chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram, Computerised tomogram head, Fatigue, Headache, Immediate post-injection reaction
Clinical narrative: Immediately after the vaccine - headache and fatigue that lasted a couple of days. July -It woke me up; not a normal headache. I knew something was wrong. My husband took me to ER and they transferred me to a hospital. I had a subarachnoid hemorrhage in the brain; 3 days ICU -(Neuro ICU) in the hospital. I had to take some kind of medicine. I stayed in ICU for 3 days and then I was there for overnight after that. I went home with medication. Sept 15- back for a check-up and everything looked really - back to the hospital.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Intensive care, Sleep disorder, Subarachnoid haemorrhage
Clinical narrative: Immediately after the vaccine - headache and fatigue that lasted a couple of days. July -It woke me up; not a normal headache. I knew something was wrong. My husband took me to ER and they transferred me to a hospital. I had a subarachnoid hemorrhage in the brain; 3 days ICU -(Neuro ICU) in the hospital. I had to take some kind of medicine. I stayed in ICU for 3 days and then I was there for overnight after that. I went home with medication. Sept 15- back for a check-up and everything looked really - back to the hospital.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Feeling cold, Hyperhidrosis, Hypersomnia, Memory impairment
Clinical narrative: My first shot was on 4/7/2021 and my second shot was on 4/28/2021.   Around 6AM on 4/29/2021, my skin was very sensitive to touch. I pushed the sheets covering me off of my body because they felt rough and painful. I checked my temperature and it was 102 F. I had to work for a few hours. Around 10AM, I got back into bed because I could not remain upright. I took 3 Advil liquid gels. I could not move all day. I drank some water. I do not remember much, just that I had fevers all day into the night. The fever would break for about an hour during which time I would sleep, and then come back again. I did not check my temperature again, but I knew what I was feeling was consistent with a high fever. I did not eat and drank only lime flavored La Croix seltzer water. I was extremely nauseous. Every four hours, I would take two Advil liquid gels to keep the fever down.  I slept from about 3am to 6am on 4/30/2021. I tried drinking weak black tea when I woke and threw it up. My temperature was 103 F. I took three Advil liquid gels. This day continued much the same as the previous one. I ate two cups of plain brown rice. I did not check my temperature again, but was certain I had a very high fever, because I was very cold and shaking in between bouts of sweating. Again, I took 2 Advil liquid gels at intervals.  When I woke up around 8am on 5/1/2021, I ate some plain, dry cereal. I checked my temperature and it was 101 F. I took 3 Advil liquid gels. I slept for the full day. I was very weak on 5/2/201 and in the days after. I felt back to normal by 5/5/2021.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Posture abnormal, Pyrexia, Sensitive skin, Sleep disorder
Clinical narrative: My first shot was on 4/7/2021 and my second shot was on 4/28/2021.   Around 6AM on 4/29/2021, my skin was very sensitive to touch. I pushed the sheets covering me off of my body because they felt rough and painful. I checked my temperature and it was 102 F. I had to work for a few hours. Around 10AM, I got back into bed because I could not remain upright. I took 3 Advil liquid gels. I could not move all day. I drank some water. I do not remember much, just that I had fevers all day into the night. The fever would break for about an hour during which time I would sleep, and then come back again. I did not check my temperature again, but I knew what I was feeling was consistent with a high fever. I did not eat and drank only lime flavored La Croix seltzer water. I was extremely nauseous. Every four hours, I would take two Advil liquid gels to keep the fever down.  I slept from about 3am to 6am on 4/30/2021. I tried drinking weak black tea when I woke and threw it up. My temperature was 103 F. I took three Advil liquid gels. This day continued much the same as the previous one. I ate two cups of plain brown rice. I did not check my temperature again, but was certain I had a very high fever, because I was very cold and shaking in between bouts of sweating. Again, I took 2 Advil liquid gels at intervals.  When I woke up around 8am on 5/1/2021, I ate some plain, dry cereal. I checked my temperature and it was 101 F. I took 3 Advil liquid gels. I slept for the full day. I was very weak on 5/2/201 and in the days after. I felt back to normal by 5/5/2021.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Tenderness, Tremor, Vomiting
