chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Inguinal hernia, Lactic acidosis, Localised oedema, Lung disorder
Clinical narrative: Patient discharged from (11) day inpatient stay from 11/12/2021-11/23/2021.  Patient was admitted through the emergency room with sepsis.  COVID positive.  Due to severity of his illness see was placed on remdesivir and Decadron also empiric antibiotic therapy.  Blood cultures were drawn and came back positive although they were polymicrobial as suspected overall contaminant.  Despite that he was continued on IV antibiotics along with the antivirals.  He was recovering from the COVID developed a increase in lactic acid was given fluids and continued with antibiotics a work broadened.  Responded quickly to that therapy.  He was doing well at the time of his discharge at discharge is white count was normal hemoglobin was stable at 12. 3. His lactic acid was normal at discharge his electrolytes were normal chest x-ray did show evidence of an infiltrate which probably should be repeated in about a week or 2 clinically he did not have evidence of bacterial pneumonia.  I suspect this is residual from his COVID infection.  He is at high risk for aspiration so will discharge him on Augmentin to complete his therapy.   Patient was seen by PT and OT.  In addition he was seen by General surgery regarding a decubitus.  He did not feel that this was the site of infection the area looked relatively clean.   Patient will be discharged to extended care facility
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Lung infiltration, Lung opacity, Lymph node calcification, Osteoarthritis, Pleural effusion
Clinical narrative: Patient discharged from (11) day inpatient stay from 11/12/2021-11/23/2021.  Patient was admitted through the emergency room with sepsis.  COVID positive.  Due to severity of his illness see was placed on remdesivir and Decadron also empiric antibiotic therapy.  Blood cultures were drawn and came back positive although they were polymicrobial as suspected overall contaminant.  Despite that he was continued on IV antibiotics along with the antivirals.  He was recovering from the COVID developed a increase in lactic acid was given fluids and continued with antibiotics a work broadened.  Responded quickly to that therapy.  He was doing well at the time of his discharge at discharge is white count was normal hemoglobin was stable at 12. 3. His lactic acid was normal at discharge his electrolytes were normal chest x-ray did show evidence of an infiltrate which probably should be repeated in about a week or 2 clinically he did not have evidence of bacterial pneumonia.  I suspect this is residual from his COVID infection.  He is at high risk for aspiration so will discharge him on Augmentin to complete his therapy.   Patient was seen by PT and OT.  In addition he was seen by General surgery regarding a decubitus.  He did not feel that this was the site of infection the area looked relatively clean.   Patient will be discharged to extended care facility
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary calcification, Pulmonary granuloma, SARS-CoV-2 test positive, Sepsis, Spinal osteoarthritis
Clinical narrative: Patient discharged from (11) day inpatient stay from 11/12/2021-11/23/2021.  Patient was admitted through the emergency room with sepsis.  COVID positive.  Due to severity of his illness see was placed on remdesivir and Decadron also empiric antibiotic therapy.  Blood cultures were drawn and came back positive although they were polymicrobial as suspected overall contaminant.  Despite that he was continued on IV antibiotics along with the antivirals.  He was recovering from the COVID developed a increase in lactic acid was given fluids and continued with antibiotics a work broadened.  Responded quickly to that therapy.  He was doing well at the time of his discharge at discharge is white count was normal hemoglobin was stable at 12. 3. His lactic acid was normal at discharge his electrolytes were normal chest x-ray did show evidence of an infiltrate which probably should be repeated in about a week or 2 clinically he did not have evidence of bacterial pneumonia.  I suspect this is residual from his COVID infection.  He is at high risk for aspiration so will discharge him on Augmentin to complete his therapy.   Patient was seen by PT and OT.  In addition he was seen by General surgery regarding a decubitus.  He did not feel that this was the site of infection the area looked relatively clean.   Patient will be discharged to extended care facility
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Splenic calcification, Splenic granuloma, Umbilical hernia, White blood cell count normal
