the past few days.  Patient was recently hospitalized in state at the beginning of August, he came back to state to live with his son while his apartment is getting ready in state.  He states he has been in state for approximately 8 days and he is felt that his breathing declining gradually.  Patient tested positive for COVID-19 today.  He denies any fever, chills he does admit to productive cough with yellow sputum.  In ER patient underwent a CTA to rule out PE, there is no evidence of pulmonary embolism, there were multiple pulmonary nodules stable from previous as well as a spiculated nodule in the LLL.  Patient states that his symptoms seem to worsen throughout the day, he feels the best right when he wakes up in the morning.  Patient states he has lost approximately 60 pounds over the past 5 years.  While in the EC his respiratory rate and pulse ox have fluctuated.  Patient will be admitted to hospital for further monitoring and continued IV steroids. Chest X - Ray - No acute pulmonary Process CTA PE - Neg for PE, multiple pulmonary nodules   Place in Contact/Respiratory Isolation  Infectious Disease Consult  Decadron 6 mg daily, Lovenox daily Pulmonary Consult  Troponin x3 - Negative  Telemetry Monitoring  Breathing Treatments as needed Fall Precautions, Pain Management Monitor Lytes, replace when indicated  Medications, Labs,, Imaging Reviewed  Resume Norvasc for hypertension DVT/GI Prophylaxis  Full Code   8/19/22- Pt stable for dc today. On RA. Will continue decadron course. Resume home advair and spiriva. Cardio c/s for bradycardia with pauses. Cleared pt for dc with f/u OP. Given + RF, pt to f/u with rheum OP
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray normal, Dyspnoea, Irregular breathing, Oxygen saturation abnormal, Pain
Clinical narrative: 79y.o. male with past medical history of COPD, hypertension, Mobitz type I AV block, pulmonary nodules, COVID-19 February 2022 who presented to Hospital for shortness of breath that was worsening over the past few days.  Patient was recently hospitalized in state at the beginning of August, he came back to state to live with his son while his apartment is getting ready in state.  He states he has been in state for approximately 8 days and he is felt that his breathing declining gradually.  Patient tested positive for COVID-19 today.  He denies any fever, chills he does admit to productive cough with yellow sputum.  In ER patient underwent a CTA to rule out PE, there is no evidence of pulmonary embolism, there were multiple pulmonary nodules stable from previous as well as a spiculated nodule in the LLL.  Patient states that his symptoms seem to worsen throughout the day, he feels the best right when he wakes up in the morning.  Patient states he has lost approximately 60 pounds over the past 5 years.  While in the EC his respiratory rate and pulse ox have fluctuated.  Patient will be admitted to hospital for further monitoring and continued IV steroids. Chest X - Ray - No acute pulmonary Process CTA PE - Neg for PE, multiple pulmonary nodules   Place in Contact/Respiratory Isolation  Infectious Disease Consult  Decadron 6 mg daily, Lovenox daily Pulmonary Consult  Troponin x3 - Negative  Telemetry Monitoring  Breathing Treatments as needed Fall Precautions, Pain Management Monitor Lytes, replace when indicated  Medications, Labs,, Imaging Reviewed  Resume Norvasc for hypertension DVT/GI Prophylaxis  Full Code   8/19/22- Pt stable for dc today. On RA. Will continue decadron course. Resume home advair and spiriva. Cardio c/s for bradycardia with pauses. Cleared pt for dc with f/u OP. Given + RF, pt to f/u with rheum OP
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Productive cough, Pulmonary mass, Rheumatoid factor positive, SARS-CoV-2 test positive, Sputum discoloured
Clinical narrative: 79y.o. male with past medical history of COPD, hypertension, Mobitz type I AV block, pulmonary nodules, COVID-19 February 2022 who presented to Hospital for shortness of breath that was worsening over the past few days.  Patient was recently hospitalized in state at the beginning of August, he came back to state to live with his son while his apartment is getting ready in state.  He states he has been in state for approximately 8 days and he is felt that his breathing declining gradually.  Patient tested positive for COVID-19 today.  He denies any fever, chills he does admit to productive cough with yellow sputum.  In ER patient underwent a CTA to rule out PE, there is no evidence of pulmonary embolism, there were multiple pulmonary nodules stable from previous as well as a spiculated nodule in the LLL.  