chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Barrett's oesophagus, Blood creatinine increased, Blood glucose increased, COVID-19, Colonoscopy abnormal
Clinical narrative: 63y.o. female with a past medical history of type 2 diabetes mellitus, ischemic cardiomyopathy, ACS s/p stent x2 on in July 2022 who presented for chief complaint of rectal bleeding.  Patient reported large blood clots per rectum for the preceding 3 days.  She is currently on aspirin and Effient for recent history of stents.  Patient denied prior history of rectal bleeding, no history of colonoscopy in the past.  Patient also reported lightheadedness, cough and pleuritic chest pain aggravated by coughing.  Patient is fully vaccinated against COVID.  In the ED patient noted to have borderline hypotension, vitals otherwise stable.  Initial labs remarkable for creatinine 1.16, glucose 264, hemoglobin 8.6 (11.5 in). Additional information for Item 18:  in July), hematocrit 27.5, COVID-positive.  Aspirin and Effient recommended to be continued per academic cardiology service.  She was started on gentle fluids and was admitted with consult to GI, infectious disease, endocrinology, and cardiology services. Patient noted to have acute drop in hgb on 10/12 requiring 1unit PRBC. She subsequently underwent EGD/colonoscopy that day which was remarkable for esophageal mucosal changes classified as Barrett's stage C2-M3 per Prague criteria, diverticulosis in the sigmoid colon without evidence of diverticular bleeding and mucosal tear in the rectum, noted to be actively bleeding for which clips x2 were placed.  Due to poor prep follow up EGD/colonoscopy recommended in 1 year which was discussed w/patient. Pt noted to have borderline BP for which antihypertensive regimen was adjusted to only Entresto at current dosage. Hold parameters were discussed with the patient and she has her own BP cuff. Patient was also treated with a 3 day course of remdesivir per ID recommendations. Endocrinology was following for T2DM and adjustments to insulin were recommended as patient reported low blood glucoses in the AM at home. Patient is stable at this time for discharge with recommendation to follow up with GI, endocrinology, and cardiology was an outpatient.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Diverticulum, Diverticulum intestinal, Dizziness, Haematocrit decreased
Clinical narrative: 63y.o. female with a past medical history of type 2 diabetes mellitus, ischemic cardiomyopathy, ACS s/p stent x2 on in July 2022 who presented for chief complaint of rectal bleeding.  Patient reported large blood clots per rectum for the preceding 3 days.  She is currently on aspirin and Effient for recent history of stents.  Patient denied prior history of rectal bleeding, no history of colonoscopy in the past.  Patient also reported lightheadedness, cough and pleuritic chest pain aggravated by coughing.  Patient is fully vaccinated against COVID.  In the ED patient noted to have borderline hypotension, vitals otherwise stable.  Initial labs remarkable for creatinine 1.16, glucose 264, hemoglobin 8.6 (11.5 in). Additional information for Item 18:  in July), hematocrit 27.5, COVID-positive.  Aspirin and Effient recommended to be continued per academic cardiology service.  She was started on gentle fluids and was admitted with consult to GI, infectious disease, endocrinology, and cardiology services. Patient noted to have acute drop in hgb on 10/12 requiring 1unit PRBC. She subsequently underwent EGD/colonoscopy that day which was remarkable for esophageal mucosal changes classified as Barrett's stage C2-M3 per Prague criteria, diverticulosis in the sigmoid colon without evidence of diverticular bleeding and mucosal tear in the rectum, noted to be actively bleeding for which clips x2 were placed.  Due to poor prep follow up EGD/colonoscopy recommended in 1 year which was discussed w/patient. Pt noted to have borderline BP for which antihypertensive regimen was adjusted to only Entresto at current dosage. Hold parameters were discussed with the patient and she has her own BP cuff. Patient was also treated with a 3 day course of remdesivir per ID recommendations. Endocrinology was following for T2DM and adjustments to insulin were recommended as patient reported low blood glucoses in the AM at home. Patient is stable at this time for discharge with recommendation to follow up with GI, endocrinology, and cardiology was an outpatient.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Haemostasis, Hypotension, Oesophagogastroduodenoscopy abnormal, Pleuritic pain
Clinical narrative: 63y.o. female with a past medical history of type 2 diabetes mellitus, ischemic cardiomyopathy, ACS s/p stent x2 on in July 2022 who presented for chief complaint of rectal bleeding.  Patient reported large blood clots per rectum for the preceding 3 days.  She is currently on aspirin and Effient for recent history of stents.  Patient denied prior history of rectal bleeding, no history of colonoscopy in the past.  Patient also reported lightheadedness, cough and pleuritic chest pain aggravated by coughing.  Patient is fully vaccinated against COVID.  In the ED patient noted to have borderline hypotension, vitals otherwise stable.  Initial labs remarkable for creatinine 1.16, glucose 264, hemoglobin 8.6 (11.5 in). Additional information for Item 18:  in July), hematocrit 27.5, COVID-positive.  Aspirin and Effient recommended to be continued per academic cardiology service.  She was started on gentle fluids and was admitted with consult to GI, infectious disease, endocrinology, and cardiology services. Patient noted to have acute drop in hgb on 10/12 requiring 1unit PRBC. She subsequently underwent EGD/colonoscopy that day which was remarkable for esophageal mucosal changes classified as Barrett's stage C2-M3 per Prague criteria, diverticulosis in the sigmoid colon without evidence of diverticular bleeding and mucosal tear in the rectum, noted to be actively bleeding for which clips x2 were placed.  Due to poor prep follow up EGD/colonoscopy recommended in 1 year which was discussed w/patient. Pt noted to have borderline BP for which antihypertensive regimen was adjusted to only Entresto at current dosage. Hold parameters were discussed with the patient and she has her own BP cuff. Patient was also treated with a 3 day course of remdesivir per ID recommendations. Endocrinology was following for T2DM and adjustments to insulin were recommended as patient reported low blood glucoses in the AM at home. Patient is stable at this time for discharge with recommendation to follow up with GI, endocrinology, and cardiology was an outpatient.
