chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 92.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Procalcitonin normal, Renal impairment, SARS-CoV-2 test positive, Urinary tract infection, Urine analysis abnormal
Clinical narrative: Pt is a 94 yo female w/ hx of HTN, HLD, AAA, CKD, DM, neuropathy, ILD, spinal stenosis, TIA who presented to ED secondary to weakness. Over the past week, pt w/ weakness, fatigue. She tested positive for COVID on 9/25. She had progressive sx, poor PO intake, cough, She was brought to ED for further care as she lives alone. Upon arrival to ED, BP 150/53, HR 62, afebrile, no hypoxia, no leukocytosis, Hgb 10.7, plts 218. Na 136, K 4.4, Cr 1.37. MG 1.7. Repeat UA concerning for UTI. +COVID. CXR w/ similar interstitial opacities. Pt given IVFs. Abx initiated for UTI. Pt admitted for further care. Stable on RA, afebrile. ID consulted. Cont 5 day course of paxlovid. Urine cx w/ strep agalactiae. Was on  Rocephin, transitioned to Keflex BID to complete 7 days total. Procal WNL. Nephro followed, renal function improved w/ IVFs. PT/OT rec home w/ therapies, physical assist. Pt stable for Dc home w/ home therapies.
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: 71y.o. male with PMHx of Alcohol abuse, started drinking because his family is in Country and he has his son that lives nearby.  Patient went to elsewhere and was transferred here to facility via Ambulance.  Patient drinks about 1 fifth a day of alcohol.  Patient stated that he stopped drinking for awhile and restarted again.  Patient states his doctor has put him on librium and ativan in he past bu that seems not to be helping his situation. Discussed discharge plans with his son
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Confusional state, Diverticulitis, Klebsiella infection, Lethargy
Clinical narrative: 78-year-old man with past medical history of COPD, CKD, recurrent UTIs, HTN, and recurrent DVT who came to the emergency department with increased confusion and lethargy.  Work-up revealed acute uncomplicated diverticulitis, in addition to Klebsiella UTI, started on cefepime and metronidazole, received IV fluid hydration, he was found to be COVID-positive, evaluated by PRIVATE, started on Solu-Medrol, and received 3 doses of remdesivir.  Remains on room air, mental status improved and returned to baseline.  Evaluated by PRIVATE with recommendation for discharge on Augmentin to complete total of 10 days of antibiotics.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: 78-year-old man with past medical history of COPD, CKD, recurrent UTIs, HTN, and recurrent DVT who came to the emergency department with increased confusion and lethargy.  Work-up revealed acute uncomplicated diverticulitis, in addition to Klebsiella UTI, started on cefepime and metronidazole, received IV fluid hydration, he was found to be COVID-positive, evaluated by PRIVATE, started on Solu-Medrol, and received 3 doses of remdesivir.  Remains on room air, mental status improved and returned to baseline.  Evaluated by PRIVATE with recommendation for discharge on Augmentin to complete total of 10 days of antibiotics.
Age: 29.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Delivery, Maternal exposure before pregnancy, SARS-CoV-2 test positive
Clinical narrative: Method of Delivery: Vaginal, Spontaneous
Age: 27.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Back pain, COVID-19, Discomfort, Gait disturbance, Intervertebral disc protrusion
Clinical narrative: Fri Oct 07, 2022 29-year-old male with a past medical history of COVID-19 infection on 9-18-20 22, left lower extremity DVT and pulmonary embolus appreciated on 9/28/2022 at emergency department for chief complaint of "leg pain." The patient reports that he has been having intense swelling and pain in his right gluteal region that began this morning.  In addition, the patient is having a shooting radicular-like pain going down the posterior region of his left lower extremity on the right-hand side and causing extreme discomfort.  In addition, the patient has a herniated disc at the level of L5-S1 that is causing pain and stiffness in the patient's back decreasing his passive range of motion. The patient has extreme pain with ambulation secondary to his neuropathic pain, Valium 5 mg tablets and Toradol 50 mg ordered administered to diminish patient's symptoms of muscle tightness and pain.  Vital signs reviewed and are stable at present.  Sat Oct 08, 2022 Patient will be discharged with 5 mg of Valium every 8 hours for the next 3 days.  Patient informed to take prednisone 20 mg twice a day for the next 5 days.  Continue taking your gabapentin as prescribed.  Take Valium 5 mg every 8 hours, as needed, for muscle relaxation.  Take Tylenol 500 mg every 8 hours, as needed, for the next 7 days to decrease inflammation of muscle bodies.  Follow-up for reevaluation of neuropathic pain with your primary care doctor within the next week.
Age: 27.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Joint range of motion decreased, Muscle tightness, Musculoskeletal stiffness, Myalgia, Neuralgia
Clinical narrative: Fri Oct 07, 2022 29-year-old male with a past medical history of COVID-19 infection on 9-18-20 22, left lower extremity DVT and pulmonary embolus appreciated on 9/28/2022 at emergency department for chief complaint of "leg pain." The patient reports that he has been having intense swelling and pain in his right gluteal region that began this morning.  In addition, the patient is having a shooting radicular-like pain going down the posterior region of his left lower extremity on the right-hand side and causing extreme discomfort.  In addition, the patient has a herniated disc at the level of L5-S1 that is causing pain and stiffness in the patient's back decreasing his passive range of motion. The patient has extreme pain with ambulation secondary to his neuropathic pain, Valium 5 mg tablets and Toradol 50 mg ordered administered to diminish patient's symptoms of muscle tightness and pain.  Vital signs reviewed and are stable at present.  Sat Oct 08, 2022 Patient will be discharged with 5 mg of Valium every 8 hours for the next 3 days.  Patient informed to take prednisone 20 mg twice a day for the next 5 days.  Continue taking your gabapentin as prescribed.  Take Valium 5 mg every 8 hours, as needed, for muscle relaxation.  Take Tylenol 500 mg every 8 hours, as needed, for the next 7 days to decrease inflammation of muscle bodies.  Follow-up for reevaluation of neuropathic pain with your primary care doctor within the next week.