Patient states that his symptoms seem to worsen throughout the day, he feels the best right when he wakes up in the morning.  Patient states he has lost approximately 60 pounds over the past 5 years.  While in the EC his respiratory rate and pulse ox have fluctuated.  Patient will be admitted to hospital for further monitoring and continued IV steroids. Chest X - Ray - No acute pulmonary Process CTA PE - Neg for PE, multiple pulmonary nodules   Place in Contact/Respiratory Isolation  Infectious Disease Consult  Decadron 6 mg daily, Lovenox daily Pulmonary Consult  Troponin x3 - Negative  Telemetry Monitoring  Breathing Treatments as needed Fall Precautions, Pain Management Monitor Lytes, replace when indicated  Medications, Labs,, Imaging Reviewed  Resume Norvasc for hypertension DVT/GI Prophylaxis  Full Code   8/19/22- Pt stable for dc today. On RA. Will continue decadron course. Resume home advair and spiriva. Cardio c/s for bradycardia with pauses. Cleared pt for dc with f/u OP. Given + RF, pt to f/u with rheum OP
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Troponin normal
Clinical narrative: 79y.o. male with past medical history of COPD, hypertension, Mobitz type I AV block, pulmonary nodules, COVID-19 February 2022 who presented to Hospital for shortness of breath that was worsening over the past few days.  Patient was recently hospitalized in state at the beginning of August, he came back to state to live with his son while his apartment is getting ready in state.  He states he has been in state for approximately 8 days and he is felt that his breathing declining gradually.  Patient tested positive for COVID-19 today.  He denies any fever, chills he does admit to productive cough with yellow sputum.  In ER patient underwent a CTA to rule out PE, there is no evidence of pulmonary embolism, there were multiple pulmonary nodules stable from previous as well as a spiculated nodule in the LLL.  Patient states that his symptoms seem to worsen throughout the day, he feels the best right when he wakes up in the morning.  Patient states he has lost approximately 60 pounds over the past 5 years.  While in the EC his respiratory rate and pulse ox have fluctuated.  Patient will be admitted to hospital for further monitoring and continued IV steroids. Chest X - Ray - No acute pulmonary Process CTA PE - Neg for PE, multiple pulmonary nodules   Place in Contact/Respiratory Isolation  Infectious Disease Consult  Decadron 6 mg daily, Lovenox daily Pulmonary Consult  Troponin x3 - Negative  Telemetry Monitoring  Breathing Treatments as needed Fall Precautions, Pain Management Monitor Lytes, replace when indicated  Medications, Labs,, Imaging Reviewed  Resume Norvasc for hypertension DVT/GI Prophylaxis  Full Code   8/19/22- Pt stable for dc today. On RA. Will continue decadron course. Resume home advair and spiriva. Cardio c/s for bradycardia with pauses. Cleared pt for dc with f/u OP. Given + RF, pt to f/u with rheum OP
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: ADMINISTERED EXPIRED VACCINE
Age: 72.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Pain, Rectal prolapse repair, Robotic surgery, SARS-CoV-2 test positive
Clinical narrative: 73 y.o. F who presented for Robotic Rectopexy. Postoperative course was uncomplicated. Diet was advanced to regular diet and patient was taking sufficient PO intake to maintain hydration. Pain was controlled on PO medications. Patient was ambulating. The patient was deemed stable for discharge on 8/20.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Fatigue, Intracranial mass, Magnetic resonance imaging, SARS-CoV-2 test positive
Clinical narrative: 72-year-old female with insignificant past medical history here as a transfer from outside facility. Patient went in for 2 days of worsening fatigue and some mild urinary incontinence. She was found to be positive for COVID19 infection was found to have a new frontal brain mass with large amount of vasogenic edema. Was transferred here for higher level of care. Patient denies recent fevers, chills, chest pain, shortness of breath, cough, abdominal pain, nausea, vomiting, diarrhea, dysuria, blood in her urine. Ambulatory. 8/23/22- Pt feels well. Deneis CP, SOB or dizziness. MRI completed and reviewed. Per neurosurg, pt cleared for discharge on decadron and keppra and to follow up with them OP for elective surgery in 2 weeks. Pt to f/u with pcp and specialists and continue current medication regimen.
