chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Arterial catheterisation, Asthenia, Blood lactic acid increased, Blood pressure decreased, COVID-19
Clinical narrative: Discharge Provider:  MD Primary Care Provider: MD Admission Date: 8/25/2022 Discharge Date: 8/29/2022  PRESENTING PROBLEM: Severe sepsis [A41.9, R65.20] COVID [U07.1] Suspected COVID-19 virus infection [Z20.822] COVID-19 [U07.1] Sepsis  [A41.9]   HOSPITAL COURSE: Per ICU transfer summary: "Patient is a 73 year old with NIDDM, HTN, and GERD who presented to ED 8/25 with generalized weakness, fever and fall from standing.  In ED, she was febrile to 39.1C with stable vitals.  Labs were significant for LA 2.7, WBC 3800, and she was found to be COVID-19 positive.  CXR was clear.  She was given 4L NS and admitted for further care.  After admission, her BP dropped and she was brought to ICU where arterial line was placed which showed adequate BP.  She did not require vasopressors.  She had episodes of sinus bradycardia (HR down into 30s, similar to a previous admission in 2019 for Influenza A) with some associated hypotension that improved with volume, overall improved over time.  She continued to require only room air oxygen - CXRs did show some increased interstitial infiltrates 8/27 but improved by 8/28.  No therapy for COVID was started.  She has been very deconditioned - requiring assistance with mobility.  PT/OT ordered."   She was transferred to the Hospitalist service on 8/28/2022. She was evaluated by PT/OT who recommended home with assist as needed. Home valsartan-HCTZ was held on DC until she follow up with her PCP as an outpatient. She was discharged home in stable condition on 8/29/2022.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Fall, Hypotension, Intensive care, Lung infiltration
Clinical narrative: Discharge Provider:  MD Primary Care Provider: MD Admission Date: 8/25/2022 Discharge Date: 8/29/2022  PRESENTING PROBLEM: Severe sepsis [A41.9, R65.20] COVID [U07.1] Suspected COVID-19 virus infection [Z20.822] COVID-19 [U07.1] Sepsis  [A41.9]   HOSPITAL COURSE: Per ICU transfer summary: "Patient is a 73 year old with NIDDM, HTN, and GERD who presented to ED 8/25 with generalized weakness, fever and fall from standing.  In ED, she was febrile to 39.1C with stable vitals.  Labs were significant for LA 2.7, WBC 3800, and she was found to be COVID-19 positive.  CXR was clear.  She was given 4L NS and admitted for further care.  After admission, her BP dropped and she was brought to ICU where arterial line was placed which showed adequate BP.  She did not require vasopressors.  She had episodes of sinus bradycardia (HR down into 30s, similar to a previous admission in 2019 for Influenza A) with some associated hypotension that improved with volume, overall improved over time.  She continued to require only room air oxygen - CXRs did show some increased interstitial infiltrates 8/27 but improved by 8/28.  No therapy for COVID was started.  She has been very deconditioned - requiring assistance with mobility.  PT/OT ordered."   She was transferred to the Hospitalist service on 8/28/2022. She was evaluated by PT/OT who recommended home with assist as needed. Home valsartan-HCTZ was held on DC until she follow up with her PCP as an outpatient. She was discharged home in stable condition on 8/29/2022.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Mobility decreased, Physical deconditioning, Pyrexia, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Discharge Provider:  MD Primary Care Provider: MD Admission Date: 8/25/2022 Discharge Date: 8/29/2022  PRESENTING PROBLEM: Severe sepsis [A41.9, R65.20] COVID [U07.1] Suspected COVID-19 virus infection [Z20.822] COVID-19 [U07.1] Sepsis  [A41.9]   HOSPITAL COURSE: Per ICU transfer summary: "Patient is a 73 year old with NIDDM, HTN, and GERD who presented to ED 8/25 with generalized weakness, fever and fall from standing.  In ED, she was febrile to 39.1C with stable vitals.  Labs were significant for LA 2.7, WBC 3800, and she was found to be COVID-19 positive.  CXR was clear.  She was given 4L NS and admitted for further care.  After admission, her BP dropped and she was brought to ICU where arterial line was placed which showed adequate BP.  She did not require vasopressors.  She had episodes of sinus bradycardia (HR down into 30s, similar to a previous admission in 2019 for Influenza A) with some associated hypotension that improved with volume, overall improved over time.  She continued to require only room air oxygen - CXRs did show some increased interstitial infiltrates 8/27 but improved by 8/28.  No therapy for COVID was started.  She has been very deconditioned - requiring assistance with mobility.  PT/OT ordered."   She was transferred to the Hospitalist service on 8/28/2022. She was evaluated by PT/OT who recommended home with assist as needed. Home valsartan-HCTZ was held on DC until she follow up with her PCP as an outpatient. She was discharged home in stable condition on 8/29/2022.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Sinus bradycardia, White blood cell count decreased
Clinical narrative: Discharge Provider:  MD Primary Care Provider: MD Admission Date: 8/25/2022 Discharge Date: 8/29/2022  PRESENTING PROBLEM: Severe sepsis [A41.9, R65.20] COVID [U07.1] Suspected COVID-19 virus infection [Z20.822] COVID-19 [U07.1] Sepsis  [A41.9]   HOSPITAL COURSE: Per ICU transfer summary: "Patient is a 73 year old with NIDDM, HTN, and GERD who presented to ED 8/25 with generalized weakness, fever and fall from standing.  In ED, she was febrile to 39.1C with stable vitals.  Labs were significant for LA 2.7, WBC 3800, and she was found to be COVID-19 positive.  CXR was clear.  She was given 4L NS and admitted for further care.  After admission, her BP dropped and she was brought to ICU where arterial line was placed which showed adequate BP.  She did not require vasopressors.  She had episodes of sinus bradycardia (HR down into 30s, similar to a previous admission in 2019 for Influenza A) with some associated hypotension that improved with volume, overall improved over time.  She continued to require only room air oxygen - CXRs did show some increased interstitial infiltrates 8/27 but improved by 8/28.  No therapy for COVID was started.  She has been very deconditioned - requiring assistance with mobility.  PT/OT ordered."   She was transferred to the Hospitalist service on 8/28/2022. She was evaluated by PT/OT who recommended home with assist as needed. Home valsartan-HCTZ was held on DC until she follow up with her PCP as an outpatient. She was discharged home in stable condition on 8/29/2022.
