chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Asthenia, Atrial fibrillation
Clinical narrative: The patient is a 77 y.o. female patient of a MD with history of chronic back pain, GERD, HLD, paroxysmal afib on coumadin, HTN, and peripheral neuropathy presented to the Hospital with cough and weakness.   Acute hypoxic respiratory failure d/t COVID-19 pneumonia P/w 1 week history of headache, dry cough, and weakness. Pt reporting diarrhea x 2 days, now resolved (took imodium at home). Mild wheezing on exam, improved Pt fully vaccinated plus one booster Afebrile. Pt initially hypoxic at 87%, now satting >94% on  room air ambulating CRP nl CXR: Perihilar coarsened interstitial markings and bronchial wall thickening Decadron 6mg daily for 10 days  Encourage IS use PT/OT/SW   Acute kidney injury vs CKD Initial Cr 1.1 remain at same level x 3, probably pt's baseline. GFR 50.  Likely prerenal given poor PO intake secondary to diarrhea and COVID UA and urine culture ordered   P Atrial fibrillation HTN/ HLD HDS on admission, slightly bradycardic ~ 59 Continue coumadin, flecainide, and diltiazem Pharmacy consulted for warfarin dosing, therapeutic now 3.5   Pre- DM Hba1c 5.9 BS elevated in context of steroids therapy. Diet education before discharge   Chronic back pain PRN tylenol
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Blood creatinine normal, Blood glucose increased, Bradycardia, Bronchial wall thickening, C-reactive protein normal
Clinical narrative: The patient is a 77 y.o. female patient of a MD with history of chronic back pain, GERD, HLD, paroxysmal afib on coumadin, HTN, and peripheral neuropathy presented to the Hospital with cough and weakness.   Acute hypoxic respiratory failure d/t COVID-19 pneumonia P/w 1 week history of headache, dry cough, and weakness. Pt reporting diarrhea x 2 days, now resolved (took imodium at home). Mild wheezing on exam, improved Pt fully vaccinated plus one booster Afebrile. Pt initially hypoxic at 87%, now satting >94% on  room air ambulating CRP nl CXR: Perihilar coarsened interstitial markings and bronchial wall thickening Decadron 6mg daily for 10 days  Encourage IS use PT/OT/SW   Acute kidney injury vs CKD Initial Cr 1.1 remain at same level x 3, probably pt's baseline. GFR 50.  Likely prerenal given poor PO intake secondary to diarrhea and COVID UA and urine culture ordered   P Atrial fibrillation HTN/ HLD HDS on admission, slightly bradycardic ~ 59 Continue coumadin, flecainide, and diltiazem Pharmacy consulted for warfarin dosing, therapeutic now 3.5   Pre- DM Hba1c 5.9 BS elevated in context of steroids therapy. Diet education before discharge   Chronic back pain PRN tylenol
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chronic kidney disease, Condition aggravated
Clinical narrative: The patient is a 77 y.o. female patient of a MD with history of chronic back pain, GERD, HLD, paroxysmal afib on coumadin, HTN, and peripheral neuropathy presented to the Hospital with cough and weakness.   Acute hypoxic respiratory failure d/t COVID-19 pneumonia P/w 1 week history of headache, dry cough, and weakness. Pt reporting diarrhea x 2 days, now resolved (took imodium at home). Mild wheezing on exam, improved Pt fully vaccinated plus one booster Afebrile. Pt initially hypoxic at 87%, now satting >94% on  room air ambulating CRP nl CXR: Perihilar coarsened interstitial markings and bronchial wall thickening Decadron 6mg daily for 10 days  Encourage IS use PT/OT/SW   Acute kidney injury vs CKD Initial Cr 1.1 remain at same level x 3, probably pt's baseline. GFR 50.  Likely prerenal given poor PO intake secondary to diarrhea and COVID UA and urine culture ordered   P Atrial fibrillation HTN/ HLD HDS on admission, slightly bradycardic ~ 59 Continue coumadin, flecainide, and diltiazem Pharmacy consulted for warfarin dosing, therapeutic now 3.5   Pre- DM Hba1c 5.9 BS elevated in context of steroids therapy. Diet education before discharge   Chronic back pain PRN tylenol
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Diarrhoea, Glomerular filtration rate decreased, Glucose tolerance impaired, Glycosylated haemoglobin increased
Clinical narrative: The patient is a 77 y.o. female patient of a MD with history of chronic back pain, GERD, HLD, paroxysmal afib on coumadin, HTN, and peripheral neuropathy presented to the Hospital with cough and weakness.   Acute hypoxic respiratory failure d/t COVID-19 pneumonia P/w 1 week history of headache, dry cough, and weakness. Pt reporting diarrhea x 2 days, now resolved (took imodium at home). Mild wheezing on exam, improved Pt fully vaccinated plus one booster Afebrile. Pt initially hypoxic at 87%, now satting >94% on  room air ambulating CRP nl CXR: Perihilar coarsened interstitial markings and bronchial wall thickening Decadron 6mg daily for 10 days  Encourage IS use PT/OT/SW   Acute kidney injury vs CKD Initial Cr 1.1 remain at same level x 3, probably pt's baseline. GFR 50.  Likely prerenal given poor PO intake secondary to diarrhea and COVID UA and urine culture ordered   P Atrial fibrillation HTN/ HLD HDS on admission, slightly bradycardic ~ 59 Continue coumadin, flecainide, and diltiazem Pharmacy consulted for warfarin dosing, therapeutic now 3.5   Pre- DM Hba1c 5.9 BS elevated in context of steroids therapy. Diet education before discharge   Chronic back pain PRN tylenol
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Hyperlipidaemia, Hypertension, Hypophagia, Interstitial lung disease
Clinical narrative: The patient is a 77 y.o. female patient of a MD with history of chronic back pain, GERD, HLD, paroxysmal afib on coumadin, HTN, and peripheral neuropathy presented to the Hospital with cough and weakness.   Acute hypoxic respiratory failure d/t COVID-19 pneumonia P/w 1 week history of headache, dry cough, and weakness. Pt reporting diarrhea x 2 days, now resolved (took imodium at home). Mild wheezing on exam, improved Pt fully vaccinated plus one booster Afebrile. Pt initially hypoxic at 87%, now satting >94% on  room air ambulating CRP nl CXR: Perihilar coarsened interstitial markings and bronchial wall thickening Decadron 6mg daily for 10 days  Encourage IS use PT/OT/SW   Acute kidney injury vs CKD Initial Cr 1.1 remain at same level x 3, probably pt's baseline. GFR 50.  Likely prerenal given poor PO intake secondary to diarrhea and COVID UA and urine culture ordered   P Atrial fibrillation HTN/ HLD HDS on admission, slightly bradycardic ~ 59 Continue coumadin, flecainide, and diltiazem Pharmacy consulted for warfarin dosing, therapeutic now 3.5   Pre- DM Hba1c 5.9 BS elevated in context of steroids therapy. Diet education before discharge   Chronic back pain PRN tylenol
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Ear pain, Neck pain, Pain in jaw, Sinusitis, Toothache
Clinical narrative: 2/24/2023 Pain started in right ear and then went down into upper teeth, followed by lower teeth, and then jaw and then into the neck. This happened over the course of 5 days. Saw Doctor 3/1, upon examination, diagnosed as a sinus infection. Proscribed Amoxiclav for 14 days. This did clear up slowly over the course of the month.
