chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Blood lactic acid, Blood pressure increased, Brain natriuretic peptide increased, COVID-19, Chest X-ray abnormal
Clinical narrative: Patient is an 80 year old gentleman with a past medical history of Parkinson's disease and dementia, T2DM, hypertension, lower extremity edema, impaired mobility, falls, BPH, OSA who has been admitted to Hospital 11/9/2023 with weakness and lethargy, COVID-19 infection.   Sepsis Possible aspiration pneumonia Present on admission: no Etiology: Unclear etiology, possible aspiration pneumonia SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90 Cautious IV fluids due to volume status. Check blood and urine cultures Check x-ray of the chest showed new bibasilar infiltrates. Lactic acid 1.0 Start vancomycin and Zosyn Obtain CT brain due to worsening encephalopathy Check CBC, CMP, and ammonia Mental status back to baseline, continue course of antibiotics on discharge Patient stable for discharge with close outpatient follow-up   Acute metabolic encephalopathy, improving Weakness Lethargy Falls History of dementia and Parkinson's, see below; acute encephalopathy likely exacerbated by COVID-19 PT/OT/CM following We will need SNF placement     Acute hypoxemic respiratory failure, now resolved Covid-19 Virus Infection, resolved Possible covid Encephalopathy  Date of onset of symptoms: 11/7/2023  Date of covid positive test: 11/9/2023 Vaccination status: vaccinated Imaging: CXR 11/9 no acute findings Medical therapy: Remdesivir, finishing 11/13; IV steroids.  Discontinue steroids since he is on room air BNP was elevated at 1351, s/p IV diuresis Symptoms of COVID resolved and the patient can come out of isolation Mechanical Fall  Low back pain  Knee pain  Images reviewed , no fracture or dislocation Pain control  Avoid narcotics given the patient's altered mental status PRN Tylenol PT/OT   Acute kidney injury, resolved Baseline Cr appears to be ~0.8-1 Of note patient did receive IV diuresis on admission, now stopped Holding losartan as below   Hypertension Elevated blood pressure on admission Holding losartan due to AKI.  Can resume on discharge and will need to follow-up kidney functions as an outpatient. Hydralazine 10 mg IV as needed every 6 hours for elevated blood pressure BP well controlled at this time   Parkinsonism Dementia Continue carbidopa levodopa, donepezil   Dysphagia Noted per SLP evaluation Follow dietary recommendations   NIDDM2 Diet controlled Keep BG between 140 and 180 Last A1c x3 less than 6   BPH Tamsulosin Foley Anemia Continue to monitor Outpatient evaluation and management
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Computerised tomogram head abnormal, Culture urine, Diuretic therapy, Dysphagia
Clinical narrative: Patient is an 80 year old gentleman with a past medical history of Parkinson's disease and dementia, T2DM, hypertension, lower extremity edema, impaired mobility, falls, BPH, OSA who has been admitted to Hospital 11/9/2023 with weakness and lethargy, COVID-19 infection.   Sepsis Possible aspiration pneumonia Present on admission: no Etiology: Unclear etiology, possible aspiration pneumonia SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90 Cautious IV fluids due to volume status. Check blood and urine cultures Check x-ray of the chest showed new bibasilar infiltrates. Lactic acid 1.0 Start vancomycin and Zosyn Obtain CT brain due to worsening encephalopathy Check CBC, CMP, and ammonia Mental status back to baseline, continue course of antibiotics on discharge Patient stable for discharge with close outpatient follow-up   Acute metabolic encephalopathy, improving Weakness Lethargy Falls History of dementia and Parkinson's, see below; acute encephalopathy likely exacerbated by COVID-19 PT/OT/CM following We will need SNF placement     Acute hypoxemic respiratory failure, now resolved Covid-19 Virus Infection, resolved Possible covid Encephalopathy  Date of onset of symptoms: 11/7/2023  Date of covid positive test: 11/9/2023 Vaccination status: vaccinated Imaging: CXR 11/9 no acute findings Medical therapy: Remdesivir, finishing 11/13; IV steroids.  Discontinue steroids since he is on room air BNP was elevated at 1351, s/p IV diuresis Symptoms of COVID resolved and the patient can come out of isolation Mechanical Fall  Low back pain  Knee pain  Images reviewed , no fracture or dislocation Pain control  Avoid narcotics given the patient's altered mental status PRN Tylenol PT/OT   Acute kidney injury, resolved Baseline Cr appears to be ~0.8-1 Of note patient did receive IV diuresis on admission, now stopped Holding losartan as below   Hypertension Elevated blood pressure on admission Holding losartan due to AKI.  