chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Eosinophil percentage decreased, Fall, Fibrin D dimer increased, Full blood count abnormal, Glomerular filtration rate
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Glomerular filtration rate decreased, Glucose urine absent, Haematocrit decreased, Haematocrit normal, Haemoglobin decreased
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Immature granulocyte count increased, Immature granulocyte percentage increased, Influenza A virus test negative, Influenza B virus test, Leukocytosis
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Lung opacity, Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin decreased
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Mean cell volume normal, Mean platelet volume normal, Metabolic function test abnormal, Monocyte count decreased, Monocyte count normal
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Monocyte percentage, Musculoskeletal chest pain, Neutrophil count increased, Neutrophil percentage increased, Nitrite urine absent
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Nucleated red cells, Oxygen saturation decreased, Platelet count decreased, Pneumonia, Protein total decreased
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Protein urine absent, Pulmonary congestion, Pyrexia, Red blood cell count normal, Red cell distribution width increased
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, SARS-CoV-2 test, SARS-CoV-2 test positive, Specific gravity urine normal, Streptococcus test
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Urinary sediment, Urinary sediment present, Urine analysis, Urine ketone body absent, Urine leukocyte esterase
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Urobilinogen urine, White blood cell count increased, White blood cells urine negative, White blood cells urine positive, pH urine normal
Clinical narrative: 3/7/21 ER to inpatient Admission   (covid positive 3/7/21) 3/11/21 Transferred to higher level of care  Date of Service: 3/8/2021            Chief complaint:  Chest congestion   HPI:  Patient is a 78 y.o. male with PMH significant for hypertension, obesity, coronary artery disease and CKD admitted to acute care from ED peR Dr with pneumonia due to COVID-19.  Patient presented to ER brought in by EMS from local residence.  Was complaining of chest congestion.  Patient had been seen in ER earlier same morning complaining of cough.  Was afebrile at that time.  Oximetry 95%.  Rapid COVID positive.  Patient given Decadron 6 mg IV, albuterol inhaler, zinc and BAM(bamlarnivimab 700 mg) IV x1.  Patient discharged home.  Return later that evening per EMS with shortness of breath.  Complaining that congestion was getting worse.  Was now febrile & had fallen trying to get out of recliner.  Vitals upon arrival-temp 102.8° pulse 87 respirations 24 blood pressure 169/71 oximetry 99% on 2 L. patient given Rocephin 1 g IV piggyback, azithromycin 500 mg IV piggyback, normal saline bolus 1 L & acetaminophen  1000 mg IV in ER.  Labs revealed mild leukocytosis white blood cell count 12.5.  Glucose elevated to a 9 but patient had received Decadron previously.  BUN 32 creatinine 1.8.  D-dimer 1240.  No CT chest obtained due to patient's renal status.  Patient subsequently admitted to acute care for further evaluation and treatment to include IV antibiotics supplemental oxygen pulmonary hygiene.  Patient has received 1st COVID vaccine and due to have 2nd vaccine on March 20.   Upon admission patient was continued on Rocephin and azithromycin IV piggyback & Decadron 6 mg IVPB.  Continued hydration fluids normal saline at 100 cc/hour.  Started on IV Remdesivir with loading dose.  DuoNeb nebulizers q.6 hours.  Patient continued on home regimen less Plavix.  Was started on Lovenox 40 mg subcu daily for DVT prevention.  Patient maintaining oxygenation on 2-3 L.  Had initially been on 2.  Was increased to 3 this morning due to decrease in oximetry down to 92%.  Patient continues with exertional dyspnea.  Does have loose nonproductive cough.  Is complaining of pain to the left lower chest wall with cough.  Describes as sharp.  Denies any actual chest pain.  No nausea vomiting.  Last BM yesterday described as normal.  Blood cultures pending no growth at present.  Is currently resting in bed. Is in negative air pressure room.  COVID precautions observed. CASE DISCUSSED WITH DR
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Lip swelling, Swelling face
Clinical narrative: Pt woke this morning 2/12/2021 at 8:30 and he had swelling to his lips and rt side of face (cheek area), Pt reported at 3:30pm still noted lip swollen and rt cheek swollen but not as much as when he awoke at 8:30