Age: 61.0
Sex: M
Vaccine: COVID19
Symptoms: Rectal haemorrhage, Red blood cell transfusion, SARS-CoV-2 test positive, Thrombosis
Clinical narrative: 63y.o. female with a past medical history of type 2 diabetes mellitus, ischemic cardiomyopathy, ACS s/p stent x2 on in July 2022 who presented for chief complaint of rectal bleeding.  Patient reported large blood clots per rectum for the preceding 3 days.  She is currently on aspirin and Effient for recent history of stents.  Patient denied prior history of rectal bleeding, no history of colonoscopy in the past.  Patient also reported lightheadedness, cough and pleuritic chest pain aggravated by coughing.  Patient is fully vaccinated against COVID.  In the ED patient noted to have borderline hypotension, vitals otherwise stable.  Initial labs remarkable for creatinine 1.16, glucose 264, hemoglobin 8.6 (11.5 in). Additional information for Item 18:  in July), hematocrit 27.5, COVID-positive.  Aspirin and Effient recommended to be continued per academic cardiology service.  She was started on gentle fluids and was admitted with consult to GI, infectious disease, endocrinology, and cardiology services. Patient noted to have acute drop in hgb on 10/12 requiring 1unit PRBC. She subsequently underwent EGD/colonoscopy that day which was remarkable for esophageal mucosal changes classified as Barrett's stage C2-M3 per Prague criteria, diverticulosis in the sigmoid colon without evidence of diverticular bleeding and mucosal tear in the rectum, noted to be actively bleeding for which clips x2 were placed.  Due to poor prep follow up EGD/colonoscopy recommended in 1 year which was discussed w/patient. Pt noted to have borderline BP for which antihypertensive regimen was adjusted to only Entresto at current dosage. Hold parameters were discussed with the patient and she has her own BP cuff. Patient was also treated with a 3 day course of remdesivir per ID recommendations. Endocrinology was following for T2DM and adjustments to insulin were recommended as patient reported low blood glucoses in the AM at home. Patient is stable at this time for discharge with recommendation to follow up with GI, endocrinology, and cardiology was an outpatient.
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Colonoscopy, Diverticulum, Fatigue, Gastritis
Clinical narrative: 75y.o. female with a past medical history of PE, DVT on Eliquis, GERD, hypertension, thyroid cancer, hypothyroidism who presented to the ED for chief complaint of abnormal labs.  Patient noted to have hemoglobin of 6.5 on routine labs ordered by PCP.  Patient reported fatigue recently and believed that she may have contracted COVID 3 weeks ago from her husband however tested negative twice at home with the latest being 2 days ago.  She was found to be COVID-positive in the ED, she is fully vaccinated.  Initial labs remarkable for hemoglobin of 6.5, stool guaiac negative.  Patient was transfused 1 unit and of PRBCs.  She is admitted with consult to GI service and hematology. Patient underwent EGD/colonocsopy on 10/12
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Haemoglobin decreased, Haemorrhage intracranial, Laboratory test abnormal, Large intestine polyp, Occult blood negative
Clinical narrative: 75y.o. female with a past medical history of PE, DVT on Eliquis, GERD, hypertension, thyroid cancer, hypothyroidism who presented to the ED for chief complaint of abnormal labs.  Patient noted to have hemoglobin of 6.5 on routine labs ordered by PCP.  Patient reported fatigue recently and believed that she may have contracted COVID 3 weeks ago from her husband however tested negative twice at home with the latest being 2 days ago.  She was found to be COVID-positive in the ED, she is fully vaccinated.  Initial labs remarkable for hemoglobin of 6.5, stool guaiac negative.  Patient was transfused 1 unit and of PRBCs.  She is admitted with consult to GI service and hematology. Patient underwent EGD/colonocsopy on 10/12
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Oesophagogastroduodenoscopy, Red blood cell transfusion, SARS-CoV-2 test positive
Clinical narrative: 75y.o. female with a past medical history of PE, DVT on Eliquis, GERD, hypertension, thyroid cancer, hypothyroidism who presented to the ED for chief complaint of abnormal labs.  Patient noted to have hemoglobin of 6.5 on routine labs ordered by PCP.  Patient reported fatigue recently and believed that she may have contracted COVID 3 weeks ago from her husband however tested negative twice at home with the latest being 2 days ago.  She was found to be COVID-positive in the ED, she is fully vaccinated.  Initial labs remarkable for hemoglobin of 6.5, stool guaiac negative.  Patient was transfused 1 unit and of PRBCs.  She is admitted with consult to GI service and hematology. Patient underwent EGD/colonocsopy on 10/12
Age: 11.0
Sex: F
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient was inadvertently given the Pfizer Bivalent vaccine as her first Covid vaccine instead of the Monovalent vaccine.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cardiac pacemaker evaluation, Catheterisation cardiac abnormal, Chest X-ray normal, Computerised tomogram head normal
Clinical narrative: 90y.o. male with multiple medical problems including CAD, dementia, paroxysmal atrial fibrillation, sick sinus syndrome status post permanent pacemaker who presented to ED on 10/7/2022 from a local hospital for cardiology consultation.  Patient was evaluated at the hospital after sustaining a fall/syncopal episode.  Per notes his wife heard a noise and found patient on the floor. He had a scalp laceration that was repaired at a facility. His PPM was interrogated and showed a 2-minute run of V. tach. Troponin was elevated (175, 378, 504, 663). He underwent cardiac cath on 10/9 which showed multivessel disease, successful PCI and stent placement. Family requested transfer to our facility as this is where he receives most of his care. Patient was placed on IV heparin drip. CT head/cervical spine negative, chest x-ray, pelvic x-ray negative. He is now S/P post pacemaker upgrade to ICD implant by Dr. on 10/11/22. Pts post-operative course was complicated by confusion, fevers due to COVID-19 infection. He is s/p remdesivir and dexamethasone and has since been removed from isolation.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Computerised tomogram normal, Confusional state, Coronary arterial stent insertion, Coronary artery disease, Fall
