chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Abnormal loss of weight, Cardiac failure congestive, Chronic obstructive pulmonary disease, Chronic sinusitis, Cough
Clinical narrative: Narrative: 84 yo male patient with the following problem list: PROBLEM LAST MOD PROVIDER Chronic congestive heart failure (SCT 88805009) 11/29/2021 (ICD-10-CM I50.22) Abnormal weight loss (SCT 267024001) (ICD-10-CM 11/19/2021 R63.4) Chronic sinusitis (SCT 40055000) (ICD-10-CM 11/19/2021 J32.9) Chronic obstructive lung disease (SCT 13645005) 11/19/2021 (ICD-10-CM J44.9) Urinary incontinence (SCT 165232002) (ICD-10-CM 11/19/2021 R32.) Chronic cough (SCT 68154008) (ICD-10-CM R05.3) 11/19/2021 Restlessness behavior (SCT 162221009) (ICD-10-CM 06/30/2021 R45.1) History of alcohol abuse (SCT 371434005) 01/03/2020 (ICD-10-CM F10.21) History of partial gastrectomy (SCT 01/03/2020 107701000119101) (ICD-10-CM Z98.890) Seen by palliative care service (SCT 441874000) 09/21/2021 (ICD-10-CM Z51.5), Onset 12/00/2019 Cerebral infarction (SCT 432504007) (ICD-10-CM 09/06/2019 I63.9) Hyperlipidemia (SCT 55822004) (ICD-10-CM E78.2) 11/08/2018 Benign essential hypertension (SCT 1201005) 11/08/2018 (ICD-10-CM I10.) Vascular dementia without behavioral disturbance 11/29/2021 (SCT 16276361000119109) (ICD-10-CM F01.50) Probable Major Vascular Neurocognitive Disorder Gastroesophageal reflux disease (SCT 235595009) 11/08/2018 (ICD-10-CM K21.9) Benign prostatic hyperplasia (SCT 266569009) 11/08/2018 (ICD-10-CM N40.0) Patient passed while in Hospice care on 12/15/21 @ 1145 AM. Pt had received covid vaccines on 1/14/21 & 2/11/21. This death is likely not related to the vaccinations due to patient's comorbidities, advanced age, and length of time from vaccine administration.
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Death, Restlessness, Urinary incontinence, Vascular dementia
Clinical narrative: Narrative: 84 yo male patient with the following problem list: PROBLEM LAST MOD PROVIDER Chronic congestive heart failure (SCT 88805009) 11/29/2021 (ICD-10-CM I50.22) Abnormal weight loss (SCT 267024001) (ICD-10-CM 11/19/2021 R63.4) Chronic sinusitis (SCT 40055000) (ICD-10-CM 11/19/2021 J32.9) Chronic obstructive lung disease (SCT 13645005) 11/19/2021 (ICD-10-CM J44.9) Urinary incontinence (SCT 165232002) (ICD-10-CM 11/19/2021 R32.) Chronic cough (SCT 68154008) (ICD-10-CM R05.3) 11/19/2021 Restlessness behavior (SCT 162221009) (ICD-10-CM 06/30/2021 R45.1) History of alcohol abuse (SCT 371434005) 01/03/2020 (ICD-10-CM F10.21) History of partial gastrectomy (SCT 01/03/2020 107701000119101) (ICD-10-CM Z98.890) Seen by palliative care service (SCT 441874000) 09/21/2021 (ICD-10-CM Z51.5), Onset 12/00/2019 Cerebral infarction (SCT 432504007) (ICD-10-CM 09/06/2019 I63.9) Hyperlipidemia (SCT 55822004) (ICD-10-CM E78.2) 11/08/2018 Benign essential hypertension (SCT 1201005) 11/08/2018 (ICD-10-CM I10.) Vascular dementia without behavioral disturbance 11/29/2021 (SCT 16276361000119109) (ICD-10-CM F01.50) Probable Major Vascular Neurocognitive Disorder Gastroesophageal reflux disease (SCT 235595009) 11/08/2018 (ICD-10-CM K21.9) Benign prostatic hyperplasia (SCT 266569009) 11/08/2018 (ICD-10-CM N40.0) Patient passed while in Hospice care on 12/15/21 @ 1145 AM. Pt had received covid vaccines on 1/14/21 & 2/11/21. This death is likely not related to the vaccinations due to patient's comorbidities, advanced age, and length of time from vaccine administration.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood creatine increased, Brain natriuretic peptide normal, COVID-19, Chest X-ray abnormal, Chest pain
Clinical narrative: Narrative: Admission Date: Nov 30,2021 Discharge Date: Dec 4,2021 Condition of patient at discharge: Stable 75 yo with past medical history of COPD on 2L O2 and recurrent urethral strictures (s/p multiple interventions, self caths), HLD, ocular MG, OSA, GERD, and PTSD who presented to the Emergency Department (ED) for a 4 day history of fever/chills. Patient stated that 4 days prior, he began experiencing fever/chills, with maximum temperature of 102F. States chronic cough from COPD has remained stable without sputum production. Denies urinary symptoms, chest pain, diarrhea, abdominal pain, and rashes. States he has never had fever/chills like this which prompted ED visit today. Patient drove himself without oxygen supplementation. Denies any sick contacts. Vaccinated x2 with Pfizer on 1/22/21 and 2/16/21. In ED patient found hypoxic into 70's on RA and altered but quickly recovered to baseline Aox3 with supplemental oxygen 3L NC. Otherwise HDS and afebrile. Labs significant for COVID-19 positive, pancytopenia (WBC 1.38, Hgb 13.7, Platelets 71), negative troponin, negative BNP, and creatine 1.46 (baseline 1.4). Patient was admitted, he did not come with his home O2 and unable to be sent home without it. He received a total of 6 days of remdesivir and dexamethasone. Patient finished azithromycin course (3 days), and 5 days of the ceftriaxone. He was discharged on 2 more days of cefdinir to finish a 7-day course. Twelve days after discharge, on 12/16/2021, the patient presented to the ED again complaining of chest pain and shortness of breath. He was readmitted to the ICU. Leading diagnosis is organizing Pneumonia post COVID. Received IV antibiotics. CT w/pulmonary fibrosis new since August 2021. Started on Prednisone 80 mg daily(1mg/kg) for organizing Pneumonia and a prolonged taper as below. Discharged to home.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chills, Computerised tomogram thorax abnormal, Coronary artery disease, Dyspnoea, Haemoglobin decreased