Can resume on discharge and will need to follow-up kidney functions as an outpatient. Hydralazine 10 mg IV as needed every 6 hours for elevated blood pressure BP well controlled at this time   Parkinsonism Dementia Continue carbidopa levodopa, donepezil   Dysphagia Noted per SLP evaluation Follow dietary recommendations   NIDDM2 Diet controlled Keep BG between 140 and 180 Last A1c x3 less than 6   BPH Tamsulosin Foley Anemia Continue to monitor Outpatient evaluation and management
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Fall, Full blood count, Hypertension, Lethargy, Lung infiltration
Clinical narrative: Patient is an 80 year old gentleman with a past medical history of Parkinson's disease and dementia, T2DM, hypertension, lower extremity edema, impaired mobility, falls, BPH, OSA who has been admitted to Hospital 11/9/2023 with weakness and lethargy, COVID-19 infection.   Sepsis Possible aspiration pneumonia Present on admission: no Etiology: Unclear etiology, possible aspiration pneumonia SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90 Cautious IV fluids due to volume status. Check blood and urine cultures Check x-ray of the chest showed new bibasilar infiltrates. Lactic acid 1.0 Start vancomycin and Zosyn Obtain CT brain due to worsening encephalopathy Check CBC, CMP, and ammonia Mental status back to baseline, continue course of antibiotics on discharge Patient stable for discharge with close outpatient follow-up   Acute metabolic encephalopathy, improving Weakness Lethargy Falls History of dementia and Parkinson's, see below; acute encephalopathy likely exacerbated by COVID-19 PT/OT/CM following We will need SNF placement     Acute hypoxemic respiratory failure, now resolved Covid-19 Virus Infection, resolved Possible covid Encephalopathy  Date of onset of symptoms: 11/7/2023  Date of covid positive test: 11/9/2023 Vaccination status: vaccinated Imaging: CXR 11/9 no acute findings Medical therapy: Remdesivir, finishing 11/13; IV steroids.  Discontinue steroids since he is on room air BNP was elevated at 1351, s/p IV diuresis Symptoms of COVID resolved and the patient can come out of isolation Mechanical Fall  Low back pain  Knee pain  Images reviewed , no fracture or dislocation Pain control  Avoid narcotics given the patient's altered mental status PRN Tylenol PT/OT   Acute kidney injury, resolved Baseline Cr appears to be ~0.8-1 Of note patient did receive IV diuresis on admission, now stopped Holding losartan as below   Hypertension Elevated blood pressure on admission Holding losartan due to AKI.  Can resume on discharge and will need to follow-up kidney functions as an outpatient. Hydralazine 10 mg IV as needed every 6 hours for elevated blood pressure BP well controlled at this time   Parkinsonism Dementia Continue carbidopa levodopa, donepezil   Dysphagia Noted per SLP evaluation Follow dietary recommendations   NIDDM2 Diet controlled Keep BG between 140 and 180 Last A1c x3 less than 6   BPH Tamsulosin Foley Anemia Continue to monitor Outpatient evaluation and management
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Mental status changes, Metabolic encephalopathy, Metabolic function test, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Patient is an 80 year old gentleman with a past medical history of Parkinson's disease and dementia, T2DM, hypertension, lower extremity edema, impaired mobility, falls, BPH, OSA who has been admitted to Hospital 11/9/2023 with weakness and lethargy, COVID-19 infection.   Sepsis Possible aspiration pneumonia Present on admission: no Etiology: Unclear etiology, possible aspiration pneumonia SIRS criteria: Temperature greater than 100.4 or less than 96.8, Heart rate greater than 90 Cautious IV fluids due to volume status. Check blood and urine cultures Check x-ray of the chest showed new bibasilar infiltrates. Lactic acid 1.0 Start vancomycin and Zosyn Obtain CT brain due to worsening encephalopathy Check CBC, CMP, and ammonia Mental status back to baseline, continue course of antibiotics on discharge Patient stable for discharge with close outpatient follow-up   Acute metabolic encephalopathy, improving Weakness Lethargy Falls History of dementia and Parkinson's, see below; acute encephalopathy likely exacerbated by COVID-19 PT/OT/CM following We will need SNF placement     Acute hypoxemic respiratory failure, now resolved Covid-19 Virus Infection, resolved Possible covid Encephalopathy  Date of onset of symptoms: 11/7/2023  Date of covid positive test: 11/9/2023 Vaccination status: vaccinated Imaging: CXR 11/9 no acute findings Medical therapy: Remdesivir, finishing 11/13; IV steroids.  