Clinical narrative: 90y.o. male with multiple medical problems including CAD, dementia, paroxysmal atrial fibrillation, sick sinus syndrome status post permanent pacemaker who presented to ED on 10/7/2022 from a local hospital for cardiology consultation.  Patient was evaluated at the hospital after sustaining a fall/syncopal episode.  Per notes his wife heard a noise and found patient on the floor. He had a scalp laceration that was repaired at a facility. His PPM was interrogated and showed a 2-minute run of V. tach. Troponin was elevated (175, 378, 504, 663). He underwent cardiac cath on 10/9 which showed multivessel disease, successful PCI and stent placement. Family requested transfer to our facility as this is where he receives most of his care. Patient was placed on IV heparin drip. CT head/cervical spine negative, chest x-ray, pelvic x-ray negative. He is now S/P post pacemaker upgrade to ICD implant by Dr. on 10/11/22. Pts post-operative course was complicated by confusion, fevers due to COVID-19 infection. He is s/p remdesivir and dexamethasone and has since been removed from isolation.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Implantable defibrillator insertion, Percutaneous coronary intervention, Post procedural complication, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: 90y.o. male with multiple medical problems including CAD, dementia, paroxysmal atrial fibrillation, sick sinus syndrome status post permanent pacemaker who presented to ED on 10/7/2022 from a local hospital for cardiology consultation.  Patient was evaluated at the hospital after sustaining a fall/syncopal episode.  Per notes his wife heard a noise and found patient on the floor. He had a scalp laceration that was repaired at a facility. His PPM was interrogated and showed a 2-minute run of V. tach. Troponin was elevated (175, 378, 504, 663). He underwent cardiac cath on 10/9 which showed multivessel disease, successful PCI and stent placement. Family requested transfer to our facility as this is where he receives most of his care. Patient was placed on IV heparin drip. CT head/cervical spine negative, chest x-ray, pelvic x-ray negative. He is now S/P post pacemaker upgrade to ICD implant by Dr. on 10/11/22. Pts post-operative course was complicated by confusion, fevers due to COVID-19 infection. He is s/p remdesivir and dexamethasone and has since been removed from isolation.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Skin laceration, Syncope, Troponin increased, Ventricular tachycardia, Wound closure
Clinical narrative: 90y.o. male with multiple medical problems including CAD, dementia, paroxysmal atrial fibrillation, sick sinus syndrome status post permanent pacemaker who presented to ED on 10/7/2022 from a local hospital for cardiology consultation.  Patient was evaluated at the hospital after sustaining a fall/syncopal episode.  Per notes his wife heard a noise and found patient on the floor. He had a scalp laceration that was repaired at a facility. His PPM was interrogated and showed a 2-minute run of V. tach. Troponin was elevated (175, 378, 504, 663). He underwent cardiac cath on 10/9 which showed multivessel disease, successful PCI and stent placement. Family requested transfer to our facility as this is where he receives most of his care. Patient was placed on IV heparin drip. CT head/cervical spine negative, chest x-ray, pelvic x-ray negative. He is now S/P post pacemaker upgrade to ICD implant by Dr. on 10/11/22. Pts post-operative course was complicated by confusion, fevers due to COVID-19 infection. He is s/p remdesivir and dexamethasone and has since been removed from isolation.
Age: 89.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: X-ray of pelvis and hip normal
Clinical narrative: 90y.o. male with multiple medical problems including CAD, dementia, paroxysmal atrial fibrillation, sick sinus syndrome status post permanent pacemaker who presented to ED on 10/7/2022 from a local hospital for cardiology consultation.  Patient was evaluated at the hospital after sustaining a fall/syncopal episode.  Per notes his wife heard a noise and found patient on the floor. He had a scalp laceration that was repaired at a facility. His PPM was interrogated and showed a 2-minute run of V. tach. Troponin was elevated (175, 378, 504, 663). He underwent cardiac cath on 10/9 which showed multivessel disease, successful PCI and stent placement. Family requested transfer to our facility as this is where he receives most of his care. Patient was placed on IV heparin drip. CT head/cervical spine negative, chest x-ray, pelvic x-ray negative. He is now S/P post pacemaker upgrade to ICD implant by Dr. on 10/11/22. Pts post-operative course was complicated by confusion, fevers due to COVID-19 infection. He is s/p remdesivir and dexamethasone and has since been removed from isolation.
Age: 70.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Aphonia, Asthenia, COVID-19, Headache, Oropharyngeal pain
Clinical narrative: I was fine in the morning when I woke up and went to church. I had lunch with a friend, during lunch my throat started hurting. I was unable to donate blood as a precaution. On Monday my throat was much worse, so I made an appointment to go in and be tested for strep throat. On Tuesday I went in and had a rapid antigen COVID-19 test that came back positive. I had a headache, no fever, lost my voice for three weeks and a really bad sore throat, no cough. Little sinus drainage, no energy. I came home rested did not take any medication, just used my supplements and I am feeling much better.
