chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood chloride decreased, Blood creatinine increased, Blood potassium, Blood urea increased, Brain natriuretic peptide increased
Clinical narrative: Hospitalized 01/12/2022; COVID-19 positive 01/12/2022; fully vaccinated  Discharge Provider: MD  Primary Care Provider : MD DETAILS OF HOSPITAL STAY Hospital Course: Patient is a 86 y.o. female with PMH of Type 2 DM (diet controlled), HTN, HLD, CAD, GERD, OSA who presented with cough, hoarse voice and shortness of breath. The patient reported symptoms that started on 1/7.    At Hospital patient was found to be hypoxic to 88% and was placed on 3 L oxygen via nasal cannula.   Chest x-ray was obtained showing mild cardiomegaly but no evidence of pneumonia.  Initial laboratory workup showed slightly low chloride 97, baseline kidney function with creatinine of 1.12, BUN 28. CBC showed no leukocytosis, stable hemoglobin of 10.5, normal platelets.  BNP normal at 353. She received a dose of Decadron prior to transfer.  The patient was transferred here to another Hospital for admission.   During admission the patient had minimal oxygen requirements. She was treated with dexamethasone and remdesivir. Blood pressure was low-normal during admission so her home antihypertensives were held. The patient was weaned to room air on 1/14 and she reported improvement. She was discharged on dexamethasone to complete steroid course. Lisinopril and Spironolacton-HCTZ were discontinued due to normotensive blood pressures with Lasix and Metoprolol alone. Recommend follow-up with PCP for blood pressure check and re-evaluation of potassium.   Will replace the patient's CPAP. She uses nightly CPAP for OSA. Home CPAP machine is not working properly and therefore the patient requires a replacement
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Cardiomegaly, Chest X-ray abnormal, Cough, Dysphonia
Clinical narrative: Hospitalized 01/12/2022; COVID-19 positive 01/12/2022; fully vaccinated  Discharge Provider: MD  Primary Care Provider : MD DETAILS OF HOSPITAL STAY Hospital Course: Patient is a 86 y.o. female with PMH of Type 2 DM (diet controlled), HTN, HLD, CAD, GERD, OSA who presented with cough, hoarse voice and shortness of breath. The patient reported symptoms that started on 1/7.    At Hospital patient was found to be hypoxic to 88% and was placed on 3 L oxygen via nasal cannula.   Chest x-ray was obtained showing mild cardiomegaly but no evidence of pneumonia.  Initial laboratory workup showed slightly low chloride 97, baseline kidney function with creatinine of 1.12, BUN 28. CBC showed no leukocytosis, stable hemoglobin of 10.5, normal platelets.  BNP normal at 353. She received a dose of Decadron prior to transfer.  The patient was transferred here to another Hospital for admission.   During admission the patient had minimal oxygen requirements. She was treated with dexamethasone and remdesivir. Blood pressure was low-normal during admission so her home antihypertensives were held. The patient was weaned to room air on 1/14 and she reported improvement. She was discharged on dexamethasone to complete steroid course. Lisinopril and Spironolacton-HCTZ were discontinued due to normotensive blood pressures with Lasix and Metoprolol alone. Recommend follow-up with PCP for blood pressure check and re-evaluation of potassium.   Will replace the patient's CPAP. She uses nightly CPAP for OSA. Home CPAP machine is not working properly and therefore the patient requires a replacement
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Full blood count, Haemoglobin decreased, Hypotension, Hypoxia
Clinical narrative: Hospitalized 01/12/2022; COVID-19 positive 01/12/2022; fully vaccinated  Discharge Provider: MD  Primary Care Provider : MD DETAILS OF HOSPITAL STAY Hospital Course: Patient is a 86 y.o. female with PMH of Type 2 DM (diet controlled), HTN, HLD, CAD, GERD, OSA who presented with cough, hoarse voice and shortness of breath. The patient reported symptoms that started on 1/7.    At Hospital patient was found to be hypoxic to 88% and was placed on 3 L oxygen via nasal cannula.   Chest x-ray was obtained showing mild cardiomegaly but no evidence of pneumonia.  Initial laboratory workup showed slightly low chloride 97, baseline kidney function with creatinine of 1.12, BUN 28. CBC showed no leukocytosis, stable hemoglobin of 10.5, normal platelets.  BNP normal at 353. She received a dose of Decadron prior to transfer.  The patient was transferred here to another Hospital for admission.   During admission the patient had minimal oxygen requirements. She was treated with dexamethasone and remdesivir. Blood pressure was low-normal during admission so her home antihypertensives were held. The patient was weaned to room air on 1/14 and she reported improvement. She was discharged on dexamethasone to complete steroid course. Lisinopril and Spironolacton-HCTZ were discontinued due to normotensive blood pressures with Lasix and Metoprolol alone. Recommend follow-up with PCP for blood pressure check and re-evaluation of potassium.   Will replace the patient's CPAP. She uses nightly CPAP for OSA. Home CPAP machine is not working properly and therefore the patient requires a replacement
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Platelet count normal, Positive airway pressure therapy, SARS-CoV-2 test positive, Sleep apnoea syndrome