Age: 66.0
Sex: M
Vaccine: PNC20
Symptoms: Erythema, Mouth swelling, Nasal congestion, Peripheral swelling, Swelling face
Clinical narrative: facial swelling (may have started within day after, he doesn't recall), including nares, oral cavity - getting worse daily, swelling and redness just distal to vaccination site, swelling, redness opposite arm of vaccination.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Pulmonary embolism, Sepsis
Clinical narrative: I26.99 ACUTE PULMONARY EMBOLISM 9/6/2022 SEPSIS UNSPECIFIED ORGANISM J96.00 ACUTE RESPIRATORY FAILURE 9/5/2022 SEPSIS UNSPECIFIED ORGANISM
Age: 30.0
Sex: F
Vaccine: VARCEL
Symptoms: Erythema, Muscular weakness, Pain in extremity, Pruritus, Swelling
Clinical narrative: Sporadic sharp pains in arm, arm weakness redness, swelling and itching
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Arrhythmia, Asthenia, Atrial fibrillation, Brain natriuretic peptide increased
Clinical narrative: Patient is a 86 y.o. male with a history of dementia, atrial fibrillation (Eliquis) and sHFrEF who presented to Hospital 3/3/2023 with dizziness and low BP's at home. Found to be in atrial fibrillation RVR and COVID positive. Blood pressure and symptoms improved with IV fluids CXR showed suspected right basilar infiltrate.   1. Acute hypoxemic respiratory failure: due to COVID. CXR showed bronchial wall thickening with right basilar infiltrate. Required 2 L nasal cannula on admit, weaned to room air at time of discharge. 2. COVID-19 pneumonia: Unvaccinated. Tested (+) 3/3/23. Mild headache and generalized weakness without cough or dyspnea. Dexamethasone prescribed at discharge. 3. Sepsis without shock: Tachycardic, tachypneic and hypotensive on admission secondary to acute viral pneumonia and arrhythmia. BP responsive to IV fluids. No signs of end-organ damage. Did not warrant IV antibiotics or blood cultures.  4. Atrial fibrillation with RVR: First diagnosed in 2/2022 and converted to sinus rhythm spontaneously. Potentially triggered but not being on home metoprolol and COVID. Metoprolol prescribed at discharge, DOAC cost prohibitive and pt unable to do coumadin. Pt to follow up with cardiology outpatient  5. Cardiomyopathy: Follows with Dr. (also intended f/u at facility?). TTE 2/2022 EF 25% with severe LA enlargement. LHC 3/2/22 mild non-obstructive disease felt discordant to degree of myopathy. Remains clinically compensated (suspect elevated BNP related to COVID). Home lasix prescribed as PRN given pt's improvement with IV fluids  6. Elevated troponin: Troponin 51, repeat 51. Not consistent with acute coronary syndrome. 7. Hypertension: per history, Held home losartan at discharge and prescribed lasix as PRN 8. Mood disorder: No longer taking zoloft as pt prefers not to take many medications and per son will maximize medical therapy with required cardiology medications  9. Dementia: No longer on home donepezil  10. Code status: DNR-CCA/DNI
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Bronchial wall thickening, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated
Clinical narrative: Patient is a 86 y.o. male with a history of dementia, atrial fibrillation (Eliquis) and sHFrEF who presented to Hospital 3/3/2023 with dizziness and low BP's at home. Found to be in atrial fibrillation RVR and COVID positive. Blood pressure and symptoms improved with IV fluids CXR showed suspected right basilar infiltrate.   1. Acute hypoxemic respiratory failure: due to COVID. CXR showed bronchial wall thickening with right basilar infiltrate. Required 2 L nasal cannula on admit, weaned to room air at time of discharge. 2. COVID-19 pneumonia: Unvaccinated. Tested (+) 3/3/23. Mild headache and generalized weakness without cough or dyspnea. Dexamethasone prescribed at discharge. 3. Sepsis without shock: Tachycardic, tachypneic and hypotensive on admission secondary to acute viral pneumonia and arrhythmia. BP responsive to IV fluids. No signs of end-organ damage. Did not warrant IV antibiotics or blood cultures.  4. Atrial fibrillation with RVR: First diagnosed in 2/2022 and converted to sinus rhythm spontaneously. Potentially triggered but not being on home metoprolol and COVID. Metoprolol prescribed at discharge, DOAC cost prohibitive and pt unable to do coumadin. Pt to follow up with cardiology outpatient  5. Cardiomyopathy: Follows with Dr. (also intended f/u at facility?). TTE 2/2022 EF 25% with severe LA enlargement. LHC 3/2/22 mild non-obstructive disease felt discordant to degree of myopathy. Remains clinically compensated (suspect elevated BNP related to COVID). Home lasix prescribed as PRN given pt's improvement with IV fluids  6. Elevated troponin: Troponin 51, repeat 51. Not consistent with acute coronary syndrome. 7. Hypertension: per history, Held home losartan at discharge and prescribed lasix as PRN 8. Mood disorder: No longer taking zoloft as pt prefers not to take many medications and per son will maximize medical therapy with required cardiology medications  9. Dementia: No longer on home donepezil  10. Code status: DNR-CCA/DNI
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dizziness, Headache, Hypotension, Lung infiltration, Pneumonia viral
