chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 4.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Anticoagulant therapy, COVID-19, Diarrhoea, Headache
Clinical narrative: Currently Admitted to a local Hospital Admission date 8/31/2022-Current  Patient is a 4 y.o. female with past medical history of chronic constipation and recent history of COVID-19 infection (8/8) admitted for suspected MIS-C vs Kawasaki Disease. Patient has a 4 day history of persistent fever, new onset rash, swelling of her fingers, cervical lymphadenopathy, erythematous mucus membranes, strawberry tongue, erythematous lips, and bilateral conjunctivitis with no drainage. Initial work up notable for elevated inflammatory markers (Ferritin 481, CRP 38.2, ESR 28, Procalcitonin 1.02, Fibrinogen 408, and D-dimer 3130), leukopenia (WBC 4.34), thrombocytopenia (Platelets 106), and elevetated absolute lymphocyte count (0.91). Coagulation and cardiac studies are within normal limits (PT/PTT, INR, and NT-Pro BNP). ECG 9/1 shows sinus tachycardia. Patient will have an echocardiogram today to evaluate for cardiac involvement. Differential diagnosis includes Kawasaki vs MIS-C, however due to presentation 3 weeks after COVID-19 positivity the most likely diagnosis is MIS-C.
Age: 4.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hepatic enzyme increased, Illness, Immunoglobulin therapy, Inflammatory marker increased, Lymphadenopathy
Clinical narrative: Currently Admitted to a local Hospital Admission date 8/31/2022-Current  Patient is a 4 y.o. female with past medical history of chronic constipation and recent history of COVID-19 infection (8/8) admitted for suspected MIS-C vs Kawasaki Disease. Patient has a 4 day history of persistent fever, new onset rash, swelling of her fingers, cervical lymphadenopathy, erythematous mucus membranes, strawberry tongue, erythematous lips, and bilateral conjunctivitis with no drainage. Initial work up notable for elevated inflammatory markers (Ferritin 481, CRP 38.2, ESR 28, Procalcitonin 1.02, Fibrinogen 408, and D-dimer 3130), leukopenia (WBC 4.34), thrombocytopenia (Platelets 106), and elevetated absolute lymphocyte count (0.91). Coagulation and cardiac studies are within normal limits (PT/PTT, INR, and NT-Pro BNP). ECG 9/1 shows sinus tachycardia. Patient will have an echocardiogram today to evaluate for cardiac involvement. Differential diagnosis includes Kawasaki vs MIS-C, however due to presentation 3 weeks after COVID-19 positivity the most likely diagnosis is MIS-C.
Age: 4.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Multisystem inflammatory syndrome in children, Pyrexia, SARS-CoV-2 antibody test positive, SARS-CoV-2 test positive, Thrombocytopenia
Clinical narrative: Currently Admitted to a local Hospital Admission date 8/31/2022-Current  Patient is a 4 y.o. female with past medical history of chronic constipation and recent history of COVID-19 infection (8/8) admitted for suspected MIS-C vs Kawasaki Disease. Patient has a 4 day history of persistent fever, new onset rash, swelling of her fingers, cervical lymphadenopathy, erythematous mucus membranes, strawberry tongue, erythematous lips, and bilateral conjunctivitis with no drainage. Initial work up notable for elevated inflammatory markers (Ferritin 481, CRP 38.2, ESR 28, Procalcitonin 1.02, Fibrinogen 408, and D-dimer 3130), leukopenia (WBC 4.34), thrombocytopenia (Platelets 106), and elevetated absolute lymphocyte count (0.91). Coagulation and cardiac studies are within normal limits (PT/PTT, INR, and NT-Pro BNP). ECG 9/1 shows sinus tachycardia. Patient will have an echocardiogram today to evaluate for cardiac involvement. Differential diagnosis includes Kawasaki vs MIS-C, however due to presentation 3 weeks after COVID-19 positivity the most likely diagnosis is MIS-C.
