chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Imprisonment, Intestinal strangulation, Lactic acidosis, Lung infiltration, Lung opacity
Clinical narrative: Discharge Diagnoses and Associated Hospital Course:   Patient is a 78 y.o. male with history of HTN, HLD, DM, prior SBOs managed conservatively (11/2019), L CVA with residual deficit (7/14/22) who presented to hospital as transfer on 12/12/2022 with concern for SBO 2/2 internal hernia & strangulated small bowel.    Admitted with these risk variables:Encephalopathy, Acute Kidney Injury, Chronic Kidney Disease, and Acidosis. Please see assessment and plan for further details.   CT A/P IV Contrast (12/12): SBO w/ incarceration & strangulation 2/2 internal mesenteric hernia in R abdomen & pelvis. Suspicious for small bowel ischemia.    SBO w/ concern for strangulated small bowel Lactic Acidosis, resolved  AKI on CKD, resolved  Hyperglycemia, resolved COVID Positive - s/p reduction of small bowel volvulus, LOA on 12/13/2022 - kept intubated post-op; extubated 12/13 to HHFNC; now on RA  - NGT removed 12/15 - Postoperatively, the patient had slow return of bowel function, his diet and activity were advanced cautiously.  He was maintained on DVT prophylaxis throughout his hospitalization.  Please refer to daily progress notes for detailed clinical progression.   COVID-19 infection tested positive 12/12/2022, unsure symptoms due to encephalopathy however noted hypoxia on presentation with bilateral infiltrates. Decadron started 12/13/22, stopped 12/19/22. Patient on RA as of 12/17/22.   Acute respiratory failure with hypoxia CXR with mild opacities in lung base, possibly sec to aspiration vs COVID 19. required O2 prior to surgery. Remained intubated postoperatively 12/13/22 extubated to HHFNC. Required 60L HHFNC with fiO2 50% 12/14/22. Resolved.   Acute Metabolic encephalopathy noted on admit. Unclear baseline, suspect sec to above. Management as noted. Remains intermittently confused as of 12/18/22   AKI on CKD stage 3  baseline Cr 1.5-2. On admission 4.39. S/p IVF. Resolved. Monitored.  PAF or PSVT EKG in ED showed afib with RVR rate 150's. No history of a fib, +history of SVT, rate back to 110's spontaneously. Repeat EKGs with sinus tachycardia. S/p scheduled IV metoprolol, transitioned to home metoprolol. Continue telemetry monitoring. Recommended outpatient follow-up with cardiology.   DM2 hold oral medications, SSI.    HTN  continue home amlodipine. Held home hydrochlorothiazide, lisinopril for soft BP. Restart as tolerated.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Metabolic encephalopathy, SARS-CoV-2 test positive, Scan with contrast abnormal, Sinus tachycardia, Small intestinal obstruction
Clinical narrative: Discharge Diagnoses and Associated Hospital Course:   Patient is a 78 y.o. male with history of HTN, HLD, DM, prior SBOs managed conservatively (11/2019), L CVA with residual deficit (7/14/22) who presented to hospital as transfer on 12/12/2022 with concern for SBO 2/2 internal hernia & strangulated small bowel.    Admitted with these risk variables:Encephalopathy, Acute Kidney Injury, Chronic Kidney Disease, and Acidosis. Please see assessment and plan for further details.   CT A/P IV Contrast (12/12): SBO w/ incarceration & strangulation 2/2 internal mesenteric hernia in R abdomen & pelvis. Suspicious for small bowel ischemia.    SBO w/ concern for strangulated small bowel Lactic Acidosis, resolved  AKI on CKD, resolved  Hyperglycemia, resolved COVID Positive - s/p reduction of small bowel volvulus, LOA on 12/13/2022 - kept intubated post-op; extubated 12/13 to HHFNC; now on RA  - NGT removed 12/15 - Postoperatively, the patient had slow return of bowel function, his diet and activity were advanced cautiously.  He was maintained on DVT prophylaxis throughout his hospitalization.  Please refer to daily progress notes for detailed clinical progression.   COVID-19 infection tested positive 12/12/2022, unsure symptoms due to encephalopathy however noted hypoxia on presentation with bilateral infiltrates. Decadron started 12/13/22, stopped 12/19/22. Patient on RA as of 12/17/22.   Acute respiratory failure with hypoxia CXR with mild opacities in lung base, possibly sec to aspiration vs COVID 19. required O2 prior to surgery. Remained intubated postoperatively 12/13/22 extubated to HHFNC. Required 60L HHFNC with fiO2 50% 12/14/22. Resolved.   Acute Metabolic encephalopathy noted on admit. Unclear baseline, suspect sec to above. Management as noted. Remains intermittently confused as of 12/18/22   AKI on CKD stage 3  baseline Cr 1.5-2. On admission 4.39. S/p IVF. Resolved. Monitored.  PAF or PSVT EKG in ED showed afib with RVR rate 150's. No history of a fib, +history of SVT, rate back to 110's spontaneously. Repeat EKGs with sinus tachycardia. S/p scheduled IV metoprolol, transitioned to home metoprolol. Continue telemetry monitoring. Recommended outpatient follow-up with cardiology.   DM2 hold oral medications, SSI.    HTN  continue home amlodipine. Held home hydrochlorothiazide, lisinopril for soft BP. Restart as tolerated.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, Cardiac failure, Cardiac failure acute