Clinical narrative: My first shot was on 4/7/2021 and my second shot was on 4/28/2021.   Around 6AM on 4/29/2021, my skin was very sensitive to touch. I pushed the sheets covering me off of my body because they felt rough and painful. I checked my temperature and it was 102 F. I had to work for a few hours. Around 10AM, I got back into bed because I could not remain upright. I took 3 Advil liquid gels. I could not move all day. I drank some water. I do not remember much, just that I had fevers all day into the night. The fever would break for about an hour during which time I would sleep, and then come back again. I did not check my temperature again, but I knew what I was feeling was consistent with a high fever. I did not eat and drank only lime flavored La Croix seltzer water. I was extremely nauseous. Every four hours, I would take two Advil liquid gels to keep the fever down.  I slept from about 3am to 6am on 4/30/2021. I tried drinking weak black tea when I woke and threw it up. My temperature was 103 F. I took three Advil liquid gels. This day continued much the same as the previous one. I ate two cups of plain brown rice. I did not check my temperature again, but was certain I had a very high fever, because I was very cold and shaking in between bouts of sweating. Again, I took 2 Advil liquid gels at intervals.  When I woke up around 8am on 5/1/2021, I ate some plain, dry cereal. I checked my temperature and it was 101 F. I took 3 Advil liquid gels. I slept for the full day. I was very weak on 5/2/201 and in the days after. I felt back to normal by 5/5/2021.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cardio-respiratory arrest, Death, End stage renal disease, SARS-CoV-2 test positive
Clinical narrative: Breakthrough COVID-19 case with unknown symptom status. Death 8/19/21. From Vital Records COD = CARDIOPULMONARY ARREST, COVID 19, END STAGE RENAL FAILURE. Per vital records, COD ICD Codes include: Not yet coded ; Other Significant Conditions include: None listed. place of death: HOSPITAL-INPATIENT,  HOSPITAL; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occ/ind: COMANPY
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID-19 case with unknown symptom status. Death 8/19/21. From Vital Records COD = CARDIOPULMONARY ARREST, COVID 19, END STAGE RENAL FAILURE. Per vital records, COD ICD Codes include: Not yet coded ; Other Significant Conditions include: None listed. place of death: HOSPITAL-INPATIENT,  HOSPITAL; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occ/ind: COMANPY
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Aggression, Anger, Impatience, Libido increased, Palpitations
Clinical narrative: Increased anger and aggression, less patience. Level of anger has increased as well to the point of heart palpations.   An increase in libido.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoacusis, Tinnitus
Clinical narrative: About 6 hours after the vaccine I woke up from a nap with a humming noise in my left ear (same side as injection). It sounds like a quick pulsating noise and it interrupts my hearing. The quality of sound in the effected ear sounds slightly muffled. When I listen to a person's voice on the phone using the effected ear their voice has a slight robotic quality to it. The condition has not progressed as of now -- 3 days after the vaccine -- however I am concerned if I should receive my second shot.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Inappropriate schedule of product administration
Clinical narrative: PT RECEIVED VACCINE AT DAY 22 INSTEAD OF DAY 28. PT REPORTS ONLY FATIGUE
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: PATIENT RECEIVED THE VACCINE FROM EITHER LOT # 024C21A OR # 007C21A. IT IS NOT KNOWN WHICH LOT. BOTH LOTS WERE OUT OF THE FREEZER FOR 4 TO 18 DAYS MORE THAN THE RECOMMENDED 30 DAYS.  MODERNA EXPECTS VACCINES TO HAVE REMAINED SUFFICIENTLY EFFICACIOUS.  PATIENTS DID NOT HAVE ANY NEGATIVE OUTCOMES SO FAR.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Dehydration, Diarrhoea, Headache, Influenza like illness, Maternal exposure during breast feeding