Discontinue steroids since he is on room air BNP was elevated at 1351, s/p IV diuresis Symptoms of COVID resolved and the patient can come out of isolation Mechanical Fall  Low back pain  Knee pain  Images reviewed , no fracture or dislocation Pain control  Avoid narcotics given the patient's altered mental status PRN Tylenol PT/OT   Acute kidney injury, resolved Baseline Cr appears to be ~0.8-1 Of note patient did receive IV diuresis on admission, now stopped Holding losartan as below   Hypertension Elevated blood pressure on admission Holding losartan due to AKI.  Can resume on discharge and will need to follow-up kidney functions as an outpatient. Hydralazine 10 mg IV as needed every 6 hours for elevated blood pressure BP well controlled at this time   Parkinsonism Dementia Continue carbidopa levodopa, donepezil   Dysphagia Noted per SLP evaluation Follow dietary recommendations   NIDDM2 Diet controlled Keep BG between 140 and 180 Last A1c x3 less than 6   BPH Tamsulosin Foley Anemia Continue to monitor Outpatient evaluation and management
Age: 79.0
Sex: F
Vaccine: FLUA4
Symptoms: Injection site erythema, Injection site pain
Clinical narrative: Soreness and redness of the injection site that won't go away
Age: 66.0
Sex: M
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: VACCINE FROZEN INSTAD OF REFRIGERATED
Age: 64.0
Sex: F
Vaccine: VARZOS
Symptoms: Abdominal pain upper, Chills, Headache, Injection site pain, Injection site swelling
Clinical narrative: Headache, muscle aches, swelling and pain at site of injection, fever, chills, stomach pain
Age: 64.0
Sex: F
Vaccine: VARZOS
Symptoms: Myalgia, Pyrexia
Clinical narrative: Headache, muscle aches, swelling and pain at site of injection, fever, chills, stomach pain
Age: 13.0
Sex: F
Vaccine: UNK
Symptoms: Extra dose administered, No adverse event
Clinical narrative: pt has no sxs, extra hpv was mistake given by ma
Age: 68.0
Sex: F
Vaccine: RSV
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Patient was given a send RSV vaccine. Pt received  Abrysvo 12/18/23 and came in on 12/27/23 asking for another RSV vaccine and recieved Arexvy on 12/27/23. Pt didn't have any symptoms as of  12/28/23 at 9:58am
Age: 66.0
Sex: M
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: VACCINE FROZEN INSTEAD OF REFRIGERATED
Age: 4.0
Sex: M
Vaccine: FLUN4
Symptoms: No adverse event
Clinical narrative: No adverse event occured.
Age: 1.83
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product preparation error
Clinical narrative: No diluent used with vaccine, resulting in higher than authorized dose.  0.3 mL of undiluted vaccine administered. Patient made aware of error and advised to monitor for adverse reactions.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Arthralgia, Asthenia, Atrial fibrillation, COVID-19
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of atrial fibrillation, HTN, OSA, GERD, fibromyalgia, hypothyroidism presented to Hospital with weakness, cough, vomiting, SOB, palpitations noted to have COVID infection and atrial fibrillation in RVR.     Acute hypoxic respiratory failure Covid-19 Virus Infection Date of onset of symptoms: 11/15/2023 Symptoms present on admission: weakness, fatigue, dyspnea, cough Date of covid positive test: 11/17/2023 Vaccination status: vaccinated Imaging: CXR non-acute Oxygen requirements on admission: none Current oxygen requirements: 1 L NC Medical therapy: S/p IV azithromycin and IV ceftriaxone ID was consulted Patient is out of isolation     Permanent atrial fibrillation In RVR on admission S/p Cardizem drip, remains rate controlled Cardiology was consulted and has signed off Echocardiogram pending still - hopefully can be completed prior to discharge Goal Mg ~2 and K ~4 Meds: Metoprolol, lisinopril, warfarin   Hypothyroidism Continue current levothyroxine   Fibromyalgia Left shoulder pain Noted per ID on 11/22, XR L shoulder: moderate degenerative change of left AC joint, subacromial narrowing suggestive of rotator cuff pathology Continue home Lyrica   Generalized weakness PT/OT, scaling for HHC  Care management   Migraines--doing better Tylenol and tramadol as needed Flexeril as needed