Clinical narrative: Narrative: Admission Date: Nov 30,2021 Discharge Date: Dec 4,2021 Condition of patient at discharge: Stable 75 yo with past medical history of COPD on 2L O2 and recurrent urethral strictures (s/p multiple interventions, self caths), HLD, ocular MG, OSA, GERD, and PTSD who presented to the Emergency Department (ED) for a 4 day history of fever/chills. Patient stated that 4 days prior, he began experiencing fever/chills, with maximum temperature of 102F. States chronic cough from COPD has remained stable without sputum production. Denies urinary symptoms, chest pain, diarrhea, abdominal pain, and rashes. States he has never had fever/chills like this which prompted ED visit today. Patient drove himself without oxygen supplementation. Denies any sick contacts. Vaccinated x2 with Pfizer on 1/22/21 and 2/16/21. In ED patient found hypoxic into 70's on RA and altered but quickly recovered to baseline Aox3 with supplemental oxygen 3L NC. Otherwise HDS and afebrile. Labs significant for COVID-19 positive, pancytopenia (WBC 1.38, Hgb 13.7, Platelets 71), negative troponin, negative BNP, and creatine 1.46 (baseline 1.4). Patient was admitted, he did not come with his home O2 and unable to be sent home without it. He received a total of 6 days of remdesivir and dexamethasone. Patient finished azithromycin course (3 days), and 5 days of the ceftriaxone. He was discharged on 2 more days of cefdinir to finish a 7-day course. Twelve days after discharge, on 12/16/2021, the patient presented to the ED again complaining of chest pain and shortness of breath. He was readmitted to the ICU. Leading diagnosis is organizing Pneumonia post COVID. Received IV antibiotics. CT w/pulmonary fibrosis new since August 2021. Started on Prednisone 80 mg daily(1mg/kg) for organizing Pneumonia and a prolonged taper as below. Discharged to home.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypoxia, Intensive care, Laboratory test abnormal, Left ventricular hypertrophy, Lung opacity
Clinical narrative: Narrative: Admission Date: Nov 30,2021 Discharge Date: Dec 4,2021 Condition of patient at discharge: Stable 75 yo with past medical history of COPD on 2L O2 and recurrent urethral strictures (s/p multiple interventions, self caths), HLD, ocular MG, OSA, GERD, and PTSD who presented to the Emergency Department (ED) for a 4 day history of fever/chills. Patient stated that 4 days prior, he began experiencing fever/chills, with maximum temperature of 102F. States chronic cough from COPD has remained stable without sputum production. Denies urinary symptoms, chest pain, diarrhea, abdominal pain, and rashes. States he has never had fever/chills like this which prompted ED visit today. Patient drove himself without oxygen supplementation. Denies any sick contacts. Vaccinated x2 with Pfizer on 1/22/21 and 2/16/21. In ED patient found hypoxic into 70's on RA and altered but quickly recovered to baseline Aox3 with supplemental oxygen 3L NC. Otherwise HDS and afebrile. Labs significant for COVID-19 positive, pancytopenia (WBC 1.38, Hgb 13.7, Platelets 71), negative troponin, negative BNP, and creatine 1.46 (baseline 1.4). Patient was admitted, he did not come with his home O2 and unable to be sent home without it. He received a total of 6 days of remdesivir and dexamethasone. Patient finished azithromycin course (3 days), and 5 days of the ceftriaxone. He was discharged on 2 more days of cefdinir to finish a 7-day course. Twelve days after discharge, on 12/16/2021, the patient presented to the ED again complaining of chest pain and shortness of breath. He was readmitted to the ICU. Leading diagnosis is organizing Pneumonia post COVID. Received IV antibiotics. CT w/pulmonary fibrosis new since August 2021. Started on Prednisone 80 mg daily(1mg/kg) for organizing Pneumonia and a prolonged taper as below. Discharged to home.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Organising pneumonia, Pancytopenia, Platelet count decreased, Pulmonary fibrosis, Pyrexia
Clinical narrative: Narrative: Admission Date: Nov 30,2021 Discharge Date: Dec 4,2021 Condition of patient at discharge: Stable 75 yo with past medical history of COPD on 2L O2 and recurrent urethral strictures (s/p multiple interventions, self caths), HLD, ocular MG, OSA, GERD, and PTSD who presented to the Emergency Department (ED) for a 4 day history of fever/chills. Patient stated that 4 days prior, he began experiencing fever/chills, with maximum temperature of 102F. States chronic cough from COPD has remained stable without sputum production. Denies urinary symptoms, chest pain, diarrhea, abdominal pain, and rashes. States he has never had fever/chills like this which prompted ED visit today. Patient drove himself without oxygen supplementation. Denies any sick contacts. Vaccinated x2 with Pfizer on 1/22/21 and 2/16/21. In ED patient found hypoxic into 70's on RA and altered but quickly recovered to baseline Aox3 with supplemental oxygen 3L NC. Otherwise HDS and afebrile. Labs significant for COVID-19 positive, pancytopenia (WBC 1.38, Hgb 13.7, Platelets 71), negative troponin, negative BNP, and creatine 1.46 (baseline 1.4). Patient was admitted, he did not come with his home O2 and unable to be sent home without it. He received a total of 6 days of remdesivir and dexamethasone. Patient finished azithromycin course (3 days), and 5 days of the ceftriaxone. He was discharged on 2 more days of cefdinir to finish a 7-day course. Twelve days after discharge, on 12/16/2021, the patient presented to the ED again complaining of chest pain and shortness of breath. He was readmitted to the ICU. Leading diagnosis is organizing Pneumonia post COVID. Received IV antibiotics. CT w/pulmonary fibrosis new since August 2021. Started on Prednisone 80 mg daily(1mg/kg) for organizing Pneumonia and a prolonged taper as below. Discharged to home.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Splenomegaly, Troponin normal, White blood cell count decreased