Clinical narrative: I had severe nausea throwing up and diarrhea for a whole day and a half. I experienced severe dehydration. I am nursing my newborn I was not able to nurse him for two days due to the severe dehydration and diarrhea. I had fever around 102. I called the nurse line at my doctor office to see if I needed to come in for an appointment or go to the ER and I was told if I did not urinate for 8 hours to go to the ER but I was able to urinate after 7 1/2 hours.  I was told to drink pidilite and do the BRAT diet. I also had a bad headache and achiness. I felt like I got him with the flu.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain, Pyrexia, Vomiting
Clinical narrative: I had severe nausea throwing up and diarrhea for a whole day and a half. I experienced severe dehydration. I am nursing my newborn I was not able to nurse him for two days due to the severe dehydration and diarrhea. I had fever around 102. I called the nurse line at my doctor office to see if I needed to come in for an appointment or go to the ER and I was told if I did not urinate for 8 hours to go to the ER but I was able to urinate after 7 1/2 hours.  I was told to drink pidilite and do the BRAT diet. I also had a bad headache and achiness. I felt like I got him with the flu.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: PATIENT RECEIVED THE VACCINE FROM EITHER LOT # 024C21A OR # 007C21A. IT IS NOT KNOWN WHICH LOT. BOTH LOTS WERE OUT OF THE FREEZER FOR 4 TO 18 DAYS MORE THAN THE RECOMMENDED 30 DAYS.  MODERNA EXPECTS VACCINES TO HAVE REMAINED SUFFICIENTLY EFFICACIOUS.  PATIENTS DID NOT HAVE ANY NEGATIVE OUTCOMES SO FAR.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Myalgia, Nausea, Neck pain, Throat tightness
Clinical narrative: Patient states that within two minutes, she began feeling nauseated and lightheaded. Patient waited 15 minutes in the pharmacy, then decided to drive home. Patient developed a sore neck and muscle aches once home. Patient also stated that she experienced throat clinching, although she never had closing of the airways or difficulty breathing. Patient called her doctor when she experienced the throat clinching and the doctor told her to stay home since she did not have difficulty breathing. Patient stated that she took Tylenol and rested for 3 days and that the symptoms were completely resolved after 3 days. Patient called the pharmacy on 10/4/21 to report these adverse events and she stated that she has no lasting adverse effects two weeks post-vaccine.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED THE VACCINE FROM EITHER LOT # 024C21A OR # 007C21A. IT IS NOT KNOWN WHICH LOT. BOTH LOTS WERE OUT OF THE FREEZER FOR 4 TO 18 DAYS MORE THAN THE RECOMMENDED 30 DAYS.  MODERNA EXPECTS VACCINES TO HAVE REMAINED SUFFICIENTLY EFFICACIOUS.  PATIENTS DID NOT HAVE ANY NEGATIVE OUTCOMES SO FAR.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: PATIENT RECEIVED THE VACCINE FROM EITHER LOT # 024C21A OR # 007C21A. IT IS NOT KNOWN WHICH LOT. BOTH LOTS WERE OUT OF THE FREEZER FOR 4 TO 18 DAYS MORE THAN THE RECOMMENDED 30 DAYS.  MODERNA EXPECTS VACCINES TO HAVE REMAINED SUFFICIENTLY EFFICACIOUS.  PATIENTS DID NOT HAVE ANY NEGATIVE OUTCOMES SO FAR.
Age: 22.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: pt received expired dose of Janssen vaccine
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Chest X-ray, Chest discomfort, Dyspnoea, Electrocardiogram
Clinical narrative: Hives, Itching, Redness, Tight chest, Difficulty breathing/slight wheezing, tachycardia, elevated blood pressure. Received 1 epipen to the thigh, Solumedrol, Benadryl, Hydroxyzine, Albuterol. Monitored for 2.5 hours, transferred to hospital and monitored for another 2 hours. Discharged with RX for Prednisone x 4 days
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Full blood count, Metabolic function test, Pruritus, Tachycardia
Clinical narrative: Hives, Itching, Redness, Tight chest, Difficulty breathing/slight wheezing, tachycardia, elevated blood pressure. Received 1 epipen to the thigh, Solumedrol, Benadryl, Hydroxyzine, Albuterol. Monitored for 2.5 hours, transferred to hospital and monitored for another 2 hours. Discharged with RX for Prednisone x 4 days
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria, Wheezing
Clinical narrative: Hives, Itching, Redness, Tight chest, Difficulty breathing/slight wheezing, tachycardia, elevated blood pressure. Received 1 epipen to the thigh, Solumedrol, Benadryl, Hydroxyzine, Albuterol. Monitored for 2.5 hours, transferred to hospital and monitored for another 2 hours. Discharged with RX for Prednisone x 4 days
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Angina pectoris, Blepharospasm, Chest pain, Ear pain