Clinical narrative: Hospitalized 01/12/2022; COVID-19 positive 01/12/2022; fully vaccinated  Discharge Provider: MD  Primary Care Provider : MD DETAILS OF HOSPITAL STAY Hospital Course: Patient is a 86 y.o. female with PMH of Type 2 DM (diet controlled), HTN, HLD, CAD, GERD, OSA who presented with cough, hoarse voice and shortness of breath. The patient reported symptoms that started on 1/7.    At Hospital patient was found to be hypoxic to 88% and was placed on 3 L oxygen via nasal cannula.   Chest x-ray was obtained showing mild cardiomegaly but no evidence of pneumonia.  Initial laboratory workup showed slightly low chloride 97, baseline kidney function with creatinine of 1.12, BUN 28. CBC showed no leukocytosis, stable hemoglobin of 10.5, normal platelets.  BNP normal at 353. She received a dose of Decadron prior to transfer.  The patient was transferred here to another Hospital for admission.   During admission the patient had minimal oxygen requirements. She was treated with dexamethasone and remdesivir. Blood pressure was low-normal during admission so her home antihypertensives were held. The patient was weaned to room air on 1/14 and she reported improvement. She was discharged on dexamethasone to complete steroid course. Lisinopril and Spironolacton-HCTZ were discontinued due to normotensive blood pressures with Lasix and Metoprolol alone. Recommend follow-up with PCP for blood pressure check and re-evaluation of potassium.   Will replace the patient's CPAP. She uses nightly CPAP for OSA. Home CPAP machine is not working properly and therefore the patient requires a replacement
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Mobility decreased
Clinical narrative: patient said his temperature was 92 degrees and could not get out of bed
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Computerised tomogram, Dizziness, Ischaemic stroke, Ultrasound scan
Clinical narrative: Vertigo and dizziness started about 7 days after shot.  On  Jan 4 at 8:30am a Ischemic stroke on right side of brain occurred.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Vertigo, X-ray
Clinical narrative: Vertigo and dizziness started about 7 days after shot.  On  Jan 4 at 8:30am a Ischemic stroke on right side of brain occurred.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza A virus test, Influenza B virus test, Mental status changes, SARS-CoV-2 test
Clinical narrative: Altered Mental Status
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy breast abnormal, Breast cancer female, Breast cancer stage I, Lymphadenopathy, Radiotherapy
Clinical narrative: Swollen lymph nodes on left breast. Underwent surgery and began radiation on 01/25/2022.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Surgery
Clinical narrative: Swollen lymph nodes on left breast. Underwent surgery and began radiation on 01/25/2022.
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Oropharyngeal pain, Pain
Clinical narrative: FEVER, FATIGUE, COUGH, CONGESTION, ST, RHNORRHEA, BODY ACHES
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 RNA
Clinical narrative: FEVER, FATIGUE, COUGH, CONGESTION, ST, RHNORRHEA, BODY ACHES
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Hypersensitivity, Pruritus, Urticaria
Clinical narrative: Severe allergic reaction with itchy hives all over the body but particular along legs and arms. Onset of allergic reaction was about 24 hours after receipt of vaccine. Treatment taken includes OTC allergy medicine
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Anticoagulant therapy, Blood glucose normal, COVID-19
Clinical narrative: Patient is fully vaccinated. Hospitalized 12/26/2021 and COVID +. Admission dx: hypoxia and COVID 19. 65y.o. male with a past medical history of Hepatitis C, liver transplant, DM, HTN presenting for hypoglycemia. Patient states that he his friends noticed that he was pale, and were worried about him, and called EMS. He reportedly had a glucose in the 50s on EMS arrival, He  states that he has been eating and drinking well.  Patient notes that he has been experiencing dyspnea at rest over the past week. In the ED,vitals were significant SpO2 of 80% on room air. He was placed on 15L non-rebreather with improvement in saturations.AKI (1.81). DVT Prophylaxis: Lovenox Imaging:  Diffuse patchy airspace/interstitial opacities. Acute Hypoxic Respiratory Failure secondary to COVID Pneumonia.  Treatment: oxygen, lovenox, decadron, remdesivir. Discharged.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Dyspnoea at rest, Hypoglycaemia, Hypoxia, Imaging procedure abnormal
Clinical narrative: Patient is fully vaccinated. Hospitalized 12/26/2021 and COVID +. Admission dx: hypoxia and COVID 19. 65y.o. male with a past medical history of Hepatitis C, liver transplant, DM, HTN presenting for hypoglycemia. Patient states that he his friends noticed that he was pale, and were worried about him, and called EMS. He reportedly had a glucose in the 50s on EMS arrival, He  states that he has been eating and drinking well.  Patient notes that he has been experiencing dyspnea at rest over the past week. In the ED,vitals were significant SpO2 of 80% on room air. He was placed on 15L non-rebreather with improvement in saturations.AKI (1.81). DVT Prophylaxis: Lovenox Imaging:  Diffuse patchy airspace/interstitial opacities. Acute Hypoxic Respiratory Failure secondary to COVID Pneumonia.  Treatment: oxygen, lovenox, decadron, remdesivir. Discharged.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Pallor, SARS-CoV-2 test positive
