chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 80.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Streptococcus test positive, Thrombocytopenia, Ultrasound Doppler normal, Urinary tract infection, Urine analysis abnormal
Clinical narrative: Patient hospitalized;  COVID-19 positive (8.29.21);  fully vaccinated  Admission Date: 8/29/2021 Discharge Date: 09/01/2021 DISCHARGE INSTRUCTIONS Discharge Disposition: Home with services - Nursing Discharge Recommendations:  1. Covid-19: Will complete 3 days of decadron treatment outpatient.  2. UTI: Will complete 3 days of Omnicef treatment outpatient. 3. Follow up with PCP within 1-2 weeks regarding Covid-19, UTI, and CHF DETAILS OF HOSPITAL STAY Hospital Course: Patient is a 80 y.o. male with PMHx of DM2, CHF, CKD and multiple co-morbidities who presented with 2 days of fatigue, weakness, fevers, and cough with slight mucus production.    In the ED, he had elevated RR, hypoxic requiring 2L NC. Covid testing was positive. He was slightly anemic with thrombocytopenia and absolute lymphopenia. His blood sugars were 219, UA was concerning for infection, BNP elevated, CXR consistent with CHF. He was given fluids and started on Rocephin. He was admitted for Severe Covid-19 infection with acute hypoxic respiratory failure, abnormal UA, and acute on chronic CHF exacerbation.   On the unit, he was started on decadron and remdesivir. He initially required 2L NC. We continued rocephin for his abnormal UA and followed cultures. We started him on Lasix 40mg for Acute on Chronic CHF exacerbation.    Patient respiratory status improved during hospital stay, weaned to room air. Urine cultures grew Group G B-hemolytic Streptococci and he continued treatment with rocephin. Toward the end of his hospital stay, he had a significantly elevated d-dimer, though he was asymptomatic. Subsequent bilateral doppler USV of UE and LE was negative for DVT. Patient was able to be discharged and placed on 3 days of decadron and 3 days of Omnicef. Length of Hospital Stay: 3  Condition on Discharge: Stable and improved.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster
Clinical narrative: Emergency room physician saw patient on 09/07/21, approximately 4 days after 2nd dose of Pfizer Covid vaccine.  MD reports patient appears to have shingles on nose, lower lip, and left cheek.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Patient presented to emergency department on 8/26/2021 with fatigue, cough, and congestion. She tested positive for COVID-19 on 8/23/2021 at an outside facility. She was treated with dexamethasone and supplemental oxygen. She was discharged to rehab facility on 9/1/2021.
Age: 50.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site pain
Clinical narrative: Continue left shoulder pain after vaccine. Prescribing anti-inflammatories and  PT
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac stress test, Cardiomegaly, Dyspnoea
Clinical narrative: I was experiencing complications breathing. I could not even walk from the door to the car without feeling like I couldn't catch my breath. I went to see my doctor around May, I believe. I do not really remember. He did a stress test to check my heart. He saw that my heart was enlarged. I have another appointment coming up soon (next month, October) to see him again.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, C-reactive protein, Eye swelling, Genital swelling, Lip swelling
Clinical narrative: Swollen tongue very large, followed two days later with swollen lip, followed in next days with lip in different area, swollen toes, penis, eye, heal, and increase itchiness.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Peripheral swelling, Pruritus, Swollen tongue
Clinical narrative: Swollen tongue very large, followed two days later with swollen lip, followed in next days with lip in different area, swollen toes, penis, eye, heal, and increase itchiness.
Age: 57.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dizziness, Dry mouth, Feeling abnormal, Hyperhidrosis
Clinical narrative: Bad feeling running throughout body, broke out in sweat as if she was going to faint, dry mouthed and after 45 minutes she started to feel better.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Chest discomfort, Cough, Fatigue, Oropharyngeal pain, Pyrexia
Clinical narrative: It started out with a feeling of phlegm in my throat, the following day sore throat, fatigue, some coughing. I had 102 temperature and aches, so I went in for a test the following day. The urgent care tested me, and I was positive, they put me on albuterol, prednisone, and a cough suppressant benzonatate. I was so fatigued. I went to ER in morning on August 29th, I had felt heaviness in my chest, and they checked my heart, and they gave me monoclonal antibodies that afternoon. I started to improve with my symptoms. I still am fatigued.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: It started out with a feeling of phlegm in my throat, the following day sore throat, fatigue, some coughing. I had 102 temperature and aches, so I went in for a test the following day. The urgent care tested me, and I was positive, they put me on albuterol, prednisone, and a cough suppressant benzonatate. I was so fatigued. I went to ER in morning on August 29th, I had felt heaviness in my chest, and they checked my heart, and they gave me monoclonal antibodies that afternoon. I started to improve with my symptoms. I still am fatigued.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: After I got the 2nd dose,  I noticed a ringing in my ears.   I noticed it has been happening since February  2021 so I decided to get it check out.  I did not link it to the vaccine initially, but I spoke to my doctor who also had patients reporting the same symptom after the vaccine. My PCP referred me to an ENT and the ENT sent me to an audiologist and the audiologist sent me to another specialist.  I was advised that there's nothing that can be done except using hearing aids or using a sound machine.  I am suffering from the tinnitus 24/7 and it has not resolved.