Age: 71.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Urinary incontinence, Vasogenic cerebral oedema
Clinical narrative: 72-year-old female with insignificant past medical history here as a transfer from outside facility. Patient went in for 2 days of worsening fatigue and some mild urinary incontinence. She was found to be positive for COVID19 infection was found to have a new frontal brain mass with large amount of vasogenic edema. Was transferred here for higher level of care. Patient denies recent fevers, chills, chest pain, shortness of breath, cough, abdominal pain, nausea, vomiting, diarrhea, dysuria, blood in her urine. Ambulatory. 8/23/22- Pt feels well. Deneis CP, SOB or dizziness. MRI completed and reviewed. Per neurosurg, pt cleared for discharge on decadron and keppra and to follow up with them OP for elective surgery in 2 weeks. Pt to f/u with pcp and specialists and continue current medication regimen.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Biliary obstruction, Biliary tract dilation procedure, COVID-19, Endoscopic retrograde cholangiopancreatography, Fatigue
Clinical narrative: This is an 82-year-old male with a history of CAD with previous CABG x2 5/2017, PAF on Eliquis, HTN, T2DM, dyslipidemia, history of PPM in 2010, OSA, history of TIA 2021 originally presented to the ER on 8/18/2022 due to abnormal LFTs.  Patient was noted to be having complaints of fatigue and recent 5 pound weight loss.  There was concern for biliary tree obstruction.  He went for ERCP on 8/22/2022 with dilation and stent placement.  Repeat ERCP was performed on 8/26/2022.  Patient now may require to go to the OR due to left-sided bile duct occlusion with possible left hepatectomy and Roux-en-Y reconstruction. Discharged home.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Liver function test abnormal, SARS-CoV-2 test positive, Stent placement, Surgical procedure repeated, Weight decreased
Clinical narrative: This is an 82-year-old male with a history of CAD with previous CABG x2 5/2017, PAF on Eliquis, HTN, T2DM, dyslipidemia, history of PPM in 2010, OSA, history of TIA 2021 originally presented to the ER on 8/18/2022 due to abnormal LFTs.  Patient was noted to be having complaints of fatigue and recent 5 pound weight loss.  There was concern for biliary tree obstruction.  He went for ERCP on 8/22/2022 with dilation and stent placement.  Repeat ERCP was performed on 8/26/2022.  Patient now may require to go to the OR due to left-sided bile duct occlusion with possible left hepatectomy and Roux-en-Y reconstruction. Discharged home.
Age: 88.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest pain, Gangrene, Limb injury, SARS-CoV-2 test positive
Clinical narrative: 89 year old female with history significant for CAD with stenting, HTN, PAD, DM type II, CKD stage III, HLD presents to the hospital with gangrenous left heel wound. RRT called overnight for complaints of chest pain, now resolved. Cardiology consulted for further evaluation. Patient seen and evaluated this afternoon. Had brief episode of CP early this morning though resolved on its own. No current CP at this time. No SOB, dizziness, palpitations, paresthesias. Safe to discharge.
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood sodium decreased, COVID-19, Cough, Hyponatraemia, Hypovolaemia
Clinical narrative: This is a 67y.o. female who follows Dr She presents with Cough and hx COVID with DIB. She was also noted to have low sodium on labs -she was seen by nephro - she got IVF and then tolvaptan - sodium improved - she has no symptoms but was monitored This was prob some SIADH, with a component of mild volume depletion - she may have had a component of dec osmoles from dec intake She will continue some fluid restriction and follow with nephro, getting labs in a week or so -her COVID remained stable - she did not require any adjunctive treatment except supportive care and albuterol -possible COPD - she was given albuterol inhaler and was advised to follow with pulmonary - with her smoking history and the hyponatremia, lung cancer screening imaging will be considered
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Laboratory test, SARS-CoV-2 test positive
Clinical narrative: This is a 67y.o. female who follows Dr She presents with Cough and hx COVID with DIB. She was also noted to have low sodium on labs -she was seen by nephro - she got IVF and then tolvaptan - sodium improved - she has no symptoms but was monitored This was prob some SIADH, with a component of mild volume depletion - she may have had a component of dec osmoles from dec intake She will continue some fluid restriction and follow with nephro, getting labs in a week or so -her COVID remained stable - she did not require any adjunctive treatment except supportive care and albuterol -possible COPD - she was given albuterol inhaler and was advised to follow with pulmonary - with her smoking history and the hyponatremia, lung cancer screening imaging will be considered