Clinical narrative: Patient is fully vaccinated. Hospitalized 12/26/2021 and COVID +. Admission dx: hypoxia and COVID 19. 65y.o. male with a past medical history of Hepatitis C, liver transplant, DM, HTN presenting for hypoglycemia. Patient states that he his friends noticed that he was pale, and were worried about him, and called EMS. He reportedly had a glucose in the 50s on EMS arrival, He  states that he has been eating and drinking well.  Patient notes that he has been experiencing dyspnea at rest over the past week. In the ED,vitals were significant SpO2 of 80% on room air. He was placed on 15L non-rebreather with improvement in saturations.AKI (1.81). DVT Prophylaxis: Lovenox Imaging:  Diffuse patchy airspace/interstitial opacities. Acute Hypoxic Respiratory Failure secondary to COVID Pneumonia.  Treatment: oxygen, lovenox, decadron, remdesivir. Discharged.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: PATIENT WAS VACCINATED ON 01/21/2022. PATIENT WITH A SECOND DOSE ADMINISTERED ON 12/06/2021 AND THE REINFORCEMENT WAS ADMINISTERED BEFORE 5 MONTHS. A FAMILY MEMBER WAS CALLED TO VERIFY THE MINOR'S HEALTH STATUS.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Erythema, Fatigue, Headache, Injection site reaction
Clinical narrative: Injection site reaction, red swollen welt about the size of a silver dollar, headache, body aches, chills, low grade fever, hives on bilateral legs, chest, back,  wrists, and back of neck, and extreme fatigue.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia, Swelling, Urticaria
Clinical narrative: Injection site reaction, red swollen welt about the size of a silver dollar, headache, body aches, chills, low grade fever, hives on bilateral legs, chest, back,  wrists, and back of neck, and extreme fatigue.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Autoimmune disorder, Blood test, Rheumatoid factor increased
Clinical narrative: Where should I begin??  RH factor increased dramatically to 69, diagnosed with an autoimmune disease still trying to be determined. I have had over $2,000 worth of extensive bloodwork done. Tested for lupus, lymes Sjogren's syndrome, ANA screen IFA POSITIVE.  I had NO symptoms a year ago until I received the first shot - it is not a vaccine. Vaccine's eliminate.  The scar on my upper left arm from the polio VACCINE is proof.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: covid +
Age: 15.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: NO AVERSE REACTION/EFFECT NOTED DURING THE 15MINUTES WAIT. THE PT/MOM WAS LATER CONTACTED AND THERE WAS NO ADVERSE REACTION/COMPLAINT VOICED. PT'S MOM STATE " HE'S FINE AND I'M FINE TOO. THANK YOU FOR CHECKING ON US"
Age: 8.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product preparation issue
Clinical narrative: Patient was given higher dose then recommended.  The vaccine was not diluted.  There was no adverse event that happened to the child..
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Ten days after receiving the Moderna booster shot, I developed hives across my entire face and body. I visited an ER on 12/18/2021 to seek treatment. 6 weeks after the booster, I am still struggling with full-body hives which are affecting my everyday life.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Fatigue, Pain, Rhinorrhoea
Clinical narrative: Cough, fatigue, runny nose, and body aches starting 1/21/22.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Asthenia, Immediate post-injection reaction, Injected limb mobility decreased, Pain in extremity
Clinical narrative: Immediate very intense arm pain that lasted 4 (+) weeks after vaccination. After a few months pain lessen a little but never went away. New symptoms developed shoulder pain, weakness, difficulty / limited movement of the left arm, impossible to raise the left arm above a certain level. Pain level fluctuates between 4-8, but never below 4.
Age: 6.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product preparation error
Clinical narrative: Patient was given high then recommended dose.  The vaccine was not diluted.  There was no adverse event that happened to the patient.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram, COVID-19, Chest pain, Dyspnoea, Electrocardiogram normal
Clinical narrative: Patient is fully vaccinated.  COVID positve on 12/26/2021 at ED visit. 21yo female presents with COVID concern. She reports multiple exposure to COVID including her boyfriend who she lives with. States onset of shortness of breath and chest pain that is worse with inspiration since yesterday. The sharp pain comes and go and has not had pain like this before. She also states that she has a frontal headache which is somewhat similar to her previous headaches. Had 1 episode of vomiting which has now resolved. CTA was negative for PE. U/S duplex was negative for DVTs bilaterally.EKG was negative for acute ischemia.Vitals within normal limits on arrival. No hypoxia or respiratory distress. Pt discharged from ED. Given information for monoclonal antibodies.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Exposure to SARS-CoV-2, Headache, Painful respiration, SARS-CoV-2 test positive, Ultrasound Doppler
Clinical narrative: Patient is fully vaccinated.  COVID positve on 12/26/2021 at ED visit. 21yo female presents with COVID concern. She reports multiple exposure to COVID including her boyfriend who she lives with. States onset of shortness of breath and chest pain that is worse with inspiration since yesterday. The sharp pain comes and go and has not had pain like this before. She also states that she has a frontal headache which is somewhat similar to her previous headaches. Had 1 episode of vomiting which has now resolved. CTA was negative for PE. U/S duplex was negative for DVTs bilaterally.EKG was negative for acute ischemia.Vitals within normal limits on arrival. No hypoxia or respiratory distress. Pt discharged from ED. Given information for monoclonal antibodies.