Age: 27.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pain, Pain in extremity, Peripheral swelling, Radicular pain, SARS-CoV-2 test positive
Clinical narrative: Fri Oct 07, 2022 29-year-old male with a past medical history of COVID-19 infection on 9-18-20 22, left lower extremity DVT and pulmonary embolus appreciated on 9/28/2022 at emergency department for chief complaint of "leg pain." The patient reports that he has been having intense swelling and pain in his right gluteal region that began this morning.  In addition, the patient is having a shooting radicular-like pain going down the posterior region of his left lower extremity on the right-hand side and causing extreme discomfort.  In addition, the patient has a herniated disc at the level of L5-S1 that is causing pain and stiffness in the patient's back decreasing his passive range of motion. The patient has extreme pain with ambulation secondary to his neuropathic pain, Valium 5 mg tablets and Toradol 50 mg ordered administered to diminish patient's symptoms of muscle tightness and pain.  Vital signs reviewed and are stable at present.  Sat Oct 08, 2022 Patient will be discharged with 5 mg of Valium every 8 hours for the next 3 days.  Patient informed to take prednisone 20 mg twice a day for the next 5 days.  Continue taking your gabapentin as prescribed.  Take Valium 5 mg every 8 hours, as needed, for muscle relaxation.  Take Tylenol 500 mg every 8 hours, as needed, for the next 7 days to decrease inflammation of muscle bodies.  Follow-up for reevaluation of neuropathic pain with your primary care doctor within the next week.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthritis, Blood test abnormal, Lumbar spinal stenosis, Magnetic resonance imaging abnormal, Magnetic resonance imaging spinal abnormal
Clinical narrative: I have an autoimmune disease. Mid to late September, 2022, I started to notice some nerve pain going down my leg. In November, 2022, my doctor ran some tests and my blood shows Rheumatoid Arthritis. I did three weeks of physical therapy and received a steroid injection in my hip area and I changed my diet to an inflammation diet. I also got a prescription for meloxicam.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Neuralgia, Oedema, Rheumatoid arthritis
Clinical narrative: I have an autoimmune disease. Mid to late September, 2022, I started to notice some nerve pain going down my leg. In November, 2022, my doctor ran some tests and my blood shows Rheumatoid Arthritis. I did three weeks of physical therapy and received a steroid injection in my hip area and I changed my diet to an inflammation diet. I also got a prescription for meloxicam.
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Cough, Dyspnoea, Fatigue, Hip fracture
Clinical narrative: 73 year old male with COPD, BPH, HLD, seizures, HTN presented to ER with fatigue, SOB. Recently admitted for leg/hip fracture. His neighbor was apparently covid positive. He started developing sore throat, dry cough, fatigue, SOB, fever. Was found to be COVID + in ER. Admitted to hospital medicine. Completed 5 day remdesivir dose on 10/4. Worked w PT who rec SAR vs home w homecare. Pt prefers DC home w homecare. Pt was feeling well on day of discharge and medically stable for discharge. Pt was present during discharge planning and agreeable to plan.
Age: 72.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lower limb fracture, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: 73 year old male with COPD, BPH, HLD, seizures, HTN presented to ER with fatigue, SOB. Recently admitted for leg/hip fracture. His neighbor was apparently covid positive. He started developing sore throat, dry cough, fatigue, SOB, fever. Was found to be COVID + in ER. Admitted to hospital medicine. Completed 5 day remdesivir dose on 10/4. Worked w PT who rec SAR vs home w homecare. Pt prefers DC home w homecare. Pt was feeling well on day of discharge and medically stable for discharge. Pt was present during discharge planning and agreeable to plan.
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal abscess, Abscess, COVID-19, Central venous catheterisation, Drain placement
Clinical narrative: This is a 37y.o. male with pmh of bipolar disorder and recent polytrauma from an MVC s/p R colectomy complicated by an anastomotic leak now s/p L colectomy, small bowel resection, and end ileostomy on 8/3/22 complicated by multiple abscesses s/p percutaneous drains. The patient was admitted 9/29/22 from SAR for AMS and was found to have an intraabdominal abscess and COVID-19. The patient was evaluated by neurology and psychiarty who diagnosed metabolic encephalopathy and titrated psychiatric medications. The patients AMS resolved. He also underwent drain placement and IV antibiotic therapy which continued for several weeks with serial imaging revealing a partially resolving abscess. The drain was removed and follow-up imaging revealed a stable collection composed of more air than fluid compared to prior imaging. The patient received a PICC line and will receive two weeks of zosyn therapy at SAR with follow-up imaging. SAR placement was coordinated with family once he was medically stable for discharge.