Clinical narrative: Narrative: Admission Date: Nov 30,2021 Discharge Date: Dec 4,2021 Condition of patient at discharge: Stable 75 yo with past medical history of COPD on 2L O2 and recurrent urethral strictures (s/p multiple interventions, self caths), HLD, ocular MG, OSA, GERD, and PTSD who presented to the Emergency Department (ED) for a 4 day history of fever/chills. Patient stated that 4 days prior, he began experiencing fever/chills, with maximum temperature of 102F. States chronic cough from COPD has remained stable without sputum production. Denies urinary symptoms, chest pain, diarrhea, abdominal pain, and rashes. States he has never had fever/chills like this which prompted ED visit today. Patient drove himself without oxygen supplementation. Denies any sick contacts. Vaccinated x2 with Pfizer on 1/22/21 and 2/16/21. In ED patient found hypoxic into 70's on RA and altered but quickly recovered to baseline Aox3 with supplemental oxygen 3L NC. Otherwise HDS and afebrile. Labs significant for COVID-19 positive, pancytopenia (WBC 1.38, Hgb 13.7, Platelets 71), negative troponin, negative BNP, and creatine 1.46 (baseline 1.4). Patient was admitted, he did not come with his home O2 and unable to be sent home without it. He received a total of 6 days of remdesivir and dexamethasone. Patient finished azithromycin course (3 days), and 5 days of the ceftriaxone. He was discharged on 2 more days of cefdinir to finish a 7-day course. Twelve days after discharge, on 12/16/2021, the patient presented to the ED again complaining of chest pain and shortness of breath. He was readmitted to the ICU. Leading diagnosis is organizing Pneumonia post COVID. Received IV antibiotics. CT w/pulmonary fibrosis new since August 2021. Started on Prednisone 80 mg daily(1mg/kg) for organizing Pneumonia and a prolonged taper as below. Discharged to home.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Chills, Pyrexia
Clinical narrative: Narrative: COVID infection after COVID vaccine 06/03 COVID vaccine dose #1 (of 1) 12/18/ pt c/o chills, fever, loss of taste or smell, COVID positive no further information documented.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Narrative: COVID infection after COVID vaccine 06/03 COVID vaccine dose #1 (of 1) 12/18/ pt c/o chills, fever, loss of taste or smell, COVID positive no further information documented.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Asthma, COVID-19, Condition aggravated, Cough, Dyspnoea
Clinical narrative: Narrative:  Patient is an 85 yo who presents to the ED due to NOV 21, 2021 Subjective/Chief Complaint: Cough x 1 week. Objective: Significant bilateral dependent edema, which pt states is worsened. States home-use hospital bed is broken and cannot elevate feet as he normally does. Reports compliance with diuretic medication regimen, but greatly decreased urine production x 1 week. He has been covid vaccinated x 2 (no booster). Patient with history of asthma on chronic prednisone, presents with 1 week of dry cough he denies any fever or chills no chest pain. States that he gets a little short of breath when he is a coughing fit however otherwise does not have any shortness of breath. Has been using his inhaler more often than usual. Did have some ill family members in the home before all this started. HOSPITAL COURSE: slow but good progress have been encouraging greater in room activity, movement, States has been trying to use bedside incentive spirometry, but coughing at times has made it difficult. Flutter valve added. Typically somnolent in a.m. CPAP use in place. Patient has improved to point where he is off oxygen and appears closer to baseline. Discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Gravitational oedema, Positive airway pressure therapy, SARS-CoV-2 test positive, Sick relative, Somnolence
Clinical narrative: Narrative:  Patient is an 85 yo who presents to the ED due to NOV 21, 2021 Subjective/Chief Complaint: Cough x 1 week. Objective: Significant bilateral dependent edema, which pt states is worsened. States home-use hospital bed is broken and cannot elevate feet as he normally does. Reports compliance with diuretic medication regimen, but greatly decreased urine production x 1 week. He has been covid vaccinated x 2 (no booster). Patient with history of asthma on chronic prednisone, presents with 1 week of dry cough he denies any fever or chills no chest pain. States that he gets a little short of breath when he is a coughing fit however otherwise does not have any shortness of breath. Has been using his inhaler more often than usual. Did have some ill family members in the home before all this started. HOSPITAL COURSE: slow but good progress have been encouraging greater in room activity, movement, States has been trying to use bedside incentive spirometry, but coughing at times has made it difficult. Flutter valve added. Typically somnolent in a.m. CPAP use in place. Patient has improved to point where he is off oxygen and appears closer to baseline. Discharged home.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Urine output decreased
Clinical narrative: Narrative:  Patient is an 85 yo who presents to the ED due to NOV 21, 2021 Subjective/Chief Complaint: Cough x 1 week. Objective: Significant bilateral dependent edema, which pt states is worsened. States home-use hospital bed is broken and cannot elevate feet as he normally does. Reports compliance with diuretic medication regimen, but greatly decreased urine production x 1 week. He has been covid vaccinated x 2 (no booster). Patient with history of asthma on chronic prednisone, presents with 1 week of dry cough he denies any fever or chills no chest pain. States that he gets a little short of breath when he is a coughing fit however otherwise does not have any shortness of breath. Has been using his inhaler more often than usual. Did have some ill family members in the home before all this started. HOSPITAL COURSE: slow but good progress have been encouraging greater in room activity, movement, States has been trying to use bedside incentive spirometry, but coughing at times has made it difficult. Flutter valve added. Typically somnolent in a.m. CPAP use in place. Patient has improved to point where he is off oxygen and appears closer to baseline. Discharged home.