Clinical narrative: Clinical Summary Patient is a 58 y.o. male with a history of CAD with multiple PCIs, recent hospitalization at hospital 12/7/22-12/17/22 for multivessel CAD s/p CABG with Dr. 12/9/22, IDDM2 who presented to hospital 12/23/22 with sudden onset shortness of breath, episode of chest pain and hypoxia. Found to have suspected CHF exacerbation with CXR showing pulmonary edema and NT Pro BNP up to 5,579 in the ED and subsequently found to have COVID.      1. Acute hypoxic respiratory failure: Hypoxia noted by medics, briefly required BiPAP in ED transitioned back to O2 by NC therafter. Suspected due to pulmonary edema. CTPA - neg for PE. Covid-19 + on 12/23/22. Treatment as below for pulm edema. Resolved and on RA. 2. Covid - 19: Tested + on 12/23/22 same day as Symptoms onset. Given hypoxemia and presentation, Case discussed with Dr. and Dr. (on Call ID) and pt started on IV Remdezivir x  5 days which ended on 12/28/22. Symptoms resolved. 3. Acute on chronic HFrEF with acute pulmonary edema/pleural effusion: CXR noted interstitial edema in ED. NT Pro BNP 5,579 (increased from 2,775 two weeks prior). Preop EF 35-40%, repeat TTE done 12/23/22 in ED noted slightly improved EF of 46% with regional WMA consistent with ischemic cardiomyopathy. No pericardial effusion. Left pleural effusion noted on TTE and CXR and CTPA on admission. IV diuresis initiated and switched to lasix oral as an outpatient per recs with BID for 3 days with daily after for a week.  4. Acute chest pain: Episode occurred en route to hospital at rest and self-abated. Troponin elevated as below but down significantly from recent admission. EKG in ED without acute ischemic changes. CTPA neg. CTS followed 5. CAD with recent CABG: CABG x4 12/9/22 with Dr. (CTS). Continued home aspirin, statin, BB and amiodarone. CTS followed 6. Paroxysmal atrial fibrillation: Occurred in the setting of CAD/CABG. S/p LA maze and clipping of left atrial appendage 12/9/22. Home BB continued. Not on AC. Rate controlled.  7. IDDM2: Last A1c - 9.1% BG 142 on admission. Home meds include Levemir + Lispro + Metformin. Will need to follow with pcp for glucose control.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Chest pain, Condition aggravated, Coronary artery bypass
Clinical narrative: Clinical Summary Patient is a 58 y.o. male with a history of CAD with multiple PCIs, recent hospitalization at hospital 12/7/22-12/17/22 for multivessel CAD s/p CABG with Dr. 12/9/22, IDDM2 who presented to hospital 12/23/22 with sudden onset shortness of breath, episode of chest pain and hypoxia. Found to have suspected CHF exacerbation with CXR showing pulmonary edema and NT Pro BNP up to 5,579 in the ED and subsequently found to have COVID.      1. Acute hypoxic respiratory failure: Hypoxia noted by medics, briefly required BiPAP in ED transitioned back to O2 by NC therafter. Suspected due to pulmonary edema. CTPA - neg for PE. Covid-19 + on 12/23/22. Treatment as below for pulm edema. Resolved and on RA. 2. Covid - 19: Tested + on 12/23/22 same day as Symptoms onset. Given hypoxemia and presentation, Case discussed with Dr. and Dr. (on Call ID) and pt started on IV Remdezivir x  5 days which ended on 12/28/22. Symptoms resolved. 3. Acute on chronic HFrEF with acute pulmonary edema/pleural effusion: CXR noted interstitial edema in ED. NT Pro BNP 5,579 (increased from 2,775 two weeks prior). Preop EF 35-40%, repeat TTE done 12/23/22 in ED noted slightly improved EF of 46% with regional WMA consistent with ischemic cardiomyopathy. No pericardial effusion. Left pleural effusion noted on TTE and CXR and CTPA on admission. IV diuresis initiated and switched to lasix oral as an outpatient per recs with BID for 3 days with daily after for a week.  4. Acute chest pain: Episode occurred en route to hospital at rest and self-abated. Troponin elevated as below but down significantly from recent admission. EKG in ED without acute ischemic changes. CTPA neg. CTS followed 5. CAD with recent CABG: CABG x4 12/9/22 with Dr. (CTS). Continued home aspirin, statin, BB and amiodarone. CTS followed 6. Paroxysmal atrial fibrillation: Occurred in the setting of CAD/CABG. S/p LA maze and clipping of left atrial appendage 12/9/22. Home BB continued. Not on AC. Rate controlled.  7. IDDM2: Last A1c - 9.1% BG 142 on admission. Home meds include Levemir + Lispro + Metformin. Will need to follow with pcp for glucose control.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Coronary artery disease, Cox-Maze procedure, Diuretic therapy, Dyspnoea, Echocardiogram abnormal
Clinical narrative: Clinical Summary Patient is a 58 y.o. male with a history of CAD with multiple PCIs, recent hospitalization at hospital 12/7/22-12/17/22 for multivessel CAD s/p CABG with Dr. 12/9/22, IDDM2 who presented to hospital 12/23/22 with sudden onset shortness of breath, episode of chest pain and hypoxia. Found to have suspected CHF exacerbation with CXR showing pulmonary edema and NT Pro BNP up to 5,579 in the ED and subsequently found to have COVID.      1. Acute hypoxic respiratory failure: Hypoxia noted by medics, briefly required BiPAP in ED transitioned back to O2 by NC therafter. Suspected due to pulmonary edema. CTPA - neg for PE. Covid-19 + on 12/23/22. Treatment as below for pulm edema. Resolved and on RA. 2. Covid - 19: Tested + on 12/23/22 same day as Symptoms onset. Given hypoxemia and presentation, Case discussed with Dr. and Dr. (on Call ID) and pt started on IV Remdezivir x  5 days which ended on 12/28/22. Symptoms resolved. 3. Acute on chronic HFrEF with acute pulmonary edema/pleural effusion: CXR noted interstitial edema in ED. NT Pro BNP 5,579 (increased from 2,775 two weeks prior). Preop EF 35-40%, repeat TTE done 12/23/22 in ED noted slightly improved EF of 46% with regional WMA consistent with ischemic cardiomyopathy. No pericardial effusion. Left pleural effusion noted on TTE and CXR and CTPA on admission. IV diuresis initiated and switched to lasix oral as an outpatient per recs with BID for 3 days with daily after for a week.  4. Acute chest pain: Episode occurred en route to hospital at rest and self-abated. Troponin elevated as below but down significantly from recent admission. EKG in ED without acute ischemic changes. CTPA neg. CTS followed 5. CAD with recent CABG: CABG x4 12/9/22 with Dr. (CTS). Continued home aspirin, statin, BB and amiodarone. CTS followed 6. Paroxysmal atrial fibrillation: Occurred in the setting of CAD/CABG. S/p LA maze and clipping of left atrial appendage 12/9/22. Home BB continued. Not on AC. Rate controlled.  7. IDDM2: Last A1c - 9.1% BG 142 on admission. Home meds include Levemir + Lispro + Metformin. Will need to follow with pcp for glucose control.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Ejection fraction decreased, Glycosylated haemoglobin increased, Hypoxia, Ischaemic cardiomyopathy, Left atrial appendage closure implant