Age: 36.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Drain removal, Ileostomy, Mental status changes, Metabolic encephalopathy, SARS-CoV-2 test positive
Clinical narrative: This is a 37y.o. male with pmh of bipolar disorder and recent polytrauma from an MVC s/p R colectomy complicated by an anastomotic leak now s/p L colectomy, small bowel resection, and end ileostomy on 8/3/22 complicated by multiple abscesses s/p percutaneous drains. The patient was admitted 9/29/22 from SAR for AMS and was found to have an intraabdominal abscess and COVID-19. The patient was evaluated by neurology and psychiarty who diagnosed metabolic encephalopathy and titrated psychiatric medications. The patients AMS resolved. He also underwent drain placement and IV antibiotic therapy which continued for several weeks with serial imaging revealing a partially resolving abscess. The drain was removed and follow-up imaging revealed a stable collection composed of more air than fluid compared to prior imaging. The patient received a PICC line and will receive two weeks of zosyn therapy at SAR with follow-up imaging. SAR placement was coordinated with family once he was medically stable for discharge.
Age: 66.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Headache, Paranasal sinus hypersecretion, Respiratory tract congestion, SARS-CoV-2 test negative
Clinical narrative: Starting 10/04/2022, I had a burning sensation in my throat for a couple of days. On the Thursday that week, I did a PCR test for COVID-19 (10/06/2022) and the following day (Friday) it came back positive. I called my doctor that day to see if I needed to start PAXLOVID, but due to not having many symptoms we decided not to start it. I had congestion and a slight headache. I was able to exercise and do normal activities that Saturday and Sunday. I wasn't negative until 10/10/2022. On 10/12/2022, I got the nasal congestion back for about 2 weeks with sinus drainage. On 10/17, I called her in regards to a sinus infection and was put on a Z-PAK for 10 days. When it did not work, I called my doctor who referred me to an ENT. On 12/06/2022, I ended up being treated for a sinus infection by an ENT and it just now cleared with usage of MEDROL dose pack and doxycycline.
Age: 66.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sinusitis, Throat irritation
Clinical narrative: Starting 10/04/2022, I had a burning sensation in my throat for a couple of days. On the Thursday that week, I did a PCR test for COVID-19 (10/06/2022) and the following day (Friday) it came back positive. I called my doctor that day to see if I needed to start PAXLOVID, but due to not having many symptoms we decided not to start it. I had congestion and a slight headache. I was able to exercise and do normal activities that Saturday and Sunday. I wasn't negative until 10/10/2022. On 10/12/2022, I got the nasal congestion back for about 2 weeks with sinus drainage. On 10/17, I called her in regards to a sinus infection and was put on a Z-PAK for 10 days. When it did not work, I called my doctor who referred me to an ENT. On 12/06/2022, I ended up being treated for a sinus infection by an ENT and it just now cleared with usage of MEDROL dose pack and doxycycline.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Breech presentation, COVID-19, Caesarean section, Pre-eclampsia, SARS-CoV-2 test positive
Clinical narrative: Pre-Operative Diagnosis:EARLY ARRIVAL FOR COVID TESTING               Primary Cesarean Section  Dichorionic DiamnioticTwins   Breech Pre-eclampsia Post-Operative Diagnosis:EARLY ARRIVAL FOR COVID TESTING               Primary Cesarean Section  Dichorionic DiamnioticTwins   Breech Pre-eclampsia
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Twin pregnancy
Clinical narrative: Pre-Operative Diagnosis:EARLY ARRIVAL FOR COVID TESTING               Primary Cesarean Section  Dichorionic DiamnioticTwins   Breech Pre-eclampsia Post-Operative Diagnosis:EARLY ARRIVAL FOR COVID TESTING               Primary Cesarean Section  Dichorionic DiamnioticTwins   Breech Pre-eclampsia
Age: 54.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Aspiration pleural cavity, COVID-19, Chest X-ray normal, Condition aggravated, Cough
Clinical narrative: 55y.o. female with metastatic breast CA to liver (undergoing IV chem last session 9/09), right exudative pleural effusion s/p thoracocentesis (presumed malignant, cytology negative though), who presents with complaints of cough, rhinorrhea, and exertional shortness of breath with covid-19 test positive at urgent care and increased right pleural effusion. Found to be COVID+ on 9/30, s/p 3 doses IV Remdesivir. Thoracentesis performed 10/3 by pulmonology with extraction of 1.1L of fluid and visible improvement on CXR without complication.  Repeat chest x-ray following the procedure showed improvement of the pleural effusion negative for pneumothorax.  Pleural fluid analysis suggest exudative etiology, further studies
Age: 54.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Dyspnoea exertional, Pleural effusion, Pleural fluid analysis abnormal, Rhinorrhoea
Clinical narrative: 55y.o. female with metastatic breast CA to liver (undergoing IV chem last session 9/09), right exudative pleural effusion s/p thoracocentesis (presumed malignant, cytology negative though), who presents with complaints of cough, rhinorrhea, and exertional shortness of breath with covid-19 test positive at urgent care and increased right pleural effusion. Found to be COVID+ on 9/30, s/p 3 doses IV Remdesivir. Thoracentesis performed 10/3 by pulmonology with extraction of 1.1L of fluid and visible improvement on CXR without complication.  Repeat chest x-ray following the procedure showed improvement of the pleural effusion negative for pneumothorax.  Pleural fluid analysis suggest exudative etiology, further studies
Age: 54.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 55y.o. female with metastatic breast CA to liver (undergoing IV chem last session 9/09), right exudative pleural effusion s/p thoracocentesis (presumed malignant, cytology negative though), who presents with complaints of cough, rhinorrhea, and exertional shortness of breath with covid-19 test positive at urgent care and increased right pleural effusion. Found to be COVID+ on 9/30, s/p 3 doses IV Remdesivir. Thoracentesis performed 10/3 by pulmonology with extraction of 1.1L of fluid and visible improvement on CXR without complication.  Repeat chest x-ray following the procedure showed improvement of the pleural effusion negative for pneumothorax.  Pleural fluid analysis suggest exudative etiology, further studies