Age: 39.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: POSITIVE COVID
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, Bradycardia, COVID-19, COVID-19 pneumonia
Clinical narrative: Date of Admission  09/03/2021   Date of Discharge  09/06/2021   Reason for Hospitalization   Covid+ 10 days, increased shortness of breath  Hospital Course   Please see admission H&P for complete details.  Briefly, the patient is a 77-year-old gentleman with very few medical problems who presented acutely with a worsening 3 to 4-day history of diarrhea nausea and vomiting.  He was brought in by his son who was concerned had recently been diagnosed with COVID-19.  According to him and the son he had symptoms for several weeks but only began to get worse that 3 to 4 days prior to presentation.  He is unable to eat or drink prior to this.  He had been prescribed hydroxychloroquine by her primary care provider as well as prednisone.  He was noted to be hypoxemic while in the emergency room.  He was started on dexamethasone and admitted to our inpatient unit.  He was vaccinated  Discharge Diagnoses      1.  Hypoxemia secondary to COVID-19  As above the patient was noted to be hypoxemic secondary to COVID-19.  He had a CT scan to evaluate for pulmonary emboli which was negative.  However, it did show findings consistent with groundglass opacities as we typically see with COVID-19.  He did peak at a total of 6 L required on 2 days post admission.  Was able to wean down to 3 L with activity.  He will be discharged with home oxygen and likely will require this from 1 to 2 months.  He should follow-up with his primary care provider as needed to determine any ongoing need for this.  He should avoid any activity involving fire or flames.  He is experience welder and is actually very familiar with these precautions  2.  COVID-19 pneumonia  As above patient was admitted with COVID-19 pneumonia.  He did also have GI symptoms with this.  I do suspect that he he was more acute than the family had thought.  Interestingly he had also had these skin lesions on his chest back thighs and legs that could be the cause of much of his prior discomfort.  However, I cannot quantify this.  He did respond to dexamethasone.  We started him on on remdesivir but stopped after noting bradycardia which is a known side effect of this medication.  3.  Dehydration likely secondary to diarrhea and vomiting secondary to COVID-19  Upon admission patient had mild AKI with creatinine of 1.3.  This responded well to fluid administration.  4.  Cutaneous skin lesions  The patient has extensive patches and plaques of his chest lower legs and around his waistband area he is says he has had these lesions for several years.  They tend to get better with steroid cream.  He has never had a biopsy of these.  Photos of these lesions were shared with her dermatology team who is on-call.  My personal concern is for cutaneous lymphoma.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram abnormal, Condition aggravated, Dehydration, Diarrhoea, Dyspnoea
Clinical narrative: Date of Admission  09/03/2021   Date of Discharge  09/06/2021   Reason for Hospitalization   Covid+ 10 days, increased shortness of breath  Hospital Course   Please see admission H&P for complete details.  Briefly, the patient is a 77-year-old gentleman with very few medical problems who presented acutely with a worsening 3 to 4-day history of diarrhea nausea and vomiting.  He was brought in by his son who was concerned had recently been diagnosed with COVID-19.  According to him and the son he had symptoms for several weeks but only began to get worse that 3 to 4 days prior to presentation.  He is unable to eat or drink prior to this.  He had been prescribed hydroxychloroquine by her primary care provider as well as prednisone.  He was noted to be hypoxemic while in the emergency room.  He was started on dexamethasone and admitted to our inpatient unit.  He was vaccinated  Discharge Diagnoses      1.  Hypoxemia secondary to COVID-19  As above the patient was noted to be hypoxemic secondary to COVID-19.  He had a CT scan to evaluate for pulmonary emboli which was negative.  However, it did show findings consistent with groundglass opacities as we typically see with COVID-19.  He did peak at a total of 6 L required on 2 days post admission.  Was able to wean down to 3 L with activity.  He will be discharged with home oxygen and likely will require this from 1 to 2 months.  He should follow-up with his primary care provider as needed to determine any ongoing need for this.  He should avoid any activity involving fire or flames.  He is experience welder and is actually very familiar with these precautions  2.  COVID-19 pneumonia  As above patient was admitted with COVID-19 pneumonia.  He did also have GI symptoms with this.  I do suspect that he he was more acute than the family had thought.  Interestingly he had also had these skin lesions on his chest back thighs and legs that could be the cause of much of his prior discomfort.  However, I cannot quantify this.  He did respond to dexamethasone.  We started him on on remdesivir but stopped after noting bradycardia which is a known side effect of this medication.  3.  Dehydration likely secondary to diarrhea and vomiting secondary to COVID-19  Upon admission patient had mild AKI with creatinine of 1.3.  This responded well to fluid administration.  4.  Cutaneous skin lesions  The patient has extensive patches and plaques of his chest lower legs and around his waistband area he is says he has had these lesions for several years.  They tend to get better with steroid cream.  He has never had a biopsy of these.  Photos of these lesions were shared with her dermatology team who is on-call.  My personal concern is for cutaneous lymphoma.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Exposure to SARS-CoV-2, Feeding disorder, Gastrointestinal disorder, Hypoxia, Lung opacity