Age: 22.0
Sex: M
Vaccine: COVID19
Symptoms: Autoimmune haemolytic anaemia, Dizziness, Headache, Jaundice
Clinical narrative: Dizziness, Headache, jaundiced sclera Narrative:  Patient has hx of rheumatoid arthritis. Received Moderna booster 12/11/21. Developed headache 12/14/21, dizziness 12/15/21, and jaundiced sclera on 12/16/21. Admitted to Hospital on 12/17/21 and diagnosed with auto-immune induced hemolytic anemia. Per employee, his physicians suspect Moderna booster adverse reaction. treated with high dose corticosteroids. Employee to be discharged from hospital today.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Fatigue, Feeling abnormal
Clinical narrative: Narrative: "I can't get a deep breath, I am tired" "I'm not the same person after the vaccine"
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, COVID-19, Cardiac telemetry, Dyspnoea, Intensive care
Clinical narrative: Narrative:  This is a 75 yo patient COVID Vaccinated (x3 Pfizer vaccine,booster 10/19) with PMH of Essential HTN,Hyperlipidemia recently Dx with COVID+ (10/17/2021) admitted after came to ED for complaint of SOB with O2 sat of 87% at RA,CTA chest : suboptimal for PE but with Extensive multifocal GGO's.Admitted 10/21 to COVID Unit Med Telemetry and upgraded to ICU (10/22/2021) due to increased O2 requirement to 60 LHFNC and 57% FIO2 and downgraded back to the medical telemetry COVID Unit 10/24/2021. Patient said he is 99% back to his baseline and is ready to go home. He could not wait. He has been afebrile. He has been having good appetite and been active. Discharged to home.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, SARS-CoV-2 test positive
Clinical narrative: Narrative:  This is a 75 yo patient COVID Vaccinated (x3 Pfizer vaccine,booster 10/19) with PMH of Essential HTN,Hyperlipidemia recently Dx with COVID+ (10/17/2021) admitted after came to ED for complaint of SOB with O2 sat of 87% at RA,CTA chest : suboptimal for PE but with Extensive multifocal GGO's.Admitted 10/21 to COVID Unit Med Telemetry and upgraded to ICU (10/22/2021) due to increased O2 requirement to 60 LHFNC and 57% FIO2 and downgraded back to the medical telemetry COVID Unit 10/24/2021. Patient said he is 99% back to his baseline and is ready to go home. He could not wait. He has been afebrile. He has been having good appetite and been active. Discharged to home.
Age: 92.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Cerebrovascular accident, Death, Fall
Clinical narrative: Narrative:  92yo male had 2 visits to the ED on 10/20/21 and on 11/16/21 for unexplained weakness. Pt then was taken back to the ER on 11/17/21 for a fall and had a CVA. Pt then was transferred to another hospital and facility was notified on 12/6/21 that pt passed on 12/5/21 at hospital from CVA. Pt had received covid vaccines on 2/3/21 & 3/4/21. This death is not related to covid vaccines.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary incontinence
Clinical narrative: Narrative: An 80yo male with PMH of DM, HTN, Coronary arteriosclerosis, Hyperlipidemia, DVT of lower extremities, Impaired Cognition, PVD and CKD Received Pfizer's Covid -19 vaccine per policy and protocol without complication Frist dose on 04/05/2021 and second dose on 04/26/2021 Per reporting Physician's on April 16, 2021, the patient's wife called on 04/15/2021 and reported he had a new urinary incontinence x 4 days after first dose of Covid-19 vaccine
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Asymptomatic COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
Clinical narrative: Narrative:  COVID infection following COVID vaccine series 03/08 COVID vaccine dose #1 03/29 COVID vaccine dose #2 11/03 COVID vaccine dose #3 12/18 pt reported close exposure to person with COVID, COVID positive, no symptoms
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Bladder cancer stage IV, Death, Neoplasm malignant, Small intestinal obstruction
Clinical narrative: Narrative:  83 yo male patient died during inpatient hospice admission on 12/17/2021. Death was caused by: Small Bowel Obstruction in the setting malignancy (stage IV bladder cancer). Pt. had received covid vaccines on 2/5/21 & 2/26/21. This death is not related to covid vaccines.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Narrative: Patient with COVID-19 after complete vaccination with Pfizer vaccine.