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chills, Cough, Dyspnoea, Pyrexia
Clinical narrative: Patient is a 76-year-old male with a history of moderately severe COPD on home oxygen, CVA, CAD and peripheral vascular disease presented to the emergency room with worsening shortness of breath, fevers, chills and nonproductive cough.  Home positive test for COVID.  Patient required increased level of oxygen when he entered the ER at 4 L.  He was evaluated by infectious disease.  Started on remdesivir.  He was also started on IV steroids.  Oxygen supplementation.  By day 3, patient was beginning to feel better.  Steroids started to wean, and then eventually switched to oral prednisone.  Recommendation was 40 mg a day for 5 days at discharge.  Patient was feeling much better on the day of discharge, was on 3 L oxygen.  Oxygen saturations remained above 90% even with ambulation inside the room.  He was asked to follow-up with his primary care and his pulmonologist.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient is a 76-year-old male with a history of moderately severe COPD on home oxygen, CVA, CAD and peripheral vascular disease presented to the emergency room with worsening shortness of breath, fevers, chills and nonproductive cough.  Home positive test for COVID.  Patient required increased level of oxygen when he entered the ER at 4 L.  He was evaluated by infectious disease.  Started on remdesivir.  He was also started on IV steroids.  Oxygen supplementation.  By day 3, patient was beginning to feel better.  Steroids started to wean, and then eventually switched to oral prednisone.  Recommendation was 40 mg a day for 5 days at discharge.  Patient was feeling much better on the day of discharge, was on 3 L oxygen.  Oxygen saturations remained above 90% even with ambulation inside the room.  He was asked to follow-up with his primary care and his pulmonologist.
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Back pain, COVID-19, Dementia, Fall, Orthosis user
Clinical narrative: Patient is 85y.o. male who was admitted to the hospital with mid back pain after a fall at the home few days prior. He has moderate-advanced dementia. Retired psychiatrist. Lives in - memory care unit.  Found to have T12 fracture. Ortho spine recommended surgery (considered an unstable fracture with small chance of fragment mobilization). Family decided against surgery in the complex context of advanced age and dementia. Eventually a vertebroplasty was performed. He has no pain. He needs to wear CASH brace unless in bed or sitting.
Age: 83.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Thoracic vertebral fracture, Vertebroplasty
Clinical narrative: Patient is 85y.o. male who was admitted to the hospital with mid back pain after a fall at the home few days prior. He has moderate-advanced dementia. Retired psychiatrist. Lives in - memory care unit.  Found to have T12 fracture. Ortho spine recommended surgery (considered an unstable fracture with small chance of fragment mobilization). Family decided against surgery in the complex context of advanced age and dementia. Eventually a vertebroplasty was performed. He has no pain. He needs to wear CASH brace unless in bed or sitting.
Age: 60.0
Sex: F
Vaccine: FLUC4
Symptoms: Extra dose administered
Clinical narrative: Pt mistakenly given a flu immunization after already receiving one this season.
Age: 14.0
Sex: M
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: expired pfizer bivalent booster expired on 12/5/22
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Gastrointestinal haemorrhage
Clinical narrative: ADMISSION DIAGNOSIS: 1. COVID-19.  2. Gastrointestinal bleed.  GI has deferred endoscopy to outpatient.  3. End-stage renal disease via left arm AV fistula Monday, Wednesday, Friday, ??.  4. Coronary artery disease, sees Dr.  5. Hypertension.  6. Diabetes.  7. Hyperlipidemia.  8. Ex-smoker.   DISCHARGE DIAGNOSIS: 1. COVID-19.  2. Gastrointestinal bleed.  GI has deferred endoscopy to outpatient.  3. End-stage renal disease via left arm AV fistula Monday, Wednesday, Friday, ?.  4. Coronary artery disease, sees Dr.  5. Hypertension.  6. Diabetes.  7. Hyperlipidemia.  8. Ex-smoker.    The patient feels well.  The patient completed his 3-day of remdesivir.  If the patient is non hypoxic, the patient can be discharged after dialysis today.
Age: 33.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anxiety, COVID-19, Condition aggravated, SARS-CoV-2 test positive
Clinical narrative: The patient is a 34y.o.  female PMH of depression, anxiety, recent COVID-19 infection who presents for evaluation of worsening anxiety.   Patient reports a 5 day history of worsening in her anxiety. She woke up on Monday morning, experiencing severe anxiety. This occurred every morning for the past few days, however yesterday persisted throughout the day prompting her visit to the ED. Patient was seen for follow-up today.  She reports that she is feeling much better than yesterday.
Age: 92.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Influenza virus test negative, Malaise, Nasopharyngitis, Oropharyngeal pain
Clinical narrative: Tuesday night, I went to bed with some symptoms. I didn't feel well so I took a Benadryl to help me sleep and felt like I had a cold. I also took some Tylenol as well. The next morning my throat was sore and it felt like a worse cold. My daughter took me to urgent care immediately because of the sore throat. Just felt like I had a very severe cold with a sore throat. At urgent care, I was prescribed Paxlovid.
Age: 92.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Streptococcus test negative
Clinical narrative: Tuesday night, I went to bed with some symptoms. I didn't feel well so I took a Benadryl to help me sleep and felt like I had a cold. I also took some Tylenol as well. The next morning my throat was sore and it felt like a worse cold. My daughter took me to urgent care immediately because of the sore throat. Just felt like I had a very severe cold with a sore throat. At urgent care, I was prescribed Paxlovid.