Clinical narrative: Date of Admission  09/03/2021   Date of Discharge  09/06/2021   Reason for Hospitalization   Covid+ 10 days, increased shortness of breath  Hospital Course   Please see admission H&P for complete details.  Briefly, the patient is a 77-year-old gentleman with very few medical problems who presented acutely with a worsening 3 to 4-day history of diarrhea nausea and vomiting.  He was brought in by his son who was concerned had recently been diagnosed with COVID-19.  According to him and the son he had symptoms for several weeks but only began to get worse that 3 to 4 days prior to presentation.  He is unable to eat or drink prior to this.  He had been prescribed hydroxychloroquine by her primary care provider as well as prednisone.  He was noted to be hypoxemic while in the emergency room.  He was started on dexamethasone and admitted to our inpatient unit.  He was vaccinated  Discharge Diagnoses      1.  Hypoxemia secondary to COVID-19  As above the patient was noted to be hypoxemic secondary to COVID-19.  He had a CT scan to evaluate for pulmonary emboli which was negative.  However, it did show findings consistent with groundglass opacities as we typically see with COVID-19.  He did peak at a total of 6 L required on 2 days post admission.  Was able to wean down to 3 L with activity.  He will be discharged with home oxygen and likely will require this from 1 to 2 months.  He should follow-up with his primary care provider as needed to determine any ongoing need for this.  He should avoid any activity involving fire or flames.  He is experience welder and is actually very familiar with these precautions  2.  COVID-19 pneumonia  As above patient was admitted with COVID-19 pneumonia.  He did also have GI symptoms with this.  I do suspect that he he was more acute than the family had thought.  Interestingly he had also had these skin lesions on his chest back thighs and legs that could be the cause of much of his prior discomfort.  However, I cannot quantify this.  He did respond to dexamethasone.  We started him on on remdesivir but stopped after noting bradycardia which is a known side effect of this medication.  3.  Dehydration likely secondary to diarrhea and vomiting secondary to COVID-19  Upon admission patient had mild AKI with creatinine of 1.3.  This responded well to fluid administration.  4.  Cutaneous skin lesions  The patient has extensive patches and plaques of his chest lower legs and around his waistband area he is says he has had these lesions for several years.  They tend to get better with steroid cream.  He has never had a biopsy of these.  Photos of these lesions were shared with her dermatology team who is on-call.  My personal concern is for cutaneous lymphoma.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Sick relative, Skin lesion, Vomiting
Clinical narrative: Date of Admission  09/03/2021   Date of Discharge  09/06/2021   Reason for Hospitalization   Covid+ 10 days, increased shortness of breath  Hospital Course   Please see admission H&P for complete details.  Briefly, the patient is a 77-year-old gentleman with very few medical problems who presented acutely with a worsening 3 to 4-day history of diarrhea nausea and vomiting.  He was brought in by his son who was concerned had recently been diagnosed with COVID-19.  According to him and the son he had symptoms for several weeks but only began to get worse that 3 to 4 days prior to presentation.  He is unable to eat or drink prior to this.  He had been prescribed hydroxychloroquine by her primary care provider as well as prednisone.  He was noted to be hypoxemic while in the emergency room.  He was started on dexamethasone and admitted to our inpatient unit.  He was vaccinated  Discharge Diagnoses      1.  Hypoxemia secondary to COVID-19  As above the patient was noted to be hypoxemic secondary to COVID-19.  He had a CT scan to evaluate for pulmonary emboli which was negative.  However, it did show findings consistent with groundglass opacities as we typically see with COVID-19.  He did peak at a total of 6 L required on 2 days post admission.  Was able to wean down to 3 L with activity.  He will be discharged with home oxygen and likely will require this from 1 to 2 months.  He should follow-up with his primary care provider as needed to determine any ongoing need for this.  He should avoid any activity involving fire or flames.  He is experience welder and is actually very familiar with these precautions  2.  COVID-19 pneumonia  As above patient was admitted with COVID-19 pneumonia.  He did also have GI symptoms with this.  I do suspect that he he was more acute than the family had thought.  Interestingly he had also had these skin lesions on his chest back thighs and legs that could be the cause of much of his prior discomfort.  However, I cannot quantify this.  He did respond to dexamethasone.  We started him on on remdesivir but stopped after noting bradycardia which is a known side effect of this medication.  3.  Dehydration likely secondary to diarrhea and vomiting secondary to COVID-19  Upon admission patient had mild AKI with creatinine of 1.3.  This responded well to fluid administration.  4.  Cutaneous skin lesions  The patient has extensive patches and plaques of his chest lower legs and around his waistband area he is says he has had these lesions for several years.  They tend to get better with steroid cream.  He has never had a biopsy of these.  Photos of these lesions were shared with her dermatology team who is on-call.  My personal concern is for cutaneous lymphoma.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Breakthrough case
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia, Magnetic resonance imaging
Clinical narrative: Numbness in left arm and leg increasing over several hours  Additional medications not fitting in #9:  Crestor, famotidine latanaprost eye drops, dorzolamide HCl/timolol maleate eye drops
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Chills, Decreased appetite, Mobility decreased, Pruritus
Clinical narrative: No reactions on first dose. After second dose started to feel weak, feverish, stayed in bed for 12 days, chills, no appetite, constantly  vomiting,  itchy hives on arms, back, chest, and the back of thighs.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Urticaria, Vomiting