Clinical narrative: Clinical Summary Patient is a 58 y.o. male with a history of CAD with multiple PCIs, recent hospitalization at hospital 12/7/22-12/17/22 for multivessel CAD s/p CABG with Dr. 12/9/22, IDDM2 who presented to hospital 12/23/22 with sudden onset shortness of breath, episode of chest pain and hypoxia. Found to have suspected CHF exacerbation with CXR showing pulmonary edema and NT Pro BNP up to 5,579 in the ED and subsequently found to have COVID.      1. Acute hypoxic respiratory failure: Hypoxia noted by medics, briefly required BiPAP in ED transitioned back to O2 by NC therafter. Suspected due to pulmonary edema. CTPA - neg for PE. Covid-19 + on 12/23/22. Treatment as below for pulm edema. Resolved and on RA. 2. Covid - 19: Tested + on 12/23/22 same day as Symptoms onset. Given hypoxemia and presentation, Case discussed with Dr. and Dr. (on Call ID) and pt started on IV Remdezivir x  5 days which ended on 12/28/22. Symptoms resolved. 3. Acute on chronic HFrEF with acute pulmonary edema/pleural effusion: CXR noted interstitial edema in ED. NT Pro BNP 5,579 (increased from 2,775 two weeks prior). Preop EF 35-40%, repeat TTE done 12/23/22 in ED noted slightly improved EF of 46% with regional WMA consistent with ischemic cardiomyopathy. No pericardial effusion. Left pleural effusion noted on TTE and CXR and CTPA on admission. IV diuresis initiated and switched to lasix oral as an outpatient per recs with BID for 3 days with daily after for a week.  4. Acute chest pain: Episode occurred en route to hospital at rest and self-abated. Troponin elevated as below but down significantly from recent admission. EKG in ED without acute ischemic changes. CTPA neg. CTS followed 5. CAD with recent CABG: CABG x4 12/9/22 with Dr. (CTS). Continued home aspirin, statin, BB and amiodarone. CTS followed 6. Paroxysmal atrial fibrillation: Occurred in the setting of CAD/CABG. S/p LA maze and clipping of left atrial appendage 12/9/22. Home BB continued. Not on AC. Rate controlled.  7. IDDM2: Last A1c - 9.1% BG 142 on admission. Home meds include Levemir + Lispro + Metformin. Will need to follow with pcp for glucose control.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: N-terminal prohormone brain natriuretic peptide increased, Pleural effusion, Positive airway pressure therapy, Pulmonary oedema, SARS-CoV-2 test positive
Clinical narrative: Clinical Summary Patient is a 58 y.o. male with a history of CAD with multiple PCIs, recent hospitalization at hospital 12/7/22-12/17/22 for multivessel CAD s/p CABG with Dr. 12/9/22, IDDM2 who presented to hospital 12/23/22 with sudden onset shortness of breath, episode of chest pain and hypoxia. Found to have suspected CHF exacerbation with CXR showing pulmonary edema and NT Pro BNP up to 5,579 in the ED and subsequently found to have COVID.      1. Acute hypoxic respiratory failure: Hypoxia noted by medics, briefly required BiPAP in ED transitioned back to O2 by NC therafter. Suspected due to pulmonary edema. CTPA - neg for PE. Covid-19 + on 12/23/22. Treatment as below for pulm edema. Resolved and on RA. 2. Covid - 19: Tested + on 12/23/22 same day as Symptoms onset. Given hypoxemia and presentation, Case discussed with Dr. and Dr. (on Call ID) and pt started on IV Remdezivir x  5 days which ended on 12/28/22. Symptoms resolved. 3. Acute on chronic HFrEF with acute pulmonary edema/pleural effusion: CXR noted interstitial edema in ED. NT Pro BNP 5,579 (increased from 2,775 two weeks prior). Preop EF 35-40%, repeat TTE done 12/23/22 in ED noted slightly improved EF of 46% with regional WMA consistent with ischemic cardiomyopathy. No pericardial effusion. Left pleural effusion noted on TTE and CXR and CTPA on admission. IV diuresis initiated and switched to lasix oral as an outpatient per recs with BID for 3 days with daily after for a week.  4. Acute chest pain: Episode occurred en route to hospital at rest and self-abated. Troponin elevated as below but down significantly from recent admission. EKG in ED without acute ischemic changes. CTPA neg. CTS followed 5. CAD with recent CABG: CABG x4 12/9/22 with Dr. (CTS). Continued home aspirin, statin, BB and amiodarone. CTS followed 6. Paroxysmal atrial fibrillation: Occurred in the setting of CAD/CABG. S/p LA maze and clipping of left atrial appendage 12/9/22. Home BB continued. Not on AC. Rate controlled.  7. IDDM2: Last A1c - 9.1% BG 142 on admission. Home meds include Levemir + Lispro + Metformin. Will need to follow with pcp for glucose control.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin increased
Clinical narrative: Clinical Summary Patient is a 58 y.o. male with a history of CAD with multiple PCIs, recent hospitalization at hospital 12/7/22-12/17/22 for multivessel CAD s/p CABG with Dr. 12/9/22, IDDM2 who presented to hospital 12/23/22 with sudden onset shortness of breath, episode of chest pain and hypoxia. Found to have suspected CHF exacerbation with CXR showing pulmonary edema and NT Pro BNP up to 5,579 in the ED and subsequently found to have COVID.      1. Acute hypoxic respiratory failure: Hypoxia noted by medics, briefly required BiPAP in ED transitioned back to O2 by NC therafter. Suspected due to pulmonary edema. CTPA - neg for PE. Covid-19 + on 12/23/22. Treatment as below for pulm edema. Resolved and on RA. 2. Covid - 19: Tested + on 12/23/22 same day as Symptoms onset. Given hypoxemia and presentation, Case discussed with Dr. and Dr. (on Call ID) and pt started on IV Remdezivir x  5 days which ended on 12/28/22. Symptoms resolved. 