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Ascites, Blood calcium decreased, Blood glucose increased, Blood lactic acid, Blood urea increased
Clinical narrative: This is a COVID+  82y.o. female w/ PMH of HTN, suspected Takotsubo's cardiomyopathy, HFrEF EF 35% on 2L home O2, prior breast cancer s/p R mastectomy 2002, newly diangosed pancreatic adenocarcinoma cancer with diffuse metastasis, and SBO on TPN who presented to HCF on 10/02 with shortness of breath. Pt has had increasing O2 requirement at home for the past 2 weeks, and was found collapsed and unconscious on bathroom floor by her husband. In the ED, pt was tachypneic RR 25, otherwise vitals WNL. Stroke team was activated due to slight left facial droop and subtle left arm weakness, however this was later reported as chronic and baseline for  her, initial stroke workup was negative, brain MRI still needed to be needed to be completed.  Labs notable for positive COVID test.  Lactic acid 1.4.  WBC elevated at 18.5.  Hgb 8.5 (appears to be at baseline). BMP remarkable for BUN of 36, calcium 7.6, hyperglycemia 216. D-dimer elevated to 2107, however CT-PE was negative. UA negative for infection. CT head showed no acute intracranial process, prominence of the CSF spaces with progression and periventricular white matter changes. EKG NSR with possible Left atrial enlargement . Chest Xray showed worsening pulmonary edema. She was started on 15 L nonrebreather and weaned to 5L. Medical team was consulted, pt received Decadron for 10 days. On physical exam patient was fluid overloaded (pulmonary B lines on bedside echo and 2+ b/l LE edema) and had signs of pleural effusion, ascites. She was also started on Lasix 40 mg BID. IR was consulted for paracentesis, it was attempted but they were unable to remove any fluid. Throughout the remainder of her hospital stay, she she remained on 4-5L of oxygen. Pt's ascites, increased oxygen demand, BLE edema were determined likely 2/2 pancreatic cancer metastasis to her pelvis, liver  and small bowel. Oncology was consulted and determined that the pt had a poor prognosis and she was not a candidate for aggressive chemotherapy
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest X-ray abnormal, Computerised tomogram thorax normal, Dyspnoea, Echocardiogram abnormal
Clinical narrative: This is a COVID+  82y.o. female w/ PMH of HTN, suspected Takotsubo's cardiomyopathy, HFrEF EF 35% on 2L home O2, prior breast cancer s/p R mastectomy 2002, newly diangosed pancreatic adenocarcinoma cancer with diffuse metastasis, and SBO on TPN who presented to HCF on 10/02 with shortness of breath. Pt has had increasing O2 requirement at home for the past 2 weeks, and was found collapsed and unconscious on bathroom floor by her husband. In the ED, pt was tachypneic RR 25, otherwise vitals WNL. Stroke team was activated due to slight left facial droop and subtle left arm weakness, however this was later reported as chronic and baseline for  her, initial stroke workup was negative, brain MRI still needed to be needed to be completed.  Labs notable for positive COVID test.  Lactic acid 1.4.  WBC elevated at 18.5.  Hgb 8.5 (appears to be at baseline). BMP remarkable for BUN of 36, calcium 7.6, hyperglycemia 216. D-dimer elevated to 2107, however CT-PE was negative. UA negative for infection. CT head showed no acute intracranial process, prominence of the CSF spaces with progression and periventricular white matter changes. EKG NSR with possible Left atrial enlargement . Chest Xray showed worsening pulmonary edema. She was started on 15 L nonrebreather and weaned to 5L. Medical team was consulted, pt received Decadron for 10 days. On physical exam patient was fluid overloaded (pulmonary B lines on bedside echo and 2+ b/l LE edema) and had signs of pleural effusion, ascites. She was also started on Lasix 40 mg BID. IR was consulted for paracentesis, it was attempted but they were unable to remove any fluid. Throughout the remainder of her hospital stay, she she remained on 4-5L of oxygen. Pt's ascites, increased oxygen demand, BLE edema were determined likely 2/2 pancreatic cancer metastasis to her pelvis, liver  and small bowel. Oncology was consulted and determined that the pt had a poor prognosis and she was not a candidate for aggressive chemotherapy
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Electrocardiogram abnormal, Facial paralysis, Fibrin D dimer increased, Haemoglobin decreased, Hyperglycaemia
Clinical narrative: This is a COVID+  82y.o. female w/ PMH of HTN, suspected Takotsubo's cardiomyopathy, HFrEF EF 35% on 2L home O2, prior breast cancer s/p R mastectomy 2002, newly diangosed pancreatic adenocarcinoma cancer with diffuse metastasis, and SBO on TPN who presented to HCF on 10/02 with shortness of breath. Pt has had increasing O2 requirement at home for the past 2 weeks, and was found collapsed and unconscious on bathroom floor by her husband. In the ED, pt was tachypneic RR 25, otherwise vitals WNL. Stroke team was activated due to slight left facial droop and subtle left arm weakness, however this was later reported as chronic and baseline for  her, initial stroke workup was negative, brain MRI still needed to be needed to be completed.  Labs notable for positive COVID test.  Lactic acid 1.4.  WBC elevated at 18.5.  Hgb 8.5 (appears to be at baseline). BMP remarkable for BUN of 36, calcium 7.6, hyperglycemia 216. D-dimer elevated to 2107, however CT-PE was negative. UA negative for infection. CT head showed no acute intracranial process, prominence of the CSF spaces with progression and periventricular white matter changes. EKG NSR with possible Left atrial enlargement . Chest Xray showed worsening pulmonary edema. She was started on 15 L nonrebreather and weaned to 5L. Medical team was consulted, pt received Decadron for 10 days. On physical exam patient was fluid overloaded (pulmonary B lines on bedside echo and 2+ b/l LE edema) and had signs of pleural effusion, ascites. She was also started on Lasix 40 mg BID. IR was consulted for paracentesis, it was attempted but they were unable to remove any fluid. Throughout the remainder of her hospital stay, she she remained on 4-5L of oxygen. Pt's ascites, increased oxygen demand, BLE edema were determined likely 2/2 pancreatic cancer metastasis to her pelvis, liver  and small bowel. Oncology was consulted and determined that the pt had a poor prognosis and she was not a candidate for aggressive chemotherapy
