chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Sex: M
Vaccine: RSV
Symptoms: Amnesia, Confusional state, Coordination abnormal, Disorientation, Dizziness
Clinical narrative: feel mentally disoriented; loss of memory; mental confusion; Very fatigued; Headache; dizziness; lack of coordination; This is a spontaneous report received from a Consumer or other non HCP.  A male patient received rsv vaccine prot.subunit pref 2v (ABRYSVO), on 05Dec2023 at 15:45 as dose 1, single (Lot number: HM7645, Expiration Date: Feb2025, Batch number: PAA209777), in left arm for immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: HEADACHE (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering"; FATIGUE (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "Very fatigued"; DIZZINESS (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering"; DISORIENTATION (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "feel mentally disoriented"; COORDINATION ABNORMAL (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "lack of coordination"; AMNESIA (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "loss of memory"; CONFUSIONAL STATE (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "mental confusion". Therapeutic measures were not taken as a result of disorientation, amnesia, confusional state, fatigue, headache, dizziness, coordination abnormal.  The information on the batch/lot number for rsv vaccine prot.subunit pref 2v  will be requested and submitted if and when received.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202300444483 same reporter/drug/event, different patients;
Sex: M
Vaccine: RSV
Symptoms: Fatigue, Headache
Clinical narrative: feel mentally disoriented; loss of memory; mental confusion; Very fatigued; Headache; dizziness; lack of coordination; This is a spontaneous report received from a Consumer or other non HCP.  A male patient received rsv vaccine prot.subunit pref 2v (ABRYSVO), on 05Dec2023 at 15:45 as dose 1, single (Lot number: HM7645, Expiration Date: Feb2025, Batch number: PAA209777), in left arm for immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: HEADACHE (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering"; FATIGUE (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "Very fatigued"; DIZZINESS (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering"; DISORIENTATION (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "feel mentally disoriented"; COORDINATION ABNORMAL (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "lack of coordination"; AMNESIA (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "loss of memory"; CONFUSIONAL STATE (non-serious) with onset 06Dec2023 at 20:00, outcome "recovering", described as "mental confusion". Therapeutic measures were not taken as a result of disorientation, amnesia, confusional state, fatigue, headache, dizziness, coordination abnormal.  The information on the batch/lot number for rsv vaccine prot.subunit pref 2v  will be requested and submitted if and when received.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202300444483 same reporter/drug/event, different patients;
Sex: U
Vaccine: COVID19
Symptoms: Palpitations
Clinical narrative: heart palpitations; This is a spontaneous report received from a Consumer or other non HCP from medical information team, Program ID.  A patient (age and gender not provided) received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "Supraventricular tachycardia" (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: PALPITATIONS (non-serious), outcome "unknown", described as "heart palpitations".  The information on the batch/lot number for BNT162b2 omi xbb.1.5 will be requested and submitted if and when received.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Feeling abnormal, Tremor
Clinical narrative: felt so bad; tremors; This is a spontaneous report received from a Nurse.  An 84-year-old female patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 02Dec2022 as dose 5 (booster), single (Lot number: GL0446) at the age of 84 years for covid-19 immunisation. The patient's relevant medical history included: "Cholesterol" (unspecified if ongoing), notes: Cholesterol; "hearing aids" (unspecified if ongoing), notes: I have got hearing aids; "hearing problem" (unspecified if ongoing), notes: I have hearing problem; "bones" (unspecified if ongoing); "anxiety" (unspecified if ongoing); "stomach" (unspecified if ongoing); "afib" (unspecified if ongoing); "blood thinner" (unspecified if ongoing); "blood pressure " (unspecified if ongoing); "nerves" (unspecified if ongoing). Concomitant medication(s) included: SIMVASTATIN; CALCIUM 600 MG WITH VITAMIN D taken for bone disorder; LORAZEPAM taken for anxiety; OMEPRAZOLE taken for gastrointestinal disorder; ASPIRIN 81 taken for atrial fibrillation, anticoagulant therapy; LOSARTAN taken for blood pressure measurement; LEXAPRO taken for nervous system disorder, anxiety. Vaccination history included: comirnaty (Dose 1, Single), administration date: 20Jan2021, for covid-19 immunization; comirnaty (Dose 2, Single), administration date: 10Feb2021, for covid-19 immunization; comirnaty (Dose 3 (BOOSTER), Single (lot FE3590)), administration date: 15Oct2021, for covid-19 immunization; comirnaty (Dose 4 (BOOSTER), Single (lot FK9894)), administration date: 13May2022, for covid-19 immunization, reaction(s): "shingles", "Afib"; Influenza vaccine (Flu vaccine (October unspecified year)), for immunization. The following information was reported: FEELING ABNORMAL (non-serious), outcome "unknown", described as "felt so bad"; TREMOR (non-serious), outcome "unknown", described as "tremors".  Additional information: the reporter stated that " December 2, 2022 I have the vaccine and that's when I felt so bad and I got some tremors and so then I got the regular flu vaccine in October (unspecified year)."; Sender's Comments: Linked Report(s) : US-PFIZER INC-202300451898 same patient, different dose number/event;US-PFIZER INC-202300451941 same patient, different dose number/event;
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Vaccination failure
Clinical narrative: Treatment of COVID-19; Treatment of COVID-19; This is a spontaneous report received from a Consumer or other non HCP.  A 61-year-old female patient received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), on 22Sep2023 as dose 1, single (Batch/Lot number: unknown) at the age of 61 years, in left arm for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (DOSE 1 , MANUFACTURER UNKNOWN), for Covid-19 immunization; Covid-19 vaccine (DOSE 2, MANUFACTURER UNKNOWN), for Covid-19 immunization; Covid-19 vaccine (DOSE 3 (BOOSTER), MANUFACTURER UNKNOWN), for Covid-19 immunization; Covid-19 vaccine (DOSE 4 (BOOSTER), MANUFACTURER UNKNOWN), for COVID-19 immunization; Covid-19 vaccine (DOSE 5 (BOOSTER), MANUFACTURER UNKNOWN), for COVID-19 immunization. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset Dec2023, outcome "unknown" and all described as "Treatment of COVID-19". Therapeutic measures were taken as a result of vaccination failure, covid-19 with paxlovid from 10Dec2023 to 14Dec2023.  No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Vaccination failure
Clinical narrative: COVID 19 Treatment; COVID 19 Treatment; This is a spontaneous report received from a Consumer or other non HCP.  A 58-year-old female patient (not pregnant) received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), on 01Nov2023 as dose 1, single (Batch/Lot number: unknown) at the age of 58 years, in left arm for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (DOSE 1, SINGLE; MANUFACTURER UNKNOWN), for COVID-19 immunization; Covid-19 vaccine (DOSE 2, SINGLE; MANUFACTURER UNKNOWN), for COVID-19 immunization; Covid-19 vaccine (DOSE 3 (BOOSTER), SINGLE; MANUFACTURER UNKNOWN), for COVID-19 immunization. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset Dec2023, outcome "unknown" and all described as "COVID 19 Treatment". Therapeutic measures were taken as a result of vaccination failure, covid-19.  Clinical course: Patient took Anti viral treatment with Paxlovid for COVID-19 from 11Dec2023 to 16Dec2023. The patient had no known allergies and other medical history.  The information on the batch/lot number for BNT162b2 omi xbb.1.5 will be requested and submitted if and when received.