Age: 70.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Paranasal sinus hypersecretion, SARS-CoV-2 test positive
Clinical narrative: I was fine in the morning when I woke up and went to church. I had lunch with a friend, during lunch my throat started hurting. I was unable to donate blood as a precaution. On Monday my throat was much worse, so I made an appointment to go in and be tested for strep throat. On Tuesday I went in and had a rapid antigen COVID-19 test that came back positive. I had a headache, no fever, lost my voice for three weeks and a really bad sore throat, no cough. Little sinus drainage, no energy. I came home rested did not take any medication, just used my supplements and I am feeling much better.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Aggression, COVID-19, Confusional state, Conversion disorder, Dehydration
Clinical narrative: The patient is a 82y.o.  male admitted at a local Hospital since 10/7/2022  8:38 PM with the diagnoses of Hypernatremia.  Patient has a history of dementia and has been living at a assisted living facility.  And has been exhibiting aggressive behaviors on and off.  He has been refusing his psychotropic medications.  The patient was in the process of being transferred to a Geri psych unit however being admitted to our medical floor for treatment of dehydration.  Patient has a bed waiting at another Hospital    Patient continues to be confused.  He is unable to have a logical conversation.
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hypernatraemia, Refusal of treatment by patient, SARS-CoV-2 test positive
Clinical narrative: The patient is a 82y.o.  male admitted at a local Hospital since 10/7/2022  8:38 PM with the diagnoses of Hypernatremia.  Patient has a history of dementia and has been living at a assisted living facility.  And has been exhibiting aggressive behaviors on and off.  He has been refusing his psychotropic medications.  The patient was in the process of being transferred to a Geri psych unit however being admitted to our medical floor for treatment of dehydration.  Patient has a bed waiting at another Hospital    Patient continues to be confused.  He is unable to have a logical conversation.
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest pain, Coronary artery bypass, Coronary artery disease, Electrocardiogram ST segment depression
Clinical narrative: 67 year old female admitted to local Hospital with chest pain.  The chest pain has been pesent for 2-3 weeks prior to admission. The patient was scheduled for a stress 10/7, overnight she had intermittent worsening chest pain . The chest pain was substernal, radiated to her left arm, and was described as an aching sensation. In the  EC she was hypertensive (185/74) and tachycardic (110's). A Level I AMI was paged due to EKG concerning for ischemia, with ST elevation in aVR and diffuse ST depression. Due to patient's hemodynamic instability and critical left main disease, patient was scheduled for emergent CABG on 10/7/2022. The patient was taken to the operating room on 10/07/2022 and underwent the
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Electrocardiogram ST segment elevation, Hypertension, Intensive care, Pain, SARS-CoV-2 test positive
Clinical narrative: 67 year old female admitted to local Hospital with chest pain.  The chest pain has been pesent for 2-3 weeks prior to admission. The patient was scheduled for a stress 10/7, overnight she had intermittent worsening chest pain . The chest pain was substernal, radiated to her left arm, and was described as an aching sensation. In the  EC she was hypertensive (185/74) and tachycardic (110's). A Level I AMI was paged due to EKG concerning for ischemia, with ST elevation in aVR and diffuse ST depression. Due to patient's hemodynamic instability and critical left main disease, patient was scheduled for emergent CABG on 10/7/2022. The patient was taken to the operating room on 10/07/2022 and underwent the
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Tachycardia
Clinical narrative: 67 year old female admitted to local Hospital with chest pain.  The chest pain has been pesent for 2-3 weeks prior to admission. The patient was scheduled for a stress 10/7, overnight she had intermittent worsening chest pain . The chest pain was substernal, radiated to her left arm, and was described as an aching sensation. In the  EC she was hypertensive (185/74) and tachycardic (110's). A Level I AMI was paged due to EKG concerning for ischemia, with ST elevation in aVR and diffuse ST depression. Due to patient's hemodynamic instability and critical left main disease, patient was scheduled for emergent CABG on 10/7/2022. The patient was taken to the operating room on 10/07/2022 and underwent the
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood alkaline phosphatase increased, COVID-19, Computerised tomogram abdomen abnormal
Clinical narrative: a 82y.o. female with history of CAD hypertension A. fib on Eliquis, asthma, GERD, hyperlipidemia, hypothyroidism, hypertension presented with complaints of diarrhea  On admission vitals were stable.  Labs showed elevated liver function tests ALP of 139 AST 60, ALT of 41.  White count 3.2.  COVID-19 was positive. CT abdomen and pelvis showed SMA artery stenosis .   Patient presented with diarrhea  Stable T11 compression fracture.  C. difficile was ordered however as diarrhea resolved was not sent . Patient needs outpatient follow-up with orthopedic spine   For stable T11 compression fracture. PT OT evaluated recommended home with home health care.  Discussed with patient and husband Were agreeable with the plan.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Diarrhoea, Laboratory test, Liver function test increased, Mesenteric artery stenosis, SARS-CoV-2 test positive