Clinical narrative: Patient is a 86 y.o. male with a history of dementia, atrial fibrillation (Eliquis) and sHFrEF who presented to Hospital 3/3/2023 with dizziness and low BP's at home. Found to be in atrial fibrillation RVR and COVID positive. Blood pressure and symptoms improved with IV fluids CXR showed suspected right basilar infiltrate.   1. Acute hypoxemic respiratory failure: due to COVID. CXR showed bronchial wall thickening with right basilar infiltrate. Required 2 L nasal cannula on admit, weaned to room air at time of discharge. 2. COVID-19 pneumonia: Unvaccinated. Tested (+) 3/3/23. Mild headache and generalized weakness without cough or dyspnea. Dexamethasone prescribed at discharge. 3. Sepsis without shock: Tachycardic, tachypneic and hypotensive on admission secondary to acute viral pneumonia and arrhythmia. BP responsive to IV fluids. No signs of end-organ damage. Did not warrant IV antibiotics or blood cultures.  4. Atrial fibrillation with RVR: First diagnosed in 2/2022 and converted to sinus rhythm spontaneously. Potentially triggered but not being on home metoprolol and COVID. Metoprolol prescribed at discharge, DOAC cost prohibitive and pt unable to do coumadin. Pt to follow up with cardiology outpatient  5. Cardiomyopathy: Follows with Dr. (also intended f/u at facility?). TTE 2/2022 EF 25% with severe LA enlargement. LHC 3/2/22 mild non-obstructive disease felt discordant to degree of myopathy. Remains clinically compensated (suspect elevated BNP related to COVID). Home lasix prescribed as PRN given pt's improvement with IV fluids  6. Elevated troponin: Troponin 51, repeat 51. Not consistent with acute coronary syndrome. 7. Hypertension: per history, Held home losartan at discharge and prescribed lasix as PRN 8. Mood disorder: No longer taking zoloft as pt prefers not to take many medications and per son will maximize medical therapy with required cardiology medications  9. Dementia: No longer on home donepezil  10. Code status: DNR-CCA/DNI
Age: 85.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sepsis, Tachycardia, Tachypnoea, Troponin increased
Clinical narrative: Patient is a 86 y.o. male with a history of dementia, atrial fibrillation (Eliquis) and sHFrEF who presented to Hospital 3/3/2023 with dizziness and low BP's at home. Found to be in atrial fibrillation RVR and COVID positive. Blood pressure and symptoms improved with IV fluids CXR showed suspected right basilar infiltrate.   1. Acute hypoxemic respiratory failure: due to COVID. CXR showed bronchial wall thickening with right basilar infiltrate. Required 2 L nasal cannula on admit, weaned to room air at time of discharge. 2. COVID-19 pneumonia: Unvaccinated. Tested (+) 3/3/23. Mild headache and generalized weakness without cough or dyspnea. Dexamethasone prescribed at discharge. 3. Sepsis without shock: Tachycardic, tachypneic and hypotensive on admission secondary to acute viral pneumonia and arrhythmia. BP responsive to IV fluids. No signs of end-organ damage. Did not warrant IV antibiotics or blood cultures.  4. Atrial fibrillation with RVR: First diagnosed in 2/2022 and converted to sinus rhythm spontaneously. Potentially triggered but not being on home metoprolol and COVID. Metoprolol prescribed at discharge, DOAC cost prohibitive and pt unable to do coumadin. Pt to follow up with cardiology outpatient  5. Cardiomyopathy: Follows with Dr. (also intended f/u at facility?). TTE 2/2022 EF 25% with severe LA enlargement. LHC 3/2/22 mild non-obstructive disease felt discordant to degree of myopathy. Remains clinically compensated (suspect elevated BNP related to COVID). Home lasix prescribed as PRN given pt's improvement with IV fluids  6. Elevated troponin: Troponin 51, repeat 51. Not consistent with acute coronary syndrome. 7. Hypertension: per history, Held home losartan at discharge and prescribed lasix as PRN 8. Mood disorder: No longer taking zoloft as pt prefers not to take many medications and per son will maximize medical therapy with required cardiology medications  9. Dementia: No longer on home donepezil  10. Code status: DNR-CCA/DNI
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure
Clinical narrative: J96.00 ACUTE RESPIRATORY FAILURE 10/13/2021 J96.90 RESPIRATORY FAILURE, UNSPECIFIED ACUITY 10/18/2021
Age: 43.0
Sex: M
Vaccine: COVID19-2
Symptoms: Aphasia, Chills, Cold sweat, Fatigue, Haemoptysis
Clinical narrative: I started out with aches and chills and fatigue. I went to the doctor and was prescribed a cough syrup, Prednisone, and Promethazine DM. About a week later I went back to the clinic and given a 10-day course steriod, a inhaler and cough syrup.  I went back a third time on 03/30/2023 Benzonatate for the cough and another steriod to help with the cough and whatever virus I have. During the week one I started having a cough that was worse with blood. That why we went back a second time. I cough so hard I tore something in my throat and was unable to talk for four days. My coughs followed with mucus. Now the cough is still productive. The doctor suggests that I may need to come back due to possible pneumonia tomorrow. I had no fever at all, and I have been checking. If anything, I'm clammy and under my normal temp.  I had been tested for COVID-19; Strep and Flu, all were negative. There was a lot of fatigue through this entire process. I am not over the fatigue.