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Hypervolaemia, Intestinal metastasis, Loss of consciousness, Metabolic function test abnormal, Metastases to liver
Clinical narrative: This is a COVID+  82y.o. female w/ PMH of HTN, suspected Takotsubo's cardiomyopathy, HFrEF EF 35% on 2L home O2, prior breast cancer s/p R mastectomy 2002, newly diangosed pancreatic adenocarcinoma cancer with diffuse metastasis, and SBO on TPN who presented to HCF on 10/02 with shortness of breath. Pt has had increasing O2 requirement at home for the past 2 weeks, and was found collapsed and unconscious on bathroom floor by her husband. In the ED, pt was tachypneic RR 25, otherwise vitals WNL. Stroke team was activated due to slight left facial droop and subtle left arm weakness, however this was later reported as chronic and baseline for  her, initial stroke workup was negative, brain MRI still needed to be needed to be completed.  Labs notable for positive COVID test.  Lactic acid 1.4.  WBC elevated at 18.5.  Hgb 8.5 (appears to be at baseline). BMP remarkable for BUN of 36, calcium 7.6, hyperglycemia 216. D-dimer elevated to 2107, however CT-PE was negative. UA negative for infection. CT head showed no acute intracranial process, prominence of the CSF spaces with progression and periventricular white matter changes. EKG NSR with possible Left atrial enlargement . Chest Xray showed worsening pulmonary edema. She was started on 15 L nonrebreather and weaned to 5L. Medical team was consulted, pt received Decadron for 10 days. On physical exam patient was fluid overloaded (pulmonary B lines on bedside echo and 2+ b/l LE edema) and had signs of pleural effusion, ascites. She was also started on Lasix 40 mg BID. IR was consulted for paracentesis, it was attempted but they were unable to remove any fluid. Throughout the remainder of her hospital stay, she she remained on 4-5L of oxygen. Pt's ascites, increased oxygen demand, BLE edema were determined likely 2/2 pancreatic cancer metastasis to her pelvis, liver  and small bowel. Oncology was consulted and determined that the pt had a poor prognosis and she was not a candidate for aggressive chemotherapy
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Metastases to pelvis, Muscular weakness, Oedema peripheral, Pancreatic carcinoma metastatic, Paracentesis
Clinical narrative: This is a COVID+  82y.o. female w/ PMH of HTN, suspected Takotsubo's cardiomyopathy, HFrEF EF 35% on 2L home O2, prior breast cancer s/p R mastectomy 2002, newly diangosed pancreatic adenocarcinoma cancer with diffuse metastasis, and SBO on TPN who presented to HCF on 10/02 with shortness of breath. Pt has had increasing O2 requirement at home for the past 2 weeks, and was found collapsed and unconscious on bathroom floor by her husband. In the ED, pt was tachypneic RR 25, otherwise vitals WNL. Stroke team was activated due to slight left facial droop and subtle left arm weakness, however this was later reported as chronic and baseline for  her, initial stroke workup was negative, brain MRI still needed to be needed to be completed.  Labs notable for positive COVID test.  Lactic acid 1.4.  WBC elevated at 18.5.  Hgb 8.5 (appears to be at baseline). BMP remarkable for BUN of 36, calcium 7.6, hyperglycemia 216. D-dimer elevated to 2107, however CT-PE was negative. UA negative for infection. CT head showed no acute intracranial process, prominence of the CSF spaces with progression and periventricular white matter changes. EKG NSR with possible Left atrial enlargement . Chest Xray showed worsening pulmonary edema. She was started on 15 L nonrebreather and weaned to 5L. Medical team was consulted, pt received Decadron for 10 days. On physical exam patient was fluid overloaded (pulmonary B lines on bedside echo and 2+ b/l LE edema) and had signs of pleural effusion, ascites. She was also started on Lasix 40 mg BID. IR was consulted for paracentesis, it was attempted but they were unable to remove any fluid. Throughout the remainder of her hospital stay, she she remained on 4-5L of oxygen. Pt's ascites, increased oxygen demand, BLE edema were determined likely 2/2 pancreatic cancer metastasis to her pelvis, liver  and small bowel. Oncology was consulted and determined that the pt had a poor prognosis and she was not a candidate for aggressive chemotherapy
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pleural effusion, Procedural failure, Pulmonary oedema, SARS-CoV-2 test positive, Syncope
Clinical narrative: This is a COVID+  82y.o. female w/ PMH of HTN, suspected Takotsubo's cardiomyopathy, HFrEF EF 35% on 2L home O2, prior breast cancer s/p R mastectomy 2002, newly diangosed pancreatic adenocarcinoma cancer with diffuse metastasis, and SBO on TPN who presented to HCF on 10/02 with shortness of breath. Pt has had increasing O2 requirement at home for the past 2 weeks, and was found collapsed and unconscious on bathroom floor by her husband. In the ED, pt was tachypneic RR 25, otherwise vitals WNL. Stroke team was activated due to slight left facial droop and subtle left arm weakness, however this was later reported as chronic and baseline for  her, initial stroke workup was negative, brain MRI still needed to be needed to be completed.  Labs notable for positive COVID test.  Lactic acid 1.4.  WBC elevated at 18.5.  Hgb 8.5 (appears to be at baseline). BMP remarkable for BUN of 36, calcium 7.6, hyperglycemia 216. D-dimer elevated to 2107, however CT-PE was negative. UA negative for infection. CT head showed no acute intracranial process, prominence of the CSF spaces with progression and periventricular white matter changes. EKG NSR with possible Left atrial enlargement . Chest Xray showed worsening pulmonary edema. She was started on 15 L nonrebreather and weaned to 5L. Medical team was consulted, pt received Decadron for 10 days. On physical exam patient was fluid overloaded (pulmonary B lines on bedside echo and 2+ b/l LE edema) and had signs of pleural effusion, ascites. She was also started on Lasix 40 mg BID. IR was consulted for paracentesis, it was attempted but they were unable to remove any fluid. Throughout the remainder of her hospital stay, she she remained on 4-5L of oxygen. Pt's ascites, increased oxygen demand, BLE edema were determined likely 2/2 pancreatic cancer metastasis to her pelvis, liver  and small bowel. Oncology was consulted and determined that the pt had a poor prognosis and she was not a candidate for aggressive chemotherapy