Clinical narrative: About 1.5-2 weeks after getting my second dose I noticed sharp pains in my chest/heart that would shoot up to my ear. It was very scary and something I had never experienced before in my entire life. The chest pains came at random times and subsided after about 3 weeks from when they started.  About 1.5-2 weeks after getting my second dose I had ear pain in my canal and on the surrounding area of my ear. One time it last for several hours and was extremely painful. I had never experienced something like this before the vacinne. About 3.5 weeks after getting my second dose my left eyelid started twitching on and off ALL day and has been going on ever since. It's very strange and the twitching can be provoked just by touching./rubbing my eye or standing in the shower while water is hitting my face. I saw my PCP about this problem and he said to monitor for another month.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy
Clinical narrative: Swollen lymph node in right supraclavicular area
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Dyspnoea, Exposure to SARS-CoV-2, Myalgia
Clinical narrative: cough and shortness of breath. Pt notes his wife and daughter are recently covid-19 +. He tested negative ~10 days ago but developed symptoms ~2 days ago. He notes cough, shortness of breath, myalgias. ? Fever. No vomiting. No alleviating or aggravating factors.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test negative, Sick relative
Clinical narrative: cough and shortness of breath. Pt notes his wife and daughter are recently covid-19 +. He tested negative ~10 days ago but developed symptoms ~2 days ago. He notes cough, shortness of breath, myalgias. ? Fever. No vomiting. No alleviating or aggravating factors.
Age: 0.67
Sex: M
Vaccine: DTAPIPV
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse event.  Reporting a vaccine administration error.  Administered the Kinrix vaccine to an 8 month old when the vaccine is only approved for children 4 through 6 years of age.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chest discomfort, Fatigue, Headache, Injection site erythema
Clinical narrative: Headache, fatigue, next. Morning heaviness in chest, severe muscle and joint pain two-3 days later. Large red hard, hot lump in injected arm
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site induration, Injection site mass, Injection site warmth, Myalgia
Clinical narrative: Headache, fatigue, next. Morning heaviness in chest, severe muscle and joint pain two-3 days later. Large red hard, hot lump in injected arm
Age: 27.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: patient received expired  dose of Janssen covid vaccination
Age: 69.0
Sex: F
Vaccine: FLUA4
Symptoms: Dyspnoea, Flushing, Movement disorder, Muscle spasms
Clinical narrative: After flu vac, walked and got into my to car. Suddenly breathing felt tight,face flushed and then SEVERE low back spasm. Unable to move for 5 minutes, then opened windows for air and to call for help. After another 5 min, back pain subsided enough to drive  and completely subsided after 15min.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dizziness, Dyspnoea, Fatigue, Headache
Clinical narrative: Shortness of breath, chest pain, rapid and irregular heart rate, headache, dizziness, fatigue, lightheadedness, pins and needles in extremities
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate increased, Heart rate irregular, Paraesthesia
Clinical narrative: Shortness of breath, chest pain, rapid and irregular heart rate, headache, dizziness, fatigue, lightheadedness, pins and needles in extremities
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Pain in extremity, Pyrexia
Clinical narrative: After receiving the vaccine, that same day, my symptoms started around 6 that evening when I got really tired. I went home and went to bed through the night until 10AM the next morning. When I woke up I had a fever of about 100 degrees. I was still really tired. I had a headache. I spent that entire day in bed. I was still tired the following day but was bale to go to work. My right arm was sore. The soreness lasted about 4 to 5 days. The fatigued lasted for about 3 or 4 days.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Nausea, Pain, Pyrexia, Vomiting
Clinical narrative: complaint of COUGH, FEVER & NAUSEA The patient describes cough ongoing for nearly eight weeks, following the confirmation of COV19 infection on 8/5/21.  In the past three days, she has had fever to 104.9F (reportedly), nausea, with NB emesis and body aches.  Cough is minimally productive of white phlegm, no hemoptysis.  No chest discomfort, dyspnea, asymmetric calf pain/swelling, orthopnea, pedal edema, neck stiffness, HA, vision or speech changes, focal numbness or weakness, diarrhea, abdominal pain, or urinary complaint.