Age: 21.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Patient is fully vaccinated.  COVID positve on 12/26/2021 at ED visit. 21yo female presents with COVID concern. She reports multiple exposure to COVID including her boyfriend who she lives with. States onset of shortness of breath and chest pain that is worse with inspiration since yesterday. The sharp pain comes and go and has not had pain like this before. She also states that she has a frontal headache which is somewhat similar to her previous headaches. Had 1 episode of vomiting which has now resolved. CTA was negative for PE. U/S duplex was negative for DVTs bilaterally.EKG was negative for acute ischemia.Vitals within normal limits on arrival. No hypoxia or respiratory distress. Pt discharged from ED. Given information for monoclonal antibodies.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Menstrual disorder
Clinical narrative: Menstruation affected.  Period has been 38-40 days rather than 28.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy, Pain in extremity
Clinical narrative: My arm is swollen under the armpit all the way down to the  start of the breast tissue.  There is throbbing pain in the arm also.
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Asthenia, Blood creatinine increased, Blood lactic acid decreased, COVID-19
Clinical narrative: Breakthrough COVID infection. Patient is a 45 yo M who reported to the ED on 1/14 for weakness and abdominal pain x 1 day. He also missed his dialysis because he didn't feel good. Pt. denied any other symptoms. ED workup included EKG showing sinus tachycardia, CT Abd/Pelvis showed bibasilar tree-in-bud and confluet opacities, concerning for infective bronchiolitis and bronchopneumonia. Lactic acid 2.5, Creatinine 12.73. Pt given IV Abx, IV steroids, IV fluids and received immediate dialysis.
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram abdomen abnormal, Dialysis, Electrocardiogram abnormal, Lung opacity, Malaise
Clinical narrative: Breakthrough COVID infection. Patient is a 45 yo M who reported to the ED on 1/14 for weakness and abdominal pain x 1 day. He also missed his dialysis because he didn't feel good. Pt. denied any other symptoms. ED workup included EKG showing sinus tachycardia, CT Abd/Pelvis showed bibasilar tree-in-bud and confluet opacities, concerning for infective bronchiolitis and bronchopneumonia. Lactic acid 2.5, Creatinine 12.73. Pt given IV Abx, IV steroids, IV fluids and received immediate dialysis.
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Sinus tachycardia, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID infection. Patient is a 45 yo M who reported to the ED on 1/14 for weakness and abdominal pain x 1 day. He also missed his dialysis because he didn't feel good. Pt. denied any other symptoms. ED workup included EKG showing sinus tachycardia, CT Abd/Pelvis showed bibasilar tree-in-bud and confluet opacities, concerning for infective bronchiolitis and bronchopneumonia. Lactic acid 2.5, Creatinine 12.73. Pt given IV Abx, IV steroids, IV fluids and received immediate dialysis.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Blood lactic acid increased, COVID-19, Chills, Cough, Dyspnoea
Clinical narrative: 86 Y/O male was Dx with COVID end of December by his PCP and was given cough syrup for distressing cough. Patient progressively became SOB and worsening cough so came to ER. He was not treated with PO steroids per his wife. ER he was in hypoxic resp failure so was placed on BIPAP/CPAP. Currently he is on CPAP mode ventilation. He has OSA and uses CPAP at home. He has been started on IV dexamethasone and Remdesvir loading. He denies fever but C/O chills. Lactic acid was elevated however decreased to < 2.0 after treatment Procalcitonin is > 3.o. Presented to ED from nursing home 1/11/22.  Re-tested upon arrival to ED on 1/11/22 COVID +  T: 97.9 °F  TMIN: 97.5 °F  TMAX: 98.8 °F  HR: 71  RR: 27  BP: 119/84  SpO2: 95%
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Mechanical ventilation, Positive airway pressure therapy, Procalcitonin, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: 86 Y/O male was Dx with COVID end of December by his PCP and was given cough syrup for distressing cough. Patient progressively became SOB and worsening cough so came to ER. He was not treated with PO steroids per his wife. ER he was in hypoxic resp failure so was placed on BIPAP/CPAP. Currently he is on CPAP mode ventilation. He has OSA and uses CPAP at home. He has been started on IV dexamethasone and Remdesvir loading. He denies fever but C/O chills. Lactic acid was elevated however decreased to < 2.0 after treatment Procalcitonin is > 3.o. Presented to ED from nursing home 1/11/22.  Re-tested upon arrival to ED on 1/11/22 COVID +  T: 97.9 °F  TMIN: 97.5 °F  TMAX: 98.8 °F  HR: 71  RR: 27  BP: 119/84  SpO2: 95%
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute left ventricular failure, Acute myocardial infarction, Acute pulmonary oedema, Acute respiratory failure, Akinesia