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Vaccination failure
Clinical narrative: Treatment of COVID-19; Treatment of COVID-19; This is a spontaneous report received from a Consumer or other non HCP.  A 70-year-old male patient received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), on 13Oct2023 at 13:30 as dose 1, single (Lot number: HG2282) at the age of 69 years, in right arm for covid-19 immunisation. The patient had no relevant medical history. The patient's concomitant medications were not reported. Vaccination history included: moderna (Dose Number: 1, Batch/Lot No: 029L20A, Location of injection: Right Arm, Vaccine Administration Time: 02:00 PM), administration date: 16Jan2021, when the patient was 67-year-old, for Covid-19 Immunization; moderna (Dose Number: 2, Batch/Lot No: 030M20A, Location of injection: Right Arm, Vaccine Administration Time: 01:30 PM), administration date: 13Feb2021, when the patient was 67-year-old, for Covid-19 Immunization; moderna (Dose Number: 3, Batch/Lot No: 048C21A, Location of injection: Right Arm, Vaccine Administration Time: 01:00 PM), administration date: 03Nov2021, when the patient was 68-year-old, for Covid-19 Immunization; moderna (Dose Number: 4, Batch/Lot No: 001M121A, Location of injection: Right Arm, Vaccine Administration Time: 01:00 PM), administration date: 02May2022, when the patient was 68-year-old, for Covid-19 Immunization; moderna (Dose Number: 5, Batch/Lot No: AS7144B, Location of injection: Right arm, Vaccine Administration Time: 01:00 PM), administration date: 07Sep2022, when the patient was 68-year-old, for Covid-19 Immunization. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 2023, outcome "not recovered" and all described as "Treatment of COVID-19". Therapeutic measures were taken as a result of vaccination failure, covid-19.  Clinical Information: Patient received anti-viral COVID 19 Treatment with Paxlovid from 11Dec2023 to 15Dec2023 (lot number: GK0249) and no other medication in 2weeks.
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Drug ineffective
Clinical narrative: Treatment of COVID-19; Treatment of COVID-19; This is a spontaneous report received from a Consumer or other non HCP.  A 43-year-old male patient received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), in 2023 as dose 1, single (Batch/Lot number: unknown), in left arm for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (DOSE 1; MANUFACTURER UNKNOWN), for COVID-19 immunisation; Covid-19 vaccine (DOSE 2; MANUFACTURER UNKNOWN), for COVID-19 immunisation; Covid-19 vaccine (DOSE 3 (BOOSTER); MANUFACTURER UNKNOWN), for COVID-19 immunisation. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant) all with onset Dec2023, outcome "unknown" and all described as "Treatment of COVID-19". Therapeutic measures were taken as a result of drug ineffective, covid-19 with Paxlovid from 12Dec2023 to 17Dec2023.  The information on the batch/lot number for BNT162b2 omi xbb.1.5 will be requested and submitted if and when received.