Clinical narrative: Patient discharged from (11) day inpatient stay from 11/12/2021-11/23/2021.  Patient was admitted through the emergency room with sepsis.  COVID positive.  Due to severity of his illness see was placed on remdesivir and Decadron also empiric antibiotic therapy.  Blood cultures were drawn and came back positive although they were polymicrobial as suspected overall contaminant.  Despite that he was continued on IV antibiotics along with the antivirals.  He was recovering from the COVID developed a increase in lactic acid was given fluids and continued with antibiotics a work broadened.  Responded quickly to that therapy.  He was doing well at the time of his discharge at discharge is white count was normal hemoglobin was stable at 12. 3. His lactic acid was normal at discharge his electrolytes were normal chest x-ray did show evidence of an infiltrate which probably should be repeated in about a week or 2 clinically he did not have evidence of bacterial pneumonia.  I suspect this is residual from his COVID infection.  He is at high risk for aspiration so will discharge him on Augmentin to complete his therapy.   Patient was seen by PT and OT.  In addition he was seen by General surgery regarding a decubitus.  He did not feel that this was the site of infection the area looked relatively clean.   Patient will be discharged to extended care facility
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Chills, Erythema, Extra dose administered, Gait disturbance, Pain in extremity
Clinical narrative: My son had covid in Dec 2020. He was given 1 shot of J&J vaccine on March 20, 2021 (had a low fever for a few days.) He was given booster of Moderna on 11/20/2021 and had a fever/ chills for a few days...  then on day 5 his hands swelled up and became very red and itchy, and his feet became very sensitive on the bottoms. He said walking felt like his feet were totally bruised. He couldn't bend his fingers easily bc they're so swollen. The pediatrician told him to take one Zyrtec a day and it should feel better within 2 weeks. Day 6, a fever spiked again. 101.7. We are now on day 7. He isn't awake yet, but this is pretty awful.
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Peripheral swelling, Pruritus, Pyrexia
Clinical narrative: My son had covid in Dec 2020. He was given 1 shot of J&J vaccine on March 20, 2021 (had a low fever for a few days.) He was given booster of Moderna on 11/20/2021 and had a fever/ chills for a few days...  then on day 5 his hands swelled up and became very red and itchy, and his feet became very sensitive on the bottoms. He said walking felt like his feet were totally bruised. He couldn't bend his fingers easily bc they're so swollen. The pediatrician told him to take one Zyrtec a day and it should feel better within 2 weeks. Day 6, a fever spiked again. 101.7. We are now on day 7. He isn't awake yet, but this is pretty awful.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Asthenia, Bacterial test, Bacterial test positive, Bladder catheterisation
Clinical narrative: Patient discharged after ( 2) day inpatient stay. 11/22-11/24/2021 The patient is a 92 y.o. male who presents today with shortness of breath and fatigue.  The patient has a pertinent medical history for coronary artery disease, hypertension, hyperlipidemia, and PE in August and currently on Eliquis until 11/24 (plan to continue while inpatient).  Additionally the patient sustained a fall in July with a right hip fracture and subsequently underwent an ORIF with cable fixation and currently has persistent inability to void since the fall.  He has had a urinary catheter since this fall.  History has been obtained from the patient and his daughter.  The patient tested positive for COVID-19 on 11/18.  He reports symptoms started on 11/16 at include fatigue, weakness, cough in these have progressed over the following days which led him to seek the ER.  While in the ER he was found to be mildly hypoxic at 88-90% on room air and was placed on 1 L nasal cannula.  He was given dexamethasone remdesivir for treatment of COVID -19. While in the ER his CRP was quite elevated at 134.3 and a procalcitonin was elevated at 0.45.  He was given Rocephin and azithromycin for possible bacterial pneumonia   The patient's daughter met with hospice this am, and requests that patient be discharged from hospital back to his home.  She will sign him onto hospice this afternoon.  Per her wishes, patient will be discharged on oxygen and given prescriptions for dexamethasone and antibiotics.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Blood culture negative, C-reactive protein increased, COVID-19, Chest X-ray abnormal, Cough