Age: 71.0
Sex: U
Vaccine: COVID19
Symptoms: Pulmonary embolism
Clinical narrative: bilat PE .. 6 months after vaccine
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: patient received expired dose of janssen covid vaccine
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Injection site bruising, Injection site erythema
Clinical narrative: I received only the Pfizer booster vaccine at this location on 9/30/21. About 2 hours after receiving my booster shot, a rather large patch of redness appeared just below the injection site . Returned to pharmacy today 10/4/21 & showed it to vaccinator. He noticed a good-sized black & blue mark at vaccine site & said he noted same effect on another who was also on a blood thinner. I reported I was there not about the black & blue mark but rather patch of redness. He said he'd never seen that before. Recommended I file this report & he was reporting it also on his end. Redness still there but getting lighter each day. No treatment was offered nor given. I was expecting that. I just felt it should be reported.
Age: 41.0
Sex: M
Vaccine: COVID19
Symptoms: Angioplasty, Coronary artery occlusion, Laboratory test, Myocardial infarction, Stent placement
Clinical narrative: Suffered a left anterior descending artery blockage/heart attack resulting in an emergency angioplasty and stenting. No known prior cardiac history nor any familial history of heart conditions. Treatment is still ongoing though normal life has resumed. Recovery has gone well, despite periodic setbacks.
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Nausea, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough COVID-19 case with symptom onset 8/3/2021: Nausea/Vomiting, Cough
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Breakthrough COVID-19 case with symptom onset 8/3/2021: Nausea/Vomiting, Cough
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Dyspnoea, Exercise test, Fatigue, Headache
Clinical narrative: Immediately after vaccine c/o headache, then fatigue that evening. Following day fatigue, muscle weakness/tightness, nausea, body aches. 2nd day thru today c/o muscle weakness/tightness, fatigue, SOBOE, chest tightness.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Muscle tightness, Muscular weakness, Nausea, Pain
Clinical narrative: Immediately after vaccine c/o headache, then fatigue that evening. Following day fatigue, muscle weakness/tightness, nausea, body aches. 2nd day thru today c/o muscle weakness/tightness, fatigue, SOBOE, chest tightness.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test, SARS-CoV-2 test negative
Clinical narrative: Immediately after vaccine c/o headache, then fatigue that evening. Following day fatigue, muscle weakness/tightness, nausea, body aches. 2nd day thru today c/o muscle weakness/tightness, fatigue, SOBOE, chest tightness.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Ageusia, Bone pain, Bronchitis, Chapped lips, Chest pain
Clinical narrative: 2nd dose had headache, body n bone aches. 3rd dose. After 5 hrs of vaccine bad nausea. At 12:30  am wed morn, bones n skin hurt so bad could hardly walk along with severe chills and headache. Lasted til 10:00 am. Then felt like throat n lungs burning, like bronchitis, tongue feels swollen n tingly with loss of taste. Lips are darker color with tingling and swelling feeling along with sensation of severe chappedness. Wed thru Friday afternoon couldn't eat due to severe nausea n headache. This is Monday October 4 and my lips, tongue throat and lungs have not changed. I went to doctors office n was told it's a neurological affect from the Pfizer vaccine but felt he was blowing me off. It was not my regular PCP. He said to take 25mg of benedryl 2x a day for about 4 days and follow up with regular PCP there. Then as I was leaving, I heard him making comments n laughing.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Chills, Gait disturbance, Headache, Lip discolouration, Lip swelling
Clinical narrative: 2nd dose had headache, body n bone aches. 3rd dose. After 5 hrs of vaccine bad nausea. At 12:30  am wed morn, bones n skin hurt so bad could hardly walk along with severe chills and headache. Lasted til 10:00 am. Then felt like throat n lungs burning, like bronchitis, tongue feels swollen n tingly with loss of taste. Lips are darker color with tingling and swelling feeling along with sensation of severe chappedness. Wed thru Friday afternoon couldn't eat due to severe nausea n headache. This is Monday October 4 and my lips, tongue throat and lungs have not changed. I went to doctors office n was told it's a neurological affect from the Pfizer vaccine but felt he was blowing me off. It was not my regular PCP. He said to take 25mg of benedryl 2x a day for about 4 days and follow up with regular PCP there. Then as I was leaving, I heard him making comments n laughing.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Nausea, Pain, Pain of skin, Paraesthesia oral, Swollen tongue