Age: 81.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Tachypnoea, Urine analysis normal, White blood cell count increased
Clinical narrative: This is a COVID+  82y.o. female w/ PMH of HTN, suspected Takotsubo's cardiomyopathy, HFrEF EF 35% on 2L home O2, prior breast cancer s/p R mastectomy 2002, newly diangosed pancreatic adenocarcinoma cancer with diffuse metastasis, and SBO on TPN who presented to HCF on 10/02 with shortness of breath. Pt has had increasing O2 requirement at home for the past 2 weeks, and was found collapsed and unconscious on bathroom floor by her husband. In the ED, pt was tachypneic RR 25, otherwise vitals WNL. Stroke team was activated due to slight left facial droop and subtle left arm weakness, however this was later reported as chronic and baseline for  her, initial stroke workup was negative, brain MRI still needed to be needed to be completed.  Labs notable for positive COVID test.  Lactic acid 1.4.  WBC elevated at 18.5.  Hgb 8.5 (appears to be at baseline). BMP remarkable for BUN of 36, calcium 7.6, hyperglycemia 216. D-dimer elevated to 2107, however CT-PE was negative. UA negative for infection. CT head showed no acute intracranial process, prominence of the CSF spaces with progression and periventricular white matter changes. EKG NSR with possible Left atrial enlargement . Chest Xray showed worsening pulmonary edema. She was started on 15 L nonrebreather and weaned to 5L. Medical team was consulted, pt received Decadron for 10 days. On physical exam patient was fluid overloaded (pulmonary B lines on bedside echo and 2+ b/l LE edema) and had signs of pleural effusion, ascites. She was also started on Lasix 40 mg BID. IR was consulted for paracentesis, it was attempted but they were unable to remove any fluid. Throughout the remainder of her hospital stay, she she remained on 4-5L of oxygen. Pt's ascites, increased oxygen demand, BLE edema were determined likely 2/2 pancreatic cancer metastasis to her pelvis, liver  and small bowel. Oncology was consulted and determined that the pt had a poor prognosis and she was not a candidate for aggressive chemotherapy
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Amnesia, Blood creatinine increased, Chest X-ray normal, Computerised tomogram head normal, Haemodialysis
Clinical narrative: This is a 72y.o. male  with PMH significant for ESRD on HD T/T/S, HTN, DM, CVA, BPH, GERD, HLD who was sent  to ED from a center for syncopal episode while getting HD.  The patient doesn't recall the event, he only remembers that he had breakfast prior to HD and went to his session as usual, he says he was told he had completed HD session. Per primary note he had another syncopal episode 3 weeks ago due to low BP.  ED his vitals were stable, labs showed creatinine 4.29, trop 0.04, hgb 10.5. CXR unremarkable.  Head CT no acute process. He was admitted to medicine for further management, nephrology is consulted to resume HD
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Haemoglobin decreased, Hypotension, Laboratory test, SARS-CoV-2 test positive, Syncope
Clinical narrative: This is a 72y.o. male  with PMH significant for ESRD on HD T/T/S, HTN, DM, CVA, BPH, GERD, HLD who was sent  to ED from a center for syncopal episode while getting HD.  The patient doesn't recall the event, he only remembers that he had breakfast prior to HD and went to his session as usual, he says he was told he had completed HD session. Per primary note he had another syncopal episode 3 weeks ago due to low BP.  ED his vitals were stable, labs showed creatinine 4.29, trop 0.04, hgb 10.5. CXR unremarkable.  Head CT no acute process. He was admitted to medicine for further management, nephrology is consulted to resume HD
Age: 70.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Troponin
Clinical narrative: This is a 72y.o. male  with PMH significant for ESRD on HD T/T/S, HTN, DM, CVA, BPH, GERD, HLD who was sent  to ED from a center for syncopal episode while getting HD.  The patient doesn't recall the event, he only remembers that he had breakfast prior to HD and went to his session as usual, he says he was told he had completed HD session. Per primary note he had another syncopal episode 3 weeks ago due to low BP.  ED his vitals were stable, labs showed creatinine 4.29, trop 0.04, hgb 10.5. CXR unremarkable.  Head CT no acute process. He was admitted to medicine for further management, nephrology is consulted to resume HD
Age: 59.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Acute kidney injury, Anaemia, COVID-19, Cardiac flutter, Chest X-ray normal
Clinical narrative: 61y.o. female with PMH of  Asthma, Carotid artery occlusion, CVA with left hemiparesis (06/13/2020), DM type 2, Fatty liver, HTN (hypertension) who presented to EC on 10/2/2022 with AMS. It is thought that possible pt was given her mother's medications by mistake, causing the AMS. Pt was also diagnosed with COVID 2 days PTA.  Labs noted acute kidney injury, chronic anemia, and positive covid testing. Head CT was negative for acute findings. Chest x-ray was negative for pneumonia. Troponin was negative. ECG appeared abnormal with question of PACs versus possible flutter waves. She was not hypoxic.She was seen by ID, no indication for antiviral or steroid at this time/ remains on room air. Mentation is at baseline.