Age: 43.0
Sex: M
Vaccine: COVID19-2
Symptoms: Influenza virus test negative, Pain, Pharyngeal disorder, Productive cough, SARS-CoV-2 test negative
Clinical narrative: I started out with aches and chills and fatigue. I went to the doctor and was prescribed a cough syrup, Prednisone, and Promethazine DM. About a week later I went back to the clinic and given a 10-day course steriod, a inhaler and cough syrup.  I went back a third time on 03/30/2023 Benzonatate for the cough and another steriod to help with the cough and whatever virus I have. During the week one I started having a cough that was worse with blood. That why we went back a second time. I cough so hard I tore something in my throat and was unable to talk for four days. My coughs followed with mucus. Now the cough is still productive. The doctor suggests that I may need to come back due to possible pneumonia tomorrow. I had no fever at all, and I have been checking. If anything, I'm clammy and under my normal temp.  I had been tested for COVID-19; Strep and Flu, all were negative. There was a lot of fatigue through this entire process. I am not over the fatigue.
Age: 43.0
Sex: M
Vaccine: COVID19-2
Symptoms: Secretion discharge, Streptococcus test negative, Viral infection
Clinical narrative: I started out with aches and chills and fatigue. I went to the doctor and was prescribed a cough syrup, Prednisone, and Promethazine DM. About a week later I went back to the clinic and given a 10-day course steriod, a inhaler and cough syrup.  I went back a third time on 03/30/2023 Benzonatate for the cough and another steriod to help with the cough and whatever virus I have. During the week one I started having a cough that was worse with blood. That why we went back a second time. I cough so hard I tore something in my throat and was unable to talk for four days. My coughs followed with mucus. Now the cough is still productive. The doctor suggests that I may need to come back due to possible pneumonia tomorrow. I had no fever at all, and I have been checking. If anything, I'm clammy and under my normal temp.  I had been tested for COVID-19; Strep and Flu, all were negative. There was a lot of fatigue through this entire process. I am not over the fatigue.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperthermia, Hypoxia, Small intestinal obstruction
Clinical narrative: R09.02 HYPOXIA 2/26/2022 SMALL BOWEL OBSTRUCTION R09.02 HYPOXIA 2/26/2022 HYPERNATREMIA
Age: 60.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: COVID-19, Cough, Ear infection, Exposure to SARS-CoV-2, Nasal congestion
Clinical narrative: I became sick with COVID-19 two days after my husband had symptoms. It felt like a bad cold for about a week. I felt better but I had a lingering consistent cough. I had nasal congestion that also continued. I went to see my doctor after a month of persistent cough. The doctor told me I developed a sinus infection and an ear infection and put me on Augmentin. After six days of taking the Augmentin, the cough was gone and then I finished the ten-day course.
Age: 60.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Nasopharyngitis, SARS-CoV-2 test positive, Sinusitis
Clinical narrative: I became sick with COVID-19 two days after my husband had symptoms. It felt like a bad cold for about a week. I felt better but I had a lingering consistent cough. I had nasal congestion that also continued. I went to see my doctor after a month of persistent cough. The doctor told me I developed a sinus infection and an ear infection and put me on Augmentin. After six days of taking the Augmentin, the cough was gone and then I finished the ten-day course.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Dysphonia, Headache, Pyrexia
Clinical narrative: After my vaccine, I experienced COVID-19 on 03/27/2023. My symptoms scratchy throat, hoarseness progressed into a terrible headache, runny nose and progressed into a yucky cough. My doctor called a prescription for PAXLOVID yesterday evening and I took my second dose this morning. The runny nose has slowed down, the cough is still croppy, but has decreased in frequency and my headaches comes and goes. We had gone on a cruise and had a slight fever in the evenings at night time, but no fever today. I did two self tests for COVID-19 tests at home on 03/29/2023. I also took the Omicron vaccine on 09/9/2022.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: After my vaccine, I experienced COVID-19 on 03/27/2023. My symptoms scratchy throat, hoarseness progressed into a terrible headache, runny nose and progressed into a yucky cough. My doctor called a prescription for PAXLOVID yesterday evening and I took my second dose this morning. The runny nose has slowed down, the cough is still croppy, but has decreased in frequency and my headaches comes and goes. We had gone on a cruise and had a slight fever in the evenings at night time, but no fever today. I did two self tests for COVID-19 tests at home on 03/29/2023. I also took the Omicron vaccine on 09/9/2022.