Clinical narrative: Hospitalized 01/16/2022-still currently admitted; COVID-19 positive 01/16/2022; fully vaccinated plus booster  Admitting Diagnosis: Acute hypoxemic respiratory failure due to COVID-19  Admitted: 1/16/2022  1:35 PM  ASSESSMENT / PLAN: Patient is a 75 y.o. male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, PVD status post fem-pop bypass who is admitted to the intensive care unit for further management of acute hypoxic respiratory failure and NSTEMI.  New was hypoxic requiring BiPAP with 100% FiO2.  His EKG showed ST depressions and elevated troponins he had further chest pain in the ER.  Case was discussed with interventional cardiology from ER no recommendation for emergent catheterization recommended heparin and transfer to Hospital. Given patient's tenuous respiratory status and requiring BiPAP recommended intubation prior to transfer patient was intubated.  Upon arrival to medical intensive care unit patient was requiring pressors.  And had cool lower extremities.  We ordered stat echocardiogram and placed arterial line.   # Acute hypoxic respiratory failure with bilateral pulmonary infiltrates Pulmonary edema secondary to HF COVID 19 Hx of COPD Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event.   Plan:  o Empiric coverage with Unasyn o Blood cultures, sputum culture, bronchoscopy with BAL and associated labs, antigens and cultures o Dexamethasone 6 mg for 10 days o Finish course of remdesivir started at outside hospital o Titrate oxygen to maintain saturation greater than 90% o Albuterol PRN 01/20/22 notes: 1. Acute hypoxic respiratory failure - resolved Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event. Patient does have a history of COPD. Patient was successfully extubated to room air on 1/20/22 with no immediate issues. Plan: - COVID 19 - Continue Decadron 6mg qd for 10 d (1/26) - Continue to monitor respiratory status overnight post-extubation - titrate to maintain >90%SpO2 - albuterol PRN - Possible bacterial PNA - unlikely given overall clinical picture showing greater cardiogenic component with little signs of bacterial infection - Cultures NGTD - Unasyn 5 days, last day tomorrow (1/21)
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Arterial catheterisation, Blood culture negative, Brain natriuretic peptide increased, Bronchoalveolar lavage
Clinical narrative: Hospitalized 01/16/2022-still currently admitted; COVID-19 positive 01/16/2022; fully vaccinated plus booster  Admitting Diagnosis: Acute hypoxemic respiratory failure due to COVID-19  Admitted: 1/16/2022  1:35 PM  ASSESSMENT / PLAN: Patient is a 75 y.o. male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, PVD status post fem-pop bypass who is admitted to the intensive care unit for further management of acute hypoxic respiratory failure and NSTEMI.  New was hypoxic requiring BiPAP with 100% FiO2.  His EKG showed ST depressions and elevated troponins he had further chest pain in the ER.  Case was discussed with interventional cardiology from ER no recommendation for emergent catheterization recommended heparin and transfer to Hospital. Given patient's tenuous respiratory status and requiring BiPAP recommended intubation prior to transfer patient was intubated.  Upon arrival to medical intensive care unit patient was requiring pressors.  And had cool lower extremities.  We ordered stat echocardiogram and placed arterial line.   # Acute hypoxic respiratory failure with bilateral pulmonary infiltrates Pulmonary edema secondary to HF COVID 19 Hx of COPD Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event.   Plan:  o Empiric coverage with Unasyn o Blood cultures, sputum culture, bronchoscopy with BAL and associated labs, antigens and cultures o Dexamethasone 6 mg for 10 days o Finish course of remdesivir started at outside hospital o Titrate oxygen to maintain saturation greater than 90% o Albuterol PRN 01/20/22 notes: 1. Acute hypoxic respiratory failure - resolved Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event. Patient does have a history of COPD. Patient was successfully extubated to room air on 1/20/22 with no immediate issues. Plan: - COVID 19 - Continue Decadron 6mg qd for 10 d (1/26) - Continue to monitor respiratory status overnight post-extubation - titrate to maintain >90%SpO2 - albuterol PRN - Possible bacterial PNA - unlikely given overall clinical picture showing greater cardiogenic component with little signs of bacterial infection - Cultures NGTD - Unasyn 5 days, last day tomorrow (1/21)
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Bronchoscopy, COVID-19, COVID-19 pneumonia, Cardiac failure, Chest pain
Clinical narrative: Hospitalized 01/16/2022-still currently admitted; COVID-19 positive 01/16/2022; fully vaccinated plus booster  Admitting Diagnosis: Acute hypoxemic respiratory failure due to COVID-19  Admitted: 1/16/2022  1:35 PM  ASSESSMENT / PLAN: Patient is a 75 y.o. male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, PVD status post fem-pop bypass who is admitted to the intensive care unit for further management of acute hypoxic respiratory failure and NSTEMI.  New was hypoxic requiring BiPAP with 100% FiO2.  His EKG showed ST depressions and elevated troponins he had further chest pain in the ER.  Case was discussed with interventional cardiology from ER no recommendation for emergent catheterization recommended heparin and transfer to Hospital. Given patient's tenuous respiratory status and requiring BiPAP recommended intubation prior to transfer patient was intubated.  Upon arrival to medical intensive care unit patient was requiring pressors.  And had cool lower extremities.  We ordered stat echocardiogram and placed arterial line.   # Acute hypoxic respiratory failure with bilateral pulmonary infiltrates Pulmonary edema secondary to HF COVID 19 Hx of COPD Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event.   