Clinical narrative: No reactions on first dose. After second dose started to feel weak, feverish, stayed in bed for 12 days, chills, no appetite, constantly  vomiting,  itchy hives on arms, back, chest, and the back of thighs.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Influenza virus test, Pain, Pyrexia, SARS-CoV-2 test negative
Clinical narrative: I had episodes 3 times of running an elevated fever. Head colds are not uncommon for me but running a fever is. The first time I ran a fever, it was 101.8 along with body aches and a headache. I called the doctor at this point. Each time, I was sent to have a covid test done. I?ve had 3 covid tests done since receiving the vaccine. Each time was negative. The second testing did result positive for strep. Due to the strep I was put on antibiotics for 10 days. This last time, I didn?t have the same head cold but I did run a fever again which got up to 100.8. for me that is elevated because my normal temperature is 97.6
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Streptococcal infection, Streptococcus test positive
Clinical narrative: I had episodes 3 times of running an elevated fever. Head colds are not uncommon for me but running a fever is. The first time I ran a fever, it was 101.8 along with body aches and a headache. I called the doctor at this point. Each time, I was sent to have a covid test done. I?ve had 3 covid tests done since receiving the vaccine. Each time was negative. The second testing did result positive for strep. Due to the strep I was put on antibiotics for 10 days. This last time, I didn?t have the same head cold but I did run a fever again which got up to 100.8. for me that is elevated because my normal temperature is 97.6
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Peripheral swelling, Skin discolouration, Vision blurred
Clinical narrative: Extreme pain and swelling in arm down to finger tips, lack of blood flow. Hands and fingers were turning white, rings had to be removed from swelling.  Swelling  and pain for 3 days.  Also, Eye sight was blurry the day of injection  and still persisting now on day 8.  Hard to focus on reading materials up close. No prior vision problems prior to injection
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Chills, Headache, Influenza like illness, Injection site pain
Clinical narrative: I began to experience headache and slight fever (99.6) at approximately 6 PM on Thursday, 9/2, along with soreness at the injection site.  These symptoms persisted the following day at which time I began experiencing general muscles aches all over my body, similar to a flu, as well as chills and chest pains on the evening of 9.3.  However, all symptoms had resolved by the time I woke on the morning of 9.4.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Myalgia, Pyrexia
Clinical narrative: I began to experience headache and slight fever (99.6) at approximately 6 PM on Thursday, 9/2, along with soreness at the injection site.  These symptoms persisted the following day at which time I began experiencing general muscles aches all over my body, similar to a flu, as well as chills and chest pains on the evening of 9.3.  However, all symptoms had resolved by the time I woke on the morning of 9.4.
Age: 66.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Headache, Pain in extremity, Vomiting
Clinical narrative: chills, vomiting, sore arm, severe headache
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Bronchiectasis, COVID-19, Computerised tomogram thorax abnormal, Condition aggravated, Cough
Clinical narrative: Hospitalized 8.30.21;  COVID-19 positive 8.31.21; fully vaccinated  Admission Date: 8/30/2021 Discharge Date: 09/06/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia of both lungs due to Pseudomonas species, unspecified part of lung [J15.1] Pseudomonal pneumonia [J15.1] Bronchiectasis [J47.9]   HOSPITAL COURSE: Patient is a 74 y.o. who has a past medical history significant for long-standing severe bronchiectasis of unclear etiology, heart failure with reduced ejection (NICM) complicated by severe aortic stenosis (for which she is currently undergoing evaluation for TAVR), atrial flutter on chronic Eliquis, and chronic anemia. She was admitted 8/30 for presumed exacerbation of her chronic bronchiectasis, with recent sputum cx having grown multi-drug resistant Pseudomonas aeruginosa. Historically, she has hx of isolation of multiple morphotypes of Pseudomonas, as well as hx of Burkholderia and Citrobacter in the past. She was admitted on the recommendation of her primary pulmonologist. She had failed 2 rounds of ciprofloxacin this month and was still having increased sputum production, cough. She grew pseudomonas again 8/19 but was resistant to oral agents. She was started initially on meropenem but after beign seen by ID was transitioned to ceftazidime which she tolerated well. CT thorax showed new foci of patchy and nodular infiltrates. Film array incidentally returned positive with COVID-19. She did have ongoing hemoptysis but NOT massive and was controlled. SHe was seen by pulmonology and ID throughout her course. Hemoptysis improved and stabilized. She was back to her baseline 2L O2. ID recommended continuing ceftaz through 9/14. SHe had a midline placed on 9/6 and was discharged home in stable condition with home visiting nurses and infusion setup to start at 1700 today. Her eliquis was resumed and she was told to monitor for further hemoptysis. PCP was messaged to have their staff set up a follow up appointment, even if virtual.   ROS Patient feels good today. Ready to go home. Excited to get home. No new symptoms. Coughing improving slowly. No further significant hemoptysis. No fevers no chills. Breathing easier.    CONSULTS / RECOMMENDATION: pulm ID INPATIENT PROCEDURES: Midline placed 09/06/2021
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Haemoptysis, Imaging procedure abnormal, Lung infiltration, Pneumonia pseudomonal, Sputum culture positive