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test, Vaccination failure
Clinical narrative: COVID 19 Treatment; COVID 19 Treatment; This is a spontaneous report received from a Consumer or other non HCP.  A 51-year-old male patient received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), on 10Oct2023 as dose 1, single (Batch/Lot number: unknown), in left arm for covid-19 immunisation. The patient's relevant medical history included: "Type 1 diabetic" (unspecified if ongoing). The patient's concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (DOSE 1, MANUFACTURER UNKNOWN), for COVID-19 immunization; Covid-19 vaccine (DOSE 2, MANUFACTURER UNKNOWN), for COVID-19 immunization; Covid-19 vaccine (DOSE 3 (Booster), MANUFACTURER UNKNOWN), for COVID-19 immunization; Covid-19 vaccine (DOSE 4 (Booster), MANUFACTURER UNKNOWN), for COVID-19 immunization; Covid-19 vaccine (DOSE 5 (Booster) , MANUFACTURER UNKNOWN), for COVID-19 immunization. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 2023, outcome "unknown" and all described as "COVID 19 Treatment". The patient underwent the following laboratory tests and procedures: SARS-CoV-2 test: Negative, notes: Covid symptoms reoccured after initial infection  while taking Paxlovid and testing negative for  several days, paxlovid rebound . Therapeutic measures were taken as a result of vaccination failure, covid-19.  Clinical information: Patient received anti-viral COVID 19 Treatment with Paxlovid from 11Dec2023 to 16Dec2023.  No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Vaccination failure
Clinical narrative: COVID 19 Treatment; COVID 19 Treatment; This is a spontaneous report received from a Consumer or other non HCP.  A 47-year-old female patient received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), on 17Nov2023 as dose 1, single (Batch/Lot number: unknown) at the age of 47 years, in left arm for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Dose 4 (Booster), manufacturer unknown), for Covid-19 immunization; Covid-19 vaccine (Dose 3 (Booster), manufacturer unknown), for Covid-19 immunization; Covid-19 vaccine (Dose 2, manufacturer unknown), for Covid-19 immunization; Covid-19 vaccine (Dose 1, manufacturer unknown), for Covid-19 immunization. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 2023, outcome "not recovered" and all described as "COVID 19 Treatment". Therapeutic measures were taken as a result of vaccination failure, covid-19.  Clinical information: Patient received anti-viral COVID 19 Treatment with Paxlovid from 10Dec2023 to 14Dec2023 and no other medication in 2weeks.  No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Vaccination failure
Clinical narrative: COVID 19 Treatment; COVID 19 Treatment; This is a spontaneous report received from a Consumer or other non HCP.  A 64-year-old female patient (not pregnant) received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), on 28Oct2023 at 12:30 as dose 1, single (Batch/Lot number: unknown) at the age of 64 years, in left arm for covid-19 immunisation. The patient's relevant medical history included: "asthma" (unspecified if ongoing); "Allergy" (unspecified if ongoing); "FH" (unspecified if ongoing). Concomitant medication(s) included: FLONASE [FLUTICASONE PROPIONATE], start date: 04Jan2012; CLARINEX [DESLORATADINE], start date: 03Mar2011; ZETIA, start date: 13Mar2019; LIPITOR, start date: 15May2008, stop date: 09Dec2023. Past drug history included: Clindamycin, reaction(s): "Allergy". Vaccination history included: pfizer / biontech (Dose 5 (Booster), single, Batch/Lot No: GH9694, Location of injection: Arm Left, Vaccine Administration Time: 04:00 PM), administration date: 16Sep2022, when the patient was 63-year-old, for COVID-19 Immunization; pfizer / biontech (Dose 4 (Booster), single, Batch/Lot No: FP4554, Location of injection: Arm Left, Vaccine Administration Time: 12:00 PM), administration date: 27Jun2022, when the patient was 63-year-old, for COVID-19 Immunization; pfizer / biontech (Dose 3 (Booster), single, Batch/Lot No: 33130BA, Location of injection: Arm Left, Vaccine Administration Time: 01:00 PM), administration date: 06Dec2021, when the patient was 62-year-old, for COVID-19 Immunization; pfizer / biontech (Dose Number: 2, Batch/Lot No: EW0172, Location of injection: Arm Left, Vaccine Administration Time: 02:15 PM), administration date: 23Apr2021, when the patient was 62-year-old, for COVID-19 Immunization; pfizer / biontech (Dose Number: 1, Batch/Lot No: EW0150, Location of injection: Arm Left, Vaccine Administration Time: 03:00 PM), administration date: 02Apr2021, when the patient was 62-year-old, for COVID-19 Immunization. The following information was reported: VACCINATION FAILURE (medically significant), COVID-19 (medically significant) all with onset 2023, outcome "unknown" and all described as "COVID 19 Treatment". Therapeutic measures were taken as a result of vaccination failure, covid-19.  Clinical information: Patient received anti-viral COVID 19 Treatment with Paxlovid from 09Dec2023 to 14Dec2023 and other medication was received in 2weeks.  The information on the batch/lot number for BNT162b2 omi xbb.1.5 will be requested and submitted if and when received.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19, COVID19-2
Symptoms: COVID-19, Death
Clinical narrative: Pt admitted to hospital with covid on 12/16/23 and pt died on 12/22/2023
Age: 61.0
Sex: M
Vaccine: FLU4, VARZOS
Symptoms: Chest X-ray, Chest pain, Gait inability, Laboratory test, Pain
Clinical narrative: Patient was hospitalized for pneumonia a week prior to receiving the above vaccines. Since receiving vaccines patient has had severe aches, couldn't walk, and has had severe chest pain. Patient states this all started within 3 days after receiving Shingrix and Influenza. Patient went to the ER on 12/14/23 and 12/20/23