Plan:  o Empiric coverage with Unasyn o Blood cultures, sputum culture, bronchoscopy with BAL and associated labs, antigens and cultures o Dexamethasone 6 mg for 10 days o Finish course of remdesivir started at outside hospital o Titrate oxygen to maintain saturation greater than 90% o Albuterol PRN 01/20/22 notes: 1. Acute hypoxic respiratory failure - resolved Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event. Patient does have a history of COPD. Patient was successfully extubated to room air on 1/20/22 with no immediate issues. Plan: - COVID 19 - Continue Decadron 6mg qd for 10 d (1/26) - Continue to monitor respiratory status overnight post-extubation - titrate to maintain >90%SpO2 - albuterol PRN - Possible bacterial PNA - unlikely given overall clinical picture showing greater cardiogenic component with little signs of bacterial infection - Cultures NGTD - Unasyn 5 days, last day tomorrow (1/21)
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Condition aggravated, Coronary artery disease, Dysphagia, Echocardiogram, Echocardiogram abnormal
Clinical narrative: Hospitalized 01/16/2022-still currently admitted; COVID-19 positive 01/16/2022; fully vaccinated plus booster  Admitting Diagnosis: Acute hypoxemic respiratory failure due to COVID-19  Admitted: 1/16/2022  1:35 PM  ASSESSMENT / PLAN: Patient is a 75 y.o. male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, PVD status post fem-pop bypass who is admitted to the intensive care unit for further management of acute hypoxic respiratory failure and NSTEMI.  New was hypoxic requiring BiPAP with 100% FiO2.  His EKG showed ST depressions and elevated troponins he had further chest pain in the ER.  Case was discussed with interventional cardiology from ER no recommendation for emergent catheterization recommended heparin and transfer to Hospital. Given patient's tenuous respiratory status and requiring BiPAP recommended intubation prior to transfer patient was intubated.  Upon arrival to medical intensive care unit patient was requiring pressors.  And had cool lower extremities.  We ordered stat echocardiogram and placed arterial line.   # Acute hypoxic respiratory failure with bilateral pulmonary infiltrates Pulmonary edema secondary to HF COVID 19 Hx of COPD Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event.   Plan:  o Empiric coverage with Unasyn o Blood cultures, sputum culture, bronchoscopy with BAL and associated labs, antigens and cultures o Dexamethasone 6 mg for 10 days o Finish course of remdesivir started at outside hospital o Titrate oxygen to maintain saturation greater than 90% o Albuterol PRN 01/20/22 notes: 1. Acute hypoxic respiratory failure - resolved Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event. Patient does have a history of COPD. Patient was successfully extubated to room air on 1/20/22 with no immediate issues. Plan: - COVID 19 - Continue Decadron 6mg qd for 10 d (1/26) - Continue to monitor respiratory status overnight post-extubation - titrate to maintain >90%SpO2 - albuterol PRN - Possible bacterial PNA - unlikely given overall clinical picture showing greater cardiogenic component with little signs of bacterial infection - Cultures NGTD - Unasyn 5 days, last day tomorrow (1/21)
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Ejection fraction decreased, Electrocardiogram ST segment depression, Endotracheal intubation, Hypoxia, Intensive care
Clinical narrative: Hospitalized 01/16/2022-still currently admitted; COVID-19 positive 01/16/2022; fully vaccinated plus booster  Admitting Diagnosis: Acute hypoxemic respiratory failure due to COVID-19  Admitted: 1/16/2022  1:35 PM  ASSESSMENT / PLAN: Patient is a 75 y.o. male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, PVD status post fem-pop bypass who is admitted to the intensive care unit for further management of acute hypoxic respiratory failure and NSTEMI.  New was hypoxic requiring BiPAP with 100% FiO2.  His EKG showed ST depressions and elevated troponins he had further chest pain in the ER.  Case was discussed with interventional cardiology from ER no recommendation for emergent catheterization recommended heparin and transfer to Hospital. Given patient's tenuous respiratory status and requiring BiPAP recommended intubation prior to transfer patient was intubated.  Upon arrival to medical intensive care unit patient was requiring pressors.  And had cool lower extremities.  We ordered stat echocardiogram and placed arterial line.   # Acute hypoxic respiratory failure with bilateral pulmonary infiltrates Pulmonary edema secondary to HF COVID 19 Hx of COPD Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event.   Plan:  o Empiric coverage with Unasyn o Blood cultures, sputum culture, bronchoscopy with BAL and associated labs, antigens and cultures o Dexamethasone 6 mg for 10 days o Finish course of remdesivir started at outside hospital o Titrate oxygen to maintain saturation greater than 90% o Albuterol PRN 01/20/22 notes: 1. Acute hypoxic respiratory failure - resolved Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event. Patient does have a history of COPD. Patient was successfully extubated to room air on 1/20/22 with no immediate issues. Plan: - COVID 19 - Continue Decadron 6mg qd for 10 d (1/26) - Continue to monitor respiratory status overnight post-extubation - titrate to maintain >90%SpO2 - albuterol PRN - Possible bacterial PNA - unlikely given overall clinical picture showing greater cardiogenic component with little signs of bacterial infection - Cultures NGTD - Unasyn 5 days, last day tomorrow (1/21)