Clinical narrative: Hospitalized 8.30.21;  COVID-19 positive 8.31.21; fully vaccinated  Admission Date: 8/30/2021 Discharge Date: 09/06/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia of both lungs due to Pseudomonas species, unspecified part of lung [J15.1] Pseudomonal pneumonia [J15.1] Bronchiectasis [J47.9]   HOSPITAL COURSE: Patient is a 74 y.o. who has a past medical history significant for long-standing severe bronchiectasis of unclear etiology, heart failure with reduced ejection (NICM) complicated by severe aortic stenosis (for which she is currently undergoing evaluation for TAVR), atrial flutter on chronic Eliquis, and chronic anemia. She was admitted 8/30 for presumed exacerbation of her chronic bronchiectasis, with recent sputum cx having grown multi-drug resistant Pseudomonas aeruginosa. Historically, she has hx of isolation of multiple morphotypes of Pseudomonas, as well as hx of Burkholderia and Citrobacter in the past. She was admitted on the recommendation of her primary pulmonologist. She had failed 2 rounds of ciprofloxacin this month and was still having increased sputum production, cough. She grew pseudomonas again 8/19 but was resistant to oral agents. She was started initially on meropenem but after beign seen by ID was transitioned to ceftazidime which she tolerated well. CT thorax showed new foci of patchy and nodular infiltrates. Film array incidentally returned positive with COVID-19. She did have ongoing hemoptysis but NOT massive and was controlled. SHe was seen by pulmonology and ID throughout her course. Hemoptysis improved and stabilized. She was back to her baseline 2L O2. ID recommended continuing ceftaz through 9/14. SHe had a midline placed on 9/6 and was discharged home in stable condition with home visiting nurses and infusion setup to start at 1700 today. Her eliquis was resumed and she was told to monitor for further hemoptysis. PCP was messaged to have their staff set up a follow up appointment, even if virtual.   ROS Patient feels good today. Ready to go home. Excited to get home. No new symptoms. Coughing improving slowly. No further significant hemoptysis. No fevers no chills. Breathing easier.    CONSULTS / RECOMMENDATION: pulm ID INPATIENT PROCEDURES: Midline placed 09/06/2021
Age: 74.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Sputum increased
Clinical narrative: Hospitalized 8.30.21;  COVID-19 positive 8.31.21; fully vaccinated  Admission Date: 8/30/2021 Discharge Date: 09/06/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia of both lungs due to Pseudomonas species, unspecified part of lung [J15.1] Pseudomonal pneumonia [J15.1] Bronchiectasis [J47.9]   HOSPITAL COURSE: Patient is a 74 y.o. who has a past medical history significant for long-standing severe bronchiectasis of unclear etiology, heart failure with reduced ejection (NICM) complicated by severe aortic stenosis (for which she is currently undergoing evaluation for TAVR), atrial flutter on chronic Eliquis, and chronic anemia. She was admitted 8/30 for presumed exacerbation of her chronic bronchiectasis, with recent sputum cx having grown multi-drug resistant Pseudomonas aeruginosa. Historically, she has hx of isolation of multiple morphotypes of Pseudomonas, as well as hx of Burkholderia and Citrobacter in the past. She was admitted on the recommendation of her primary pulmonologist. She had failed 2 rounds of ciprofloxacin this month and was still having increased sputum production, cough. She grew pseudomonas again 8/19 but was resistant to oral agents. She was started initially on meropenem but after beign seen by ID was transitioned to ceftazidime which she tolerated well. CT thorax showed new foci of patchy and nodular infiltrates. Film array incidentally returned positive with COVID-19. She did have ongoing hemoptysis but NOT massive and was controlled. SHe was seen by pulmonology and ID throughout her course. Hemoptysis improved and stabilized. She was back to her baseline 2L O2. ID recommended continuing ceftaz through 9/14. SHe had a midline placed on 9/6 and was discharged home in stable condition with home visiting nurses and infusion setup to start at 1700 today. Her eliquis was resumed and she was told to monitor for further hemoptysis. PCP was messaged to have their staff set up a follow up appointment, even if virtual.   ROS Patient feels good today. Ready to go home. Excited to get home. No new symptoms. Coughing improving slowly. No further significant hemoptysis. No fevers no chills. Breathing easier.    CONSULTS / RECOMMENDATION: pulm ID INPATIENT PROCEDURES: Midline placed 09/06/2021
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Chest pain, Head discomfort, Headache
Clinical narrative: Lot of pressure in head like someone has hands on head and crushing head. Headache that won't go away.  Goes from mild to moderate.  No over counter medicine has helped. Chest pains/ pressure.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Alopecia, Haemorrhage, Laboratory test
Clinical narrative: 03/01/2021 Hair starting falling out and had to seek care from a dermatologist. 08/05/2021 Starting having extreme bleeding.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Headache, Pain, Pyrexia
Clinical narrative: Employee calling to report a reaction after receiving a COVID-19 vaccine.  Vaccine Name -  Pfizer Vaccine Date - ?  09/07/2021 Is this your first or second dose- 2nd Date of symptom onset - ? 09/07/2021 Symptoms - ? stated he had fever of 101, Headache, Body aches, and uncontrollable shivering that lasted 5 minutes Last day of work and shift - ? 09/07/2021 Home remedies- stated he took Advil at 8pm on 9/7/2021 and Tylenol at 3am on 9/8/2021 Any improvement- stated the Tyelonol helped with the HA, body aches, and fever Recommendation- Advised to continue taking Advil and Tylenol per package instructions for pain and fever. Advised if symptoms persist, worsen or ones develop to follow up with PCP.  Employee voiced understanding Employee of information ? Yes  Employee voiced any concerns ? No  Employee's questions answered to employee?s satisfaction -Yes
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Patient given a Janssen COVID vaccine and she did not meet the age criteria for the vaccine, she is only 17 and Janssen is licensed for 18 years and older.