Age: 1.0
Sex: M
Vaccine: HEPA, MMR, PNC13
Symptoms: Pyrexia, Rash
Clinical narrative: Mother reported rash and fever. Occurred 2wks after receiving MMR ll.   Roseola vs Rash from Measles vaccination. Mother was advised to monitor and recheck next week.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Hypoxia, Respiratory failure
Clinical narrative: ACUTE RESPIRATORY FAILURE 12/23/2021  CHRONIC HYPOXEMIC RESPIRATORY FAILURE 12/31/2021  ACUTE ON CHRONIC RESPIRATORY FAILURE 12/31/2021  HYPOXIA 10/15/2021  ACUTE RESPIRATORY FAILURE 12/23/2021  CHRONIC HYPOXEMIC RESPIRATORY FAILURE 12/31/2021  ACUTE ON CHRONIC RESPIRATORY FAILURE 12/31/2021  HYPOXIA 10/15/2021  ACUTE RESPIRATORY FAILURE 12/23/2021  CHRONIC HYPOXEMIC RESPIRATORY FAILURE 12/31/2021  ACUTE ON CHRONIC RESPIRATORY FAILURE 12/31/2021  HYPOXIA 10/15/2021
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram normal, Angiogram pulmonary normal, Bacterial infection, Blood culture negative, Blood glucose normal
Clinical narrative: Patient is a 74 y.o. female patient of MD with history of right 4th toe OM s/p right 4th toe amputation, essential HTN, gout presented to Hospital with "jitters."  On admission found to be febrile and testing positive for COVID-19.  During no time during hospitalization did she require supplemental oxygen.  Labs improved with fluid resuscitation.  She was initially placed on IV antibiotics which were able to be discontinued with negative infectious work-up.  She completed courses of p.o. antibiotics that she had been on outpatient while in the hospital.  With resolution of symptoms and feeling significantly improved she is to be discharged home with outpatient follow-up.  Restart home meds   Severe Sepsis COVID-19 infection Present on admission: yes Etiology: COVID 19 SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90, WBC greater than 12,000, less than 4,000, or greater than 10% bands Initial lactic acid: 3.5-> 1.7 CTA pulmonary arteries, abd pelvis with - no PE; no other acute findings XR foot - no fracture, s/p amputation 4th toe, no bone destruction, no soft tissue gas Was on Keflex, Doxy, p.o. vancomycin prior to admission, completed antibiotic courses while inpatient Culture data: COVID 19 + (3/10), blood cxx NGTD ESR 20, CRP 33.8 ECHO 3/6/2023 - EF 62%, mild LVCH, mild MVR On admission eID consulted  Previous antibiotic courses completed while inpatient and no further signs of underlying bacterial infection.     Hyperglycemia, suspect reactive Glucose 123 Last HbA1c 2/23/2022 - 5.3% A1c 4.9   Hypertension, essential BP 109/55 Hold lisinopril in setting of sepsis   Hyperlipidemia Continue Crestor   Gout, stable Continue allopurinol   History of seizure Had witnessed seizure during recent hospitalization, evaluated by neurology with no indication for AED   Right 4th toe amputation due to 4th toe OM Seen by surgeon this AM 3/10/23 and per patient, was told wound looked good and no dressing changes until next appointment
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Blood lactic acid, C-reactive protein increased, COVID-19, Echocardiogram abnormal, Ejection fraction normal
Clinical narrative: Patient is a 74 y.o. female patient of MD with history of right 4th toe OM s/p right 4th toe amputation, essential HTN, gout presented to Hospital with "jitters."  On admission found to be febrile and testing positive for COVID-19.  During no time during hospitalization did she require supplemental oxygen.  Labs improved with fluid resuscitation.  She was initially placed on IV antibiotics which were able to be discontinued with negative infectious work-up.  She completed courses of p.o. antibiotics that she had been on outpatient while in the hospital.  With resolution of symptoms and feeling significantly improved she is to be discharged home with outpatient follow-up.  Restart home meds   Severe Sepsis COVID-19 infection Present on admission: yes Etiology: COVID 19 SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90, WBC greater than 12,000, less than 4,000, or greater than 10% bands Initial lactic acid: 3.5-> 1.7 CTA pulmonary arteries, abd pelvis with - no PE; no other acute findings XR foot - no fracture, s/p amputation 4th toe, no bone destruction, no soft tissue gas Was on Keflex, Doxy, p.o. vancomycin prior to admission, completed antibiotic courses while inpatient Culture data: COVID 19 + (3/10), blood cxx NGTD ESR 20, CRP 33.8 ECHO 3/6/2023 - EF 62%, mild LVCH, mild MVR On admission eID consulted  Previous antibiotic courses completed while inpatient and no further signs of underlying bacterial infection.     Hyperglycemia, suspect reactive Glucose 123 Last HbA1c 2/23/2022 - 5.3% A1c 4.9   Hypertension, essential BP 109/55 Hold lisinopril in setting of sepsis   Hyperlipidemia Continue Crestor   Gout, stable Continue allopurinol   History of seizure Had witnessed seizure during recent hospitalization, evaluated by neurology with no indication for AED   Right 4th toe amputation due to 4th toe OM Seen by surgeon this AM 3/10/23 and per patient, was told wound looked good and no dressing changes until next appointment
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling jittery, Glycosylated haemoglobin normal, Hyperglycaemia, Laboratory test abnormal, Left ventricular hypertrophy
Clinical narrative: Patient is a 74 y.o. female patient of MD with history of right 4th toe OM s/p right 4th toe amputation, essential HTN, gout presented to Hospital with "jitters."  On admission found to be febrile and testing positive for COVID-19.  During no time during hospitalization did she require supplemental oxygen.  Labs improved with fluid resuscitation.  She was initially placed on IV antibiotics which were able to be discontinued with negative infectious work-up.  She completed courses of p.o. antibiotics that she had been on outpatient while in the hospital.  With resolution of symptoms and feeling significantly improved she is to be discharged home with outpatient follow-up.  