Age: 43.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Chills, Dyspnoea, Lethargy, Malaise, Pain
Clinical narrative: I received my first dose via intramuscular injection 4 weeks ago with no noticeable side-effects. About 7 hours after receiving my second dose, I began feeling body aches, lethargy and general malaise. I fell asleep around 10:30 and woke up with chills and a fever of 102. I attempted to fall asleep again but would wake up every hour with worsening symptoms. After almost 24 hours, I no longer have a fever but experience shortness of breath when I move.
Age: 43.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Pyrexia
Clinical narrative: I received my first dose via intramuscular injection 4 weeks ago with no noticeable side-effects. About 7 hours after receiving my second dose, I began feeling body aches, lethargy and general malaise. I fell asleep around 10:30 and woke up with chills and a fever of 102. I attempted to fall asleep again but would wake up every hour with worsening symptoms. After almost 24 hours, I no longer have a fever but experience shortness of breath when I move.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Circumstance or information capable of leading to medication error
Clinical narrative: Listed as 1st dose but it was a 3rd dose
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: patient wanted moderna bivalent vaccine but got moderna booster vaccine instead 0.5ml lot 064a22a
Age: 44.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: patient wanted moderna bivalent vaccine but got moderna booster vaccine instead ndc 807770275990.5ml lot 064a22a
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: patient wanted moderna bivalent vaccine but got moderna booster vaccine instead ndc 807770275990.5ml lot 064a22a
Age: 74.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Abdominal pain, Acute kidney injury, Asthenia, Blood creatinine increased, Blood potassium increased
Clinical narrative: 75-year-old female past medical history of AFib on Eliquis, hypertension, coronary artery disease, CKD 3, hyperlipidemia and insulin-dependent diabetes who presented to the Emergency Department on 08/25 for generalized weakness accompanied by nausea.  Apparently, she was in the emergency department the preceding day for nausea and abdominal pain as well as cough, myalgias and chills, was tested for COVID and found to be positive but given no respiratory symptoms or hypoxia was discharged.  On the subsequent visit she described her general weakness they exited the point she was unable to arise from her floor requiring transportation by EMS. Of note the patient was reportedly hypotensive for EMS at 80/30.   In the emergency department, patient was placed on routine monitoring and basic laboratory studies were obtained.  Her vital signs were stable and laboratory work was significant for unremarkable complete blood count menstruated demonstrated a creatinine of 2.16 up from only 1.09 the preceding day.  Potassium was also elevated at 5. Given her acute kidney injury in the setting of recent COVID infection she also had a chest x-ray that was without acute process.  The patient was ultimately admitted to the hospital for her AKI, felt strongly to be pre renal in this causes as the patient disclosed that she had had poor oral intake with her recent symptomatology from COVID.  She was fluid resuscitated, and received frequent laboratory draws to monitor the for kidney and her serum potassium.  With fluids, she continued to convalesce and is medically stable for discharge 08/28/2022.
Age: 74.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: COVID-19, Chest X-ray normal, Chills, Cough, Full blood count normal
Clinical narrative: 75-year-old female past medical history of AFib on Eliquis, hypertension, coronary artery disease, CKD 3, hyperlipidemia and insulin-dependent diabetes who presented to the Emergency Department on 08/25 for generalized weakness accompanied by nausea.  Apparently, she was in the emergency department the preceding day for nausea and abdominal pain as well as cough, myalgias and chills, was tested for COVID and found to be positive but given no respiratory symptoms or hypoxia was discharged.  On the subsequent visit she described her general weakness they exited the point she was unable to arise from her floor requiring transportation by EMS. Of note the patient was reportedly hypotensive for EMS at 80/30.   In the emergency department, patient was placed on routine monitoring and basic laboratory studies were obtained.  Her vital signs were stable and laboratory work was significant for unremarkable complete blood count menstruated demonstrated a creatinine of 2.16 up from only 1.09 the preceding day.  Potassium was also elevated at 5. Given her acute kidney injury in the setting of recent COVID infection she also had a chest x-ray that was without acute process.  The patient was ultimately admitted to the hospital for her AKI, felt strongly to be pre renal in this causes as the patient disclosed that she had had poor oral intake with her recent symptomatology from COVID.  She was fluid resuscitated, and received frequent laboratory draws to monitor the for kidney and her serum potassium.  With fluids, she continued to convalesce and is medically stable for discharge 08/28/2022.