Age: 50.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acoustic stimulation tests abnormal, Deafness unilateral
Clinical narrative: Sudden hearing loss in left ear.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Atrial fibrillation, COVID-19, COVID-19 pneumonia, Cough
Clinical narrative: Diagnosed with COVID on 8/27 at outside hospital after cough, shortness of breath and diarrhea x 2 weeks. Treated with steroids and remdesivir. Transferred to Medical Center on 9/2 with COVID pneumonia and intubated. continued to decline with increased respiratory support, septic shock, dual pressors and worsening renal failure. Developed new Afib and EKG showed evidence of acute MI/mycardial injury. Multi organ system failure. 9/7 family chose comfort care.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dyspnoea, Electrocardiogram abnormal, Endotracheal intubation, General physical health deterioration
Clinical narrative: Diagnosed with COVID on 8/27 at outside hospital after cough, shortness of breath and diarrhea x 2 weeks. Treated with steroids and remdesivir. Transferred to Medical Center on 9/2 with COVID pneumonia and intubated. continued to decline with increased respiratory support, septic shock, dual pressors and worsening renal failure. Developed new Afib and EKG showed evidence of acute MI/mycardial injury. Multi organ system failure. 9/7 family chose comfort care.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Multiple organ dysfunction syndrome, Myocardial injury, Renal failure, Septic shock
Clinical narrative: Diagnosed with COVID on 8/27 at outside hospital after cough, shortness of breath and diarrhea x 2 weeks. Treated with steroids and remdesivir. Transferred to Medical Center on 9/2 with COVID pneumonia and intubated. continued to decline with increased respiratory support, septic shock, dual pressors and worsening renal failure. Developed new Afib and EKG showed evidence of acute MI/mycardial injury. Multi organ system failure. 9/7 family chose comfort care.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Chest pain, Differential white blood cell count normal, Fibrin D dimer normal, Full blood count normal
Clinical narrative: Sharp L sided chest pain with inspiration. Slightly worse with exertion. No shortness of breath. CP occasionally radiated up L neck and L shoulder. Pain was not improved with positioning. NSAIDS helped lessen and dull the pain. Lasted 2 weeks.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Metabolic function test, Pain, Ultrasound chest, Urine analysis normal
Clinical narrative: Sharp L sided chest pain with inspiration. Slightly worse with exertion. No shortness of breath. CP occasionally radiated up L neck and L shoulder. Pain was not improved with positioning. NSAIDS helped lessen and dull the pain. Lasted 2 weeks.
Age: 12.0
Sex: F
Vaccine: HPV9, MNQ, TDAP
Symptoms: Gait disturbance, Headache, Posture abnormal, Tinnitus, Unresponsive to stimuli
Clinical narrative: Female was sitting with mom for the 15 minutes and mom yelled that her head went back and did not respond.  She was alert when I came out but stated ears were ringing and had a headache. Layed her on the floor with legs elevated and cold cloth to neck.  After 6 minutes sat her up and she stated she was fine.  Staff escorted her out with mom and she was walking not in a straight line.  She had stated that she had not had any breakfast prior to coming for the injection.  Mom was going to keep her home for the rest of the day.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Arthralgia, COVID-19, Cough, Headache
Clinical narrative: The next morning after the vaccine I had a headache, nausea and a fever developed. The injection site was swollen and red. My body ached which all lasted about 2 days. On 7/5 I developed a runny nose and a headache. A couch developed and my body and joint ached. I was super nauseated and lost my sense of smell. On 7/7 I visited my PCP who diagnosed me with a Sinus Infection and gave an antibiotic and I lost my taste by this time and on 7/9 I went to Urgent Care and took a COVID test which was positive.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site swelling, Nausea, Pain, Pyrexia
Clinical narrative: The next morning after the vaccine I had a headache, nausea and a fever developed. The injection site was swollen and red. My body ached which all lasted about 2 days. On 7/5 I developed a runny nose and a headache. A couch developed and my body and joint ached. I was super nauseated and lost my sense of smell. On 7/7 I visited my PCP who diagnosed me with a Sinus Infection and gave an antibiotic and I lost my taste by this time and on 7/9 I went to Urgent Care and took a COVID test which was positive.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive, Sinusitis
Clinical narrative: The next morning after the vaccine I had a headache, nausea and a fever developed. The injection site was swollen and red. My body ached which all lasted about 2 days. On 7/5 I developed a runny nose and a headache. A couch developed and my body and joint ached. I was super nauseated and lost my sense of smell. On 7/7 I visited my PCP who diagnosed me with a Sinus Infection and gave an antibiotic and I lost my taste by this time and on 7/9 I went to Urgent Care and took a COVID test which was positive.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test normal, Dysmenorrhoea, Fatigue, Heavy menstrual bleeding, Hot flush
Clinical narrative: Hot flashes, irregular periods (10 cycles in two months- each lasted 3-4 days).. painful cramping.. heavier than normal flow.  Previous cycle was 2 days per 30.. Fatigue, Irritability, weight gain
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Menstruation irregular, Ultrasound scan, Weight increased
Clinical narrative: Hot flashes, irregular periods (10 cycles in two months- each lasted 3-4 days).. painful cramping.. heavier than normal flow.  Previous cycle was 2 days per 30.. Fatigue, Irritability, weight gain