Age: 55.0
Sex: F
Vaccine: VARZOS
Symptoms: Unevaluable event
Clinical narrative: Narrative:
Age: 71.0
Sex: M
Vaccine: FLU4
Symptoms: Unevaluable event
Clinical narrative: Narrative:
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, COVID-19 pneumonia, Fall, Fatigue
Clinical narrative: Narrative:  Patient is a 72-y.o M whose past medical history includes hypertension, diabetes, hyperlipidemia, atrial fibrillation on routine anticoagulation who presents with complaints of fatigue/decreased energy over any number of days. Patient reports that on Monday, 10/18/2021 he had received his third COVID-19 booster as well as influenza vaccine. Patient then on the following day began experiencing fatigue and decreased energy in which she went to supermarket that day is having issues with ambulation. Patient had a ground-level fall at supermarket however he did not hit his head. Patient on throughout the week continue to have persistent fatigue/decreased energy in which he thought he had the flu would go away on its own. Due to worsening symptoms, patient presents to ED at onset of weekend. Admitted with Covid pneumonia and associated hypoxemia, among others. HOSPITAL COURSE: Slow improvement on oxygenation, cardiac status, and labile glycemic levels combine with sense of decreased energy in Covid positive pna patient. CONDITION AT DISCHARGE: stable in care of Self
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Gait disturbance, Hypoxia, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient is a 72-y.o M whose past medical history includes hypertension, diabetes, hyperlipidemia, atrial fibrillation on routine anticoagulation who presents with complaints of fatigue/decreased energy over any number of days. Patient reports that on Monday, 10/18/2021 he had received his third COVID-19 booster as well as influenza vaccine. Patient then on the following day began experiencing fatigue and decreased energy in which she went to supermarket that day is having issues with ambulation. Patient had a ground-level fall at supermarket however he did not hit his head. Patient on throughout the week continue to have persistent fatigue/decreased energy in which he thought he had the flu would go away on its own. Due to worsening symptoms, patient presents to ED at onset of weekend. Admitted with Covid pneumonia and associated hypoxemia, among others. HOSPITAL COURSE: Slow improvement on oxygenation, cardiac status, and labile glycemic levels combine with sense of decreased energy in Covid positive pna patient. CONDITION AT DISCHARGE: stable in care of Self
Age: 3.0
Sex: M
Vaccine: COVID19
Symptoms: Liquid product physical issue
Clinical narrative: Narrative:  NOT AN ADR A PRODUCT REPORT
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease, Condition aggravated
Clinical narrative: Narrative:  Patient is a 78 year old MALE Covid vaccinated with PMH of HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) with s/p AICD placement Feb 2021, PAD, HTN, COPD and HOT prn, DM type II non-insulin-requiring, h/o gastric ulcer,CAD with recent NonStemi 07/2021 (Type II MI),Cardiac Amyloidosis (ATTR)on Tafamidis , tobacco dependency,h/o prostate carcinoma came to the emergency room for complaint of 2 to 3 weeks of cough and COVID - 19 detected with O2 sat at RA ~89% and CTA Chest : Neg PE but + RLL infiltrate. Acute on chronic hypoxic respiratory failure:2/2 COVID Pneumonia and COPD exacerbation Acute COVID infection /Pneumonia : Vaccinated - s/p IV remdesivir (10/23 -10/27),Decadron po 10/23 - 10/26. Decadron changed to IV methylprednisolone for COPD exacerbation -s/p IV ceftriaxone and azithromycin completed 3 days therapy -LFTs: Improved after IV remdesivir COPD on home oxygen in acute exacerbation Chronic Nonobstructive CAD # Cardiac Amyloidosis on Tafamidis # Cardiomyopathy HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) compensated, with s/p AICD/pacemaker placement Feb 2021 Chronic tobacco use with dependency Type 2 diabetes mellitus non-insulin-requiring, hemoglobin A1c 6.8% (07/07/2021), complicated with neuropathy wit noted hyperglycemia 2/2 Steroids Chronic hyperlipidemia Chronic vitamin D deficiency Mild to moderate protein/calorie malnutrition, BMI of less than 18% - Obtain dietary consult for dietary supplements CONDITION AT DISCHARGE: Patient is seen and evaluated in the day of discharge, he is very comfortable laying flat speaking in full sentences. He denies any new complaints. He is feeling better and is ready to go home. He has been afebrile.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Cough, Glycosylated haemoglobin normal, Hyperglycaemia, Hyperlipidaemia, Liver function test abnormal
Clinical narrative: Narrative:  Patient is a 78 year old MALE Covid vaccinated with PMH of HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) with s/p AICD placement Feb 2021, PAD, HTN, COPD and HOT prn, DM type II non-insulin-requiring, h/o gastric ulcer,CAD with recent NonStemi 07/2021 (Type II MI),Cardiac Amyloidosis (ATTR)on Tafamidis , tobacco dependency,h/o prostate carcinoma came to the emergency room for complaint of 2 to 3 weeks of cough and COVID - 19 detected with O2 sat at RA ~89% and CTA Chest : Neg PE but + RLL infiltrate. Acute on chronic hypoxic respiratory failure:2/2 COVID Pneumonia and COPD exacerbation Acute COVID infection /Pneumonia : Vaccinated - s/p IV remdesivir (10/23 -10/27),Decadron po 10/23 - 10/26. Decadron changed to IV methylprednisolone for COPD exacerbation -s/p IV ceftriaxone and azithromycin completed 3 days therapy -LFTs: Improved after IV remdesivir COPD on home oxygen in acute exacerbation Chronic Nonobstructive CAD # Cardiac Amyloidosis on Tafamidis # Cardiomyopathy HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) compensated, with s/p AICD/pacemaker placement Feb 2021 Chronic tobacco use with dependency Type 2 diabetes mellitus non-insulin-requiring, hemoglobin A1c 6.8% (07/07/2021), complicated with neuropathy wit noted hyperglycemia 2/2 Steroids Chronic hyperlipidemia Chronic vitamin D deficiency Mild to moderate protein/calorie malnutrition, BMI of less than 18% - Obtain dietary consult for dietary supplements CONDITION AT DISCHARGE: Patient is seen and evaluated in the day of discharge, he is very comfortable laying flat speaking in full sentences. He denies any new complaints. He is feeling better and is ready to go home. He has been afebrile.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Lung infiltration, Malnutrition, Neuropathy peripheral, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: Narrative:  Patient is a 78 year old MALE Covid vaccinated with PMH of HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) with s/p AICD placement Feb 2021, PAD, HTN, COPD and HOT prn, DM type II non-insulin-requiring, h/o gastric ulcer,CAD with recent NonStemi 07/2021 (Type II MI),Cardiac Amyloidosis (ATTR)on Tafamidis , tobacco dependency,h/o prostate carcinoma came to the emergency room for complaint of 2 to 3 weeks of cough and COVID - 19 detected with O2 sat at RA ~89% and CTA Chest : Neg PE but + RLL infiltrate. Acute on chronic hypoxic respiratory failure:2/2 COVID Pneumonia and COPD exacerbation Acute COVID infection /Pneumonia : Vaccinated - s/p IV remdesivir (10/23 -10/27),Decadron po 10/23 - 10/26. Decadron changed to IV methylprednisolone for COPD exacerbation -s/p IV ceftriaxone and azithromycin completed 3 days therapy -LFTs: Improved after IV remdesivir COPD on home oxygen in acute exacerbation Chronic Nonobstructive CAD # Cardiac Amyloidosis on Tafamidis # Cardiomyopathy HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) compensated, with s/p AICD/pacemaker placement Feb 2021 Chronic tobacco use with dependency Type 2 diabetes mellitus non-insulin-requiring, hemoglobin A1c 6.8% (07/07/2021), complicated with neuropathy wit noted hyperglycemia 2/2 Steroids Chronic hyperlipidemia Chronic vitamin D deficiency Mild to moderate protein/calorie malnutrition, BMI of less than 18% - Obtain dietary consult for dietary supplements CONDITION AT DISCHARGE: Patient is seen and evaluated in the day of discharge, he is very comfortable laying flat speaking in full sentences. He denies any new complaints. He is feeling better and is ready to go home. He has been afebrile.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Vitamin D deficiency