Age: 74.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Hypophagia, Hypotension, Laboratory test, Malaise, Mobility decreased
Clinical narrative: 75-year-old female past medical history of AFib on Eliquis, hypertension, coronary artery disease, CKD 3, hyperlipidemia and insulin-dependent diabetes who presented to the Emergency Department on 08/25 for generalized weakness accompanied by nausea.  Apparently, she was in the emergency department the preceding day for nausea and abdominal pain as well as cough, myalgias and chills, was tested for COVID and found to be positive but given no respiratory symptoms or hypoxia was discharged.  On the subsequent visit she described her general weakness they exited the point she was unable to arise from her floor requiring transportation by EMS. Of note the patient was reportedly hypotensive for EMS at 80/30.   In the emergency department, patient was placed on routine monitoring and basic laboratory studies were obtained.  Her vital signs were stable and laboratory work was significant for unremarkable complete blood count menstruated demonstrated a creatinine of 2.16 up from only 1.09 the preceding day.  Potassium was also elevated at 5. Given her acute kidney injury in the setting of recent COVID infection she also had a chest x-ray that was without acute process.  The patient was ultimately admitted to the hospital for her AKI, felt strongly to be pre renal in this causes as the patient disclosed that she had had poor oral intake with her recent symptomatology from COVID.  She was fluid resuscitated, and received frequent laboratory draws to monitor the for kidney and her serum potassium.  With fluids, she continued to convalesce and is medically stable for discharge 08/28/2022.
Age: 74.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Myalgia, Nausea, SARS-CoV-2 test positive
Clinical narrative: 75-year-old female past medical history of AFib on Eliquis, hypertension, coronary artery disease, CKD 3, hyperlipidemia and insulin-dependent diabetes who presented to the Emergency Department on 08/25 for generalized weakness accompanied by nausea.  Apparently, she was in the emergency department the preceding day for nausea and abdominal pain as well as cough, myalgias and chills, was tested for COVID and found to be positive but given no respiratory symptoms or hypoxia was discharged.  On the subsequent visit she described her general weakness they exited the point she was unable to arise from her floor requiring transportation by EMS. Of note the patient was reportedly hypotensive for EMS at 80/30.   In the emergency department, patient was placed on routine monitoring and basic laboratory studies were obtained.  Her vital signs were stable and laboratory work was significant for unremarkable complete blood count menstruated demonstrated a creatinine of 2.16 up from only 1.09 the preceding day.  Potassium was also elevated at 5. Given her acute kidney injury in the setting of recent COVID infection she also had a chest x-ray that was without acute process.  The patient was ultimately admitted to the hospital for her AKI, felt strongly to be pre renal in this causes as the patient disclosed that she had had poor oral intake with her recent symptomatology from COVID.  She was fluid resuscitated, and received frequent laboratory draws to monitor the for kidney and her serum potassium.  With fluids, she continued to convalesce and is medically stable for discharge 08/28/2022.
Age: 38.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: patient wanted moderna bivalent vaccine but got moderna booster vaccine instead ndc 807770275990.5ml lot 064a22a
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Ultrasound Doppler abnormal
Clinical narrative: DVT in calf veins ... both legs
Age: 3.0
Sex: F
Vaccine: DTAPIPV, MMRV
Symptoms: Drug dispensed to wrong patient, No adverse event
Clinical narrative: Mother brought her daughter in saying she needed vaccines for school. Noted wrong child had been put on the schedule after speaking with mother and looking  at school note. Correct child was placed on schedule and nurse printed off web and vaccine consent for daughter needing vaccines. After receiving vaccines, and going to check out, mother stated she needed a note for her child to be out of school that day.  It was discovered at this time that the correct child was still at school and the sister of the child had gotten the vaccines. Mother was asked several times to verify correct child was receiving vaccines.  Mother was notified wrong child had received vaccines at check out. No adverse effects noted after receiving Kinrix and MMRV.