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Asthenopia, Dyspnoea, Fatigue, Myalgia
Clinical narrative: Extreme fatigue, very heavy feeling eyes, muscle aches, unusual joint pain, some SOB when walking
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Tremor
Clinical narrative: 08:37 Vaccine administered. Observation time increased to 30 minutes related to history of anaphylaxis. 08:50 Patient shaking and stating she needs O2. Pt placed on monitor. O2 sat 99% on room air. Patient and daughter requesting O2. Patient placed on O2 at 2L via nasal cannula. 09:05 Pt registered as ED patient. Care assumed by doctor and registered nurse. Patient monitored as ED patient and released home in stable condition.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea
Clinical narrative: Nausiated since 1st shot to date.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Heart rate increased, Hyperhidrosis, Pharyngeal swelling
Clinical narrative: Adverse reactions:  sweating, increased heart rate, swelling of the airway.  Cold compress applied to forehead, 5ml of Epinephrine    at 11:06am  ambulance called at same time as first does of epi,   5ml of epinephrine at 11:15am.  Paramedics on site at 11:13, administered Benadryl IV shortly after second dose of epinephrine.  Patient transported to clinic for monitoring.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood albumin normal, Blood magnesium normal, Blood potassium decreased, Chest discomfort, Throat tightness
Clinical narrative: Adverse reactions:  sweating, increased heart rate, swelling of the airway.  Cold compress applied to forehead, 5ml of Epinephrine    at 11:06am  ambulance called at same time as first does of epi,   5ml of epinephrine at 11:15am.  Paramedics on site at 11:13, administered Benadryl IV shortly after second dose of epinephrine.  Patient transported to clinic for monitoring.
Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Troponin
Clinical narrative: Adverse reactions:  sweating, increased heart rate, swelling of the airway.  Cold compress applied to forehead, 5ml of Epinephrine    at 11:06am  ambulance called at same time as first does of epi,   5ml of epinephrine at 11:15am.  Paramedics on site at 11:13, administered Benadryl IV shortly after second dose of epinephrine.  Patient transported to clinic for monitoring.
Age: 58.0
Sex: F
Vaccine: UNK
Symptoms: Chills, Dizziness, Fatigue, Headache, Nausea
Clinical narrative: None stated.
Age: 58.0
Sex: F
Vaccine: UNK
Symptoms: Pain
Clinical narrative: None stated.
Age: 23.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Chills, Disturbance in attention, Dizziness, Headache
Clinical narrative: Severe chills and fever, bad dizziness, headache, joint pain, inability to focus
Age: 23.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Severe chills and fever, bad dizziness, headache, joint pain, inability to focus
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Injection site swelling, Lip swelling, Urticaria
Clinical narrative: Swollen arm at injection site.  Swollen lips Hives on hands and feet that progressed into full body hives all over  Extreme fatigue
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nasal congestion, Nasopharyngitis, Oropharyngeal pain, Productive cough
Clinical narrative: Second Pfizer on 3/1, head cold and congestion on 3/7-9, with productive cough, stuffy nose, sore throat,
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, COVID-19, Cough, Dyspnoea
Clinical narrative: Vaccinated 12/20/2020.   On 12/21/2020  developed loss of taste/smell, nasal congestion, cough, and shortness of breath.  Positive COVID test.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Nasal congestion, SARS-CoV-2 test positive
Clinical narrative: Vaccinated 12/20/2020.   On 12/21/2020  developed loss of taste/smell, nasal congestion, cough, and shortness of breath.  Positive COVID test.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Back pain, Dysstasia, Joint instability, Muscle spasms
Clinical narrative: Just after midnight patient becam very weak, developed severe bilateral leg pain with cramps, his left ankle was weak and would roll. He couldn't stand and felt as though he was going to pass out. He developed low back pain as well. He was covid positive in October of 2020. The symptoms were still present 4 days later after the vaccine.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Pain in extremity, Syncope
Clinical narrative: Just after midnight patient becam very weak, developed severe bilateral leg pain with cramps, his left ankle was weak and would roll. He couldn't stand and felt as though he was going to pass out. He developed low back pain as well. He was covid positive in October of 2020. The symptoms were still present 4 days later after the vaccine.