Age: 95.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Anaemia, Bladder catheter replacement, Blood glucose increased, COVID-19
Clinical narrative: Patient is a 95 y.o. male patient with pmh urine retention with suprapubic catheter, dm2, htn, history of prostate cancer who presents to ED with confusion   Complicated UTI due to suprapubic catheter POA Severe Sepsis due to Complicated UTI  Urine retention Suprapubic catheter in place VSS. Wbc 44.86-- >40.50-- >31.96>39.2 Suprapubic catheter was changed in ED on 10/15/2023 Urine culture grew pseudomonas, vancomycin discontinued  Stool pcr negative  UA improved US renal no abscess noted Completed cefepime Daughter at bedside interested in SNF on dc.   Acute respiratory failure with hypoxia, POA Covid-19 Virus Infection Date of onset of symptoms: 10/15/2023 Symptoms present on admission: Confusion Date of covid positive test: 10/15/2023 Vaccination status?vaccinated Imaging: Chest x-ray negative for any infiltrate Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: none  Medical therapy: Completed remdesivir, on dexamethasone can be discontinued prior to discharge Consultants following: Infectious disease, recs per ID Anticipated special isolation end date: 10/25/23    Acute metabolic encephalopathy Secondary to UTI, COVID-19.Improved on exam, wife at bedside CT head unrevealing. Likely delirium, unable to sleep well overnight.   Anemia Leukocytosis Thrombocytosis On admission: WBC 44.86, RBC 4.82, hemoglobin 13.1, hematocrit 40.8, platelets 699.WBC trend as follows: 44.86-- > 40.50-- > 37.03-- > 31.96-- > 39.21 Platelet trend as follows: 699-- > 650-- > 743-- > 759-- > 793 Baseline anemia with hemoglobin most consistently ranging from ~7?13 over the last 3 years. Intermittent mild leukocytosis prior to admission Hematology recs appreciated. Labs ordered for further evaluation of abnormal CBC: BCR/ABL, JAK2 mutation, iron studies, B12, folate, LDH, uric acid, myeloma panel, erythropoietin   Elevated troponin Troponins 42-- > 49   Dm type 2 without current long term insulin use Hemoglobin A1c 7.7 Started Lantus 5 units subcu nightly (since patient started on Decadron) Hold metformin. BS noted to be elevated Continue Accu-Chek with sliding scale coverage Titrated upto regular scale while on steroids Target glucose 140?180   Essential HTN Resumed lisinopril, metoprolol
Age: 95.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Computerised tomogram head normal, Condition aggravated, Confusional state, Culture urine positive
Clinical narrative: Patient is a 95 y.o. male patient with pmh urine retention with suprapubic catheter, dm2, htn, history of prostate cancer who presents to ED with confusion   Complicated UTI due to suprapubic catheter POA Severe Sepsis due to Complicated UTI  Urine retention Suprapubic catheter in place VSS. Wbc 44.86-- >40.50-- >31.96>39.2 Suprapubic catheter was changed in ED on 10/15/2023 Urine culture grew pseudomonas, vancomycin discontinued  Stool pcr negative  UA improved US renal no abscess noted Completed cefepime Daughter at bedside interested in SNF on dc.   Acute respiratory failure with hypoxia, POA Covid-19 Virus Infection Date of onset of symptoms: 10/15/2023 Symptoms present on admission: Confusion Date of covid positive test: 10/15/2023 Vaccination status?vaccinated Imaging: Chest x-ray negative for any infiltrate Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: none  Medical therapy: Completed remdesivir, on dexamethasone can be discontinued prior to discharge Consultants following: Infectious disease, recs per ID Anticipated special isolation end date: 10/25/23    Acute metabolic encephalopathy Secondary to UTI, COVID-19.Improved on exam, wife at bedside CT head unrevealing. Likely delirium, unable to sleep well overnight.   Anemia Leukocytosis Thrombocytosis On admission: WBC 44.86, RBC 4.82, hemoglobin 13.1, hematocrit 40.8, platelets 699.WBC trend as follows: 44.86-- > 40.50-- > 37.03-- > 31.96-- > 39.21 Platelet trend as follows: 699-- > 650-- > 743-- > 759-- > 793 Baseline anemia with hemoglobin most consistently ranging from ~7?13 over the last 3 years. Intermittent mild leukocytosis prior to admission Hematology recs appreciated. Labs ordered for further evaluation of abnormal CBC: BCR/ABL, JAK2 mutation, iron studies, B12, folate, LDH, uric acid, myeloma panel, erythropoietin   Elevated troponin Troponins 42-- > 49   Dm type 2 without current long term insulin use Hemoglobin A1c 7.7 Started Lantus 5 units subcu nightly (since patient started on Decadron) Hold metformin. BS noted to be elevated Continue Accu-Chek with sliding scale coverage Titrated upto regular scale while on steroids Target glucose 140?180   Essential HTN Resumed lisinopril, metoprolol
Age: 95.0
Sex: M
Vaccine: COVID19-2
Symptoms: Delirium, Device related infection, Glycosylated haemoglobin increased, Haematocrit decreased, Haemoglobin decreased
Clinical narrative: Patient is a 95 y.o. male patient with pmh urine retention with suprapubic catheter, dm2, htn, history of prostate cancer who presents to ED with confusion   Complicated UTI due to suprapubic catheter POA Severe Sepsis due to Complicated UTI  Urine retention Suprapubic catheter in place VSS. Wbc 44.86-- >40.50-- >31.96>39.2 Suprapubic catheter was changed in ED on 10/15/2023 Urine culture grew pseudomonas, vancomycin discontinued  Stool pcr negative  UA improved US renal no abscess noted Completed cefepime Daughter at bedside interested in SNF on dc.   Acute respiratory failure with hypoxia, POA Covid-19 Virus Infection Date of onset of symptoms: 10/15/2023 Symptoms present on admission: Confusion Date of covid positive test: 10/15/2023 Vaccination status?vaccinated Imaging: Chest x-ray negative for any infiltrate Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: none  Medical therapy: Completed remdesivir, on dexamethasone can be discontinued prior to discharge Consultants following: Infectious disease, recs per ID Anticipated special isolation end date: 10/25/23    Acute metabolic encephalopathy Secondary to UTI, COVID-19.Improved on exam, wife at bedside CT head unrevealing. Likely delirium, unable to sleep well overnight.   