Age: 34.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood test, Decreased appetite, Hypertension, Nausea
Clinical narrative: No appetite the next morning and since the vaccine. Nauseous all the time
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Adenovirus test, Asthenia, Blood phosphorus decreased, Blood sodium decreased
Clinical narrative: ED to Hosp-Admission Discharged   9/2/2021 - 9/6/2021 (4 days)  Hospital Hospital Course:  Patient is an 83 y.o. year old female with a past medical history of GERD, anxiety, depression, mixed hyperlipidemia and acquired hypothyroidism, who was admitted with severe acute on chronic hyponatremia.  A problem based hospital course has been listed below;   o Acute on chronic hyponatremia, severe and symptomatic: Her sodium was 111 on admission (sodium of 127 on 8/27/2021).  This is most likely due to severe dehydration related to poor oral intake due to severe malaise, nausea and vomiting.  Urine studies along with low serum uric acid levels are suggestive of SIADH.  She received hypertonic saline due to symptomatic hyponatremia.  Due to overcorrection of sodium, she was also placed on D5 infusion at 100 mL/h as per nephrology recommendations.  Her sodium appropriately improved after that and was 130 at discharge which is close to her baseline.  She was advised to restrict total fluid intake to less than 1800 mL/day and her Wellbutrin was discontinued.  She was clinically and hemodynamically stable at the time of discharge.  She was advised to follow-up with her PCP within 5 days with repeat blood work.     o COVID-19 infection: The patient presented with severe malaise, weakness, cough, abdominal pain, nausea and vomiting.  Chest x-ray revealed no evidence of discrete infiltrate and there was no persistent hypoxia.  She received dexamethasone 6 mg IV every 24 hour for 5 days during hospital stay.  She was discharged on dexamethasone 6 mg daily for 5 more days to complete a course of 10 days of dexamethasone.     o Hypophosphatemia: Her phosphorus was down to 1.1 on 9/4/21 which improved to 2.5 after multiple repletion with IV K-Phos.   o Mixed hyperlipidemia: She is not on statin due to intolerance.   o Acquired hypothyroidism: She is on levothyroxine 50 mcg daily.   o GERD: She is on Protonix 40 mg daily.   o Anxiety/depression: Her mood is relatively stable at this time.  Her Wellbutrin was discontinued due to hyponatremia/SIADH and if needed, she should be placed on alternative antidepression/antianxiety medication as outpatient.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Bordetella test negative, COVID-19, Chest X-ray normal, Chlamydia test negative, Condition aggravated
Clinical narrative: ED to Hosp-Admission Discharged   9/2/2021 - 9/6/2021 (4 days)  Hospital Hospital Course:  Patient is an 83 y.o. year old female with a past medical history of GERD, anxiety, depression, mixed hyperlipidemia and acquired hypothyroidism, who was admitted with severe acute on chronic hyponatremia.  A problem based hospital course has been listed below;   o Acute on chronic hyponatremia, severe and symptomatic: Her sodium was 111 on admission (sodium of 127 on 8/27/2021).  This is most likely due to severe dehydration related to poor oral intake due to severe malaise, nausea and vomiting.  Urine studies along with low serum uric acid levels are suggestive of SIADH.  She received hypertonic saline due to symptomatic hyponatremia.  Due to overcorrection of sodium, she was also placed on D5 infusion at 100 mL/h as per nephrology recommendations.  Her sodium appropriately improved after that and was 130 at discharge which is close to her baseline.  She was advised to restrict total fluid intake to less than 1800 mL/day and her Wellbutrin was discontinued.  She was clinically and hemodynamically stable at the time of discharge.  She was advised to follow-up with her PCP within 5 days with repeat blood work.     o COVID-19 infection: The patient presented with severe malaise, weakness, cough, abdominal pain, nausea and vomiting.  Chest x-ray revealed no evidence of discrete infiltrate and there was no persistent hypoxia.  She received dexamethasone 6 mg IV every 24 hour for 5 days during hospital stay.  She was discharged on dexamethasone 6 mg daily for 5 more days to complete a course of 10 days of dexamethasone.     o Hypophosphatemia: Her phosphorus was down to 1.1 on 9/4/21 which improved to 2.5 after multiple repletion with IV K-Phos.   o Mixed hyperlipidemia: She is not on statin due to intolerance.   o Acquired hypothyroidism: She is on levothyroxine 50 mcg daily.   o GERD: She is on Protonix 40 mg daily.   o Anxiety/depression: Her mood is relatively stable at this time.  Her Wellbutrin was discontinued due to hyponatremia/SIADH and if needed, she should be placed on alternative antidepression/antianxiety medication as outpatient.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Coronavirus test negative, Cough, Dehydration, Enterovirus test negative, Human metapneumovirus test