Age: 5.0
Sex: F
Vaccine: DTAP
Symptoms: Expired product administered, No adverse event
Clinical narrative: No adverse reaction.  Dose given on 9/6/2022.  Lot number expired 8/22/2022
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy, Rash, Rash papular
Clinical narrative: Developed a papular rash on the right ankle 30 days after the injection. The rash spread up the left calf and to the right calf. It was first unsuccessfully treated with a topical steroid (Betamethasone Valerate) and then oral steroids, which suppressed the rash for a few months but it returned. It was then treated with a another topical treatment (Clobetasol Propionate), which clears up the rash, but it periodically return every month or so.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: Listed as 2nd dose but it was on 3rd dose
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: Listed as 2nd dose but it was the 3rd dose
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, COVID-19, Condition aggravated, Diabetic ketoacidosis, Hyperglycaemia
Clinical narrative: Discharge Provider:  Primary Care Provider: MD Admission Date: 8/24/2022 Discharge Date: Aug 28, 2022  PRESENTING PROBLEM: DKA, type 1, not at goal (HCC) [E10.10] Diabetic ketoacidosis without coma associated with type 1 diabetes mellitus (HCC) [E10.10] COVID [U07.1]   HOSPITAL COURSE: 43 y.o. female with h/o brittle type 1 IDDM with neuropathy, prior DKA, prior diabetic foot wounds resulting in bilateral BKA, HLD, depression, anxiety, chronic pain and remote seizure disorder, who admitted to the Butterworth ER on 8/24 with c/o 2-day h/o generalized abdominal discomfort with nausea and vomiting.nShe presented to an urgent care center earlier in the day and was found to be COVID positive.  Additionally, she was found to be hypotensive and markedly hyperglycemia, prompting referral to the ER. In ED, found to be in DKA, likely 2/2 COVID infection, as patient endorses compliance with her diabetic regimen. She started on Endotool. Regarding her COVID, patient was not in respiratory distress and saturating well on room air, symptomatic supportive treatment only with improvement in symptoms. Endocrinology consulted. Patient transitioned off Endotool 8/26 to subq insulin, tolerating diet, and medically stable for discharge 8/28
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Hypotension, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Discharge Provider:  Primary Care Provider: MD Admission Date: 8/24/2022 Discharge Date: Aug 28, 2022  PRESENTING PROBLEM: DKA, type 1, not at goal (HCC) [E10.10] Diabetic ketoacidosis without coma associated with type 1 diabetes mellitus (HCC) [E10.10] COVID [U07.1]   HOSPITAL COURSE: 43 y.o. female with h/o brittle type 1 IDDM with neuropathy, prior DKA, prior diabetic foot wounds resulting in bilateral BKA, HLD, depression, anxiety, chronic pain and remote seizure disorder, who admitted to the Butterworth ER on 8/24 with c/o 2-day h/o generalized abdominal discomfort with nausea and vomiting.nShe presented to an urgent care center earlier in the day and was found to be COVID positive.  Additionally, she was found to be hypotensive and markedly hyperglycemia, prompting referral to the ER. In ED, found to be in DKA, likely 2/2 COVID infection, as patient endorses compliance with her diabetic regimen. She started on Endotool. Regarding her COVID, patient was not in respiratory distress and saturating well on room air, symptomatic supportive treatment only with improvement in symptoms. Endocrinology consulted. Patient transitioned off Endotool 8/26 to subq insulin, tolerating diet, and medically stable for discharge 8/28
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebrovascular accident, Fatigue, Thrombosis
Clinical narrative: Two weeks following her second booster shot (dose #4), the patient had a stroke caused by a blood clot. Before this dose, the patient had no side effects from the other vaccinations. Patient has recovered but does still experience fatigue more than she did prior to the stroke.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Fracture, SARS-CoV-2 test positive
Clinical narrative: On 05/24/2022 I had extreme fatigue and coughing. Since I was in a rehab for a fracture in my body on the left side. I was going through so much so I thought I was just exhausted from everything that happened to me. On 05/25/2022 I test myself with a COVID-19 home test which was positive. I called my doctor who prescribed me with an infusion for 3 days.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: HOSPITALIZATION
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia
Clinical narrative: Hospitalized with COVID-19 pneumonia.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administered expired vaccine.
Age: 27.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Fundoscopy normal, Headache, Photopsia, Vision blurred
Clinical narrative: Within 20 minutes of having the injection, bright white lights overtook my vision in my left eye.  At first, it was not fully overtaking vision but just blurring it. Within the first 5-10 minutes of the episode, the bright/white light basically overtook all my vision in my left eye. There also was at one point a bit of jagged light shapes in the upper corner of my left eye vision. After roughly 15 minutes of this, my vision seemed to return to mostly normal though was slightly blurry at the edges. I also had a small headache. I think maybe after 30 minutes total my vision fully returned to normal. I have not suffered anything else since then. My right eye vision was not affected.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: ADMINISTERED EXPIRED VACCINE
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dizziness postural, Fatigue, Palpitations, Postural orthostatic tachycardia syndrome
Clinical narrative: On June 8th, woke up with severe dizziness, needed assistance. Since then I have what would qualify as POTS.  The symptoms are improving slowly with time.  Symptoms- dizzy when standing, heart racing, fatigue.
Age: 60.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: SOB
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Headache, Oropharyngeal pain, Pain in extremity, Rhinorrhoea
Clinical narrative: I had a sore arm and headache which three or four days. I took TYLENOL to help with the symptoms. Tested positive for COVID-19 via home test x 2 on 08/22/2022. I had a telehealth visit with a NP and was not prescribed anything. My symptoms started on 08/18/2022. I had a headache, sore throat and runny nose. I did not have a fever.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I had a sore arm and headache which three or four days. I took TYLENOL to help with the symptoms. Tested positive for COVID-19 via home test x 2 on 08/22/2022. I had a telehealth visit with a NP and was not prescribed anything. My symptoms started on 08/18/2022. I had a headache, sore throat and runny nose. I did not have a fever.
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Respiratory failure, SARS-CoV-2 test positive
Clinical narrative: 75 year old male admitted for hypoxic respiratory failure due to COVID infection. Admitted to hospital medicine. Followed by pulmonary and ID services. Completed five day course IV remdesivir. Felt better. Respiratory status improved. He did qualify for home O2 at discharge. Care mgmt helped set up home O2. Will need close o/p follow up with pcp and consultants. To return to ER should admission symptoms reoccur. Discharged home in stable condition.