Anemia Leukocytosis Thrombocytosis On admission: WBC 44.86, RBC 4.82, hemoglobin 13.1, hematocrit 40.8, platelets 699.WBC trend as follows: 44.86-- > 40.50-- > 37.03-- > 31.96-- > 39.21 Platelet trend as follows: 699-- > 650-- > 743-- > 759-- > 793 Baseline anemia with hemoglobin most consistently ranging from ~7?13 over the last 3 years. Intermittent mild leukocytosis prior to admission Hematology recs appreciated. Labs ordered for further evaluation of abnormal CBC: BCR/ABL, JAK2 mutation, iron studies, B12, folate, LDH, uric acid, myeloma panel, erythropoietin   Elevated troponin Troponins 42-- > 49   Dm type 2 without current long term insulin use Hemoglobin A1c 7.7 Started Lantus 5 units subcu nightly (since patient started on Decadron) Hold metformin. BS noted to be elevated Continue Accu-Chek with sliding scale coverage Titrated upto regular scale while on steroids Target glucose 140?180   Essential HTN Resumed lisinopril, metoprolol
Age: 95.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hypoxia, Leukocytosis, Metabolic encephalopathy, Platelet count increased, Poor quality sleep
Clinical narrative: Patient is a 95 y.o. male patient with pmh urine retention with suprapubic catheter, dm2, htn, history of prostate cancer who presents to ED with confusion   Complicated UTI due to suprapubic catheter POA Severe Sepsis due to Complicated UTI  Urine retention Suprapubic catheter in place VSS. Wbc 44.86-- >40.50-- >31.96>39.2 Suprapubic catheter was changed in ED on 10/15/2023 Urine culture grew pseudomonas, vancomycin discontinued  Stool pcr negative  UA improved US renal no abscess noted Completed cefepime Daughter at bedside interested in SNF on dc.   Acute respiratory failure with hypoxia, POA Covid-19 Virus Infection Date of onset of symptoms: 10/15/2023 Symptoms present on admission: Confusion Date of covid positive test: 10/15/2023 Vaccination status?vaccinated Imaging: Chest x-ray negative for any infiltrate Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: none  Medical therapy: Completed remdesivir, on dexamethasone can be discontinued prior to discharge Consultants following: Infectious disease, recs per ID Anticipated special isolation end date: 10/25/23    Acute metabolic encephalopathy Secondary to UTI, COVID-19.Improved on exam, wife at bedside CT head unrevealing. Likely delirium, unable to sleep well overnight.   Anemia Leukocytosis Thrombocytosis On admission: WBC 44.86, RBC 4.82, hemoglobin 13.1, hematocrit 40.8, platelets 699.WBC trend as follows: 44.86-- > 40.50-- > 37.03-- > 31.96-- > 39.21 Platelet trend as follows: 699-- > 650-- > 743-- > 759-- > 793 Baseline anemia with hemoglobin most consistently ranging from ~7?13 over the last 3 years. Intermittent mild leukocytosis prior to admission Hematology recs appreciated. Labs ordered for further evaluation of abnormal CBC: BCR/ABL, JAK2 mutation, iron studies, B12, folate, LDH, uric acid, myeloma panel, erythropoietin   Elevated troponin Troponins 42-- > 49   Dm type 2 without current long term insulin use Hemoglobin A1c 7.7 Started Lantus 5 units subcu nightly (since patient started on Decadron) Hold metformin. BS noted to be elevated Continue Accu-Chek with sliding scale coverage Titrated upto regular scale while on steroids Target glucose 140?180   Essential HTN Resumed lisinopril, metoprolol
Age: 95.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pseudomonas test positive, Red blood cell count normal, SARS-CoV-2 test positive, Sepsis, Stool analysis normal
Clinical narrative: Patient is a 95 y.o. male patient with pmh urine retention with suprapubic catheter, dm2, htn, history of prostate cancer who presents to ED with confusion   Complicated UTI due to suprapubic catheter POA Severe Sepsis due to Complicated UTI  Urine retention Suprapubic catheter in place VSS. Wbc 44.86-- >40.50-- >31.96>39.2 Suprapubic catheter was changed in ED on 10/15/2023 Urine culture grew pseudomonas, vancomycin discontinued  Stool pcr negative  UA improved US renal no abscess noted Completed cefepime Daughter at bedside interested in SNF on dc.   Acute respiratory failure with hypoxia, POA Covid-19 Virus Infection Date of onset of symptoms: 10/15/2023 Symptoms present on admission: Confusion Date of covid positive test: 10/15/2023 Vaccination status?vaccinated Imaging: Chest x-ray negative for any infiltrate Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: none  Medical therapy: Completed remdesivir, on dexamethasone can be discontinued prior to discharge Consultants following: Infectious disease, recs per ID Anticipated special isolation end date: 10/25/23    Acute metabolic encephalopathy Secondary to UTI, COVID-19.Improved on exam, wife at bedside CT head unrevealing. Likely delirium, unable to sleep well overnight.   Anemia Leukocytosis Thrombocytosis On admission: WBC 44.86, RBC 4.82, hemoglobin 13.1, hematocrit 40.8, platelets 699.WBC trend as follows: 44.86-- > 40.50-- > 37.03-- > 31.96-- > 39.21 Platelet trend as follows: 699-- > 650-- > 743-- > 759-- > 793 Baseline anemia with hemoglobin most consistently ranging from ~7?13 over the last 3 years. Intermittent mild leukocytosis prior to admission Hematology recs appreciated. Labs ordered for further evaluation of abnormal CBC: BCR/ABL, JAK2 mutation, iron studies, B12, folate, LDH, uric acid, myeloma panel, erythropoietin   Elevated troponin Troponins 42-- > 49   Dm type 2 without current long term insulin use Hemoglobin A1c 7.7 Started Lantus 5 units subcu nightly (since patient started on Decadron) Hold metformin. BS noted to be elevated Continue Accu-Chek with sliding scale coverage Titrated upto regular scale while on steroids Target glucose 140?180   Essential HTN Resumed lisinopril, metoprolol