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Ischaemia, Laboratory test, Lung infiltration, Peripheral coldness, Polyuria
Clinical narrative: Hospitalized 01/16/2022-still currently admitted; COVID-19 positive 01/16/2022; fully vaccinated plus booster  Admitting Diagnosis: Acute hypoxemic respiratory failure due to COVID-19  Admitted: 1/16/2022  1:35 PM  ASSESSMENT / PLAN: Patient is a 75 y.o. male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, PVD status post fem-pop bypass who is admitted to the intensive care unit for further management of acute hypoxic respiratory failure and NSTEMI.  New was hypoxic requiring BiPAP with 100% FiO2.  His EKG showed ST depressions and elevated troponins he had further chest pain in the ER.  Case was discussed with interventional cardiology from ER no recommendation for emergent catheterization recommended heparin and transfer to Hospital. Given patient's tenuous respiratory status and requiring BiPAP recommended intubation prior to transfer patient was intubated.  Upon arrival to medical intensive care unit patient was requiring pressors.  And had cool lower extremities.  We ordered stat echocardiogram and placed arterial line.   # Acute hypoxic respiratory failure with bilateral pulmonary infiltrates Pulmonary edema secondary to HF COVID 19 Hx of COPD Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event.   Plan:  o Empiric coverage with Unasyn o Blood cultures, sputum culture, bronchoscopy with BAL and associated labs, antigens and cultures o Dexamethasone 6 mg for 10 days o Finish course of remdesivir started at outside hospital o Titrate oxygen to maintain saturation greater than 90% o Albuterol PRN 01/20/22 notes: 1. Acute hypoxic respiratory failure - resolved Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event. Patient does have a history of COPD. Patient was successfully extubated to room air on 1/20/22 with no immediate issues. Plan: - COVID 19 - Continue Decadron 6mg qd for 10 d (1/26) - Continue to monitor respiratory status overnight post-extubation - titrate to maintain >90%SpO2 - albuterol PRN - Possible bacterial PNA - unlikely given overall clinical picture showing greater cardiogenic component with little signs of bacterial infection - Cultures NGTD - Unasyn 5 days, last day tomorrow (1/21)
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Positive airway pressure therapy, SARS-CoV-2 test positive, Shock, Sputum culture, Troponin increased
Clinical narrative: Hospitalized 01/16/2022-still currently admitted; COVID-19 positive 01/16/2022; fully vaccinated plus booster  Admitting Diagnosis: Acute hypoxemic respiratory failure due to COVID-19  Admitted: 1/16/2022  1:35 PM  ASSESSMENT / PLAN: Patient is a 75 y.o. male with past medical history of type 2 diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, PVD status post fem-pop bypass who is admitted to the intensive care unit for further management of acute hypoxic respiratory failure and NSTEMI.  New was hypoxic requiring BiPAP with 100% FiO2.  His EKG showed ST depressions and elevated troponins he had further chest pain in the ER.  Case was discussed with interventional cardiology from ER no recommendation for emergent catheterization recommended heparin and transfer to Hospital. Given patient's tenuous respiratory status and requiring BiPAP recommended intubation prior to transfer patient was intubated.  Upon arrival to medical intensive care unit patient was requiring pressors.  And had cool lower extremities.  We ordered stat echocardiogram and placed arterial line.   # Acute hypoxic respiratory failure with bilateral pulmonary infiltrates Pulmonary edema secondary to HF COVID 19 Hx of COPD Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event.   Plan:  o Empiric coverage with Unasyn o Blood cultures, sputum culture, bronchoscopy with BAL and associated labs, antigens and cultures o Dexamethasone 6 mg for 10 days o Finish course of remdesivir started at outside hospital o Titrate oxygen to maintain saturation greater than 90% o Albuterol PRN 01/20/22 notes: 1. Acute hypoxic respiratory failure - resolved Possible etiologies include COVID pneumonia, superimposed bacterial pneumonia, pulmonary edema secondary to heart failure.  Some of these, most likely is heart failure due to elevated BNP to 19000, reduced ejection fraction noted on echocardiogram.  Heart failure likely secondary to ischemic event. Patient does have a history of COPD. Patient was successfully extubated to room air on 1/20/22 with no immediate issues. Plan: - COVID 19 - Continue Decadron 6mg qd for 10 d (1/26) - Continue to monitor respiratory status overnight post-extubation - titrate to maintain >90%SpO2 - albuterol PRN - Possible bacterial PNA - unlikely given overall clinical picture showing greater cardiogenic component with little signs of bacterial infection - Cultures NGTD - Unasyn 5 days, last day tomorrow (1/21)
Age: 15.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: PATIENT WAS VACCINATED ON 01/21/2022. PATIENT WITH A SECOND DOSE ADMINISTERED ON 09/03/2021 AND THE REINFORCEMENT WAS ADMINISTERED BEFORE 5 MONTHS. A FAMILY MEMBER WAS CALLED TO VERIFY THE MINOR'S HEALTH STATUS.