3. Acute on chronic HFrEF with acute pulmonary edema/pleural effusion: CXR noted interstitial edema in ED. NT Pro BNP 5,579 (increased from 2,775 two weeks prior). Preop EF 35-40%, repeat TTE done 12/23/22 in ED noted slightly improved EF of 46% with regional WMA consistent with ischemic cardiomyopathy. No pericardial effusion. Left pleural effusion noted on TTE and CXR and CTPA on admission. IV diuresis initiated and switched to lasix oral as an outpatient per recs with BID for 3 days with daily after for a week.  4. Acute chest pain: Episode occurred en route to hospital at rest and self-abated. Troponin elevated as below but down significantly from recent admission. EKG in ED without acute ischemic changes. CTPA neg. CTS followed 5. CAD with recent CABG: CABG x4 12/9/22 with Dr. (CTS). Continued home aspirin, statin, BB and amiodarone. CTS followed 6. Paroxysmal atrial fibrillation: Occurred in the setting of CAD/CABG. S/p LA maze and clipping of left atrial appendage 12/9/22. Home BB continued. Not on AC. Rate controlled.  7. IDDM2: Last A1c - 9.1% BG 142 on admission. Home meds include Levemir + Lispro + Metformin. Will need to follow with pcp for glucose control.
Age: 70.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Cough, Dysgeusia, Feeling abnormal, Headache, Insomnia
Clinical narrative: I had slight cold symptoms the week before Christmas. It started feeling worse with a headache and sinus pressure. It was not that bad, but on 12/21/2022. I had a raw throat, crackling ears, really bad headache, eye was watering and nose running. I could not sleep. It felt like a really bad sinus infection. I contacted to get a virtual visit. I was given Paxlovid, my symptoms were better about a day in half later, I was surprised how much better I felt. I did have the horrible taste in my mouth. I still have the scratchy throat and sniffles with a little cough. But it is not that serious. I am back to exercising. My head is still a little clogged, I am taking Claritin for the congestion.
Age: 70.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Lacrimation increased, Nasopharyngitis, Paranasal sinus discomfort, Respiratory tract congestion, Rhinorrhoea
Clinical narrative: I had slight cold symptoms the week before Christmas. It started feeling worse with a headache and sinus pressure. It was not that bad, but on 12/21/2022. I had a raw throat, crackling ears, really bad headache, eye was watering and nose running. I could not sleep. It felt like a really bad sinus infection. I contacted to get a virtual visit. I was given Paxlovid, my symptoms were better about a day in half later, I was surprised how much better I felt. I did have the horrible taste in my mouth. I still have the scratchy throat and sniffles with a little cough. But it is not that serious. I am back to exercising. My head is still a little clogged, I am taking Claritin for the congestion.
Age: 70.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Throat irritation, Tinnitus
Clinical narrative: I had slight cold symptoms the week before Christmas. It started feeling worse with a headache and sinus pressure. It was not that bad, but on 12/21/2022. I had a raw throat, crackling ears, really bad headache, eye was watering and nose running. I could not sleep. It felt like a really bad sinus infection. I contacted to get a virtual visit. I was given Paxlovid, my symptoms were better about a day in half later, I was surprised how much better I felt. I did have the horrible taste in my mouth. I still have the scratchy throat and sniffles with a little cough. But it is not that serious. I am back to exercising. My head is still a little clogged, I am taking Claritin for the congestion.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Asthenia, Blood creatinine increased, Blood culture negative, Blood iron decreased
Clinical narrative: He is a 82 y.o. male patient of DO with history of past medical history of CAD status post stenting, BPH, hypertension, insulin-dependent type 2 diabetes mellitus, GERD, chronic tremor (on chronic primidone), and heart failure with preserved ejection fraction.  He is admitted on 12/14/2022 with generalized weakness and cough, found to be COVID-19 positive in ED.   Covid-19 Virus Infection: Date of onset of symptoms: 12/13/2022 Symptoms present on admission: Cough, decreased appetite, weakness Date of covid positive test: 12/14/2022 Imaging: Chest x-ray 12/14/2022 without acute disease Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: Steroids not indicated, started on Remdesivir -treatment completed Consultants following: Infectious disease consulted-will follow outpatient in 2 weeks Anticipated special isolation end date: 12/24/2022 T-max 101.8, afebrile for 48 hours   Mucinex 600 mg BID  Continue Remdesivir day 5/5 - completed Sputum Cx-negative Blood Cx-no growth  AKI on CKD Dehydration Diarrhea-resolved  Baseline creatinine 1.4-1.5, suspect most likely prerenal in the setting of COVID-19 illness, diarrhea, and decreased oral intake Creatinine 1.61-- >1.72-- >1.61-- >1.57-- >1.42->1.34 >1.30>1.31 Trend chemistry, avoid nephrotoxins  Generalized weakness: Fall Trauma survey in the ED including CT cervical spine and CT head without acute pathology.  Suspect generalized weakness due to COVID-19 illness PT/OT consulted, Low AM PAC score, continue therapy  Case manager consulted to assist with discharge needs Management of COVID-19 as above.  Hypertension: Hold home lisinopril and hydrochlorothiazide in setting of AKI Continue home metoprolol, amlodipine, and Imdur. Will increase Norvasc to 10 mg daily at this time, hold metoprolol, patient has been having elevated blood pressure readings with low heart rate, if kidney function stable tomorrow can likely resume home Lisinopril    Chronic normocytic anemia: No signs of bleeding on admit. Iron studies show iron deficiency  Will Start Iron supplementation  Chronic tremor: Continue home primidone  Insulin-dependent type 2 diabetes mellitus: Hold home glimepiride in the setting of AKI Home glargine reduced to 15 units from 30 given acute illness and decreased intake Sliding scale insulin Glucose stable   GERD: Continue PPI  CAD status post stenting: Heart failure with preserved ejection fraction Warm and dry on time of admission without signs of acute decompensation Continue home metoprolol Continue home Plavix and statin Not on home diuretic