Clinical narrative: ED to Hosp-Admission Discharged   9/2/2021 - 9/6/2021 (4 days)  Hospital Hospital Course:  Patient is an 83 y.o. year old female with a past medical history of GERD, anxiety, depression, mixed hyperlipidemia and acquired hypothyroidism, who was admitted with severe acute on chronic hyponatremia.  A problem based hospital course has been listed below;   o Acute on chronic hyponatremia, severe and symptomatic: Her sodium was 111 on admission (sodium of 127 on 8/27/2021).  This is most likely due to severe dehydration related to poor oral intake due to severe malaise, nausea and vomiting.  Urine studies along with low serum uric acid levels are suggestive of SIADH.  She received hypertonic saline due to symptomatic hyponatremia.  Due to overcorrection of sodium, she was also placed on D5 infusion at 100 mL/h as per nephrology recommendations.  Her sodium appropriately improved after that and was 130 at discharge which is close to her baseline.  She was advised to restrict total fluid intake to less than 1800 mL/day and her Wellbutrin was discontinued.  She was clinically and hemodynamically stable at the time of discharge.  She was advised to follow-up with her PCP within 5 days with repeat blood work.     o COVID-19 infection: The patient presented with severe malaise, weakness, cough, abdominal pain, nausea and vomiting.  Chest x-ray revealed no evidence of discrete infiltrate and there was no persistent hypoxia.  She received dexamethasone 6 mg IV every 24 hour for 5 days during hospital stay.  She was discharged on dexamethasone 6 mg daily for 5 more days to complete a course of 10 days of dexamethasone.     o Hypophosphatemia: Her phosphorus was down to 1.1 on 9/4/21 which improved to 2.5 after multiple repletion with IV K-Phos.   o Mixed hyperlipidemia: She is not on statin due to intolerance.   o Acquired hypothyroidism: She is on levothyroxine 50 mcg daily.   o GERD: She is on Protonix 40 mg daily.   o Anxiety/depression: Her mood is relatively stable at this time.  Her Wellbutrin was discontinued due to hyponatremia/SIADH and if needed, she should be placed on alternative antidepression/antianxiety medication as outpatient.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Human rhinovirus test, Hyponatraemia, Hypophagia, Hypophosphataemia, Inappropriate antidiuretic hormone secretion
Clinical narrative: ED to Hosp-Admission Discharged   9/2/2021 - 9/6/2021 (4 days)  Hospital Hospital Course:  Patient is an 83 y.o. year old female with a past medical history of GERD, anxiety, depression, mixed hyperlipidemia and acquired hypothyroidism, who was admitted with severe acute on chronic hyponatremia.  A problem based hospital course has been listed below;   o Acute on chronic hyponatremia, severe and symptomatic: Her sodium was 111 on admission (sodium of 127 on 8/27/2021).  This is most likely due to severe dehydration related to poor oral intake due to severe malaise, nausea and vomiting.  Urine studies along with low serum uric acid levels are suggestive of SIADH.  She received hypertonic saline due to symptomatic hyponatremia.  Due to overcorrection of sodium, she was also placed on D5 infusion at 100 mL/h as per nephrology recommendations.  Her sodium appropriately improved after that and was 130 at discharge which is close to her baseline.  She was advised to restrict total fluid intake to less than 1800 mL/day and her Wellbutrin was discontinued.  She was clinically and hemodynamically stable at the time of discharge.  She was advised to follow-up with her PCP within 5 days with repeat blood work.     o COVID-19 infection: The patient presented with severe malaise, weakness, cough, abdominal pain, nausea and vomiting.  Chest x-ray revealed no evidence of discrete infiltrate and there was no persistent hypoxia.  She received dexamethasone 6 mg IV every 24 hour for 5 days during hospital stay.  She was discharged on dexamethasone 6 mg daily for 5 more days to complete a course of 10 days of dexamethasone.     o Hypophosphatemia: Her phosphorus was down to 1.1 on 9/4/21 which improved to 2.5 after multiple repletion with IV K-Phos.   o Mixed hyperlipidemia: She is not on statin due to intolerance.   o Acquired hypothyroidism: She is on levothyroxine 50 mcg daily.   o GERD: She is on Protonix 40 mg daily.   o Anxiety/depression: Her mood is relatively stable at this time.  Her Wellbutrin was discontinued due to hyponatremia/SIADH and if needed, she should be placed on alternative antidepression/antianxiety medication as outpatient.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Infusion, Malaise
Clinical narrative: ED to Hosp-Admission Discharged   9/2/2021 - 9/6/2021 (4 days)  Hospital Hospital Course:  Patient is an 83 y.o. year old female with a past medical history of GERD, anxiety, depression, mixed hyperlipidemia and acquired hypothyroidism, who was admitted with severe acute on chronic hyponatremia.  A problem based hospital course has been listed below;   o Acute on chronic hyponatremia, severe and symptomatic: Her sodium was 111 on admission (sodium of 127 on 8/27/2021).  This is most likely due to severe dehydration related to poor oral intake due to severe malaise, nausea and vomiting.  Urine studies along with low serum uric acid levels are suggestive of SIADH.  She received hypertonic saline due to symptomatic hyponatremia.  Due to overcorrection of sodium, she was also placed on D5 infusion at 100 mL/h as per nephrology recommendations.  Her sodium appropriately improved after that and was 130 at discharge which is close to her baseline.  She was advised to restrict total fluid intake to less than 1800 mL/day and her Wellbutrin was discontinued.  She was clinically and hemodynamically stable at the time of discharge.  She was advised to follow-up with her PCP within 5 days with repeat blood work.     o COVID-19 infection: The patient presented with severe malaise, weakness, cough, abdominal pain, nausea and vomiting.  Chest x-ray revealed no evidence of discrete infiltrate and there was no persistent hypoxia.  She received dexamethasone 6 mg IV every 24 hour for 5 days during hospital stay.  She was discharged on dexamethasone 6 mg daily for 5 more days to complete a course of 10 days of dexamethasone.     o Hypophosphatemia: Her phosphorus was down to 1.1 on 9/4/21 which improved to 2.5 after multiple repletion with IV K-Phos.   o Mixed hyperlipidemia: She is not on statin due to intolerance.   o Acquired hypothyroidism: She is on levothyroxine 50 mcg daily.   o GERD: She is on Protonix 40 mg daily.   o Anxiety/depression: Her mood is relatively stable at this time.  Her Wellbutrin was discontinued due to hyponatremia/SIADH and if needed, she should be placed on alternative antidepression/antianxiety medication as outpatient.