Age: 75.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Asthenia, COVID-19, Lactic acidosis, Mental status changes, SARS-CoV-2 test positive
Clinical narrative: 76-year-old man with history of HTN, HLD, pulmonary nodules, diabetes, PAD, CAD status post CABG, HFpEF, and obesity who comes to the hospital altered mental status and weakness.  Was found to be COVID-positive which is probable etiology of his altered mental status, treated with 3 days of remdesivir, did not have hypoxia, did not require steroids.  No evidence of bacterial infection.  Had lactic acidosis resolved with fluids and withholding Lasix.  During this admission Lantus was  decreased to 10 units and Lasix was held.  Discussed with wife follow-up with PCP to adjust patient's medications after hospitalization.
Age: 76.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Faeces discoloured, Haemoglobin decreased, SARS-CoV-2 test positive
Clinical narrative: 77y.o. female presenting with COVID and low hemoglobin. She reported some dark stools prior to admission. Upon presentation, hemoglobin was low at 7.6. However, upon recheck it had increased to 9.6. Consideration to initial value being lab error. Regardless, she was seen by GI and recommended for eventual, outpatient endoscopy due to dark stools. She was also seen by ID and begun on 3-day course of remdesivir. She was then stable for discharge and was sent home with a course of molnupiravir to prevent progression of her COVID infection. She will follow-up with GI clinic for eventual endoscopy.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Anticoagulant therapy, Asthenia, COVID-19, Diarrhoea, Encephalopathy
Clinical narrative: 87y.o. female who presented to the hospital with relatively recent onset pronounced fatigue as well as change in mentation.  Patient has been provided information over the phone and reported patient feeling increasingly weak on waking up.  Ros to the hospital, patient tested positive for COVID-19 viral infection.  Patient has been afebrile, minimal symptoms were reported at home. According to the husband patient was in her usual state of health the day prior when they at out.  There was no reported fall. According to additional history obtained from the primary care physician that has been declined in the recent past, and patient husband was suggested to consider addition of hired help at home. Patient is on anticoagulation with Xarelto having a history of a pulmonary embolism.  Patient was undergoing a slower steroid taper receiving prednisone 7.5 mg most recently, having a history of temporal arteritis. The patient was evalauted by infectious disease, completed a 3 day course of remdesivir Neurology, rheumatology evalautions were obtained. Encephalopathy imrpoved, patient feels significantly improved today The patient daughter yesterday anad patient's significant other have reported today that patient had diarrhea in the recent past. Over the last 3 days, 1 bowel movement was reported daily by nursing. I have offered continued monitoring in the hospital and GI evalaution . The patient requests discharge home today Home care was recommended at discharge, family informed me of their plans of hiring additional help at home With history of lung and bereast CA, hematology oncology evalaution was requested, no additioanl inpatient workup was recommended.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Fatigue, Mental status changes, SARS-CoV-2 test positive
Clinical narrative: 87y.o. female who presented to the hospital with relatively recent onset pronounced fatigue as well as change in mentation.  Patient has been provided information over the phone and reported patient feeling increasingly weak on waking up.  Ros to the hospital, patient tested positive for COVID-19 viral infection.  Patient has been afebrile, minimal symptoms were reported at home. According to the husband patient was in her usual state of health the day prior when they at out.  There was no reported fall. According to additional history obtained from the primary care physician that has been declined in the recent past, and patient husband was suggested to consider addition of hired help at home. Patient is on anticoagulation with Xarelto having a history of a pulmonary embolism.  Patient was undergoing a slower steroid taper receiving prednisone 7.5 mg most recently, having a history of temporal arteritis. The patient was evalauted by infectious disease, completed a 3 day course of remdesivir Neurology, rheumatology evalautions were obtained. Encephalopathy imrpoved, patient feels significantly improved today The patient daughter yesterday anad patient's significant other have reported today that patient had diarrhea in the recent past. Over the last 3 days, 1 bowel movement was reported daily by nursing. I have offered continued monitoring in the hospital and GI evalaution . The patient requests discharge home today Home care was recommended at discharge, family informed me of their plans of hiring additional help at home With history of lung and bereast CA, hematology oncology evalaution was requested, no additioanl inpatient workup was recommended.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Abdominal distension, Abdominal pain, COVID-19, Chills, Computerised tomogram abdomen