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Blood pressure increased, COVID-19, Chest X-ray normal, Computerised tomogram head normal, Computerised tomogram normal
Clinical narrative: He is a 82 y.o. male patient of DO with history of past medical history of CAD status post stenting, BPH, hypertension, insulin-dependent type 2 diabetes mellitus, GERD, chronic tremor (on chronic primidone), and heart failure with preserved ejection fraction.  He is admitted on 12/14/2022 with generalized weakness and cough, found to be COVID-19 positive in ED.   Covid-19 Virus Infection: Date of onset of symptoms: 12/13/2022 Symptoms present on admission: Cough, decreased appetite, weakness Date of covid positive test: 12/14/2022 Imaging: Chest x-ray 12/14/2022 without acute disease Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: Steroids not indicated, started on Remdesivir -treatment completed Consultants following: Infectious disease consulted-will follow outpatient in 2 weeks Anticipated special isolation end date: 12/24/2022 T-max 101.8, afebrile for 48 hours   Mucinex 600 mg BID  Continue Remdesivir day 5/5 - completed Sputum Cx-negative Blood Cx-no growth  AKI on CKD Dehydration Diarrhea-resolved  Baseline creatinine 1.4-1.5, suspect most likely prerenal in the setting of COVID-19 illness, diarrhea, and decreased oral intake Creatinine 1.61-- >1.72-- >1.61-- >1.57-- >1.42->1.34 >1.30>1.31 Trend chemistry, avoid nephrotoxins  Generalized weakness: Fall Trauma survey in the ED including CT cervical spine and CT head without acute pathology.  Suspect generalized weakness due to COVID-19 illness PT/OT consulted, Low AM PAC score, continue therapy  Case manager consulted to assist with discharge needs Management of COVID-19 as above.  Hypertension: Hold home lisinopril and hydrochlorothiazide in setting of AKI Continue home metoprolol, amlodipine, and Imdur. Will increase Norvasc to 10 mg daily at this time, hold metoprolol, patient has been having elevated blood pressure readings with low heart rate, if kidney function stable tomorrow can likely resume home Lisinopril    Chronic normocytic anemia: No signs of bleeding on admit. Iron studies show iron deficiency  Will Start Iron supplementation  Chronic tremor: Continue home primidone  Insulin-dependent type 2 diabetes mellitus: Hold home glimepiride in the setting of AKI Home glargine reduced to 15 units from 30 given acute illness and decreased intake Sliding scale insulin Glucose stable   GERD: Continue PPI  CAD status post stenting: Heart failure with preserved ejection fraction Warm and dry on time of admission without signs of acute decompensation Continue home metoprolol Continue home Plavix and statin Not on home diuretic
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Decreased appetite, Dehydration, Diarrhoea
Clinical narrative: He is a 82 y.o. male patient of DO with history of past medical history of CAD status post stenting, BPH, hypertension, insulin-dependent type 2 diabetes mellitus, GERD, chronic tremor (on chronic primidone), and heart failure with preserved ejection fraction.  He is admitted on 12/14/2022 with generalized weakness and cough, found to be COVID-19 positive in ED.   Covid-19 Virus Infection: Date of onset of symptoms: 12/13/2022 Symptoms present on admission: Cough, decreased appetite, weakness Date of covid positive test: 12/14/2022 Imaging: Chest x-ray 12/14/2022 without acute disease Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: Steroids not indicated, started on Remdesivir -treatment completed Consultants following: Infectious disease consulted-will follow outpatient in 2 weeks Anticipated special isolation end date: 12/24/2022 T-max 101.8, afebrile for 48 hours   Mucinex 600 mg BID  Continue Remdesivir day 5/5 - completed Sputum Cx-negative Blood Cx-no growth  AKI on CKD Dehydration Diarrhea-resolved  Baseline creatinine 1.4-1.5, suspect most likely prerenal in the setting of COVID-19 illness, diarrhea, and decreased oral intake Creatinine 1.61-- >1.72-- >1.61-- >1.57-- >1.42->1.34 >1.30>1.31 Trend chemistry, avoid nephrotoxins  Generalized weakness: Fall Trauma survey in the ED including CT cervical spine and CT head without acute pathology.  Suspect generalized weakness due to COVID-19 illness PT/OT consulted, Low AM PAC score, continue therapy  Case manager consulted to assist with discharge needs Management of COVID-19 as above.  Hypertension: Hold home lisinopril and hydrochlorothiazide in setting of AKI Continue home metoprolol, amlodipine, and Imdur. Will increase Norvasc to 10 mg daily at this time, hold metoprolol, patient has been having elevated blood pressure readings with low heart rate, if kidney function stable tomorrow can likely resume home Lisinopril    Chronic normocytic anemia: No signs of bleeding on admit. Iron studies show iron deficiency  Will Start Iron supplementation  Chronic tremor: Continue home primidone  Insulin-dependent type 2 diabetes mellitus: Hold home glimepiride in the setting of AKI Home glargine reduced to 15 units from 30 given acute illness and decreased intake Sliding scale insulin Glucose stable   GERD: Continue PPI  CAD status post stenting: Heart failure with preserved ejection fraction Warm and dry on time of admission without signs of acute decompensation Continue home metoprolol Continue home Plavix and statin Not on home diuretic
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Heart rate decreased, Hypophagia, Iron deficiency, SARS-CoV-2 test positive