Clinical narrative: 2nd dose had headache, body n bone aches. 3rd dose. After 5 hrs of vaccine bad nausea. At 12:30  am wed morn, bones n skin hurt so bad could hardly walk along with severe chills and headache. Lasted til 10:00 am. Then felt like throat n lungs burning, like bronchitis, tongue feels swollen n tingly with loss of taste. Lips are darker color with tingling and swelling feeling along with sensation of severe chappedness. Wed thru Friday afternoon couldn't eat due to severe nausea n headache. This is Monday October 4 and my lips, tongue throat and lungs have not changed. I went to doctors office n was told it's a neurological affect from the Pfizer vaccine but felt he was blowing me off. It was not my regular PCP. He said to take 25mg of benedryl 2x a day for about 4 days and follow up with regular PCP there. Then as I was leaving, I heard him making comments n laughing.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Throat irritation
Clinical narrative: 2nd dose had headache, body n bone aches. 3rd dose. After 5 hrs of vaccine bad nausea. At 12:30  am wed morn, bones n skin hurt so bad could hardly walk along with severe chills and headache. Lasted til 10:00 am. Then felt like throat n lungs burning, like bronchitis, tongue feels swollen n tingly with loss of taste. Lips are darker color with tingling and swelling feeling along with sensation of severe chappedness. Wed thru Friday afternoon couldn't eat due to severe nausea n headache. This is Monday October 4 and my lips, tongue throat and lungs have not changed. I went to doctors office n was told it's a neurological affect from the Pfizer vaccine but felt he was blowing me off. It was not my regular PCP. He said to take 25mg of benedryl 2x a day for about 4 days and follow up with regular PCP there. Then as I was leaving, I heard him making comments n laughing.
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Atrial fibrillation, Chills, Condition aggravated, Differential white blood cell count normal, Disorientation
Clinical narrative: evening of 9/28/21 just tired;  9/29/21 felt like a head cold and tired 9/30/21 got dizzy, very tired, disoriented, went into afib, and almost passed out at work.  Coworkers had to call ambulance to take me to hospital.  Tests were ran, everything came back normal except me having the vaccine on the evening of 9/28/21, was discharged same day 10/1/21 still a little dizzy, a little disoriented,  tired, chills and headache 10/2/21  still a little dizzy, a little disoriented, tired and chills 10/3/21 still not feeling like myself and tired 10/4/21 finally starting  to feel like myself
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Electrocardiogram normal, Fatigue, Feeling abnormal, Full blood count normal
Clinical narrative: evening of 9/28/21 just tired;  9/29/21 felt like a head cold and tired 9/30/21 got dizzy, very tired, disoriented, went into afib, and almost passed out at work.  Coworkers had to call ambulance to take me to hospital.  Tests were ran, everything came back normal except me having the vaccine on the evening of 9/28/21, was discharged same day 10/1/21 still a little dizzy, a little disoriented,  tired, chills and headache 10/2/21  still a little dizzy, a little disoriented, tired and chills 10/3/21 still not feeling like myself and tired 10/4/21 finally starting  to feel like myself
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Metabolic function test, Nasopharyngitis, Presyncope
Clinical narrative: evening of 9/28/21 just tired;  9/29/21 felt like a head cold and tired 9/30/21 got dizzy, very tired, disoriented, went into afib, and almost passed out at work.  Coworkers had to call ambulance to take me to hospital.  Tests were ran, everything came back normal except me having the vaccine on the evening of 9/28/21, was discharged same day 10/1/21 still a little dizzy, a little disoriented,  tired, chills and headache 10/2/21  still a little dizzy, a little disoriented, tired and chills 10/3/21 still not feeling like myself and tired 10/4/21 finally starting  to feel like myself
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram, Disability, Haemorrhagic stroke, Magnetic resonance imaging
Clinical narrative: Patient had a massive hemorrhagic stroke 4 days after the Moderna vaccine. She became disabled.  She was previously healthy.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Burning sensation, Fatigue, Oedema peripheral, Pain