Age: 83.0
Sex: F
Vaccine: FLU4
Symptoms: Erythema, Pruritus, Rash
Clinical narrative: Systemic: Allergic: Itch Generalized-Medium, Systemic: Allergic: Rash Generalized-Medium, Additional Details: Patient got Fluzone high-dose on 08/26/22. She reported to pharmacy on 8/29/22 that she had bright red itchiness and rash on her neck from her flu vaccine on 8/27/22 and it went away 1 day after she got her flu shot. She used Benadryl to alleviate red itchiness on her neck after getting the vaccine
Age: 20.0
Sex: M
Vaccine: MENB
Symptoms: Blood glucose decreased, Syncope, Unresponsive to stimuli
Clinical narrative: Systemic: Fainting / Unresponsive-Severe, Additional Details: Patient fainted after receiving vaccine. He fainted again a second time during a check for blood sugar level, which was 45 at the time. Patient stated he only ate string cheese in the morning. EMT gave him glucose to which glucose came to 79.  Patient was not harmed but was taking tot he hospital for check up via ambulance.
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, UNK
Symptoms: Asthenia, Bursitis, Headache, Injection site pain, Migraine
Clinical narrative: from the start - I periodically STILL feel the injection sites (both arms) left arm more often.  but that sensation does not last very long.  probably about 1 1/2 years ago, I started feeling very very slight muscle discomfort in left arm first, then right arm followed.   Recently, either June or July, the pain has gotten a lot worse.  pain seems to move throughout my arm(s).  Left arm is much worse than right arm. It is very difficult to lift anything heavy (or with some weight) & very hard to sleep (since I sleep on my side)
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, UNK
Symptoms: Muscle discomfort, Myalgia, Osteoarthritis, Pain, Pain in extremity
Clinical narrative: from the start - I periodically STILL feel the injection sites (both arms) left arm more often.  but that sensation does not last very long.  probably about 1 1/2 years ago, I started feeling very very slight muscle discomfort in left arm first, then right arm followed.   Recently, either June or July, the pain has gotten a lot worse.  pain seems to move throughout my arm(s).  Left arm is much worse than right arm. It is very difficult to lift anything heavy (or with some weight) & very hard to sleep (since I sleep on my side)
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, UNK
Symptoms: Sleep disorder, X-ray limb
Clinical narrative: from the start - I periodically STILL feel the injection sites (both arms) left arm more often.  but that sensation does not last very long.  probably about 1 1/2 years ago, I started feeling very very slight muscle discomfort in left arm first, then right arm followed.   Recently, either June or July, the pain has gotten a lot worse.  pain seems to move throughout my arm(s).  Left arm is much worse than right arm. It is very difficult to lift anything heavy (or with some weight) & very hard to sleep (since I sleep on my side)
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pfizer 4/15/21, 5/6/21. Positive on 9/1/22
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Blood test normal, Computerised tomogram head normal, Dizziness, Nausea
Clinical narrative: Within 4 weeks of receiving the 2nd booster, I started having dizziness & nausea.  It started out being periodic symptoms & now it is constant and debilitating.  I have gone to an ENT, had a CT scan on my head, tried PT & nothing is helping.  Other people in my area have experienced similar symptoms which seem to have no clear cause & same timing.
Age: 0.75
Sex: F
Vaccine: HEP
Symptoms: Adverse event
Clinical narrative: Heplisav-B (Hepatitis B Vaccine Recombinant, Adjuvanted- ADULT DOSE) was administered to patient by primary RN; Dynavax (vaccine manufacturer) contacted and adverse event reported with RN; awaiting follow up instructions; primary MD aware
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Ascites, Atrial fibrillation, Blood creatinine increased, Blood culture positive, Blood lactic acid
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Blood thyroid stimulating hormone increased, Blood urea increased, Bundle branch block left, COVID-19, Cardioversion
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Culture positive, Echocardiogram abnormal, Ejection fraction decreased, Enterococcal bacteraemia
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Faeces discoloured, Full blood count, Gastritis, Gram stain positive, Haemoglobin decreased
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Hiatus hernia, Hypotension, Mental status changes, Mitral valve incompetence, Oesophagitis
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Oesophagogastroduodenoscopy abnormal, Pleural effusion, Positron emission tomogram abnormal, Red blood cell transfusion, SARS-CoV-2 test positive
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Sepsis, Septic shock, Tachyarrhythmia, Tachycardia, Tricuspid valve incompetence
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: White blood cell count increased