Age: 95.0
Sex: M
Vaccine: COVID19-2
Symptoms: Thrombocytosis, Troponin increased, Ultrasound kidney abnormal, Urinary retention, Urinary tract infection
Clinical narrative: Patient is a 95 y.o. male patient with pmh urine retention with suprapubic catheter, dm2, htn, history of prostate cancer who presents to ED with confusion   Complicated UTI due to suprapubic catheter POA Severe Sepsis due to Complicated UTI  Urine retention Suprapubic catheter in place VSS. Wbc 44.86-- >40.50-- >31.96>39.2 Suprapubic catheter was changed in ED on 10/15/2023 Urine culture grew pseudomonas, vancomycin discontinued  Stool pcr negative  UA improved US renal no abscess noted Completed cefepime Daughter at bedside interested in SNF on dc.   Acute respiratory failure with hypoxia, POA Covid-19 Virus Infection Date of onset of symptoms: 10/15/2023 Symptoms present on admission: Confusion Date of covid positive test: 10/15/2023 Vaccination status?vaccinated Imaging: Chest x-ray negative for any infiltrate Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: none  Medical therapy: Completed remdesivir, on dexamethasone can be discontinued prior to discharge Consultants following: Infectious disease, recs per ID Anticipated special isolation end date: 10/25/23    Acute metabolic encephalopathy Secondary to UTI, COVID-19.Improved on exam, wife at bedside CT head unrevealing. Likely delirium, unable to sleep well overnight.   Anemia Leukocytosis Thrombocytosis On admission: WBC 44.86, RBC 4.82, hemoglobin 13.1, hematocrit 40.8, platelets 699.WBC trend as follows: 44.86-- > 40.50-- > 37.03-- > 31.96-- > 39.21 Platelet trend as follows: 699-- > 650-- > 743-- > 759-- > 793 Baseline anemia with hemoglobin most consistently ranging from ~7?13 over the last 3 years. Intermittent mild leukocytosis prior to admission Hematology recs appreciated. Labs ordered for further evaluation of abnormal CBC: BCR/ABL, JAK2 mutation, iron studies, B12, folate, LDH, uric acid, myeloma panel, erythropoietin   Elevated troponin Troponins 42-- > 49   Dm type 2 without current long term insulin use Hemoglobin A1c 7.7 Started Lantus 5 units subcu nightly (since patient started on Decadron) Hold metformin. BS noted to be elevated Continue Accu-Chek with sliding scale coverage Titrated upto regular scale while on steroids Target glucose 140?180   Essential HTN Resumed lisinopril, metoprolol
Age: 95.0
Sex: M
Vaccine: COVID19-2
Symptoms: Urine analysis abnormal, White blood cell count increased
Clinical narrative: Patient is a 95 y.o. male patient with pmh urine retention with suprapubic catheter, dm2, htn, history of prostate cancer who presents to ED with confusion   Complicated UTI due to suprapubic catheter POA Severe Sepsis due to Complicated UTI  Urine retention Suprapubic catheter in place VSS. Wbc 44.86-- >40.50-- >31.96>39.2 Suprapubic catheter was changed in ED on 10/15/2023 Urine culture grew pseudomonas, vancomycin discontinued  Stool pcr negative  UA improved US renal no abscess noted Completed cefepime Daughter at bedside interested in SNF on dc.   Acute respiratory failure with hypoxia, POA Covid-19 Virus Infection Date of onset of symptoms: 10/15/2023 Symptoms present on admission: Confusion Date of covid positive test: 10/15/2023 Vaccination status?vaccinated Imaging: Chest x-ray negative for any infiltrate Oxygen requirements on admission: 2 L nasal cannula Current oxygen requirements: none  Medical therapy: Completed remdesivir, on dexamethasone can be discontinued prior to discharge Consultants following: Infectious disease, recs per ID Anticipated special isolation end date: 10/25/23    Acute metabolic encephalopathy Secondary to UTI, COVID-19.Improved on exam, wife at bedside CT head unrevealing. Likely delirium, unable to sleep well overnight.   Anemia Leukocytosis Thrombocytosis On admission: WBC 44.86, RBC 4.82, hemoglobin 13.1, hematocrit 40.8, platelets 699.WBC trend as follows: 44.86-- > 40.50-- > 37.03-- > 31.96-- > 39.21 Platelet trend as follows: 699-- > 650-- > 743-- > 759-- > 793 Baseline anemia with hemoglobin most consistently ranging from ~7?13 over the last 3 years. Intermittent mild leukocytosis prior to admission Hematology recs appreciated. Labs ordered for further evaluation of abnormal CBC: BCR/ABL, JAK2 mutation, iron studies, B12, folate, LDH, uric acid, myeloma panel, erythropoietin   Elevated troponin Troponins 42-- > 49   Dm type 2 without current long term insulin use Hemoglobin A1c 7.7 Started Lantus 5 units subcu nightly (since patient started on Decadron) Hold metformin. BS noted to be elevated Continue Accu-Chek with sliding scale coverage Titrated upto regular scale while on steroids Target glucose 140?180   Essential HTN Resumed lisinopril, metoprolol
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood bicarbonate increased, Blood lactic acid, Blood pH normal, Bradycardia
Clinical narrative: Patient. is a 46 y.o. male who is a patient of MD with significant medical history of asthma and hypertension presented to Hospital with shortness of breath.   Acute hypoxemic respiratory failure  COVID-19 virus infection Patient with symptom onset on 10/9/2023 after having attended a Buckeye's game. SPO2 90% on room air and at Pickerington freestanding ED, SPO2 88% on room air on admission CRP 12.2, lactic acid 1.3 on admission VBG pH 7.37/PCO2 54.6/PO2 30/HCO3 31.3/sats 45.2% FiO2 2 L CXR marginal inspiration, questionable faint opacities noted bilaterally Decadron plus remdesivir started on admission Monitor closely pulse ox and titrate oxygen needs accordingly DVT prophylaxis with Lovenox Incentive spirometry, self proning Lasix IV 20 mg x 1 ordered on 10/15 Room air > past 24 hours   Bradycardia, asymptomatic While patient is asleep Most likely related to untreated sleep apnea Discussed with cardiology who reviewed telemetry showing sinus bradycardia without associated heart block  Patient recently had echocardiogram and stress test as outpatient Plan to reevaluate need for repeat echocardiogram once patient is out of isolation Encourage patient to utilize CPAP at night.      