Clinical narrative: Narrative:  Patient is a 78 year old MALE Covid vaccinated with PMH of HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) with s/p AICD placement Feb 2021, PAD, HTN, COPD and HOT prn, DM type II non-insulin-requiring, h/o gastric ulcer,CAD with recent NonStemi 07/2021 (Type II MI),Cardiac Amyloidosis (ATTR)on Tafamidis , tobacco dependency,h/o prostate carcinoma came to the emergency room for complaint of 2 to 3 weeks of cough and COVID - 19 detected with O2 sat at RA ~89% and CTA Chest : Neg PE but + RLL infiltrate. Acute on chronic hypoxic respiratory failure:2/2 COVID Pneumonia and COPD exacerbation Acute COVID infection /Pneumonia : Vaccinated - s/p IV remdesivir (10/23 -10/27),Decadron po 10/23 - 10/26. Decadron changed to IV methylprednisolone for COPD exacerbation -s/p IV ceftriaxone and azithromycin completed 3 days therapy -LFTs: Improved after IV remdesivir COPD on home oxygen in acute exacerbation Chronic Nonobstructive CAD # Cardiac Amyloidosis on Tafamidis # Cardiomyopathy HFrEF LVEF ~ 20-25% (2 D ECHO 07/07/2021) compensated, with s/p AICD/pacemaker placement Feb 2021 Chronic tobacco use with dependency Type 2 diabetes mellitus non-insulin-requiring, hemoglobin A1c 6.8% (07/07/2021), complicated with neuropathy wit noted hyperglycemia 2/2 Steroids Chronic hyperlipidemia Chronic vitamin D deficiency Mild to moderate protein/calorie malnutrition, BMI of less than 18% - Obtain dietary consult for dietary supplements CONDITION AT DISCHARGE: Patient is seen and evaluated in the day of discharge, he is very comfortable laying flat speaking in full sentences. He denies any new complaints. He is feeling better and is ready to go home. He has been afebrile.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Headache, Myalgia, Pyrexia
Clinical narrative: Headache, Myalgia, Arthralgia & Fever Narrative:
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine increased, Blood lactic acid increased, Blood pressure systolic decreased, COVID-19, Chills
Clinical narrative: Narrative: Patient is a 66 year old M with PMH significant for hyperlipidemia, neurogenic bladder (self caths), OA, and osteoporosis who presents for chills. Patient notes chills developed last night and have not resolved. He has not had any other symptoms (no fever, night sweats, headache, myalgias, cough, dyspnea, chest pain, abdominal pain, nausea, vomiting, diarrhea, urinary changes). His son and daughter-in-law have had flu-like symptoms for the past few days. No one has been tested for COVID. He had his first dose of Pfizer 2/2021 and the second dose 6/2021. In the ED the patient was found to have a fever of 104.4, HR 120s, systolic BP was quite low in the 80s, labs significant for elevated WBCs, lactic. Cr, procal, and with positive COVID-19 test. HOSPITAL COURSE: Sepsis protocol initiated, has completed ceftriaxone 2 g IV, will transition for 5 day course of outpatient keflex. slow improvement in status, originally downgraded from MICU to Covid Ward. Slow but sure increase in movement / activity, as he is able to do at home. Reinforcing importance of continued med, Practitioner compliance. Elevated LE due to ongoing dependent edema, self reliance on ADL needs as able to include ongoing self catheterization due to neurogenic bladder. CONDITION AT DISCHARGE: stable in care of self to home
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Gravitational oedema, Intensive care, Laboratory test abnormal, Procalcitonin increased, Pyrexia
Clinical narrative: Narrative: Patient is a 66 year old M with PMH significant for hyperlipidemia, neurogenic bladder (self caths), OA, and osteoporosis who presents for chills. Patient notes chills developed last night and have not resolved. He has not had any other symptoms (no fever, night sweats, headache, myalgias, cough, dyspnea, chest pain, abdominal pain, nausea, vomiting, diarrhea, urinary changes). His son and daughter-in-law have had flu-like symptoms for the past few days. No one has been tested for COVID. He had his first dose of Pfizer 2/2021 and the second dose 6/2021. In the ED the patient was found to have a fever of 104.4, HR 120s, systolic BP was quite low in the 80s, labs significant for elevated WBCs, lactic. Cr, procal, and with positive COVID-19 test. HOSPITAL COURSE: Sepsis protocol initiated, has completed ceftriaxone 2 g IV, will transition for 5 day course of outpatient keflex. slow improvement in status, originally downgraded from MICU to Covid Ward. Slow but sure increase in movement / activity, as he is able to do at home. Reinforcing importance of continued med, Practitioner compliance. Elevated LE due to ongoing dependent edema, self reliance on ADL needs as able to include ongoing self catheterization due to neurogenic bladder. CONDITION AT DISCHARGE: stable in care of self to home
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, White blood cell count increased
Clinical narrative: Narrative: Patient is a 66 year old M with PMH significant for hyperlipidemia, neurogenic bladder (self caths), OA, and osteoporosis who presents for chills. Patient notes chills developed last night and have not resolved. He has not had any other symptoms (no fever, night sweats, headache, myalgias, cough, dyspnea, chest pain, abdominal pain, nausea, vomiting, diarrhea, urinary changes). His son and daughter-in-law have had flu-like symptoms for the past few days. No one has been tested for COVID. He had his first dose of Pfizer 2/2021 and the second dose 6/2021. In the ED the patient was found to have a fever of 104.4, HR 120s, systolic BP was quite low in the 80s, labs significant for elevated WBCs, lactic. Cr, procal, and with positive COVID-19 test. HOSPITAL COURSE: Sepsis protocol initiated, has completed ceftriaxone 2 g IV, will transition for 5 day course of outpatient keflex. slow improvement in status, originally downgraded from MICU to Covid Ward. Slow but sure increase in movement / activity, as he is able to do at home. Reinforcing importance of continued med, Practitioner compliance. Elevated LE due to ongoing dependent edema, self reliance on ADL needs as able to include ongoing self catheterization due to neurogenic bladder. CONDITION AT DISCHARGE: stable in care of self to home
Age: 73.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Rash macular
Clinical narrative: Narrative:  Pt. called in to PRC, reports he had second shingrix vax on 8/27 and  he has some redness, "blotchiness", and still tenderness at the injection site.  Denies any difficulty breathing, denies any blister/fluid filled rash. Denies any  fevers/chills. Denies any warmth really at site. No future workup on the patient  suggests that the reaction abated.