Clinical narrative: a 82y.o. female with history of CAD hypertension A. fib on Eliquis, asthma, GERD, hyperlipidemia, hypothyroidism, hypertension presented with complaints of diarrhea  On admission vitals were stable.  Labs showed elevated liver function tests ALP of 139 AST 60, ALT of 41.  White count 3.2.  COVID-19 was positive. CT abdomen and pelvis showed SMA artery stenosis .   Patient presented with diarrhea  Stable T11 compression fracture.  C. difficile was ordered however as diarrhea resolved was not sent . Patient needs outpatient follow-up with orthopedic spine   For stable T11 compression fracture. PT OT evaluated recommended home with home health care.  Discussed with patient and husband Were agreeable with the plan.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Spinal compression fracture, Thoracic vertebral fracture, White blood cell count decreased
Clinical narrative: a 82y.o. female with history of CAD hypertension A. fib on Eliquis, asthma, GERD, hyperlipidemia, hypothyroidism, hypertension presented with complaints of diarrhea  On admission vitals were stable.  Labs showed elevated liver function tests ALP of 139 AST 60, ALT of 41.  White count 3.2.  COVID-19 was positive. CT abdomen and pelvis showed SMA artery stenosis .   Patient presented with diarrhea  Stable T11 compression fracture.  C. difficile was ordered however as diarrhea resolved was not sent . Patient needs outpatient follow-up with orthopedic spine   For stable T11 compression fracture. PT OT evaluated recommended home with home health care.  Discussed with patient and husband Were agreeable with the plan.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Asthma, Blood lactate dehydrogenase increased, C-reactive protein increased, COVID-19, Chest X-ray abnormal
Clinical narrative: 58y.o. female with history of OSA on BiPAP, asthma, chronic respiratory failure on 3 L home oxygen, anxiety, depression presented due to complaints of difficulty in breathing,. On admission vitals were stable.  Labs showed LDH 242, CRP 37.8.  COVID-19 positive Chest x-ray showed a hazy opacity in the left costophrenic angle likely artifact. Next day after admission patient became more short of breath was placed on BiPAP Paxlovid was stopped and started on remdesivir.   Patient completed remdesivir during the hospital stay.  Was started on On IV steroids later switched to p.o. on discharge at the tapered dose for asthma exacerbation.  Patient improved during hospital stay, was back to 3 L oxygen.  Patient says she has oxygen at home , also had a portable tank with her .  Discussed with pulmonary cleared the patient for discharge, will need to follow-up outpatient with pulmonary, primary care.
Age: 56.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Dyspnoea, Lung opacity, Positive airway pressure therapy, SARS-CoV-2 test positive
Clinical narrative: 58y.o. female with history of OSA on BiPAP, asthma, chronic respiratory failure on 3 L home oxygen, anxiety, depression presented due to complaints of difficulty in breathing,. On admission vitals were stable.  Labs showed LDH 242, CRP 37.8.  COVID-19 positive Chest x-ray showed a hazy opacity in the left costophrenic angle likely artifact. Next day after admission patient became more short of breath was placed on BiPAP Paxlovid was stopped and started on remdesivir.   Patient completed remdesivir during the hospital stay.  Was started on On IV steroids later switched to p.o. on discharge at the tapered dose for asthma exacerbation.  Patient improved during hospital stay, was back to 3 L oxygen.  Patient says she has oxygen at home , also had a portable tank with her .  Discussed with pulmonary cleared the patient for discharge, will need to follow-up outpatient with pulmonary, primary care.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Dysuria, Nausea, Pollakiuria, SARS-CoV-2 test positive
Clinical narrative: 33 y/o female G1P0 and COVID ~ 1 month ago.  She presented to the hospital with intractable nausea/vomiting that has been going on for the last week.  Was seen at an Urgent Care about 2 days ago for dysuria and urinary frequency.  Diagnosed with UTI and started on Keflex.  She came to the Urgent Care due to persistent nausea/vomiting.  D/c home with outpatient OB follow-up.
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Urinary tract infection, Vomiting
Clinical narrative: 33 y/o female G1P0 and COVID ~ 1 month ago.  She presented to the hospital with intractable nausea/vomiting that has been going on for the last week.  Was seen at an Urgent Care about 2 days ago for dysuria and urinary frequency.  Diagnosed with UTI and started on Keflex.  She came to the Urgent Care due to persistent nausea/vomiting.  D/c home with outpatient OB follow-up.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Aspartate aminotransferase increased, Blood creatinine normal, Blood ethanol, Blood lactic acid
Clinical narrative: 39 yo female w/ hx of anxiety, depression, GERD, MVP, ETOH abuse, suicidal ideation who presented to ED secondary to drug overdose. Pt reported insomnia and was taking unprescribed medications from a friend, including Ambien, fentanyl. Upon arrival to ED, BP 90/62, HR 114, afebrile. WBC 18.9, Hgb 12.9, plts 384. Na 142, Cr 0.97, AST 36. LA 3.1. Trops 0.25, 0.48. EKG w/ sinus tachy. +COVID. UDS + fentanyl. ETOH <10. UA w/o infx. IVFs given. Hep gtt initiated. Placed on CIWA protocol. Pt admitted for further care. Psych consulted. Pt denies suicidal ideations. Suicide precautions lifted. Cleared for dc home.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood sodium normal, COVID-19, Drug screen positive, Electrocardiogram abnormal, Haemoglobin normal