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chills, Cough, Dyspnoea, Headache, Oropharyngeal pain
Clinical narrative: fever 102, body aches, cough, headache, sore throat, chills, shortness of breath starting 1/22/22
Age: 69.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: fever 102, body aches, cough, headache, sore throat, chills, shortness of breath starting 1/22/22
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Dyspnoea, Swollen tongue
Clinical narrative: Patient received covid vaccine at 1542. While sitting in observation, patient complained of a "heaviness" in her chest and used her rescue inhaler, 2 puffs at 1612. I offered to call EMS for her: however she refused, stated "I don't want to go to the Emergency Room". She also reacted to her first two doses of the Covid vaccine. 1615 patient took 50 mg of Benadryl that she brought with her to the clinic. 1616 patient was having difficulty breathing and heaviness was worse. Patient agreed for EMS to be called. 1617 EMS called and patient self administered her epi pen. 1618 Patient breathing easier and stated, "the heaviness is getting better". 1621 EMS arrived and took over care and monitoring of patient to transport to Emergency Department. Patients parents were with her at the clinic and were going to meet her at the Emergency Room.   Emergency Visit: Dr."This is a 46-year-old chief complaint allergic reaction.  46-year-old who apparently got her first Covid shot a while ago had some itching afterwards got her second 1 and had quite a bit itching took some Benadryl decided to get a booster shot now and when she did it today she said she started getting short of breath and feel like she her tongue was swelling so she gave herself an epi shot took some Benadryl and came in she denies any other complaints" Dr., "Please note patient is feeling much better I do think some of this was anxiety I explained to her to use her EpiPen she has an extra 1 I will send her home with some prednisone tell her to take Benadryl to I did not get any vaccinations with a Covid type in the future as this could cause a severe anaphylactic reaction" Prescription for Prednisone 80 mg po daily x5 days.  Medications received in the ED: ATIVAN, PEPCID, Solumedrol, Benadryl injection.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Underdose
Clinical narrative: Patient received a children's dose of the Pfizer Covid-19 vaccine instead of an adult dose.
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Feeling jittery
Clinical narrative: Patient was sitting in the waiting room and started to feel jittery. Patient's lips were chattering and his arms were jittery. I brought him back to the clinic room and took his BP and pulse. He started to feel some better. He sat back out in the waiting room for an additional 15 minutes.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
Clinical narrative: Covid positive through household contact.  Not due booster
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: PATIENT WAS VACCINATED ON 01/21/2022. PATIENT WITH A SECOND DOSE ADMINISTERED ON 09/20/2021 AND THE REINFORCEMENT WAS ADMINISTERED BEFORE 5 MONTHS. A FAMILY MEMBER WAS CALLED TO VERIFY THE MINOR'S HEALTH STATUS.
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Hypoxia, SARS-CoV-2 test
Clinical narrative: Shortness of breath and hypoxic to the 60%.
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Blood glucose, Dizziness, Loss of consciousness
Clinical narrative: Shortly after administration, the patient reported feeling dizzy and lightheaded, then passed out and lost consciousness for about 10-15 seconds. 911 was called and EMT arrived. Before they arrived, he had come to. I provided a damp cloth and some water. Once they arrived, they checked his vitals. While checking his blood sugar, he passed out again. Based on the 2 episodes and his vitals, he was transported by EMS to the ER for further testing.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Moderna vaccine administered at the insistence of the parent even though nurse explained the age restriction.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: Received both vaccinations against COVID, tested COVID + on 12/2/21. Symptoms started 11/29/21 which included increased shortness of breath, vomiting, general weakness, and cough. Hospitalized 5 days, 12/2/21-12/7/21
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Received both vaccinations against COVID, tested COVID + on 12/2/21. Symptoms started 11/29/21 which included increased shortness of breath, vomiting, general weakness, and cough. Hospitalized 5 days, 12/2/21-12/7/21
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Malaise
Clinical narrative: Received Covid vaccine booster dose on 11/1/21, signs and symptoms of covid began on or about 11/18/21. Signs and Symptoms included general malaise, chills, intermittent low -grade fever, SpO2 of 79% on room air, cough and shortness of breath. Testes as COVID + on 11/25/21, hospitalized 11/25/21 - 12/4/21, left the the hospital against medical advice (AMA).
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Received Covid vaccine booster dose on 11/1/21, signs and symptoms of covid began on or about 11/18/21. Signs and Symptoms included general malaise, chills, intermittent low -grade fever, SpO2 of 79% on room air, cough and shortness of breath. Testes as COVID + on 11/25/21, hospitalized 11/25/21 - 12/4/21, left the the hospital against medical advice (AMA).
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Covid positive through work contact.  Up to date with booster