Clinical narrative: Patient discharged after ( 2) day inpatient stay. 11/22-11/24/2021 The patient is a 92 y.o. male who presents today with shortness of breath and fatigue.  The patient has a pertinent medical history for coronary artery disease, hypertension, hyperlipidemia, and PE in August and currently on Eliquis until 11/24 (plan to continue while inpatient).  Additionally the patient sustained a fall in July with a right hip fracture and subsequently underwent an ORIF with cable fixation and currently has persistent inability to void since the fall.  He has had a urinary catheter since this fall.  History has been obtained from the patient and his daughter.  The patient tested positive for COVID-19 on 11/18.  He reports symptoms started on 11/16 at include fatigue, weakness, cough in these have progressed over the following days which led him to seek the ER.  While in the ER he was found to be mildly hypoxic at 88-90% on room air and was placed on 1 L nasal cannula.  He was given dexamethasone remdesivir for treatment of COVID -19. While in the ER his CRP was quite elevated at 134.3 and a procalcitonin was elevated at 0.45.  He was given Rocephin and azithromycin for possible bacterial pneumonia   The patient's daughter met with hospice this am, and requests that patient be discharged from hospital back to his home.  She will sign him onto hospice this afternoon.  Per her wishes, patient will be discharged on oxygen and given prescriptions for dexamethasone and antibiotics.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Culture urine negative, Dyspnoea, Dysuria, Fall, Fatigue
Clinical narrative: Patient discharged after ( 2) day inpatient stay. 11/22-11/24/2021 The patient is a 92 y.o. male who presents today with shortness of breath and fatigue.  The patient has a pertinent medical history for coronary artery disease, hypertension, hyperlipidemia, and PE in August and currently on Eliquis until 11/24 (plan to continue while inpatient).  Additionally the patient sustained a fall in July with a right hip fracture and subsequently underwent an ORIF with cable fixation and currently has persistent inability to void since the fall.  He has had a urinary catheter since this fall.  History has been obtained from the patient and his daughter.  The patient tested positive for COVID-19 on 11/18.  He reports symptoms started on 11/16 at include fatigue, weakness, cough in these have progressed over the following days which led him to seek the ER.  While in the ER he was found to be mildly hypoxic at 88-90% on room air and was placed on 1 L nasal cannula.  He was given dexamethasone remdesivir for treatment of COVID -19. While in the ER his CRP was quite elevated at 134.3 and a procalcitonin was elevated at 0.45.  He was given Rocephin and azithromycin for possible bacterial pneumonia   The patient's daughter met with hospice this am, and requests that patient be discharged from hospital back to his home.  She will sign him onto hospice this afternoon.  Per her wishes, patient will be discharged on oxygen and given prescriptions for dexamethasone and antibiotics.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Granuloma, Hilar lymphadenopathy, Hip fracture, Hypoxia, Lung opacity
Clinical narrative: Patient discharged after ( 2) day inpatient stay. 11/22-11/24/2021 The patient is a 92 y.o. male who presents today with shortness of breath and fatigue.  The patient has a pertinent medical history for coronary artery disease, hypertension, hyperlipidemia, and PE in August and currently on Eliquis until 11/24 (plan to continue while inpatient).  Additionally the patient sustained a fall in July with a right hip fracture and subsequently underwent an ORIF with cable fixation and currently has persistent inability to void since the fall.  He has had a urinary catheter since this fall.  History has been obtained from the patient and his daughter.  The patient tested positive for COVID-19 on 11/18.  He reports symptoms started on 11/16 at include fatigue, weakness, cough in these have progressed over the following days which led him to seek the ER.  While in the ER he was found to be mildly hypoxic at 88-90% on room air and was placed on 1 L nasal cannula.  He was given dexamethasone remdesivir for treatment of COVID -19. While in the ER his CRP was quite elevated at 134.3 and a procalcitonin was elevated at 0.45.  He was given Rocephin and azithromycin for possible bacterial pneumonia   The patient's daughter met with hospice this am, and requests that patient be discharged from hospital back to his home.  She will sign him onto hospice this afternoon.  Per her wishes, patient will be discharged on oxygen and given prescriptions for dexamethasone and antibiotics.