Clinical narrative: Patient is a 66-year-old male with PMH significant for IBS, open b/l inguinal hernia repair, and prostate cancer s/p robotic prostatectomy who presented to ER for abdominal pain with associated constipation, bloating, nausea, chills and vomiting on 8/2/2022. In the ED, the patient was afebrile and hemodynamically stable. CT A/P demonstrated small bowel obstruction with transition in the TI and an additional 1 or 2 foci of caliber transition of small bowel. NGT was placed and pain medications given. Patient was admitted to general surgery service for medical management of SBO with isolation precautions due to having tested positive for COVID-19 on 7/29/2022. NGT output monitored. On 8/3/2022, NGT was removed. Diet advanced to which patient tolerated well. Discharge instructions reviewed. Was given instructions to follow up as indicated. Reference chart for further information. To be sent home with instructions to drink lots of water and continue daily Miralax.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Constipation, Gastrointestinal tube insertion, Nausea, SARS-CoV-2 test positive, Small intestinal obstruction
Clinical narrative: Patient is a 66-year-old male with PMH significant for IBS, open b/l inguinal hernia repair, and prostate cancer s/p robotic prostatectomy who presented to ER for abdominal pain with associated constipation, bloating, nausea, chills and vomiting on 8/2/2022. In the ED, the patient was afebrile and hemodynamically stable. CT A/P demonstrated small bowel obstruction with transition in the TI and an additional 1 or 2 foci of caliber transition of small bowel. NGT was placed and pain medications given. Patient was admitted to general surgery service for medical management of SBO with isolation precautions due to having tested positive for COVID-19 on 7/29/2022. NGT output monitored. On 8/3/2022, NGT was removed. Diet advanced to which patient tolerated well. Discharge instructions reviewed. Was given instructions to follow up as indicated. Reference chart for further information. To be sent home with instructions to drink lots of water and continue daily Miralax.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: Vomiting
Clinical narrative: Patient is a 66-year-old male with PMH significant for IBS, open b/l inguinal hernia repair, and prostate cancer s/p robotic prostatectomy who presented to ER for abdominal pain with associated constipation, bloating, nausea, chills and vomiting on 8/2/2022. In the ED, the patient was afebrile and hemodynamically stable. CT A/P demonstrated small bowel obstruction with transition in the TI and an additional 1 or 2 foci of caliber transition of small bowel. NGT was placed and pain medications given. Patient was admitted to general surgery service for medical management of SBO with isolation precautions due to having tested positive for COVID-19 on 7/29/2022. NGT output monitored. On 8/3/2022, NGT was removed. Diet advanced to which patient tolerated well. Discharge instructions reviewed. Was given instructions to follow up as indicated. Reference chart for further information. To be sent home with instructions to drink lots of water and continue daily Miralax.
Age: 26.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Condition aggravated, Headache, Migraine, Nerve block
Clinical narrative: 27 y/o female with history of migraines, seizures, blindness s/p eye prosthesis, VP shunt for hydrocephalus presenting for intractable migraine. Patient was seen in Dr.s clinic who recommended admission for trial of DHE. Patient had admission in June/July and had occipital nerve block and trial PO dilaudid. She states that she has migraines daily but this is unbearable. She was admitted, found to have covid 19.  She was seen by ID and treated with remdeisir. Spoke with father on 8/16, patient is doing well, fiorect is helping. No respiratory issues. Parents also had covid-19. She had intractable headache was seen by neurology, Drs. She had norflex iv and headache and migraines improved significantly. She was eating well and also she ran out of her Quilipta and mothe rwas to bring in a refill. She improved and was discharged home. covid 19 isolation and precuations were discussed
Age: 26.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 27 y/o female with history of migraines, seizures, blindness s/p eye prosthesis, VP shunt for hydrocephalus presenting for intractable migraine. Patient was seen in Dr.s clinic who recommended admission for trial of DHE. Patient had admission in June/July and had occipital nerve block and trial PO dilaudid. She states that she has migraines daily but this is unbearable. She was admitted, found to have covid 19.  She was seen by ID and treated with remdeisir. Spoke with father on 8/16, patient is doing well, fiorect is helping. No respiratory issues. Parents also had covid-19. She had intractable headache was seen by neurology, Drs. She had norflex iv and headache and migraines improved significantly. She was eating well and also she ran out of her Quilipta and mothe rwas to bring in a refill. She improved and was discharged home. covid 19 isolation and precuations were discussed
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Angiogram pulmonary abnormal, Asthenia, Atelectasis, B-cell small lymphocytic lymphoma, COVID-19