Restart home meds   Severe Sepsis COVID-19 infection Present on admission: yes Etiology: COVID 19 SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90, WBC greater than 12,000, less than 4,000, or greater than 10% bands Initial lactic acid: 3.5-> 1.7 CTA pulmonary arteries, abd pelvis with - no PE; no other acute findings XR foot - no fracture, s/p amputation 4th toe, no bone destruction, no soft tissue gas Was on Keflex, Doxy, p.o. vancomycin prior to admission, completed antibiotic courses while inpatient Culture data: COVID 19 + (3/10), blood cxx NGTD ESR 20, CRP 33.8 ECHO 3/6/2023 - EF 62%, mild LVCH, mild MVR On admission eID consulted  Previous antibiotic courses completed while inpatient and no further signs of underlying bacterial infection.     Hyperglycemia, suspect reactive Glucose 123 Last HbA1c 2/23/2022 - 5.3% A1c 4.9   Hypertension, essential BP 109/55 Hold lisinopril in setting of sepsis   Hyperlipidemia Continue Crestor   Gout, stable Continue allopurinol   History of seizure Had witnessed seizure during recent hospitalization, evaluated by neurology with no indication for AED   Right 4th toe amputation due to 4th toe OM Seen by surgeon this AM 3/10/23 and per patient, was told wound looked good and no dressing changes until next appointment
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Mitral valve incompetence, Pyrexia, Red blood cell sedimentation rate normal, SARS-CoV-2 test positive, Seizure
Clinical narrative: Patient is a 74 y.o. female patient of MD with history of right 4th toe OM s/p right 4th toe amputation, essential HTN, gout presented to Hospital with "jitters."  On admission found to be febrile and testing positive for COVID-19.  During no time during hospitalization did she require supplemental oxygen.  Labs improved with fluid resuscitation.  She was initially placed on IV antibiotics which were able to be discontinued with negative infectious work-up.  She completed courses of p.o. antibiotics that she had been on outpatient while in the hospital.  With resolution of symptoms and feeling significantly improved she is to be discharged home with outpatient follow-up.  Restart home meds   Severe Sepsis COVID-19 infection Present on admission: yes Etiology: COVID 19 SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90, WBC greater than 12,000, less than 4,000, or greater than 10% bands Initial lactic acid: 3.5-> 1.7 CTA pulmonary arteries, abd pelvis with - no PE; no other acute findings XR foot - no fracture, s/p amputation 4th toe, no bone destruction, no soft tissue gas Was on Keflex, Doxy, p.o. vancomycin prior to admission, completed antibiotic courses while inpatient Culture data: COVID 19 + (3/10), blood cxx NGTD ESR 20, CRP 33.8 ECHO 3/6/2023 - EF 62%, mild LVCH, mild MVR On admission eID consulted  Previous antibiotic courses completed while inpatient and no further signs of underlying bacterial infection.     Hyperglycemia, suspect reactive Glucose 123 Last HbA1c 2/23/2022 - 5.3% A1c 4.9   Hypertension, essential BP 109/55 Hold lisinopril in setting of sepsis   Hyperlipidemia Continue Crestor   Gout, stable Continue allopurinol   History of seizure Had witnessed seizure during recent hospitalization, evaluated by neurology with no indication for AED   Right 4th toe amputation due to 4th toe OM Seen by surgeon this AM 3/10/23 and per patient, was told wound looked good and no dressing changes until next appointment
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Sepsis, Systemic inflammatory response syndrome, Wound, X-ray limb normal
Clinical narrative: Patient is a 74 y.o. female patient of MD with history of right 4th toe OM s/p right 4th toe amputation, essential HTN, gout presented to Hospital with "jitters."  On admission found to be febrile and testing positive for COVID-19.  During no time during hospitalization did she require supplemental oxygen.  Labs improved with fluid resuscitation.  She was initially placed on IV antibiotics which were able to be discontinued with negative infectious work-up.  She completed courses of p.o. antibiotics that she had been on outpatient while in the hospital.  With resolution of symptoms and feeling significantly improved she is to be discharged home with outpatient follow-up.  Restart home meds   Severe Sepsis COVID-19 infection Present on admission: yes Etiology: COVID 19 SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90, WBC greater than 12,000, less than 4,000, or greater than 10% bands Initial lactic acid: 3.5-> 1.7 CTA pulmonary arteries, abd pelvis with - no PE; no other acute findings XR foot - no fracture, s/p amputation 4th toe, no bone destruction, no soft tissue gas Was on Keflex, Doxy, p.o. vancomycin prior to admission, completed antibiotic courses while inpatient Culture data: COVID 19 + (3/10), blood cxx NGTD ESR 20, CRP 33.8 ECHO 3/6/2023 - EF 62%, mild LVCH, mild MVR On admission eID consulted  Previous antibiotic courses completed while inpatient and no further signs of underlying bacterial infection.     Hyperglycemia, suspect reactive Glucose 123 Last HbA1c 2/23/2022 - 5.3% A1c 4.9   Hypertension, essential BP 109/55 Hold lisinopril in setting of sepsis   Hyperlipidemia Continue Crestor   Gout, stable Continue allopurinol   History of seizure Had witnessed seizure during recent hospitalization, evaluated by neurology with no indication for AED   Right 4th toe amputation due to 4th toe OM Seen by surgeon this AM 3/10/23 and per patient, was told wound looked good and no dressing changes until next appointment
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac discomfort, Cardiac monitoring normal, Cardiac stress test normal, Electrocardiogram normal, Extrasystoles
Clinical narrative: A month after the vaccine I would wake up at night and felt like heart was spinning. Later started to feel skipping heartbeat when walking up stairs. Went to doctor and confirmed that my heart was skipping beats, had an EKG done, but nothing concrete was found. Wore a heart monitor for 2 days, but had no results. Was sent to a Cardiologist and to have a Stress test and EKG they saw that I was a little poky in one of my heart chambers, but I didn't know which one. On 8/31/2022 saw another Cardiologist who deals with electrical side of the heart, he decided to have me wear a heart monitor that for a month. Saw unusual heartbeats but was still considered in the normal range. Was scheduled for a Nuclear Stress test, the results were normal. Eventually I stopped having the episodes of skipped heart beats. Heart seems to be back to normal.