Clinical narrative: Admission Date: 8/20/2022 Discharge Date: Aug 31, 2022  PRESENTING PROBLEM: Paroxysmal atrial fibrillation (HCC) [I48.0] Sepsis (HCC) [A41.9] Atrial fibrillation with RVR (HCC) [I48.91] Septic shock (HCC) [A41.9, R65.21] COVID-19 [U07.1] Bacteremia due to Enterococcus [R78.81, B95.2]   HOSPITAL COURSE:   Patient is a 67-year-old female with a history of chronic obstructive pulmonary disease, CKD3 (baseline creatinine ~1.5), atrial fibrillation on warfarin, bicuspid aortic valve s/p bioprosthetic AVR, CHF with ejection fraction of 44% who presented with altered mentation, hypotension and wide-complex tachycardia on 8/20. Given 80 mg lidocaine by EMS en route to ED.  Hypotension and tachyarrhythmia persisted on arrival to ED (Afib with LBBB); attempt at cardioversion was unsuccessful and was started on an amiodarone gtt. Remainder of ED work up significant for BUN 59 creat 3.5, lactate 2.8, WBC19k, COVID positive. Found to have Enterococcus bacteremia. Given total 3 L IVF then started on norepi, vasopressin and stress-dose hydrocortisone. 8/20 ECHO showed LVEF 45%, bioprosthetic AV mean pressure gradient 22 mmHg, mild MR and moderate TR (limited visualization). Dark stool noted 8/21 night concerning for melena, CBC noted Hgb drop on serial draws overnight - trended from 11.2 on 8/21 AM to nadir of 7.7 overnight 8/21 along with recurrent mild hypotension - 1u pRBCs transfused with follow-up Hgb to 10.8  (suspect Hgb of 7.7 inaccurate). EGD showed a hiatal hernia, grade A esophagitis and mild gastritis. TEE 8/23 - bioprsthetic valve appeared normal, no AR, moderate MR, mod-severe TR, no clear evidence of endocarditis, but difficult to rule out   She has Enterococcus bacteremia -4/4 cultures from 08/20/2022 positive.  Positive blood cultures on 08/21/2022 for GPCs.  Enterococcus isolate is pan susceptible.PET was done.  Showed possible aortic valve graft infection, right cervical lymph node could be reactive, new small bilateral pleural effusions and a new small amount of ascites. CTS was consulted and no acute surgical intervention and recommended outpatient follow-up and to continue IV antibiotics. Infectious disease recommended continue Ampicillin and Ceftriaxone for a total of 6 wks with end date of 10/4/22.    Endocrinology was also consulted for the elevated TSH despite being on levothyroxine and they adjusted the dose.   The patient was discharged home in a stable condition. She is instructed to follow up with PCP, and ID.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Abnormal behaviour, Acute kidney injury, Anaemia, Blood glucose decreased, Blood glucose increased
Clinical narrative: Admission Date: 8/18/2022 Discharge Date: 08/21/2022 Patient is a 86 y.o. female past medical history chronic obstructive pulmonary disease, type 2 diabetes mellitus, hypertension, dementia, CKD stage 4 who presents today with altered mental status and shortness of breath.   History obtained from Daughter at bedside as patient with dementia would default to "I don't know" to all questioning.  Daughter stated that on Saturday 8/13 there was a family party and some in the attendees had recently gotten over COVID-19 infection.  Daughter endorse that multiple family members tested positive for COVID-19 thereafter including patient spouse.  Patient was feeling unwell the day after with significantly elevated blood sugars in the 360s, low-grade temp 99.6° by forehead, cough, chills, progressing to shortness of breath.  Patient had pulse ox 88-91%.  Daughter called patient's PCP on Tuesday and was offered Hecksel did but family ultimately declined due to risk of side effects.  Daughter bleed patient was improving but morning of admission 8/18 patient was found acting odd, diaphoretic, and not following commands as she usually does.  Daughter was setting up patient's medication and noted that patient took Thursdays and Fridays medications.  Patient's blood glucose was then checked by daughter was noted to be 14 associated with sweating and confusion but no tremors.  Daughter stated that patient looked ?really out of it?.  Daughter endorses patient's eating habits have been stable and not significantly decreased as she eats sweets, glue large, sandwiches throughout the day.   In the Emergency Department, patient was administered D50 W and D 10 W. Serum studies with improved blood glucose, AKI on CKD 4, acute on chronic anemia, hyponatremia and moderate electrolyte abnormalities.  Patient tested positive for COVID-19 on 08/15.  She was administered 1L IVF and continue on maintenance fluid. Patient was noted to be hypoxic pre-hospital with no documented hypoxic values in ED. Hospitalist service consulted for admission and further evaluation.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chills, Chronic kidney disease, Condition aggravated, Confusional state