Clinical narrative: 87y.o. male known to our office for management of CLL/SLL who completed 6 cycles of RminiCHOP on 7/27/2022. Pt was admitted to hospital on 8/3/2022 for SOB, cough, and subjective fevers. Pt was found to be covid19 positive in the ED. CXR with infiltrate vs atelectasis in right midlung and bilateral bases. CTA Chest PE protocol 8/4 negative for PE, showed multifocal areas of consolidation. Pt was started on empiric vanoc/cefepime on admit. ID and pulmonology were consulted. Vanco stopped. Pt remained on Cefepime x 7 days total, completed on 8/10/22. Pt was also treated with remdesivir 8/5/2022-8/8/22, and started on Decadon 6mg daily x 10 days. Pt will complete last two days as OP, course will complete on 8/13/22. Pt will also remain on PPI ppx x 1 week at discharge. Pt was neutropenic on admit. He received Neulasta on 7/27/2022, Granix started on admission due to persistent neutropenia and acute infection. Discontinued Granix 8/5 given ANC >1.0. Patient was able to be weaned back to room air on 8/11/22. PT/OT evaluated patient and recommended SAR at discharge. Patient's wife was very adamant that patient was discharged home with home care. Patient became very weak during hospitalization and requires two person assist to stand. His wife remained insistent patient be discharged to her care. Exception made to have wife come to hospital while patient in isolation so she was able to visualize patient and better understand recommendations for SAR. Wife submitted written documentation that she understands the risks of being patient home and prefers patient be discharged to her care with home care. Patient has two son's that are also available to help patient as needed. After long deliberation with patient's wife, will agreed to have patient discharged with home skilled nursing, PT, and OT. Patient's wife is an RN and was well educated on the risk she is taking on by bringing patient home. Patient will follow up in our office in 2 weeks after he is cleared from COVID 19 isolation.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Chest X-ray abnormal, Chronic lymphocytic leukaemia, Cough, Dyspnoea, Infection
Clinical narrative: 87y.o. male known to our office for management of CLL/SLL who completed 6 cycles of RminiCHOP on 7/27/2022. Pt was admitted to hospital on 8/3/2022 for SOB, cough, and subjective fevers. Pt was found to be covid19 positive in the ED. CXR with infiltrate vs atelectasis in right midlung and bilateral bases. CTA Chest PE protocol 8/4 negative for PE, showed multifocal areas of consolidation. Pt was started on empiric vanoc/cefepime on admit. ID and pulmonology were consulted. Vanco stopped. Pt remained on Cefepime x 7 days total, completed on 8/10/22. Pt was also treated with remdesivir 8/5/2022-8/8/22, and started on Decadon 6mg daily x 10 days. Pt will complete last two days as OP, course will complete on 8/13/22. Pt will also remain on PPI ppx x 1 week at discharge. Pt was neutropenic on admit. He received Neulasta on 7/27/2022, Granix started on admission due to persistent neutropenia and acute infection. Discontinued Granix 8/5 given ANC >1.0. Patient was able to be weaned back to room air on 8/11/22. PT/OT evaluated patient and recommended SAR at discharge. Patient's wife was very adamant that patient was discharged home with home care. Patient became very weak during hospitalization and requires two person assist to stand. His wife remained insistent patient be discharged to her care. Exception made to have wife come to hospital while patient in isolation so she was able to visualize patient and better understand recommendations for SAR. Wife submitted written documentation that she understands the risks of being patient home and prefers patient be discharged to her care with home care. Patient has two son's that are also available to help patient as needed. After long deliberation with patient's wife, will agreed to have patient discharged with home skilled nursing, PT, and OT. Patient's wife is an RN and was well educated on the risk she is taking on by bringing patient home. Patient will follow up in our office in 2 weeks after he is cleared from COVID 19 isolation.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Lung consolidation, Lung infiltration, Neutropenia, Neutrophil count decreased, Pyrexia
Clinical narrative: 87y.o. male known to our office for management of CLL/SLL who completed 6 cycles of RminiCHOP on 7/27/2022. Pt was admitted to hospital on 8/3/2022 for SOB, cough, and subjective fevers. Pt was found to be covid19 positive in the ED. CXR with infiltrate vs atelectasis in right midlung and bilateral bases. CTA Chest PE protocol 8/4 negative for PE, showed multifocal areas of consolidation. Pt was started on empiric vanoc/cefepime on admit. ID and pulmonology were consulted. Vanco stopped. Pt remained on Cefepime x 7 days total, completed on 8/10/22. Pt was also treated with remdesivir 8/5/2022-8/8/22, and started on Decadon 6mg daily x 10 days. Pt will complete last two days as OP, course will complete on 8/13/22. Pt will also remain on PPI ppx x 1 week at discharge. Pt was neutropenic on admit. He received Neulasta on 7/27/2022, Granix started on admission due to persistent neutropenia and acute infection. Discontinued Granix 8/5 given ANC >1.0. Patient was able to be weaned back to room air on 8/11/22. PT/OT evaluated patient and recommended SAR at discharge. Patient's wife was very adamant that patient was discharged home with home care. Patient became very weak during hospitalization and requires two person assist to stand. His wife remained insistent patient be discharged to her care. Exception made to have wife come to hospital while patient in isolation so she was able to visualize patient and better understand recommendations for SAR. Wife submitted written documentation that she understands the risks of being patient home and prefers patient be discharged to her care with home care. Patient has two son's that are also available to help patient as needed. After long deliberation with patient's wife, will agreed to have patient discharged with home skilled nursing, PT, and OT. Patient's wife is an RN and was well educated on the risk she is taking on by bringing patient home. Patient will follow up in our office in 2 weeks after he is cleared from COVID 19 isolation.