Clinical narrative: He is a 82 y.o. male patient of DO with history of past medical history of CAD status post stenting, BPH, hypertension, insulin-dependent type 2 diabetes mellitus, GERD, chronic tremor (on chronic primidone), and heart failure with preserved ejection fraction.  He is admitted on 12/14/2022 with generalized weakness and cough, found to be COVID-19 positive in ED.   Covid-19 Virus Infection: Date of onset of symptoms: 12/13/2022 Symptoms present on admission: Cough, decreased appetite, weakness Date of covid positive test: 12/14/2022 Imaging: Chest x-ray 12/14/2022 without acute disease Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: Steroids not indicated, started on Remdesivir -treatment completed Consultants following: Infectious disease consulted-will follow outpatient in 2 weeks Anticipated special isolation end date: 12/24/2022 T-max 101.8, afebrile for 48 hours   Mucinex 600 mg BID  Continue Remdesivir day 5/5 - completed Sputum Cx-negative Blood Cx-no growth  AKI on CKD Dehydration Diarrhea-resolved  Baseline creatinine 1.4-1.5, suspect most likely prerenal in the setting of COVID-19 illness, diarrhea, and decreased oral intake Creatinine 1.61-- >1.72-- >1.61-- >1.57-- >1.42->1.34 >1.30>1.31 Trend chemistry, avoid nephrotoxins  Generalized weakness: Fall Trauma survey in the ED including CT cervical spine and CT head without acute pathology.  Suspect generalized weakness due to COVID-19 illness PT/OT consulted, Low AM PAC score, continue therapy  Case manager consulted to assist with discharge needs Management of COVID-19 as above.  Hypertension: Hold home lisinopril and hydrochlorothiazide in setting of AKI Continue home metoprolol, amlodipine, and Imdur. Will increase Norvasc to 10 mg daily at this time, hold metoprolol, patient has been having elevated blood pressure readings with low heart rate, if kidney function stable tomorrow can likely resume home Lisinopril    Chronic normocytic anemia: No signs of bleeding on admit. Iron studies show iron deficiency  Will Start Iron supplementation  Chronic tremor: Continue home primidone  Insulin-dependent type 2 diabetes mellitus: Hold home glimepiride in the setting of AKI Home glargine reduced to 15 units from 30 given acute illness and decreased intake Sliding scale insulin Glucose stable   GERD: Continue PPI  CAD status post stenting: Heart failure with preserved ejection fraction Warm and dry on time of admission without signs of acute decompensation Continue home metoprolol Continue home Plavix and statin Not on home diuretic
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Sputum culture
Clinical narrative: He is a 82 y.o. male patient of DO with history of past medical history of CAD status post stenting, BPH, hypertension, insulin-dependent type 2 diabetes mellitus, GERD, chronic tremor (on chronic primidone), and heart failure with preserved ejection fraction.  He is admitted on 12/14/2022 with generalized weakness and cough, found to be COVID-19 positive in ED.   Covid-19 Virus Infection: Date of onset of symptoms: 12/13/2022 Symptoms present on admission: Cough, decreased appetite, weakness Date of covid positive test: 12/14/2022 Imaging: Chest x-ray 12/14/2022 without acute disease Oxygen requirements on admission: None Current oxygen requirements: None Medical therapy: Steroids not indicated, started on Remdesivir -treatment completed Consultants following: Infectious disease consulted-will follow outpatient in 2 weeks Anticipated special isolation end date: 12/24/2022 T-max 101.8, afebrile for 48 hours   Mucinex 600 mg BID  Continue Remdesivir day 5/5 - completed Sputum Cx-negative Blood Cx-no growth  AKI on CKD Dehydration Diarrhea-resolved  Baseline creatinine 1.4-1.5, suspect most likely prerenal in the setting of COVID-19 illness, diarrhea, and decreased oral intake Creatinine 1.61-- >1.72-- >1.61-- >1.57-- >1.42->1.34 >1.30>1.31 Trend chemistry, avoid nephrotoxins  Generalized weakness: Fall Trauma survey in the ED including CT cervical spine and CT head without acute pathology.  Suspect generalized weakness due to COVID-19 illness PT/OT consulted, Low AM PAC score, continue therapy  Case manager consulted to assist with discharge needs Management of COVID-19 as above.  Hypertension: Hold home lisinopril and hydrochlorothiazide in setting of AKI Continue home metoprolol, amlodipine, and Imdur. Will increase Norvasc to 10 mg daily at this time, hold metoprolol, patient has been having elevated blood pressure readings with low heart rate, if kidney function stable tomorrow can likely resume home Lisinopril    Chronic normocytic anemia: No signs of bleeding on admit. Iron studies show iron deficiency  Will Start Iron supplementation  Chronic tremor: Continue home primidone  Insulin-dependent type 2 diabetes mellitus: Hold home glimepiride in the setting of AKI Home glargine reduced to 15 units from 30 given acute illness and decreased intake Sliding scale insulin Glucose stable   GERD: Continue PPI  CAD status post stenting: Heart failure with preserved ejection fraction Warm and dry on time of admission without signs of acute decompensation Continue home metoprolol Continue home Plavix and statin Not on home diuretic
Age: 54.0
Sex: F
Vaccine: FLU4
Symptoms: Arthralgia, Injected limb mobility decreased, Magnetic resonance imaging, Product administered at inappropriate site
Clinical narrative: Technician cleansed the correct area over the L deltoid yet injected into the joint space/upper deltoid less than 1 in from the acromion process. Pt. felt the injection at the time, looked and saw it was in the wrong space, made statement as such to the technician. Technician apologized, placed a band-aid and departed.  Pt began immediate treatment at home with APAP, infra-red head, and ROM exercises. Despite continued self care after 30 days joint became more restricted and painful. Condition continues to deteriorate.