Clinical narrative: Admission Date: 8/18/2022 Discharge Date: 08/21/2022 Patient is a 86 y.o. female past medical history chronic obstructive pulmonary disease, type 2 diabetes mellitus, hypertension, dementia, CKD stage 4 who presents today with altered mental status and shortness of breath.   History obtained from Daughter at bedside as patient with dementia would default to "I don't know" to all questioning.  Daughter stated that on Saturday 8/13 there was a family party and some in the attendees had recently gotten over COVID-19 infection.  Daughter endorse that multiple family members tested positive for COVID-19 thereafter including patient spouse.  Patient was feeling unwell the day after with significantly elevated blood sugars in the 360s, low-grade temp 99.6° by forehead, cough, chills, progressing to shortness of breath.  Patient had pulse ox 88-91%.  Daughter called patient's PCP on Tuesday and was offered Hecksel did but family ultimately declined due to risk of side effects.  Daughter bleed patient was improving but morning of admission 8/18 patient was found acting odd, diaphoretic, and not following commands as she usually does.  Daughter was setting up patient's medication and noted that patient took Thursdays and Fridays medications.  Patient's blood glucose was then checked by daughter was noted to be 14 associated with sweating and confusion but no tremors.  Daughter stated that patient looked ?really out of it?.  Daughter endorses patient's eating habits have been stable and not significantly decreased as she eats sweets, glue large, sandwiches throughout the day.   In the Emergency Department, patient was administered D50 W and D 10 W. Serum studies with improved blood glucose, AKI on CKD 4, acute on chronic anemia, hyponatremia and moderate electrolyte abnormalities.  Patient tested positive for COVID-19 on 08/15.  She was administered 1L IVF and continue on maintenance fluid. Patient was noted to be hypoxic pre-hospital with no documented hypoxic values in ED. Hospitalist service consulted for admission and further evaluation.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dyspnoea, Electrolyte imbalance, Exposure to SARS-CoV-2, General physical condition abnormal
Clinical narrative: Admission Date: 8/18/2022 Discharge Date: 08/21/2022 Patient is a 86 y.o. female past medical history chronic obstructive pulmonary disease, type 2 diabetes mellitus, hypertension, dementia, CKD stage 4 who presents today with altered mental status and shortness of breath.   History obtained from Daughter at bedside as patient with dementia would default to "I don't know" to all questioning.  Daughter stated that on Saturday 8/13 there was a family party and some in the attendees had recently gotten over COVID-19 infection.  Daughter endorse that multiple family members tested positive for COVID-19 thereafter including patient spouse.  Patient was feeling unwell the day after with significantly elevated blood sugars in the 360s, low-grade temp 99.6° by forehead, cough, chills, progressing to shortness of breath.  Patient had pulse ox 88-91%.  Daughter called patient's PCP on Tuesday and was offered Hecksel did but family ultimately declined due to risk of side effects.  Daughter bleed patient was improving but morning of admission 8/18 patient was found acting odd, diaphoretic, and not following commands as she usually does.  Daughter was setting up patient's medication and noted that patient took Thursdays and Fridays medications.  Patient's blood glucose was then checked by daughter was noted to be 14 associated with sweating and confusion but no tremors.  Daughter stated that patient looked ?really out of it?.  Daughter endorses patient's eating habits have been stable and not significantly decreased as she eats sweets, glue large, sandwiches throughout the day.   In the Emergency Department, patient was administered D50 W and D 10 W. Serum studies with improved blood glucose, AKI on CKD 4, acute on chronic anemia, hyponatremia and moderate electrolyte abnormalities.  Patient tested positive for COVID-19 on 08/15.  She was administered 1L IVF and continue on maintenance fluid. Patient was noted to be hypoxic pre-hospital with no documented hypoxic values in ED. Hospitalist service consulted for admission and further evaluation.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperhidrosis, Hyponatraemia, Hypoxia, Malaise, Mental status changes
Clinical narrative: Admission Date: 8/18/2022 Discharge Date: 08/21/2022 Patient is a 86 y.o. female past medical history chronic obstructive pulmonary disease, type 2 diabetes mellitus, hypertension, dementia, CKD stage 4 who presents today with altered mental status and shortness of breath.   History obtained from Daughter at bedside as patient with dementia would default to "I don't know" to all questioning.  Daughter stated that on Saturday 8/13 there was a family party and some in the attendees had recently gotten over COVID-19 infection.  Daughter endorse that multiple family members tested positive for COVID-19 thereafter including patient spouse.  Patient was feeling unwell the day after with significantly elevated blood sugars in the 360s, low-grade temp 99.6° by forehead, cough, chills, progressing to shortness of breath.  Patient had pulse ox 88-91%.  Daughter called patient's PCP on Tuesday and was offered Hecksel did but family ultimately declined due to risk of side effects.  Daughter bleed patient was improving but morning of admission 8/18 patient was found acting odd, diaphoretic, and not following commands as she usually does.  Daughter was setting up patient's medication and noted that patient took Thursdays and Fridays medications.  Patient's blood glucose was then checked by daughter was noted to be 14 associated with sweating and confusion but no tremors.  Daughter stated that patient looked ?really out of it?.  Daughter endorses patient's eating habits have been stable and not significantly decreased as she eats sweets, glue large, sandwiches throughout the day.   In the Emergency Department, patient was administered D50 W and D 10 W. Serum studies with improved blood glucose, AKI on CKD 4, acute on chronic anemia, hyponatremia and moderate electrolyte abnormalities.  Patient tested positive for COVID-19 on 08/15.  She was administered 1L IVF and continue on maintenance fluid. Patient was noted to be hypoxic pre-hospital with no documented hypoxic values in ED. Hospitalist service consulted for admission and further evaluation.