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Moderna only FDA approved for 18 and older, patient is 16.
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Syringe issue
Clinical narrative: Patient was administered a prefilled Covid-19 vaccine injection in L deltoid. Patient was monitored for 15 minutes following vaccine administration. Post injection the clinic soon realized the injection was empty without the vaccine present. The "prefilled' Johnson and Johnson vaccine was pulled back to 0.5 ml and individually packed and appeared to be a single use vaccine. The patient was called and notified via phone call of the situation and that the patient unintentionally did not receive COVID-19 immunization. Advised patient to FU for any questions or concerns. Pt was advised to continue to social distance until vaccine can be received. Health department was notified. The patient  was understanding and denies any concerns.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Immediate post-injection reaction, Injection site pain
Clinical narrative: Arm became sore immediately.  About 1 week later client began to wake up at approx. 3AM with numbness in right arm from deltoid area to finger tips.  Continues to do so nightly and pain continues.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Aortic dilatation, Deep vein thrombosis, Lung opacity, Pulmonary embolism
Clinical narrative: Saddle Pulmonary embolus occurred  on March  6th the day following his first COVID-19 vaccine.  He was found to have an extensive right leg DVT but no symptoms.  He has no prior history of DVT/PE, no family history of DVT/PE, No known risk factors  for DVT/PE.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary hypertension, Right ventricular enlargement, Ultrasound Doppler abnormal
Clinical narrative: Saddle Pulmonary embolus occurred  on March  6th the day following his first COVID-19 vaccine.  He was found to have an extensive right leg DVT but no symptoms.  He has no prior history of DVT/PE, no family history of DVT/PE, No known risk factors  for DVT/PE.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: Sore arm for 3-4 days
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Dizziness, Headache, Pain, Pyrexia
Clinical narrative: Terrible headache, body pain, chills, fever of 102.8 F., weakness and dizziness.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Feeling hot, Heart rate increased
Clinical narrative: Chills then a few hours later faster heart rate and feeling very hot. Due 6/17. No pregnancy complications.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Fatigue, Headache, Hyperhidrosis
Clinical narrative: Severe headache started within 6 hrs. of injection. Had a slight rise in temperature to 99.9. Very sleepy and tired. Muscle aches in legs and buttocks. Slight nausea. Took  extra strength Tylenol. Slept off and on for next 24 hours. Had severe sweats and chills.  All symptoms were just like I had had early December, 2020 when I had COVID, as per verified by a COVID nasal test done at local hospital.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Musculoskeletal pain, Myalgia, Nausea, Somnolence
Clinical narrative: Severe headache started within 6 hrs. of injection. Had a slight rise in temperature to 99.9. Very sleepy and tired. Muscle aches in legs and buttocks. Slight nausea. Took  extra strength Tylenol. Slept off and on for next 24 hours. Had severe sweats and chills.  All symptoms were just like I had had early December, 2020 when I had COVID, as per verified by a COVID nasal test done at local hospital.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Rash, Rash papular, Urticaria
Clinical narrative: MONDAY MARCH 8, 2021 , had itching and hives on back, thighs, legs , arms and stomach. They would come and go. On Tuesday it contined and the bumps on legs and thighs were raised. Went to clinic, where I was given a prednisone shot and it helped. All hives cleared within 24 hours. Today March 12th saw my regular doctor and he suggested I report incident.  To see if 2nd dose should be administered on schedule.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Asthenia, Blood test, Fatigue, Gait disturbance