Age: 91.0
Sex: M
Vaccine: COVID19
Symptoms: Open reduction of fracture, Pneumonia, Procalcitonin increased, SARS-CoV-2 test positive
Clinical narrative: Patient discharged after ( 2) day inpatient stay. 11/22-11/24/2021 The patient is a 92 y.o. male who presents today with shortness of breath and fatigue.  The patient has a pertinent medical history for coronary artery disease, hypertension, hyperlipidemia, and PE in August and currently on Eliquis until 11/24 (plan to continue while inpatient).  Additionally the patient sustained a fall in July with a right hip fracture and subsequently underwent an ORIF with cable fixation and currently has persistent inability to void since the fall.  He has had a urinary catheter since this fall.  History has been obtained from the patient and his daughter.  The patient tested positive for COVID-19 on 11/18.  He reports symptoms started on 11/16 at include fatigue, weakness, cough in these have progressed over the following days which led him to seek the ER.  While in the ER he was found to be mildly hypoxic at 88-90% on room air and was placed on 1 L nasal cannula.  He was given dexamethasone remdesivir for treatment of COVID -19. While in the ER his CRP was quite elevated at 134.3 and a procalcitonin was elevated at 0.45.  He was given Rocephin and azithromycin for possible bacterial pneumonia   The patient's daughter met with hospice this am, and requests that patient be discharged from hospital back to his home.  She will sign him onto hospice this afternoon.  Per her wishes, patient will be discharged on oxygen and given prescriptions for dexamethasone and antibiotics.
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Arteriosclerosis coronary artery, Asthenia, Blood culture negative, Bronchial wall thickening
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cardiac dysfunction, Cardiac failure, Cardiac failure congestive
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiomegaly, Cerebral calcification, Chest X-ray abnormal, Computerised tomogram head abnormal, Condition aggravated
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Culture urine positive, Dyspnoea, Echocardiogram, Echocardiogram abnormal, Ejection fraction decreased
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Escherichia infection, Escherichia test positive, Fatigue, General physical health deterioration, Gram stain positive
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Headache, Hypertension, Intervertebral disc degeneration, Left atrial dilatation
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Left ventricular dysfunction, Legionella test, Lung consolidation, Lung infiltration, Lung opacity
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy mediastinal, Mitral valve incompetence, Mucosal hypertrophy, Packed red blood cell transfusion, Pleural effusion
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Polyuria, Procalcitonin increased, Productive cough, Pulmonary oedema, Pyrexia
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Scan with contrast abnormal, Sputum culture, Staphylococcus test negative, Streptococcus test negative
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 86.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope, Thyroid mass, Tricuspid valve incompetence, Urinary tract infection, Vertigo
Clinical narrative: Patient discharged after (7) day inpatient stay from 11/16-11/23/2021. 87-year-old female presenting to our institution with 1 week of shortness of breath and productive cough.  She also had progressive fatigue and weakness.  She was identified to be febrile at the urgent care, and directed to the emergency department for further evaluation.  Patient is vaccinated for COVID-19, but had not had her booster.  In the ER she was found to have a COVID-19 positive test and a hemoglobin of 6.7.  She received 1 unit packed red blood cells and was admitted to the hospitalist service.   In regards to her anemia, she was seen in consultation with Hematology who recommended that the patient received as needed transfusions, and follow-up as an outpatient for possible bone marrow biopsy after she recovers from COVID-19.   In regards to her COVID-19, she initially was on room air not requiring oxygen.  She received monoclonal antibody infusion.  Chest x-ray did show developing infiltrates, and the patient rapidly deteriorated, requiring high-flow nasal cannula.  She was placed on remdesivir and dexamethasone.  