Age: 65.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Cough, Nasal congestion, Oropharyngeal pain, Pyrexia
Clinical narrative: I was having a sore throat followed by nasal congestion. Then I was treated with Paxlovid, and I also had a fever of  100.8. I got a cough again 7 days later and the cough was nonconductive for 4 to 5 weeks. I took a home COVID test it was positive 14FEB23. The symptoms got worse.
Age: 65.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I was having a sore throat followed by nasal congestion. Then I was treated with Paxlovid, and I also had a fever of  100.8. I got a cough again 7 days later and the cough was nonconductive for 4 to 5 weeks. I took a home COVID test it was positive 14FEB23. The symptoms got worse.
Age: 7.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Underdose
Clinical narrative: Pt accidentally given Moderna Monovalent for 6m-5yr instead of Moderna Monovalent age 6-11 yr. No adverse reaction noted.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Feeling abnormal, Malaise, Oropharyngeal pain, Productive cough
Clinical narrative: I was first feeling really sick. It hit me like a boom, I got a fever and my throat really hurt. That was at night, the next day congestion came, and I felt awful. I took at home test and was positive. It was five days of not feeling very good. On day three I contacted the doctor and they gave me Paxlovid and finished it. The medicine made everything taste really bad. Know I think since then I have picked up the flu. I have phlegm and dull taste buds.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Taste disorder
Clinical narrative: I was first feeling really sick. It hit me like a boom, I got a fever and my throat really hurt. That was at night, the next day congestion came, and I felt awful. I took at home test and was positive. It was five days of not feeling very good. On day three I contacted the doctor and they gave me Paxlovid and finished it. The medicine made everything taste really bad. Know I think since then I have picked up the flu. I have phlegm and dull taste buds.
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Atelectasis, Atrial enlargement
Clinical narrative: Patient is a 84 y.o. male with a history hard of hearing, Afib on AC, NICM with reduced EF, pacemaker, IDDM2, CKD, OSA on CPAP who presented to medical center with SOB and recent COVID positive 2/12/23. Found to have acute hypoxic hypercarbic RF, elevated d-dimer, Echo with positive McConnel sign and transferred to hospital 2/23/2023 for further management. Course complicated by continuous BiPAP requiring transfer to MICU and further complicated by bacteremia, AKI, hyperkalemia.    1. Acute on Chronic Hypoxic Respiratory Failure: Baseline 2-4L O2 by NC (per family member) with known COPD and CHF. Acute component due to pulmonary edema, COPD, and COVID infection. Required continuous BiPAP on admit with OLH CXR: left base opacity felt to be atelectasis. Weaned to baseline oxygen at discharge  2. COVID Infection: Positive home test 2/12/23 with positive PCR 2/23/23. Vaccinated with Pfizer x5, last 9/2022. Out of window for supplemental therapies, on Decadron (last dose 3/5/23). Improved. Isolation ended 3/1/23. 3. Elevated D-dimer: D-dimer 3018 but on renal reduced AC.  VQ scan at OLH low prob PE. OLH TTE mild to moderate right ventricular size, positive McConnel sign, RVSP 35. RMH TTE 2/24/23 EF 60%, mildly dilated right ventricle with mild hypokinesis, biatrial enlargement. Bilateral lower extremity dopplers 2/24/23 without DVT. S/p heparin gtt, transitioned to home renally dosed Eliquis. Low suspicion for PE but remains on AC regardless for other indication (atrial fibrillation).  4. Bacteremia: Blood cultures 2/2 positive for staph epidermis and 1/2 positive for lactococcus garvieae on 2/23/23. TEE 3/1/23 did not reveal signs of endocarditis or pacemaker infection. IV Vanco transitioned to Cefazolin -> linezolid. Infectious disease followed 5. AKI on CKD IIIb: Follows with Dr. (Neph). Atrophic left kidney. Cr 2.05 2/3/23, uptrended to 3.6 at OLH. Renal US 2/24/23 c/w medical renal disease. Cr improved with diuresis. Nephrology followed and recommended continued supportive care. Cr improved to presumed new baseline, creatinine 1.5 at time of discharge  6. Recurrent Hyperkalemia: Present on admission, >5 and then peaked to 6.2 on 2/24/23. EKG v-paced without peaked T waves. Asymptomatic. Potassium 5.0, 4.9, 5.1 on days leading up to discharge  7. Acute on Chronic diastolic CHF with pulmonary HTN.  TTE as discussed, no pericardial effusion. Admission BNP 10k. CXR 2/23/23 with small left pleural effusion. S/p IV diuresis. Continued GDMT and lasix at discharge  8. Acute metabolic encephalopathy: Noted inpatient at times with reported waxing/waning confusion. Likely multifactorial due to above medical issues. Resolved at time of discharge  9. Elevated Troponin: initial 54, EKG V-paced without ischemic changes. Denied CP. Suspect demand ischemia. TTE as above. No further workup  10. Atrial fibrillation, hypertension, coronary artery disease, Type 2 Diabetes: management unchanged at discharge
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Atrial fibrillation, Bacteraemia, Blood creatinine increased, Blood culture positive, Blood potassium increased