Age: 71.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: COVID-19, Cough, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
Clinical narrative: Rather sudden onset of sneezing, runny nose, and coughing.  Temperature was 99.9 degrees.  Pulse was 111.  Oxygen level fluctuated between 84% and 94%.  I took Tylenol.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Malaise, Pyrexia
Clinical narrative: I had my vaccination 07/11/2022. On 11/28/2022 I started to have extreme fatigue sinus congestion and low grade fever of 100 degrees. I tested COVID-19 negative on 11/29/2022. I went to urgent care on 11/30/2022 and I tested COVID-19 positive. I was prescribed a cough medicine and PAXLOVID. I stopped after the first 2 doses due to the horrible taste from the medication. I was very sick for 2 weeks. The 3rd and 4th week was full of congestion. I still have continuous post nasal drip on 01/10/2023.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive, Sinus congestion, Upper-airway cough syndrome
Clinical narrative: I had my vaccination 07/11/2022. On 11/28/2022 I started to have extreme fatigue sinus congestion and low grade fever of 100 degrees. I tested COVID-19 negative on 11/29/2022. I went to urgent care on 11/30/2022 and I tested COVID-19 positive. I was prescribed a cough medicine and PAXLOVID. I stopped after the first 2 doses due to the horrible taste from the medication. I was very sick for 2 weeks. The 3rd and 4th week was full of congestion. I still have continuous post nasal drip on 01/10/2023.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Fatigue, Feeling abnormal, Respiratory tract congestion
Clinical narrative: I had sniffles, chest congestion, coughing, and fatigue. I tested positive for COVID-19. I went into an urgent care, and they prescribed me PAXLOVID. I still have fatigue and brain fog but I feel better.
Age: 76.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rhinorrhoea, SARS-CoV-2 test positive
Clinical narrative: I had sniffles, chest congestion, coughing, and fatigue. I tested positive for COVID-19. I went into an urgent care, and they prescribed me PAXLOVID. I still have fatigue and brain fog but I feel better.
Age: 73.0
Sex: F
Vaccine: VARZOS
Symptoms: Erythema, Pruritus
Clinical narrative: arm redness and itching
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Choking, Cough, Hypersomnia, Increased viscosity of upper respiratory secretion
Clinical narrative: After the shot I had flu like symptoms and stayed in bed for 48 hours. The first day I didn't take any medication, but I did take medication on the second day. I slept through it the first day. Then around 11/15/2022, I started getting sick with what seemed like an upper respiratory infection. Then it turned into chest congestion with head congestion. Then it turned into a sinus infection and all these symptoms occurred at the same time. I never had a fever. I tested twice for COVID-19 and both were negative. During this time, I had also taken 2 weeks worth of MUCINEX to try and combat this before calling the doctor. When I went to see my doctor, I went to get a chest x-ray and I realized I needed something to combat this. I was given a steroid, 8 day course of prednisone. I was also given doxycycline for 20 days. I felt well for exactly 2 days, 48 hours. That was around 01/01 and 01/02 where I felt well. I had no chest congestion, no wheezing, no post nasal drip. Around 01/03/2023, the symptoms started again and it's progressively getting worse up to today. Today, I have wheezing, coughing, a possible sinus infection/congestion and post nasal drip. I'm coughing so bad that it's in the upper bronchial tract. There's thick mucus that has been choking me. When I wheeze bad, I start coughing really badly and I can only force something to come up a couple times a day. According to my tests, no COVID-19 and no fever.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: Influenza like illness, Malaise, Productive cough, Respiratory symptom, Respiratory tract congestion
Clinical narrative: After the shot I had flu like symptoms and stayed in bed for 48 hours. The first day I didn't take any medication, but I did take medication on the second day. I slept through it the first day. Then around 11/15/2022, I started getting sick with what seemed like an upper respiratory infection. Then it turned into chest congestion with head congestion. Then it turned into a sinus infection and all these symptoms occurred at the same time. I never had a fever. I tested twice for COVID-19 and both were negative. During this time, I had also taken 2 weeks worth of MUCINEX to try and combat this before calling the doctor. When I went to see my doctor, I went to get a chest x-ray and I realized I needed something to combat this. I was given a steroid, 8 day course of prednisone. I was also given doxycycline for 20 days. I felt well for exactly 2 days, 48 hours. That was around 01/01 and 01/02 where I felt well. I had no chest congestion, no wheezing, no post nasal drip. Around 01/03/2023, the symptoms started again and it's progressively getting worse up to today. Today, I have wheezing, coughing, a possible sinus infection/congestion and post nasal drip. I'm coughing so bad that it's in the upper bronchial tract. There's thick mucus that has been choking me. When I wheeze bad, I start coughing really badly and I can only force something to come up a couple times a day. According to my tests, no COVID-19 and no fever.