Peripheral edema, BLE due to Chronic venous insufficiency Patient is dependent on compression stockings Elevate legs Recommend compression stocking use   Obesity BMI 33   Essential hypertension BP 164/101  Continue eplerenone, formulary equivalent of Benicar Will hold Bystolic in the setting of bradycardia Add as needed hydralazine   History of asthma Continue albuterol inhaler (neb at home, covid precludes this) Cont steroid for 10 days, mucinex    OSA Patient says insurance not approving CPAP, unclear why Patient declined CPAP while inpatient on admission 10/15 after discussion regarding bradycardia and unmanaged sleep apnea, patient agreeable to nocturnal CPAP which was ordered but not utilized
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: C-reactive protein increased, COVID-19, Cardiac stress test, Cardiac telemetry abnormal, Chest X-ray abnormal
Clinical narrative: Patient. is a 46 y.o. male who is a patient of MD with significant medical history of asthma and hypertension presented to Hospital with shortness of breath.   Acute hypoxemic respiratory failure  COVID-19 virus infection Patient with symptom onset on 10/9/2023 after having attended a Buckeye's game. SPO2 90% on room air and at Pickerington freestanding ED, SPO2 88% on room air on admission CRP 12.2, lactic acid 1.3 on admission VBG pH 7.37/PCO2 54.6/PO2 30/HCO3 31.3/sats 45.2% FiO2 2 L CXR marginal inspiration, questionable faint opacities noted bilaterally Decadron plus remdesivir started on admission Monitor closely pulse ox and titrate oxygen needs accordingly DVT prophylaxis with Lovenox Incentive spirometry, self proning Lasix IV 20 mg x 1 ordered on 10/15 Room air > past 24 hours   Bradycardia, asymptomatic While patient is asleep Most likely related to untreated sleep apnea Discussed with cardiology who reviewed telemetry showing sinus bradycardia without associated heart block  Patient recently had echocardiogram and stress test as outpatient Plan to reevaluate need for repeat echocardiogram once patient is out of isolation Encourage patient to utilize CPAP at night.      Peripheral edema, BLE due to Chronic venous insufficiency Patient is dependent on compression stockings Elevate legs Recommend compression stocking use   Obesity BMI 33   Essential hypertension BP 164/101  Continue eplerenone, formulary equivalent of Benicar Will hold Bystolic in the setting of bradycardia Add as needed hydralazine   History of asthma Continue albuterol inhaler (neb at home, covid precludes this) Cont steroid for 10 days, mucinex    OSA Patient says insurance not approving CPAP, unclear why Patient declined CPAP while inpatient on admission 10/15 after discussion regarding bradycardia and unmanaged sleep apnea, patient agreeable to nocturnal CPAP which was ordered but not utilized
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Compression garment application, Dyspnoea, Echocardiogram, Essential hypertension, Insurance issue
Clinical narrative: Patient. is a 46 y.o. male who is a patient of MD with significant medical history of asthma and hypertension presented to Hospital with shortness of breath.   Acute hypoxemic respiratory failure  COVID-19 virus infection Patient with symptom onset on 10/9/2023 after having attended a Buckeye's game. SPO2 90% on room air and at Pickerington freestanding ED, SPO2 88% on room air on admission CRP 12.2, lactic acid 1.3 on admission VBG pH 7.37/PCO2 54.6/PO2 30/HCO3 31.3/sats 45.2% FiO2 2 L CXR marginal inspiration, questionable faint opacities noted bilaterally Decadron plus remdesivir started on admission Monitor closely pulse ox and titrate oxygen needs accordingly DVT prophylaxis with Lovenox Incentive spirometry, self proning Lasix IV 20 mg x 1 ordered on 10/15 Room air > past 24 hours   Bradycardia, asymptomatic While patient is asleep Most likely related to untreated sleep apnea Discussed with cardiology who reviewed telemetry showing sinus bradycardia without associated heart block  Patient recently had echocardiogram and stress test as outpatient Plan to reevaluate need for repeat echocardiogram once patient is out of isolation Encourage patient to utilize CPAP at night.      Peripheral edema, BLE due to Chronic venous insufficiency Patient is dependent on compression stockings Elevate legs Recommend compression stocking use   Obesity BMI 33   Essential hypertension BP 164/101  Continue eplerenone, formulary equivalent of Benicar Will hold Bystolic in the setting of bradycardia Add as needed hydralazine   History of asthma Continue albuterol inhaler (neb at home, covid precludes this) Cont steroid for 10 days, mucinex    OSA Patient says insurance not approving CPAP, unclear why Patient declined CPAP while inpatient on admission 10/15 after discussion regarding bradycardia and unmanaged sleep apnea, patient agreeable to nocturnal CPAP which was ordered but not utilized
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Obesity, Obstructive sleep apnoea syndrome, Oedema peripheral, PCO2 increased