Clinical narrative: Patient is a 84 y.o. male with a history hard of hearing, Afib on AC, NICM with reduced EF, pacemaker, IDDM2, CKD, OSA on CPAP who presented to medical center with SOB and recent COVID positive 2/12/23. Found to have acute hypoxic hypercarbic RF, elevated d-dimer, Echo with positive McConnel sign and transferred to hospital 2/23/2023 for further management. Course complicated by continuous BiPAP requiring transfer to MICU and further complicated by bacteremia, AKI, hyperkalemia.    1. Acute on Chronic Hypoxic Respiratory Failure: Baseline 2-4L O2 by NC (per family member) with known COPD and CHF. Acute component due to pulmonary edema, COPD, and COVID infection. Required continuous BiPAP on admit with OLH CXR: left base opacity felt to be atelectasis. Weaned to baseline oxygen at discharge  2. COVID Infection: Positive home test 2/12/23 with positive PCR 2/23/23. Vaccinated with Pfizer x5, last 9/2022. Out of window for supplemental therapies, on Decadron (last dose 3/5/23). Improved. Isolation ended 3/1/23. 3. Elevated D-dimer: D-dimer 3018 but on renal reduced AC.  VQ scan at OLH low prob PE. OLH TTE mild to moderate right ventricular size, positive McConnel sign, RVSP 35. RMH TTE 2/24/23 EF 60%, mildly dilated right ventricle with mild hypokinesis, biatrial enlargement. Bilateral lower extremity dopplers 2/24/23 without DVT. S/p heparin gtt, transitioned to home renally dosed Eliquis. Low suspicion for PE but remains on AC regardless for other indication (atrial fibrillation).  4. Bacteremia: Blood cultures 2/2 positive for staph epidermis and 1/2 positive for lactococcus garvieae on 2/23/23. TEE 3/1/23 did not reveal signs of endocarditis or pacemaker infection. IV Vanco transitioned to Cefazolin -> linezolid. Infectious disease followed 5. AKI on CKD IIIb: Follows with Dr. (Neph). Atrophic left kidney. Cr 2.05 2/3/23, uptrended to 3.6 at OLH. Renal US 2/24/23 c/w medical renal disease. Cr improved with diuresis. Nephrology followed and recommended continued supportive care. Cr improved to presumed new baseline, creatinine 1.5 at time of discharge  6. Recurrent Hyperkalemia: Present on admission, >5 and then peaked to 6.2 on 2/24/23. EKG v-paced without peaked T waves. Asymptomatic. Potassium 5.0, 4.9, 5.1 on days leading up to discharge  7. Acute on Chronic diastolic CHF with pulmonary HTN.  TTE as discussed, no pericardial effusion. Admission BNP 10k. CXR 2/23/23 with small left pleural effusion. S/p IV diuresis. Continued GDMT and lasix at discharge  8. Acute metabolic encephalopathy: Noted inpatient at times with reported waxing/waning confusion. Likely multifactorial due to above medical issues. Resolved at time of discharge  9. Elevated Troponin: initial 54, EKG V-paced without ischemic changes. Denied CP. Suspect demand ischemia. TTE as above. No further workup  10. Atrial fibrillation, hypertension, coronary artery disease, Type 2 Diabetes: management unchanged at discharge
Age: 83.0
Sex: M
Vaccine: COVID19-2
Symptoms: Brain natriuretic peptide increased, COVID-19, Cardiac failure acute, Cardiac failure congestive, Chest X-ray abnormal
Clinical narrative: Patient is a 84 y.o. male with a history hard of hearing, Afib on AC, NICM with reduced EF, pacemaker, IDDM2, CKD, OSA on CPAP who presented to medical center with SOB and recent COVID positive 2/12/23. Found to have acute hypoxic hypercarbic RF, elevated d-dimer, Echo with positive McConnel sign and transferred to hospital 2/23/2023 for further management. Course complicated by continuous BiPAP requiring transfer to MICU and further complicated by bacteremia, AKI, hyperkalemia.    1. Acute on Chronic Hypoxic Respiratory Failure: Baseline 2-4L O2 by NC (per family member) with known COPD and CHF. Acute component due to pulmonary edema, COPD, and COVID infection. Required continuous BiPAP on admit with OLH CXR: left base opacity felt to be atelectasis. Weaned to baseline oxygen at discharge  2. COVID Infection: Positive home test 2/12/23 with positive PCR 2/23/23. Vaccinated with Pfizer x5, last 9/2022. Out of window for supplemental therapies, on Decadron (last dose 3/5/23). Improved. Isolation ended 3/1/23. 3. Elevated D-dimer: D-dimer 3018 but on renal reduced AC.  VQ scan at OLH low prob PE. OLH TTE mild to moderate right ventricular size, positive McConnel sign, RVSP 35. RMH TTE 2/24/23 EF 60%, mildly dilated right ventricle with mild hypokinesis, biatrial enlargement. Bilateral lower extremity dopplers 2/24/23 without DVT. S/p heparin gtt, transitioned to home renally dosed Eliquis. Low suspicion for PE but remains on AC regardless for other indication (atrial fibrillation).  4. Bacteremia: Blood cultures 2/2 positive for staph epidermis and 1/2 positive for lactococcus garvieae on 2/23/23. TEE 3/1/23 did not reveal signs of endocarditis or pacemaker infection. IV Vanco transitioned to Cefazolin -> linezolid. Infectious disease followed 5. AKI on CKD IIIb: Follows with Dr. (Neph). Atrophic left kidney. Cr 2.05 2/3/23, uptrended to 3.6 at OLH. Renal US 2/24/23 c/w medical renal disease. Cr improved with diuresis. Nephrology followed and recommended continued supportive care. Cr improved to presumed new baseline, creatinine 1.5 at time of discharge  6. Recurrent Hyperkalemia: Present on admission, >5 and then peaked to 6.2 on 2/24/23. EKG v-paced without peaked T waves. Asymptomatic. Potassium 5.0, 4.9, 5.1 on days leading up to discharge  7. Acute on Chronic diastolic CHF with pulmonary HTN.  TTE as discussed, no pericardial effusion. Admission BNP 10k. CXR 2/23/23 with small left pleural effusion. S/p IV diuresis. Continued GDMT and lasix at discharge  8. Acute metabolic encephalopathy: Noted inpatient at times with reported waxing/waning confusion. Likely multifactorial due to above medical issues. Resolved at time of discharge  9. Elevated Troponin: initial 54, EKG V-paced without ischemic changes. Denied CP. Suspect demand ischemia. TTE as above. No further workup  10. Atrial fibrillation, hypertension, coronary artery disease, Type 2 Diabetes: management unchanged at discharge