Age: 85.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Admission Date: 8/18/2022 Discharge Date: 08/21/2022 Patient is a 86 y.o. female past medical history chronic obstructive pulmonary disease, type 2 diabetes mellitus, hypertension, dementia, CKD stage 4 who presents today with altered mental status and shortness of breath.   History obtained from Daughter at bedside as patient with dementia would default to "I don't know" to all questioning.  Daughter stated that on Saturday 8/13 there was a family party and some in the attendees had recently gotten over COVID-19 infection.  Daughter endorse that multiple family members tested positive for COVID-19 thereafter including patient spouse.  Patient was feeling unwell the day after with significantly elevated blood sugars in the 360s, low-grade temp 99.6° by forehead, cough, chills, progressing to shortness of breath.  Patient had pulse ox 88-91%.  Daughter called patient's PCP on Tuesday and was offered Hecksel did but family ultimately declined due to risk of side effects.  Daughter bleed patient was improving but morning of admission 8/18 patient was found acting odd, diaphoretic, and not following commands as she usually does.  Daughter was setting up patient's medication and noted that patient took Thursdays and Fridays medications.  Patient's blood glucose was then checked by daughter was noted to be 14 associated with sweating and confusion but no tremors.  Daughter stated that patient looked ?really out of it?.  Daughter endorses patient's eating habits have been stable and not significantly decreased as she eats sweets, glue large, sandwiches throughout the day.   In the Emergency Department, patient was administered D50 W and D 10 W. Serum studies with improved blood glucose, AKI on CKD 4, acute on chronic anemia, hyponatremia and moderate electrolyte abnormalities.  Patient tested positive for COVID-19 on 08/15.  She was administered 1L IVF and continue on maintenance fluid. Patient was noted to be hypoxic pre-hospital with no documented hypoxic values in ED. Hospitalist service consulted for admission and further evaluation.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy artery abnormal, Blindness, Giant cell arteritis, Headache, Impaired driving ability
Clinical narrative: Pt states that two days after vaccine she developed a fever. On the third day she states she developed severe jaw pain. States she went to urgent care and was given 4mg of steroids and that helped for six days but after that the jaw pain "came back with a vengeance". States since the vaccine she has developed headaches, blurry vision, and is now partially blind without possibility of reversal. On August 14th she states she went to Hospital and was transferred to a different Hospital. States she had surgery on August 15th where they did temporal artery biopsy where she was diagnosed with "Giant Cell Arteritis" and is "a rare disease". States she was given IV steroids in the hospital for 3 days and declares she was prescribed 50mg of steroids daily that she must take for 18 months. States she can no longer drive and can only get around her home. States her primary care doctor is private and her specialist is private (Rheumatology)
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in jaw, Pyrexia, Surgery, Vision blurred
Clinical narrative: Pt states that two days after vaccine she developed a fever. On the third day she states she developed severe jaw pain. States she went to urgent care and was given 4mg of steroids and that helped for six days but after that the jaw pain "came back with a vengeance". States since the vaccine she has developed headaches, blurry vision, and is now partially blind without possibility of reversal. On August 14th she states she went to Hospital and was transferred to a different Hospital. States she had surgery on August 15th where they did temporal artery biopsy where she was diagnosed with "Giant Cell Arteritis" and is "a rare disease". States she was given IV steroids in the hospital for 3 days and declares she was prescribed 50mg of steroids daily that she must take for 18 months. States she can no longer drive and can only get around her home. States her primary care doctor is private and her specialist is private (Rheumatology)
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Myocardial infarction, Stent placement
Clinical narrative: Heart Attack Required 4 Stent's
Age: 1.0
Sex: F
Vaccine: DTPPVHBHPB, PNC13, RV5
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: Pt was given dose of Rotateq after the age of 8 months, no known symptoms of adverse effect
Age: 35.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID19.