Clinical narrative: Daughter   provided the information for her elderly mother who, at this time, was being evaluated in the ED at Medical Center .   3/5/21 -  approximately 16.5 hrs after her mother's second dose of Covid 19 vaccination, she woke up very weak and felt very tired.  3/6/21 Patient noticed rash (not raised) but reddened in the left upper arm where the injection was given.  She stated it was oval in appearance and covered most of the upper arm.  She noted a lump in her underarm of the left axilla also.  Denied any fever or other symptoms and otherwise felt fine.  On 3/9/21 she noticed a lump in the groin area and noticed that walking was a little more difficult than usual since both of her knees bothered her.  3/12/21Pt went to orthopedic surgeon and had a "cortisone injection" in the right knee.   This afternoon, the patient's daughter suggested that she go a local Urgent Care because the patient stated that the lump (previously in groin area)  "was moving."  She waited in there for over one hour and then a nurse came out and told her to go to the ED for evaluation of her left upper arm for the redness and swelling.  She went directly to the ED and is being evaluation and having bloodwork done.  Daughter said if the lab results are normal, her mother will be discharged with an oral antibiotic and benadryl
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site rash, Lymphadenopathy, Musculoskeletal discomfort
Clinical narrative: Daughter   provided the information for her elderly mother who, at this time, was being evaluated in the ED at Medical Center .   3/5/21 -  approximately 16.5 hrs after her mother's second dose of Covid 19 vaccination, she woke up very weak and felt very tired.  3/6/21 Patient noticed rash (not raised) but reddened in the left upper arm where the injection was given.  She stated it was oval in appearance and covered most of the upper arm.  She noted a lump in her underarm of the left axilla also.  Denied any fever or other symptoms and otherwise felt fine.  On 3/9/21 she noticed a lump in the groin area and noticed that walking was a little more difficult than usual since both of her knees bothered her.  3/12/21Pt went to orthopedic surgeon and had a "cortisone injection" in the right knee.   This afternoon, the patient's daughter suggested that she go a local Urgent Care because the patient stated that the lump (previously in groin area)  "was moving."  She waited in there for over one hour and then a nurse came out and told her to go to the ED for evaluation of her left upper arm for the redness and swelling.  She went directly to the ED and is being evaluation and having bloodwork done.  Daughter said if the lab results are normal, her mother will be discharged with an oral antibiotic and benadryl
Age: 66.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Angina unstable, Chest pain, Condition aggravated, Dyspnoea, Hypertensive urgency
Clinical narrative: The patient presented yesterday to an urgent care center on 3/11/2021 with chest pain, jaw pain, and shortness of breath. He reports multiple occurrences over the past week.  He was sent to the ED, where he was then admitted for hypertensive urgency/emergency vs. unstable angina.
Age: 66.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pain in jaw
Clinical narrative: The patient presented yesterday to an urgent care center on 3/11/2021 with chest pain, jaw pain, and shortness of breath. He reports multiple occurrences over the past week.  He was sent to the ED, where he was then admitted for hypertensive urgency/emergency vs. unstable angina.
Age: 66.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myocardial infarction, Chest pain, Stent placement
Clinical narrative: The patient presented yesterday to an urgent care center on 3/11/2021 with chest pain, jaw pain, and shortness of breath. He reports multiple occurrences over the past week.  He was sent to the ED, where he was then admitted for hypertensive urgency/emergency vs. unstable angina.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Interchange of vaccine products, No adverse event
Clinical narrative: no adverse reaction reported by patient, but was indicated to receive  one Covid19 vaccine NOT other, as her first dose lot# EN6201 expired 06-30-2021 given 2-18-2021.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Patient received Pfizer first dose and Moderna second dose.
Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Dry mouth, Immediate post-injection reaction, Nausea, Oropharyngeal discomfort, Palpitations
Clinical narrative: My heart started racing within a couple of minutes. I felt nauseous and my throat felt like it was closing. My mouth got dry. I had my son with me and didn?t want to scare him so I kept taking deep breaths and focusing on whether the side effect were getting worse. They didn?t. After another 5 minutes I could fee the pressure in my throat lessening and my heart rate slowed. It was terrifying but I?m thankful it didn?t progress. I didn?t seek assistance from the personnel on site. I was aware of what was going on but I?ve had anxiety attacks in the past and thought that was what it may have been until I read that an allergic reaction feels the same. If the second dose is stronger I don?t think it would be wise to attempt receiving that one.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Musculoskeletal stiffness, Nausea, Syncope
Clinical narrative: muscle stiffness during morning walk, nausea while eating cereal, stood up and fainted some nausea while on floor for 2.5 hours sleeping three hours later
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Headache, Lethargy, Nausea, Pain
Clinical narrative: Fever of 102.1, chills, body aches, nausea, headache, lethargy.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Fever of 102.1, chills, body aches, nausea, headache, lethargy.
Age: 97.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: This writer was given a list of clients to visit in the home today to administer the COVID vaccine. This particular client, answered no to having a COVID vaccine before, and to all questions on the questionnaire. This writer then administered the vaccine. While waiting in the home, this writer was walking around the kitchen and saw a note on the fridge that read: "You had your COVID vaccine on 3/9/21." I pointed this out to the client who stated she had no recollection of this note. Caregiver made to employee who confirmed pt had the vaccine previously on that date. Vitals- temp 97.8 pulse- 78 resp- 20 O2- 97% RA BP 130/76. Pt denied any symptoms. Caregiver made to pt's Dr. who advised to contact the family. MD also advised family is to monitor pt for 2 weeks for any side effects. Any concerns, they are to contact his office. MD stated ok to give tylenol PRN fever/pain. MD advised pt dx with dementia. Caregiver made to pt's emergency contact family member who is the DIL. Advised her of the situation. Daughter in law stated she will check in on pt and contact MD office with any concerns. Our on call team leader to follow up with client this evening.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: 16 year old patient administered 1st dose of Moderna COVID-19 vaccine. Parent present with patient.
Sex: F
Vaccine: COVID19
Symptoms: Syncope
Clinical narrative: PATIENT FAINTED AND FELL ON THE FLOOR
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Injection site pain, Injection site swelling, Lymphadenopathy, Pain
Clinical narrative: Reciepient reported fever,chills, body aches, swollen lymph nodes, pain/swelling at injection site. Symptoms started the night of 3/9/21 and have resolved almost resolved as of 3/12/21.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: Reciepient reported fever,chills, body aches, swollen lymph nodes, pain/swelling at injection site. Symptoms started the night of 3/9/21 and have resolved almost resolved as of 3/12/21.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Antiplatelet therapy, Bundle branch block left, Cardiac murmur, Catheterisation cardiac
Clinical narrative: 5. Brief History and Hospital Course:  Patient is a/an 79 y.o. female with a past history significant for HTN, HLD, and DM who presented to facility on 3/9/2021 with complaints of severe 8/10 right jaw pain lasting 3 minutes. EKG with new left BBB and troponin mildly elevated 8-17-35-26. She was seen by Cardiology and determined to have NSTEMI and taken for cardiac cath with drug eluting stent placed to LAD. Echo was also ordered with evidence of murmur. Cavity size is normal. Wall thickness is normal. Systolic function is normal. The estimated ejection fraction is 55%. Dyssynchronous interventricular septal motion, likely related to conduction abnormality/bundle branch block. Grade I diastolic dysfunction. Annulus is severely calcified. Severely calcified and restricted opening of posterior mitral leaflet. Mild mitral valve stenosis at the max.  She remained stable post stent placement. She remained on dual antiplatelet therapy