Age: 59.0
Sex: M
Vaccine: PPV
Symptoms: Arthralgia, Pain
Clinical narrative: Narrative:  Patient is a 59 year old male who was due for both the Prevnar13 and  Shingrix Vaccinations. He received both on 4/14/21, Prevnar13 in the L arm and  Shingrix in the R arm Patient presented to the ED on 4/19/21 with complaints of  burning pain to L elbow since receiving the vaccines. He was given Tordol in the  ED and discharged home on doxycycline, indomethacin, and Vicodin and  recommended to follow up with ortho. Patient never followed up.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Myalgia, Pyrexia
Clinical narrative: Myalgia, Fever, chills Narrative: N/A
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Blindness unilateral, Computerised tomogram head normal, Computerised tomogram neck, Laboratory test normal, Magnetic resonance imaging normal
Clinical narrative: visual loss permanantly in left eye Narrative: i am partially blind in left eye now permanently. Retinal branch occlusion was diagnosis. just completed mri with and without contrast, ct scan of neck and optical, and ultrasound and labs last week. all test returned with no findings..just blind
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Retinal vascular occlusion, Scan with contrast normal, Ultrasound scan normal
Clinical narrative: visual loss permanantly in left eye Narrative: i am partially blind in left eye now permanently. Retinal branch occlusion was diagnosis. just completed mri with and without contrast, ct scan of neck and optical, and ultrasound and labs last week. all test returned with no findings..just blind
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Ageusia, Angiogram pulmonary abnormal, Anosmia, Blood culture positive, Bronchoalveolar lavage abnormal
Clinical narrative: Narrative:  78 y/o Male with HIV, Multiple Myeloma on chemo, HTN, paroxysmal SVT, COPD and active smoker, chronic kidney disease, peripheral neuropathy, PVD. Patient recently discharged from hospital 10/31/21. At that time was admitted and treated for septic shock from e-coli bacteremia and e coli pneumonia. He was intubated, on broad spectrum abx and on pressors. Blood cultures grew 2/2 E coli and also growth in BAL. He completed a 2 week course of IV antibiotics and was discharged to a nursing facility. At that time he was COVID negative. He was also previously covid vaccinated and s/p booster. While at the nursing facility he was noted to have cough, SOB, hypoxia and low BP's. He admits to also having headache, loss of taste and smell, cough with clear sputum, SOB, fever/chills and body aches. For that reason he presented back to the ED. Patient id fully Covid vaccinated (With Booster) with PMH of HIV on HAART, multiple myeloma on chemo (lenalidomide, decadron last 10/8/21), essential hypertension, paroxysmal SVT, COPD not on HOT h/o s/p Intubation 10/2021(AHRF from sepsis), tobacco dependency, recently discharged 11/04/2021 to Care Center transferred to ED for Cough and SOB,loss of sense of taste & smell x 1 week ,O2 sat at 2 LPM NC 91%,COVID +,CTA Chest : no PE ,+GGO ,CXRAY: Neg,BP 99/59 , serum procalcitonin :0.22. Patient while in hospital continue to deteriorate and develop leukocytosis with white blood cell count of 20,000 started empirically on IV Zosyn however his respiratory status continued to worsen. His overall physical endurance has deteriorated and eventually patient requesting to be placed in end of life hospice/palliative care (12/07/2021). Patient is awaiting transfer to an inpatient hospice center.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray normal, Chills, Dyspnoea, Endotracheal intubation
Clinical narrative: Narrative:  78 y/o Male with HIV, Multiple Myeloma on chemo, HTN, paroxysmal SVT, COPD and active smoker, chronic kidney disease, peripheral neuropathy, PVD. Patient recently discharged from hospital 10/31/21. At that time was admitted and treated for septic shock from e-coli bacteremia and e coli pneumonia. He was intubated, on broad spectrum abx and on pressors. Blood cultures grew 2/2 E coli and also growth in BAL. He completed a 2 week course of IV antibiotics and was discharged to a nursing facility. At that time he was COVID negative. He was also previously covid vaccinated and s/p booster. While at the nursing facility he was noted to have cough, SOB, hypoxia and low BP's. He admits to also having headache, loss of taste and smell, cough with clear sputum, SOB, fever/chills and body aches. For that reason he presented back to the ED. Patient id fully Covid vaccinated (With Booster) with PMH of HIV on HAART, multiple myeloma on chemo (lenalidomide, decadron last 10/8/21), essential hypertension, paroxysmal SVT, COPD not on HOT h/o s/p Intubation 10/2021(AHRF from sepsis), tobacco dependency, recently discharged 11/04/2021 to Care Center transferred to ED for Cough and SOB,loss of sense of taste & smell x 1 week ,O2 sat at 2 LPM NC 91%,COVID +,CTA Chest : no PE ,+GGO ,CXRAY: Neg,BP 99/59 , serum procalcitonin :0.22. Patient while in hospital continue to deteriorate and develop leukocytosis with white blood cell count of 20,000 started empirically on IV Zosyn however his respiratory status continued to worsen. His overall physical endurance has deteriorated and eventually patient requesting to be placed in end of life hospice/palliative care (12/07/2021). Patient is awaiting transfer to an inpatient hospice center.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Escherichia bacteraemia, Escherichia test positive, General physical health deterioration, Headache, Hypotension