Clinical narrative: Patient. is a 46 y.o. male who is a patient of MD with significant medical history of asthma and hypertension presented to Hospital with shortness of breath.   Acute hypoxemic respiratory failure  COVID-19 virus infection Patient with symptom onset on 10/9/2023 after having attended a Buckeye's game. SPO2 90% on room air and at Pickerington freestanding ED, SPO2 88% on room air on admission CRP 12.2, lactic acid 1.3 on admission VBG pH 7.37/PCO2 54.6/PO2 30/HCO3 31.3/sats 45.2% FiO2 2 L CXR marginal inspiration, questionable faint opacities noted bilaterally Decadron plus remdesivir started on admission Monitor closely pulse ox and titrate oxygen needs accordingly DVT prophylaxis with Lovenox Incentive spirometry, self proning Lasix IV 20 mg x 1 ordered on 10/15 Room air > past 24 hours   Bradycardia, asymptomatic While patient is asleep Most likely related to untreated sleep apnea Discussed with cardiology who reviewed telemetry showing sinus bradycardia without associated heart block  Patient recently had echocardiogram and stress test as outpatient Plan to reevaluate need for repeat echocardiogram once patient is out of isolation Encourage patient to utilize CPAP at night.      Peripheral edema, BLE due to Chronic venous insufficiency Patient is dependent on compression stockings Elevate legs Recommend compression stocking use   Obesity BMI 33   Essential hypertension BP 164/101  Continue eplerenone, formulary equivalent of Benicar Will hold Bystolic in the setting of bradycardia Add as needed hydralazine   History of asthma Continue albuterol inhaler (neb at home, covid precludes this) Cont steroid for 10 days, mucinex    OSA Patient says insurance not approving CPAP, unclear why Patient declined CPAP while inpatient on admission 10/15 after discussion regarding bradycardia and unmanaged sleep apnea, patient agreeable to nocturnal CPAP which was ordered but not utilized
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: PO2 decreased, Peripheral venous disease, Sinus bradycardia
Clinical narrative: Patient. is a 46 y.o. male who is a patient of MD with significant medical history of asthma and hypertension presented to Hospital with shortness of breath.   Acute hypoxemic respiratory failure  COVID-19 virus infection Patient with symptom onset on 10/9/2023 after having attended a Buckeye's game. SPO2 90% on room air and at Pickerington freestanding ED, SPO2 88% on room air on admission CRP 12.2, lactic acid 1.3 on admission VBG pH 7.37/PCO2 54.6/PO2 30/HCO3 31.3/sats 45.2% FiO2 2 L CXR marginal inspiration, questionable faint opacities noted bilaterally Decadron plus remdesivir started on admission Monitor closely pulse ox and titrate oxygen needs accordingly DVT prophylaxis with Lovenox Incentive spirometry, self proning Lasix IV 20 mg x 1 ordered on 10/15 Room air > past 24 hours   Bradycardia, asymptomatic While patient is asleep Most likely related to untreated sleep apnea Discussed with cardiology who reviewed telemetry showing sinus bradycardia without associated heart block  Patient recently had echocardiogram and stress test as outpatient Plan to reevaluate need for repeat echocardiogram once patient is out of isolation Encourage patient to utilize CPAP at night.      Peripheral edema, BLE due to Chronic venous insufficiency Patient is dependent on compression stockings Elevate legs Recommend compression stocking use   Obesity BMI 33   Essential hypertension BP 164/101  Continue eplerenone, formulary equivalent of Benicar Will hold Bystolic in the setting of bradycardia Add as needed hydralazine   History of asthma Continue albuterol inhaler (neb at home, covid precludes this) Cont steroid for 10 days, mucinex    OSA Patient says insurance not approving CPAP, unclear why Patient declined CPAP while inpatient on admission 10/15 after discussion regarding bradycardia and unmanaged sleep apnea, patient agreeable to nocturnal CPAP which was ordered but not utilized
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, COVID-19 pneumonia, Chronic obstructive pulmonary disease
Clinical narrative: Patient is a 83 y.o. male patient of MD with history of chronic respiratory failure on home 2-3 L, Afib on Eliquis, HFpEF, CAD, HTN, HLD presented to Medical Center with seizure like activity and hypoxia, admitted for COVID PNA    Acute on Chronic Respiratory Failure with Hypoxia Presented with AMS and Hypoxia Secondary to COVID-19, Pleural effusions, PNA On 2L O2 at baseline, recently on HHFNC when sent to Select and was initially improved, on BIPAP on admission, now weaned to HHFNC>>3L NC CTPA (10/21) showed significant worsening of bilateral pleural fluid effusions, Large on R, mod on left  with adjacent B/L LL consolidations and extensive patchy infiltrates in RUL and LLL Currently on 2 to 3 L nasal cannula Stable to discharge per pulmonary   Covid-19 Virus Infection Date of onset of symptoms: 10/21 Symptoms present on admission: Hypoxia, AMS Date of covid positive test: 10/21 Vaccination status: vaccinated Imaging: CTPA with bilateral patchy opacities Oxygen requirements on admission: BIPAP Current oxygen requirements: HHFNC Medical therapy: completed remdesivir, continue steroids x 10 days, Completed 7 days of Cefepime Consultants following: Pulm  Anticipated special isolation end date: 11/1/23   HAP Pseudomonas Pneumonia Afebrile, Leukocytosis to 11.62k CTPA with B/L LL consolidations and extensive patchy infiltrates in RUL and LLL MRSA probe negative Sputum cx positive for Pseudomonas Vanco and Cefepime started on admission, Vanco discontinued as MRSA probe negative Completed Cefepime x 7 day course   Episode of unresponsiveness Concern for seizure like activity per Select Hospital Likely due to hypoxia due to COVID-19, PNA No CT head ordered on admission Neurology consulted, low suspicion for seizure Hold off on AED at this time Can obtain MRI brain and spot EEG if further episodes of unresponsiveness occur outside of setting of hypoxia or if seizure like activity is notes No further episodes   Hiatal hernia Difficulty eating due to hiatal hernia Chopped/soft diet per pt preference Boost TID   COPD Exacerbation due to PNA and COVID-19 Continue home AirDuo Diginhaler Continue home Duonebs Already on steroids due to COVID Chronic HFpEF HTN Echo (9/2023) with EF 50-55% Continue home  Coreg and lasix   Afib  Continue home Sotalol, Coreg and Eliquis    CAD HLD S/p previous PCI Continue home ASA and Lipitor    GOC Palliative care consulted Continue DNR CCA, okay with intubation