Clinical narrative: 39 yo female w/ hx of anxiety, depression, GERD, MVP, ETOH abuse, suicidal ideation who presented to ED secondary to drug overdose. Pt reported insomnia and was taking unprescribed medications from a friend, including Ambien, fentanyl. Upon arrival to ED, BP 90/62, HR 114, afebrile. WBC 18.9, Hgb 12.9, plts 384. Na 142, Cr 0.97, AST 36. LA 3.1. Trops 0.25, 0.48. EKG w/ sinus tachy. +COVID. UDS + fentanyl. ETOH <10. UA w/o infx. IVFs given. Hep gtt initiated. Placed on CIWA protocol. Pt admitted for further care. Psych consulted. Pt denies suicidal ideations. Suicide precautions lifted. Cleared for dc home.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Insomnia, Overdose, Platelet count normal, SARS-CoV-2 test positive, Sinus tachycardia
Clinical narrative: 39 yo female w/ hx of anxiety, depression, GERD, MVP, ETOH abuse, suicidal ideation who presented to ED secondary to drug overdose. Pt reported insomnia and was taking unprescribed medications from a friend, including Ambien, fentanyl. Upon arrival to ED, BP 90/62, HR 114, afebrile. WBC 18.9, Hgb 12.9, plts 384. Na 142, Cr 0.97, AST 36. LA 3.1. Trops 0.25, 0.48. EKG w/ sinus tachy. +COVID. UDS + fentanyl. ETOH <10. UA w/o infx. IVFs given. Hep gtt initiated. Placed on CIWA protocol. Pt admitted for further care. Psych consulted. Pt denies suicidal ideations. Suicide precautions lifted. Cleared for dc home.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Troponin, Urine analysis normal, White blood cell count increased
Clinical narrative: 39 yo female w/ hx of anxiety, depression, GERD, MVP, ETOH abuse, suicidal ideation who presented to ED secondary to drug overdose. Pt reported insomnia and was taking unprescribed medications from a friend, including Ambien, fentanyl. Upon arrival to ED, BP 90/62, HR 114, afebrile. WBC 18.9, Hgb 12.9, plts 384. Na 142, Cr 0.97, AST 36. LA 3.1. Trops 0.25, 0.48. EKG w/ sinus tachy. +COVID. UDS + fentanyl. ETOH <10. UA w/o infx. IVFs given. Hep gtt initiated. Placed on CIWA protocol. Pt admitted for further care. Psych consulted. Pt denies suicidal ideations. Suicide precautions lifted. Cleared for dc home.
Age: 30.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Delivery, Maternal exposure before pregnancy
Clinical narrative: Delivery Date: 10/10/2022  Delivery Time: 9:27 AM  Gestational Age(weeks days/7): 39 6/7      Method of Delivery: Vaginal, Spontaneous    Baby:
Age: 46.0
Sex: M
Vaccine: COVID19-2
Symptoms: No adverse event, Underdose
Clinical narrative: Patient who is an adult was given 0.25mL of the Moderna Bivalent COVID booster vaccine, which is less than the authorized dose of 0.50mL.  No adverse events were noted at the time of the administration.
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Anxiety, COVID-19, Cough, Dyspnoea, Hypertension
Clinical narrative: Hospital Course:  Cough 1 mo sob 2 days likley old covid inf per id doesn t qualify for paxlovid no risk factors for progression rec to cont doxy at dc total 5d for CAP htn bp elevated but pt very anxious; will send Vn to help fu op bp advised to self monitor and go see pcp 7d for fu Ibs, mctd, stable
Age: 84.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Pneumonia, SARS-CoV-2 test positive
Clinical narrative: Hospital Course:  Cough 1 mo sob 2 days likley old covid inf per id doesn t qualify for paxlovid no risk factors for progression rec to cont doxy at dc total 5d for CAP htn bp elevated but pt very anxious; will send Vn to help fu op bp advised to self monitor and go see pcp 7d for fu Ibs, mctd, stable
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, COVID-19, Death, Diarrhoea, Gastrointestinal haemorrhage
Clinical narrative: pt had a recent hospitalization (unsure on date and length of time) with a dx of COVID and GI bleed; general surgery consult said pt did not have a significant bleed and was able to be put back on anticoagulant; was dc'd to home with diarrhea; had been home 4 days before family was unable to reach pt, called for a welfare check; EMS found pt with no signs of life; brought to ED for evaluation; pt pronounced deceased at Hospital
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Blood cortisol, Blood sodium decreased, COVID-19, Dyspnoea, Fatigue
Clinical narrative: The patient is a 76-year-old male, who presented from home to the emergency room for more shortness of breath and fatigue and his pulse ox dropping.  In the emergency room, he was positive for active COVID (he has 2 immunizations from "Evusheld."  He is an ex-smoker with a history of non-Hodgkin's lymphoma, diagnosed 6 years ago and his last chemotherapy was about 6 months ago.  He denies chest pain and his blood pressure is low, though he has a history of hypertension.  His sodium was low as was his white blood count.  He has a history of coronary artery disease with prior myocardial infarction, gastrointestinal bleeding, and hyperlipidemia. Additional information for Item 18:  HOSPITAL COURSE:  The patient was seen in consultation by Dr. from Infectious Disease and Dr. from Pulmonary.    The patient was treated initially with his usual medications including intravenous fluids, electrolytes, oxygen, respiratory bronchodilators, and was started on dexamethasone and Remdesivir.  Dr. directed COVID therapy.  Dr. requested a TSA and cortisol level, which was drawn. He improved symptomatically.  His inflammatory markers improved significantly and he was subsequently discharged home on 10/14/2022 to follow up with Dr. from Oncology and Dr., his primary care doctor.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Hypotension, Inflammatory marker test, Oxygen saturation decreased, SARS-CoV-2 test positive, White blood cell count decreased