Clinical narrative: Narrative:  78 y/o Male with HIV, Multiple Myeloma on chemo, HTN, paroxysmal SVT, COPD and active smoker, chronic kidney disease, peripheral neuropathy, PVD. Patient recently discharged from hospital 10/31/21. At that time was admitted and treated for septic shock from e-coli bacteremia and e coli pneumonia. He was intubated, on broad spectrum abx and on pressors. Blood cultures grew 2/2 E coli and also growth in BAL. He completed a 2 week course of IV antibiotics and was discharged to a nursing facility. At that time he was COVID negative. He was also previously covid vaccinated and s/p booster. While at the nursing facility he was noted to have cough, SOB, hypoxia and low BP's. He admits to also having headache, loss of taste and smell, cough with clear sputum, SOB, fever/chills and body aches. For that reason he presented back to the ED. Patient id fully Covid vaccinated (With Booster) with PMH of HIV on HAART, multiple myeloma on chemo (lenalidomide, decadron last 10/8/21), essential hypertension, paroxysmal SVT, COPD not on HOT h/o s/p Intubation 10/2021(AHRF from sepsis), tobacco dependency, recently discharged 11/04/2021 to Care Center transferred to ED for Cough and SOB,loss of sense of taste & smell x 1 week ,O2 sat at 2 LPM NC 91%,COVID +,CTA Chest : no PE ,+GGO ,CXRAY: Neg,BP 99/59 , serum procalcitonin :0.22. Patient while in hospital continue to deteriorate and develop leukocytosis with white blood cell count of 20,000 started empirically on IV Zosyn however his respiratory status continued to worsen. His overall physical endurance has deteriorated and eventually patient requesting to be placed in end of life hospice/palliative care (12/07/2021). Patient is awaiting transfer to an inpatient hospice center.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Leukocytosis, Lung opacity, Pain, Pneumonia escherichia
Clinical narrative: Narrative:  78 y/o Male with HIV, Multiple Myeloma on chemo, HTN, paroxysmal SVT, COPD and active smoker, chronic kidney disease, peripheral neuropathy, PVD. Patient recently discharged from hospital 10/31/21. At that time was admitted and treated for septic shock from e-coli bacteremia and e coli pneumonia. He was intubated, on broad spectrum abx and on pressors. Blood cultures grew 2/2 E coli and also growth in BAL. He completed a 2 week course of IV antibiotics and was discharged to a nursing facility. At that time he was COVID negative. He was also previously covid vaccinated and s/p booster. While at the nursing facility he was noted to have cough, SOB, hypoxia and low BP's. He admits to also having headache, loss of taste and smell, cough with clear sputum, SOB, fever/chills and body aches. For that reason he presented back to the ED. Patient id fully Covid vaccinated (With Booster) with PMH of HIV on HAART, multiple myeloma on chemo (lenalidomide, decadron last 10/8/21), essential hypertension, paroxysmal SVT, COPD not on HOT h/o s/p Intubation 10/2021(AHRF from sepsis), tobacco dependency, recently discharged 11/04/2021 to Care Center transferred to ED for Cough and SOB,loss of sense of taste & smell x 1 week ,O2 sat at 2 LPM NC 91%,COVID +,CTA Chest : no PE ,+GGO ,CXRAY: Neg,BP 99/59 , serum procalcitonin :0.22. Patient while in hospital continue to deteriorate and develop leukocytosis with white blood cell count of 20,000 started empirically on IV Zosyn however his respiratory status continued to worsen. His overall physical endurance has deteriorated and eventually patient requesting to be placed in end of life hospice/palliative care (12/07/2021). Patient is awaiting transfer to an inpatient hospice center.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Procalcitonin, Productive cough, Pyrexia, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Narrative:  78 y/o Male with HIV, Multiple Myeloma on chemo, HTN, paroxysmal SVT, COPD and active smoker, chronic kidney disease, peripheral neuropathy, PVD. Patient recently discharged from hospital 10/31/21. At that time was admitted and treated for septic shock from e-coli bacteremia and e coli pneumonia. He was intubated, on broad spectrum abx and on pressors. Blood cultures grew 2/2 E coli and also growth in BAL. He completed a 2 week course of IV antibiotics and was discharged to a nursing facility. At that time he was COVID negative. He was also previously covid vaccinated and s/p booster. While at the nursing facility he was noted to have cough, SOB, hypoxia and low BP's. He admits to also having headache, loss of taste and smell, cough with clear sputum, SOB, fever/chills and body aches. For that reason he presented back to the ED. Patient id fully Covid vaccinated (With Booster) with PMH of HIV on HAART, multiple myeloma on chemo (lenalidomide, decadron last 10/8/21), essential hypertension, paroxysmal SVT, COPD not on HOT h/o s/p Intubation 10/2021(AHRF from sepsis), tobacco dependency, recently discharged 11/04/2021 to Care Center transferred to ED for Cough and SOB,loss of sense of taste & smell x 1 week ,O2 sat at 2 LPM NC 91%,COVID +,CTA Chest : no PE ,+GGO ,CXRAY: Neg,BP 99/59 , serum procalcitonin :0.22. Patient while in hospital continue to deteriorate and develop leukocytosis with white blood cell count of 20,000 started empirically on IV Zosyn however his respiratory status continued to worsen. His overall physical endurance has deteriorated and eventually patient requesting to be placed in end of life hospice/palliative care (12/07/2021). Patient is awaiting transfer to an inpatient hospice center.