Clinical narrative: Approximately 15 hours after vaccine had arm soreness and general fatigue.  By that evening, experienced extreme pain in shoulder and armpit with swelling in armpit.  Sunday morning or approximately 36 hours post vaccine, experienced a burning rash on the torso, back, neck and head along with body aches.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Rash
Clinical narrative: Approximately 15 hours after vaccine had arm soreness and general fatigue.  By that evening, experienced extreme pain in shoulder and armpit with swelling in armpit.  Sunday morning or approximately 36 hours post vaccine, experienced a burning rash on the torso, back, neck and head along with body aches.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Confusional state, Dizziness, Fatigue, Heart rate increased, Joint swelling
Clinical narrative: Extreme fatigue, dizziness, confusion, pins and needles in extremities, rapid heart rate, swelling in feet and ankles
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia, Peripheral swelling
Clinical narrative: Extreme fatigue, dizziness, confusion, pins and needles in extremities, rapid heart rate, swelling in feet and ankles
Age: 87.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Dyspnoea, Pyrexia
Clinical narrative: 88-year-old female with H/O HTN, COPD, CAD, AFib on Coumadin, COVID 19 positive few days ago, brought into the ED C/O fever and shortness of breath.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Anion gap, Anxiety, Aspartate aminotransferase increased, Atrial fibrillation
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Basophil percentage decreased, Blood alkaline phosphatase normal, Blood bicarbonate normal, Blood bilirubin normal, Blood chloride normal
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine normal, Blood glucose increased, Blood lactate dehydrogenase increased, Blood pH increased, Blood potassium normal
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Blood sodium decreased, Blood urea increased, C-reactive protein increased, COVID-19 pneumonia, Carbon dioxide normal
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Carboxyhaemoglobin, Chest X-ray, Chronic obstructive pulmonary disease, Computerised tomogram thorax, Computerised tomogram thorax abnormal
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Eosinophil percentage decreased, Fibrin D dimer, Glomerular filtration rate, Haematocrit decreased, Haemoglobin decreased
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Immature granulocyte count, Lymphocyte percentage decreased, Mean cell volume normal, Monocyte percentage, Musculoskeletal chest pain
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Neutrophil count increased, Neutrophil percentage increased, Oxygen saturation, PCO2 decreased, PO2 decreased
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Platelet count increased, Pneumonia bacterial, Poor quality sleep, Red blood cell count decreased, Red blood cell nucleated morphology
Clinical narrative: 77 Y male with COPD, rhabdomyolysis, DM, atrial fibrillation, and COVID PNA. Admitted on 9/24/2021 for worsening oxygen requirements secondary to COVID PNA in the setting of 2x vaccination Pfizer.    PLAN #Neuro: Patient without out acute neurological concerns. Atrial fibrillation active and risk for cardiogenic emboli though no acute concerns. Patient with anxiety and poor sleep since starting higher doses of steroids.  - Sedation: No sedation - Pain: No pain at time of transfer. - Continue PRN, Lidocaine Patch for the right lower rib pain.  - Tylenol 650 PRN.  - Continue: Trazadone 75mg q Nightly    #CV: new onset atrial fibrillation at time of admission hemodynamically stable with paroxsymal runs of rapid ventricular response non sustaining. Considering rate vs rhythm control with preference for rate control given comorbidity. Patient not anticoagulated.  - ASA: 81mg  - Restart: Atorvastatin 20mg    #Atrial fibrillation, new onset stable. Rate control strategy. Patient well controlled over the night. No runs of RVR as in prior nights. No feelings of palpitations, chest pain, SOB, dizziness.  - Continue: Metoprolol 25mg BID   #Pulm: h/o COPD not well documented, here with active COVID PNA with suspected superimposed bacterial PNA on recent CT chest obtained. Patient currently on HFNC at 60L and 9% FiO2 with 20 PPM iNO saturating at 95% and comfortable.   - CONTINUE: 20 ppm iNO  - CONTINUE: HFNC as needed wean as tolerated last settings as above.    # Superimposed PNA: Noted on 9/27 on interval CTA for r/o PE. No PE but notable for concern for super imposed PNA.WBC trend 5-- > 9 ->10.9 -> 13 this morning.  - S/p levofloxacin, monitor for signs of infection fever chills nausea vomiting.    #COVID PNA: POA worsening oxygen requirement. S/p remdesivir (9/28), and mAb (9/27) - CONTINUE: Methylprednisone 30mg q12hr - Con't optimize pulm toilet, IS - PT OT Evaluation and treatment today.