Age: 1.25
Sex: F
Vaccine: DTAP, HIBV
Symptoms: Rash
Clinical narrative: Rash- 5 inches in diameter
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient partially vaccinated against (1 dose), then tested positive for COVID-19.
Age: 88.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Agitation, Atrial fibrillation, COVID-19, Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: COVID vaccinated patient who admitted to hospital with complications of COVID. Provider discharge note below:  "Reason for Admission: Patient is a 89 YO year old female with past medical history of HTN, SVT s/p remote ablation, hypothyroidism, chronic bronchitis admitted with COVID viral infection. She is fully vaccinated against COVID. Brief Summary of Hospital Stay: The patient remained relatively asymptomatic other than a mild sore throat. She had no hypoxia or respiratory compromise. She did not meet criteria for active treatment, and our hospital does not have Paxlovid available for inpatients. She did experience a brief episode of atrial fibrillation, likely due to her active infection and some agitation at night. This has not recurred and she remains on her home metoprolol and Rythmol. Given history of falls the risk of anticoagulation outweighs the benefits. Nevertheless an event monitor has been ordered to monitor for further events".
Age: 32.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration
Clinical narrative: The patient received the first dose of Pfizer Covid 19 vaccine on 4/15/21. She was due for the second dose in the series on 5/6/21. She received the second dose on 4/30/21. The second dose was 7 days early.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against then tested positive for COVID-19.
Age: 88.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Cough, Dyspnoea
Clinical narrative: Patient with 3 COVID vaccinations who admitted with complications from COVID.  Provider d/c note:  "89 YO female with a PMHx of ITP, HLD, ILD, essential tremor, CAD, osteopenia, colon cancer s/p colectomy who presented with dry cough, SOB, and generalized weakness. Pt was suspected to have acute hypoxic respiratory failure 2/2 ILD and was started on prednisone 40 mg daily. Pt's oxygenation and dyspnea improved with prednisone and we were able to get her off of oxygen briefly on 8/2. However, she started requiring it again on 8/3 up to 5L NC, which we were able to wean to 2L NC before discharge. Plan to taper her off of prednisone after discharge. Of note, Pt tested positive for COVID-19 in June 2022. She was treated with steroid and paxlovid at that time. Pt given COVID-19 2nd booster on the day of discharge. Pt discharged in stable condition. Recommend weaning off oxygen as tolerated. "
Age: 88.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient with 3 COVID vaccinations who admitted with complications from COVID.  Provider d/c note:  "89 YO female with a PMHx of ITP, HLD, ILD, essential tremor, CAD, osteopenia, colon cancer s/p colectomy who presented with dry cough, SOB, and generalized weakness. Pt was suspected to have acute hypoxic respiratory failure 2/2 ILD and was started on prednisone 40 mg daily. Pt's oxygenation and dyspnea improved with prednisone and we were able to get her off of oxygen briefly on 8/2. However, she started requiring it again on 8/3 up to 5L NC, which we were able to wean to 2L NC before discharge. Plan to taper her off of prednisone after discharge. Of note, Pt tested positive for COVID-19 in June 2022. She was treated with steroid and paxlovid at that time. Pt given COVID-19 2nd booster on the day of discharge. Pt discharged in stable condition. Recommend weaning off oxygen as tolerated. "