Age: 59.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Computerised tomogram head normal, Electrocardiogram abnormal, Mental status changes, SARS-CoV-2 test positive, Supraventricular extrasystoles
Clinical narrative: 61y.o. female with PMH of  Asthma, Carotid artery occlusion, CVA with left hemiparesis (06/13/2020), DM type 2, Fatty liver, HTN (hypertension) who presented to EC on 10/2/2022 with AMS. It is thought that possible pt was given her mother's medications by mistake, causing the AMS. Pt was also diagnosed with COVID 2 days PTA.  Labs noted acute kidney injury, chronic anemia, and positive covid testing. Head CT was negative for acute findings. Chest x-ray was negative for pneumonia. Troponin was negative. ECG appeared abnormal with question of PACs versus possible flutter waves. She was not hypoxic.She was seen by ID, no indication for antiviral or steroid at this time/ remains on room air. Mentation is at baseline.
Age: 59.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Troponin normal
Clinical narrative: 61y.o. female with PMH of  Asthma, Carotid artery occlusion, CVA with left hemiparesis (06/13/2020), DM type 2, Fatty liver, HTN (hypertension) who presented to EC on 10/2/2022 with AMS. It is thought that possible pt was given her mother's medications by mistake, causing the AMS. Pt was also diagnosed with COVID 2 days PTA.  Labs noted acute kidney injury, chronic anemia, and positive covid testing. Head CT was negative for acute findings. Chest x-ray was negative for pneumonia. Troponin was negative. ECG appeared abnormal with question of PACs versus possible flutter waves. She was not hypoxic.She was seen by ID, no indication for antiviral or steroid at this time/ remains on room air. Mentation is at baseline.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest X-ray normal, Fall, Fibrin D dimer increased, Gait disturbance
Clinical narrative: Patient is 71y.o. male who was admitted to the hospital with gait instability and mechanical fall --xray w no evidence of fraction; seen by PMR and PT/OT --recom tylenol and lidoderm patches for pain control--PT recom home w home care ;  Tested covid + upon admission --CXR neg , D dimer 4000 , seen by ID and had 3 days of remdesivir --slightly hypotensive --was given iv fluids ---LEVD was negative for DVT --stable for dc home w home care
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypotension, Pain, SARS-CoV-2 test positive, Ultrasound Doppler normal, X-ray normal
Clinical narrative: Patient is 71y.o. male who was admitted to the hospital with gait instability and mechanical fall --xray w no evidence of fraction; seen by PMR and PT/OT --recom tylenol and lidoderm patches for pain control--PT recom home w home care ;  Tested covid + upon admission --CXR neg , D dimer 4000 , seen by ID and had 3 days of remdesivir --slightly hypotensive --was given iv fluids ---LEVD was negative for DVT --stable for dc home w home care
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalized with covid; fully vaccinated
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Fall, Fatigue, SARS-CoV-2 test positive
Clinical narrative: Patient is a 75-year-old female with past medical history of hypertension, hypothyroidism, dementia, with additional history as noted below presented to hospital s/p fall and with a complaint of fatigue.  Patient was subsequently found to be positive for COVID-19.  During her stay there was concern for conversion to new onset A. fib and therefore consultation was placed to cardiology for further evaluation/recommendations. Patient discharged home with skilled home care, with the following services Home PT, Skilled nursing
Age: 29.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Abdominal pain, COVID-19, Condition aggravated, Diarrhoea, Faeces discoloured
Clinical narrative: Patient is a 30-year-old female with past medical history of chronic abdominal pain, type 1 diabetes, gastroparesis, end-stage renal disease on dialysis, drug-seeking behavior, hypertension to the ED for 3-day history of nausea vomiting diarrhea ( has dark red stool) and abdominal pain. She responded well with supportive care. She had hypertensive urgency and BPs>201/121 on admission. She required couple doses of IV Hydralazine to bring it down her BPs. She tolerated well to HD and is tolerating to po diet. She also had hypoglycemia on admission and now BS improved once she started to eat. She has chronic nausea and abdominal pain from her gastroparesis. Not sure is she had some narcotic withdrawal component. She didn't have any bowel obstruction of fecal impaction. It's been challenging with multiple hospitalizations with similar issues and other complex medical problems. Mom is trying her best to support her Dtr, patient at home.