Clinical narrative: The patient is a 76-year-old male, who presented from home to the emergency room for more shortness of breath and fatigue and his pulse ox dropping.  In the emergency room, he was positive for active COVID (he has 2 immunizations from "Evusheld."  He is an ex-smoker with a history of non-Hodgkin's lymphoma, diagnosed 6 years ago and his last chemotherapy was about 6 months ago.  He denies chest pain and his blood pressure is low, though he has a history of hypertension.  His sodium was low as was his white blood count.  He has a history of coronary artery disease with prior myocardial infarction, gastrointestinal bleeding, and hyperlipidemia. Additional information for Item 18:  HOSPITAL COURSE:  The patient was seen in consultation by Dr. from Infectious Disease and Dr. from Pulmonary.    The patient was treated initially with his usual medications including intravenous fluids, electrolytes, oxygen, respiratory bronchodilators, and was started on dexamethasone and Remdesivir.  Dr. directed COVID therapy.  Dr. requested a TSA and cortisol level, which was drawn. He improved symptomatically.  His inflammatory markers improved significantly and he was subsequently discharged home on 10/14/2022 to follow up with Dr. from Oncology and Dr., his primary care doctor.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Atrioventricular block first degree, Bifascicular block, Blood bicarbonate decreased, Blood potassium increased
Clinical narrative: 71y.o. male with a past medical history of ESRD on HD, DM 2, HTN, dyslipidemia, GERD, orthostatic hypotension who presented to the ED for cc of dizziness. Patient was previously admitted on 10/4-10/7 for similar symptoms and was found to be with orthostatic hypotension. Patient was then noted to have EKG sinus rhythm with first-degree AV block, bifascicular block and EP evaluated. 2D echo with normal LVEF, no wall motion abnormalities. OP evaluation for PPM was recommended and patient was stable for discharge. Shortly after discharge he developed cough, weakness, and dizziness with fall. He does not believe he hit his head. Patient is fully vaccinated against COVID, and has received booster. In the ED, vitals noted Additional information for Item 18:  to be stable. Initial labs remarkable for bicarb 18, potassium 6.1 (hemolyzed)> 4.2, hgb 12.2, troponin 0.09 > 0.12 > 0.11 > 0.10. COVID was positive. EKG w/with normal sinus rhythm, occasional PACs, first-degree AV block. Head CT negative.  CXR with stable RLL opacity and small left pleural effusion.  Patient was admitted with consult to ID, nephrology and EP. Per EP, no need for pacemaker now, however he may require in the future if conduction disease worsens.  Orthostatics were negative. ID recommended a course of remdesivir x3 days. Patient remained stable on RA and did not require steroids. PT/OT rec HHC. HD can accept pt while being COVID+. Over the course of his hospital stay, he remained clinically stable. He is recommended to follow up with cardiology as an OP if needed.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest X-ray abnormal, Computerised tomogram head normal, Condition aggravated, Cough
Clinical narrative: 71y.o. male with a past medical history of ESRD on HD, DM 2, HTN, dyslipidemia, GERD, orthostatic hypotension who presented to the ED for cc of dizziness. Patient was previously admitted on 10/4-10/7 for similar symptoms and was found to be with orthostatic hypotension. Patient was then noted to have EKG sinus rhythm with first-degree AV block, bifascicular block and EP evaluated. 2D echo with normal LVEF, no wall motion abnormalities. OP evaluation for PPM was recommended and patient was stable for discharge. Shortly after discharge he developed cough, weakness, and dizziness with fall. He does not believe he hit his head. Patient is fully vaccinated against COVID, and has received booster. In the ED, vitals noted Additional information for Item 18:  to be stable. Initial labs remarkable for bicarb 18, potassium 6.1 (hemolyzed)> 4.2, hgb 12.2, troponin 0.09 > 0.12 > 0.11 > 0.10. COVID was positive. EKG w/with normal sinus rhythm, occasional PACs, first-degree AV block. Head CT negative.  CXR with stable RLL opacity and small left pleural effusion.  Patient was admitted with consult to ID, nephrology and EP. Per EP, no need for pacemaker now, however he may require in the future if conduction disease worsens.  Orthostatics were negative. ID recommended a course of remdesivir x3 days. Patient remained stable on RA and did not require steroids. PT/OT rec HHC. HD can accept pt while being COVID+. Over the course of his hospital stay, he remained clinically stable. He is recommended to follow up with cardiology as an OP if needed.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dizziness, Echocardiogram normal, Ejection fraction, Electrocardiogram abnormal, Fall
Clinical narrative: 71y.o. male with a past medical history of ESRD on HD, DM 2, HTN, dyslipidemia, GERD, orthostatic hypotension who presented to the ED for cc of dizziness. Patient was previously admitted on 10/4-10/7 for similar symptoms and was found to be with orthostatic hypotension. Patient was then noted to have EKG sinus rhythm with first-degree AV block, bifascicular block and EP evaluated. 2D echo with normal LVEF, no wall motion abnormalities. OP evaluation for PPM was recommended and patient was stable for discharge. Shortly after discharge he developed cough, weakness, and dizziness with fall. He does not believe he hit his head. Patient is fully vaccinated against COVID, and has received booster. In the ED, vitals noted Additional information for Item 18:  to be stable. Initial labs remarkable for bicarb 18, potassium 6.1 (hemolyzed)> 4.2, hgb 12.2, troponin 0.09 > 0.12 > 0.11 > 0.10. COVID was positive. EKG w/with normal sinus rhythm, occasional PACs, first-degree AV block. Head CT negative.  CXR with stable RLL opacity and small left pleural effusion.  Patient was admitted with consult to ID, nephrology and EP. Per EP, no need for pacemaker now, however he may require in the future if conduction disease worsens.  Orthostatics were negative. ID recommended a course of remdesivir x3 days. Patient remained stable on RA and did not require steroids. PT/OT rec HHC. HD can accept pt while being COVID+. Over the course of his hospital stay, he remained clinically stable. He is recommended to follow up with cardiology as an OP if needed.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Haemoglobin decreased, Lung opacity, Orthostatic hypotension, Pleural effusion, SARS-CoV-2 test positive