Age: 69.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test negative, Sinusitis, Symptom recurrence, Upper-airway cough syndrome, Wheezing
Clinical narrative: After the shot I had flu like symptoms and stayed in bed for 48 hours. The first day I didn't take any medication, but I did take medication on the second day. I slept through it the first day. Then around 11/15/2022, I started getting sick with what seemed like an upper respiratory infection. Then it turned into chest congestion with head congestion. Then it turned into a sinus infection and all these symptoms occurred at the same time. I never had a fever. I tested twice for COVID-19 and both were negative. During this time, I had also taken 2 weeks worth of MUCINEX to try and combat this before calling the doctor. When I went to see my doctor, I went to get a chest x-ray and I realized I needed something to combat this. I was given a steroid, 8 day course of prednisone. I was also given doxycycline for 20 days. I felt well for exactly 2 days, 48 hours. That was around 01/01 and 01/02 where I felt well. I had no chest congestion, no wheezing, no post nasal drip. Around 01/03/2023, the symptoms started again and it's progressively getting worse up to today. Today, I have wheezing, coughing, a possible sinus infection/congestion and post nasal drip. I'm coughing so bad that it's in the upper bronchial tract. There's thick mucus that has been choking me. When I wheeze bad, I start coughing really badly and I can only force something to come up a couple times a day. According to my tests, no COVID-19 and no fever.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Nasal dryness, Rhinalgia, Scab, Tension headache, Wound
Clinical narrative: I started having issues with my nasal passages being very dry so much that it makes me have scabs or it is an open sore. It is painful when it occurs, and this only started about a month after my COVID-19 shot. There is this stabbing feeling in my nose, and it is really sensitive and sore so much so that I want to breath in through my mouth rather than my nose. I have started using the Flonase when this happens and that tends to help when the pain and soreness start coming on. I got a humidifier and that will help when this starts becoming a consistent problem and I can get it to calm down for a bit and go back to normal. I do have also have sinus tension headaches at times with this but not all the time. It does tend to be worse if it is colder and it will come on more often in colder weather and sometimes, I will even wear a mask to try and help avoid this happening. I am seeing my healthcare provider tomorrow and will be discussing this issue as it is still ongoing. While it is not consistent, but it does happen sporadically which is also why I am putting that I am not recovered at this point.
Age: 53.0
Sex: M
Vaccine: COVID19-2, FLUR4
Symptoms: Cough, Fatigue, Headache, Pain, Pyrexia
Clinical narrative: Pt called on 1/6/23 around 10am saying he experienced fever,aches,headache,cough,fatigue 1-2 days after getting the shots. Side effects ressolved but he still have fatugue.
Age: 53.0
Sex: F
Vaccine: COVID19-2
Symptoms: Headache, Pain, Pyrexia
Clinical narrative: Between 1-2 days after receiving the vaccination, the patient experienced fever, aches, headaches, and fatigue. Tylenol was taken to relieve symptoms.
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Asthenia, COVID-19, Exposure to SARS-CoV-2, Headache
Clinical narrative: I was exposed on a Thursday at someone's home. I had my mask off while eating. They called us on Saturday to let us know the person tested positive for COVID-19. On Monday morning, I tested positive for COVID-19. I woke up that morning feeling unwell. I had a slight headache, joint pain, and a 99.5-degree fever. I had an occasional sneeze as well. After that, the symptoms turned into a giant head cold with a runny nose. I had a decrease in energy. My transplant coordinator prescribed molnupiravir. I took four 200MG capsules twice a day for 5 days. I had no ill effects from the medication. I was told that I had to isolate for 10 days. I tested positive for COVID-19 again at 10 days. My doctor told me to isolate for 20 days total. On days one through six, I felt like I was gradually getting better. On days seven, eight, and nine, the symptoms had a mild return.
Age: 64.0
Sex: F
Vaccine: COVID19-2
Symptoms: Malaise, Nasopharyngitis, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
Clinical narrative: I was exposed on a Thursday at someone's home. I had my mask off while eating. They called us on Saturday to let us know the person tested positive for COVID-19. On Monday morning, I tested positive for COVID-19. I woke up that morning feeling unwell. I had a slight headache, joint pain, and a 99.5-degree fever. I had an occasional sneeze as well. After that, the symptoms turned into a giant head cold with a runny nose. I had a decrease in energy. My transplant coordinator prescribed molnupiravir. I took four 200MG capsules twice a day for 5 days. I had no ill effects from the medication. I was told that I had to isolate for 10 days. I tested positive for COVID-19 again at 10 days. My doctor told me to isolate for 20 days total. On days one through six, I felt like I was gradually getting better. On days seven, eight, and nine, the symptoms had a mild return.
Age: 11.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (ex. temp./location)-
Age: 49.0
Sex: F
Vaccine: COVID19-2
Symptoms: Extra dose administered
Clinical narrative: At a mobile vaccination clinic event, the patient presented asking for the Bivalent Pfizer COVID-19 vaccination. She showed a picture of her COVID-19 Vaccine Record Card showing her primary series and monovalent booster. She did not report, nor show record of the bivalent booster she received on 9/2/22 at another facility. Patient was instructed to monitor for side effects and to report them to us, along with any questions she may have.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, COVID-19, Chest discomfort, Cough, Dry throat
Clinical narrative: I had my vaccination on 10/08/2022. I started to experience on 11/12/2022 fatigue nausea chest pressure and burning sore and dry throat headache joint pain. I didn't know if the dry mouth was due to Sjogren's. My oxygen level went to 95%. I tested COVID-19 Positive on 11/19/2022. I was prescribed Dipirona Metamizole and Notuss for the cough. I had a lot of joint pain headache and a lot of sleep spells.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Fatigue, Headache, Hypersomnia, Nausea, Oropharyngeal pain
Clinical narrative: I had my vaccination on 10/08/2022. I started to experience on 11/12/2022 fatigue nausea chest pressure and burning sore and dry throat headache joint pain. I didn't know if the dry mouth was due to Sjogren's. My oxygen level went to 95%. I tested COVID-19 Positive on 11/19/2022. I was prescribed Dipirona Metamizole and Notuss for the cough. I had a lot of joint pain headache and a lot of sleep spells.
Age: 48.0
Sex: F
Vaccine: COVID19-2
Symptoms: Oxygen saturation decreased, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: I had my vaccination on 10/08/2022. I started to experience on 11/12/2022 fatigue nausea chest pressure and burning sore and dry throat headache joint pain. I didn't know if the dry mouth was due to Sjogren's. My oxygen level went to 95%. I tested COVID-19 Positive on 11/19/2022. I was prescribed Dipirona Metamizole and Notuss for the cough. I had a lot of joint pain headache and a lot of sleep spells.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Bronchitis, Chest X-ray abnormal, Cough, Pulmonary oedema
Clinical narrative: I had progressive cough went to see doctor treated for bronchitis.