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: 87y.o. male known to our office for management of CLL/SLL who completed 6 cycles of RminiCHOP on 7/27/2022. Pt was admitted to hospital on 8/3/2022 for SOB, cough, and subjective fevers. Pt was found to be covid19 positive in the ED. CXR with infiltrate vs atelectasis in right midlung and bilateral bases. CTA Chest PE protocol 8/4 negative for PE, showed multifocal areas of consolidation. Pt was started on empiric vanoc/cefepime on admit. ID and pulmonology were consulted. Vanco stopped. Pt remained on Cefepime x 7 days total, completed on 8/10/22. Pt was also treated with remdesivir 8/5/2022-8/8/22, and started on Decadon 6mg daily x 10 days. Pt will complete last two days as OP, course will complete on 8/13/22. Pt will also remain on PPI ppx x 1 week at discharge. Pt was neutropenic on admit. He received Neulasta on 7/27/2022, Granix started on admission due to persistent neutropenia and acute infection. Discontinued Granix 8/5 given ANC >1.0. Patient was able to be weaned back to room air on 8/11/22. PT/OT evaluated patient and recommended SAR at discharge. Patient's wife was very adamant that patient was discharged home with home care. Patient became very weak during hospitalization and requires two person assist to stand. His wife remained insistent patient be discharged to her care. Exception made to have wife come to hospital while patient in isolation so she was able to visualize patient and better understand recommendations for SAR. Wife submitted written documentation that she understands the risks of being patient home and prefers patient be discharged to her care with home care. Patient has two son's that are also available to help patient as needed. After long deliberation with patient's wife, will agreed to have patient discharged with home skilled nursing, PT, and OT. Patient's wife is an RN and was well educated on the risk she is taking on by bringing patient home. Patient will follow up in our office in 2 weeks after he is cleared from COVID 19 isolation.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest X-ray abnormal, Chest tube removal, Chills, Computerised tomogram abnormal
Clinical narrative: 87y.o. year old female with a PMH of  HTN, HLD, and hypothyroidism presented on 8//4/2022 with chills, cough, SOB. Patient's X-ray on admission was concerning for PNA. She was treated with rocephin and zithromax. She tested negative twice for COVID on admission. The patient underwent left thoracic  decortication, VATS on 8/16/2022 for parapneumonic effusion. Chest tube was removed on 8/25/2022.  The patient tested positive for COVID-19 on 8/29/2022. CT values revealed: E-value 39.6 and N2 42.6. WBC 12.5. The patient is afebrile. SpO2 94%. Repeat chest x-ray was ordered.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Cough, Dyspnoea, Infectious pleural effusion, Laboratory test, Pleural decortication
Clinical narrative: 87y.o. year old female with a PMH of  HTN, HLD, and hypothyroidism presented on 8//4/2022 with chills, cough, SOB. Patient's X-ray on admission was concerning for PNA. She was treated with rocephin and zithromax. She tested negative twice for COVID on admission. The patient underwent left thoracic  decortication, VATS on 8/16/2022 for parapneumonic effusion. Chest tube was removed on 8/25/2022.  The patient tested positive for COVID-19 on 8/29/2022. CT values revealed: E-value 39.6 and N2 42.6. WBC 12.5. The patient is afebrile. SpO2 94%. Repeat chest x-ray was ordered.
Age: 85.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Thoracic operation, White blood cell count increased
Clinical narrative: 87y.o. year old female with a PMH of  HTN, HLD, and hypothyroidism presented on 8//4/2022 with chills, cough, SOB. Patient's X-ray on admission was concerning for PNA. She was treated with rocephin and zithromax. She tested negative twice for COVID on admission. The patient underwent left thoracic  decortication, VATS on 8/16/2022 for parapneumonic effusion. Chest tube was removed on 8/25/2022.  The patient tested positive for COVID-19 on 8/29/2022. CT values revealed: E-value 39.6 and N2 42.6. WBC 12.5. The patient is afebrile. SpO2 94%. Repeat chest x-ray was ordered.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Aspiration pleural cavity, Cardio-respiratory arrest, Chest pain, Death, Dyspnoea
Clinical narrative: Sx onset 7-7-22  admitted 7-11-22    given broad spectrum antibiotics initially and IV steroids and then  remdesivir stareted and IV antibiotics were d/c.  Had left sided thoracentesis due to effusion, had pneumonia.  admitted to ICU 7-12 due to shortness of breath .   was feeling better but on 7-14-22 developed chest pain and code blue was called when he became unresponsive.  He expired on 7-14-22.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Effusion, General symptom, Intensive care, Pneumonia, Unresponsive to stimuli
Clinical narrative: Sx onset 7-7-22  admitted 7-11-22    given broad spectrum antibiotics initially and IV steroids and then  remdesivir stareted and IV antibiotics were d/c.  Had left sided thoracentesis due to effusion, had pneumonia.  admitted to ICU 7-12 due to shortness of breath .   was feeling better but on 7-14-22 developed chest pain and code blue was called when he became unresponsive.  He expired on 7-14-22.
Age: 89.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Anaemia, Blood pressure fluctuation, COVID-19, Electrocardiogram abnormal, Lethargy
Clinical narrative: 91y.o. male referred for abnormal troponin and ECG.   He is known to our practice through management of permanent atrial fibrillation with multiple strokes during previous hospital admissions.  As noted previously, the patient is not on anticoagulation at the recommendation of his oncologist in the setting of mild dysplastic syndrome requiring serial blood transfusions, gait instability with falls, recent piriformis hematoma, and epistaxis.  He has currently been in the hospital since 7/19, currently in the inpatient rehab unit, and has only been out of the hospital for around 48 hours total ever since 6/26.  For the past few days the patient has been experiencing fluctuating mental status with significant lethargy and variable blood pressure values requiring multiple RRT calls.  Symptoms have been attributed to anemia, and the patient is now back to mental status after receiving blood transfusion.  During one of the RRT evaluations, ECG was noted to be mildly abnormal.  Follow-up troponin was minimally elevated 0.05, which then trended down.  Because the troponin elevation ECG changes, cardiology consult was requested.  The patient, confirmed by his wife, was not having any chest discomfort, dyspnea, or palpitations.