CT angiogram thorax was obtained, which ruled out pulmonary embolism but showed evidence of COVID-19 pneumonia and suspected CHF with pulmonary edema and small bilateral pleural effusions.  Patient was noted to have progressing left-sided infiltrates, with a significant rise in procalcitonin.  There is concern for bacterial superinfection, and the patient was started on cefepime and vancomycin.  Patient continued to have increased oxygen needs, and ultimately elected to discharge home with hospice goals of care.  She would like to be with her family.  She will complete 5 additional days of dexamethasone at discharge.   Given the finding of new congestive heart failure, the patient was started on intravenous diuretic therapy.  She diuresed well.  Echocardiogram was obtained, showing a ejection fraction of 40% with moderate dysfunction and minor regional variations.  She was noted to have an echodensity in the right atrium measuring 1.1 x 1.3 cm.  She was started on losartan as well as Coreg.  She was seen in consultation with Cardiology, they recommended anticoagulation, and repeat echocardiogram however the patient elected for hospice goals of care.     Patient also identified to have uncomplicated urinary tract infection, with E coli likely CAUTI. This was treated to completion during hospital course.   She signed up with Hospice was discharged home in stable condition with hospice
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain
Clinical narrative: Body aches, nausea
Age: 89.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anticoagulant therapy, Aortic arteriosclerosis, Aortic disorder, Asthenia
Clinical narrative: Patient currently inpatient at (8) days starting from 11/18/2021. Patient is a 90 y.o. female who presents today with shortness of breath.  History is limited from the patient, however patient's son provides additional history as possible.  Patient's son states that she was hospitalized a couple weeks ago for suspected urinary tract infection.  He states following hospitalization she had significant weakness and she was discharged to assisted living for ongoing care.  While at assisted living the patient was noted to have significant respiratory distress and fevers, for which reason the patient was sent to the ER for further evaluation.  Patient was noted to be COVID positive.  She reports being vaccinated.  Patient is somewhat immunocompromised with her CLL.  On presentation, the patient was requiring high-flow nasal cannula to maintain appropriate saturations.  Patient does report that she uses 2-3 L of oxygen at night while sleeping, however she is unsure of any specific associated pulmonary diagnosis.  Anticipated care plan was discussed with the patient and her son.  Both report should patient's respiratory status worsen intubation is not desired.  Questions have been answered to patient and son satisfaction.  ASSESSMENT/PLAN: Acute on chronic respiratory failure with hypoxia  Assessment & Plan Patient reports baseline oxygen needs of 2-3 L at night Patient was requiring high-flow nasal cannula on admission secondary to pneumonia   Continue weaning oxygen as tolerated otherwise treatment as outlined under pneumonia   * Pneumonia Assessment & Plan Patient with noted positive COVID test in the emergency department (11/18/2012) Unclear whether pneumonia is bacterial in nature or related to COVID-19.   Will continue to cover with IV Rocephin and azithromycin for potential bacterial pneumonia Additionally will start patient on 6 mg of Decadron for possible COVID pneumonia Routine monitoring of vitals Will monitor blood culture results Patient's home Eliquis should be adequate anticoagulation for patient's positive COVID status   Type 2 diabetes mellitus, without long-term current use of insulin  Assessment & Plan Very low-dose mealtime and corrective scale coverage while admitted Will continue trending patient's bedside glucose for further titration   CLL (chronic lymphocytic leukemia)  Assessment & Plan Likely cause of patient's noted leukocytosis Will continue monitoring complete blood count throughout admission   Atrial fibrillation  Assessment & Plan Continue Eliquis for anticoagulation and metoprolol for rate control   Atrophic kidney Assessment & Plan Patient's son reports a history of an atrophic kidney he states his chronically infected.  He notes patient recently underwent a 10 day antibiotic course.  UA in kidney function reviewed.  No further indication of ongoing urinary infection is noted and patient has appropriate kidney function