Clinical narrative: 71y.o. male with a past medical history of ESRD on HD, DM 2, HTN, dyslipidemia, GERD, orthostatic hypotension who presented to the ED for cc of dizziness. Patient was previously admitted on 10/4-10/7 for similar symptoms and was found to be with orthostatic hypotension. Patient was then noted to have EKG sinus rhythm with first-degree AV block, bifascicular block and EP evaluated. 2D echo with normal LVEF, no wall motion abnormalities. OP evaluation for PPM was recommended and patient was stable for discharge. Shortly after discharge he developed cough, weakness, and dizziness with fall. He does not believe he hit his head. Patient is fully vaccinated against COVID, and has received booster. In the ED, vitals noted Additional information for Item 18:  to be stable. Initial labs remarkable for bicarb 18, potassium 6.1 (hemolyzed)> 4.2, hgb 12.2, troponin 0.09 > 0.12 > 0.11 > 0.10. COVID was positive. EKG w/with normal sinus rhythm, occasional PACs, first-degree AV block. Head CT negative.  CXR with stable RLL opacity and small left pleural effusion.  Patient was admitted with consult to ID, nephrology and EP. Per EP, no need for pacemaker now, however he may require in the future if conduction disease worsens.  Orthostatics were negative. ID recommended a course of remdesivir x3 days. Patient remained stable on RA and did not require steroids. PT/OT rec HHC. HD can accept pt while being COVID+. Over the course of his hospital stay, he remained clinically stable. He is recommended to follow up with cardiology as an OP if needed.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Sinus rhythm, Supraventricular extrasystoles, Troponin
Clinical narrative: 71y.o. male with a past medical history of ESRD on HD, DM 2, HTN, dyslipidemia, GERD, orthostatic hypotension who presented to the ED for cc of dizziness. Patient was previously admitted on 10/4-10/7 for similar symptoms and was found to be with orthostatic hypotension. Patient was then noted to have EKG sinus rhythm with first-degree AV block, bifascicular block and EP evaluated. 2D echo with normal LVEF, no wall motion abnormalities. OP evaluation for PPM was recommended and patient was stable for discharge. Shortly after discharge he developed cough, weakness, and dizziness with fall. He does not believe he hit his head. Patient is fully vaccinated against COVID, and has received booster. In the ED, vitals noted Additional information for Item 18:  to be stable. Initial labs remarkable for bicarb 18, potassium 6.1 (hemolyzed)> 4.2, hgb 12.2, troponin 0.09 > 0.12 > 0.11 > 0.10. COVID was positive. EKG w/with normal sinus rhythm, occasional PACs, first-degree AV block. Head CT negative.  CXR with stable RLL opacity and small left pleural effusion.  Patient was admitted with consult to ID, nephrology and EP. Per EP, no need for pacemaker now, however he may require in the future if conduction disease worsens.  Orthostatics were negative. ID recommended a course of remdesivir x3 days. Patient remained stable on RA and did not require steroids. PT/OT rec HHC. HD can accept pt while being COVID+. Over the course of his hospital stay, he remained clinically stable. He is recommended to follow up with cardiology as an OP if needed.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chemotherapy, Diarrhoea, Febrile neutropenia, SARS-CoV-2 test positive
Clinical narrative: 68y.o. female known to me from previous hospitalization with recent diagnosis of Spindle cell sarcoma with initial evidence of SVC syndrome.  Patient receiving chemotherapy with initial doses (AIM) causing neutropenic fever and diarrheal stools. She was admitted on 10/10/22 for cycle 2 of chemotherapy.  Initial COVID test on admission Positive but determined to be persistence of viral particles in nasopharynx from prior infection in late June 2022 (rx with paxlovid). No isolation recommended.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Spindle cell sarcoma, Superior vena cava syndrome
Clinical narrative: 68y.o. female known to me from previous hospitalization with recent diagnosis of Spindle cell sarcoma with initial evidence of SVC syndrome.  Patient receiving chemotherapy with initial doses (AIM) causing neutropenic fever and diarrheal stools. She was admitted on 10/10/22 for cycle 2 of chemotherapy.  Initial COVID test on admission Positive but determined to be persistence of viral particles in nasopharynx from prior infection in late June 2022 (rx with paxlovid). No isolation recommended.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Acute kidney injury, COVID-19, Electrolyte depletion, Electrolyte substitution therapy
Clinical narrative: 57 years old male with a PMH significant for hearing loss, T2DM, HTN who was sent to hospital on 10/10/2022 from an office visit at hospital with a chief complaint of diffuse abdominal pain of 4 weeks of duration. All communication was assisted by sign language interpreter. On 10/12/2022, he reported his abdominal pain has improved and he was able to eat and drink. AKI has improved and electrolytes were repleted. ID recommended monitoring symptoms as he has a mild case with no symptoms.
Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypophagia, SARS-CoV-2 test positive
Clinical narrative: 57 years old male with a PMH significant for hearing loss, T2DM, HTN who was sent to hospital on 10/10/2022 from an office visit at hospital with a chief complaint of diffuse abdominal pain of 4 weeks of duration. All communication was assisted by sign language interpreter. On 10/12/2022, he reported his abdominal pain has improved and he was able to eat and drink. AKI has improved and electrolytes were repleted. ID recommended monitoring symptoms as he has a mild case with no symptoms.