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Condition aggravated, Cough, Dyspnoea, Fatigue
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of atrial fibrillation, HTN, OSA, GERD, fibromyalgia, hypothyroidism presented to Hospital with weakness, cough, vomiting, SOB, palpitations noted to have COVID infection and atrial fibrillation in RVR.     Acute hypoxic respiratory failure Covid-19 Virus Infection Date of onset of symptoms: 11/15/2023 Symptoms present on admission: weakness, fatigue, dyspnea, cough Date of covid positive test: 11/17/2023 Vaccination status: vaccinated Imaging: CXR non-acute Oxygen requirements on admission: none Current oxygen requirements: 1 L NC Medical therapy: S/p IV azithromycin and IV ceftriaxone ID was consulted Patient is out of isolation     Permanent atrial fibrillation In RVR on admission S/p Cardizem drip, remains rate controlled Cardiology was consulted and has signed off Echocardiogram pending still - hopefully can be completed prior to discharge Goal Mg ~2 and K ~4 Meds: Metoprolol, lisinopril, warfarin   Hypothyroidism Continue current levothyroxine   Fibromyalgia Left shoulder pain Noted per ID on 11/22, XR L shoulder: moderate degenerative change of left AC joint, subacromial narrowing suggestive of rotator cuff pathology Continue home Lyrica   Generalized weakness PT/OT, scaling for HHC  Care management   Migraines--doing better Tylenol and tramadol as needed Flexeril as needed
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Migraine, Osteoarthritis, Palpitations, Rotator cuff syndrome, Vomiting
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of atrial fibrillation, HTN, OSA, GERD, fibromyalgia, hypothyroidism presented to Hospital with weakness, cough, vomiting, SOB, palpitations noted to have COVID infection and atrial fibrillation in RVR.     Acute hypoxic respiratory failure Covid-19 Virus Infection Date of onset of symptoms: 11/15/2023 Symptoms present on admission: weakness, fatigue, dyspnea, cough Date of covid positive test: 11/17/2023 Vaccination status: vaccinated Imaging: CXR non-acute Oxygen requirements on admission: none Current oxygen requirements: 1 L NC Medical therapy: S/p IV azithromycin and IV ceftriaxone ID was consulted Patient is out of isolation     Permanent atrial fibrillation In RVR on admission S/p Cardizem drip, remains rate controlled Cardiology was consulted and has signed off Echocardiogram pending still - hopefully can be completed prior to discharge Goal Mg ~2 and K ~4 Meds: Metoprolol, lisinopril, warfarin   Hypothyroidism Continue current levothyroxine   Fibromyalgia Left shoulder pain Noted per ID on 11/22, XR L shoulder: moderate degenerative change of left AC joint, subacromial narrowing suggestive of rotator cuff pathology Continue home Lyrica   Generalized weakness PT/OT, scaling for HHC  Care management   Migraines--doing better Tylenol and tramadol as needed Flexeril as needed
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: X-ray limb abnormal
Clinical narrative: Patient is a 80 y.o. female patient of MD with history of atrial fibrillation, HTN, OSA, GERD, fibromyalgia, hypothyroidism presented to Hospital with weakness, cough, vomiting, SOB, palpitations noted to have COVID infection and atrial fibrillation in RVR.     Acute hypoxic respiratory failure Covid-19 Virus Infection Date of onset of symptoms: 11/15/2023 Symptoms present on admission: weakness, fatigue, dyspnea, cough Date of covid positive test: 11/17/2023 Vaccination status: vaccinated Imaging: CXR non-acute Oxygen requirements on admission: none Current oxygen requirements: 1 L NC Medical therapy: S/p IV azithromycin and IV ceftriaxone ID was consulted Patient is out of isolation     Permanent atrial fibrillation In RVR on admission S/p Cardizem drip, remains rate controlled Cardiology was consulted and has signed off Echocardiogram pending still - hopefully can be completed prior to discharge Goal Mg ~2 and K ~4 Meds: Metoprolol, lisinopril, warfarin   Hypothyroidism Continue current levothyroxine   Fibromyalgia Left shoulder pain Noted per ID on 11/22, XR L shoulder: moderate degenerative change of left AC joint, subacromial narrowing suggestive of rotator cuff pathology Continue home Lyrica   Generalized weakness PT/OT, scaling for HHC  Care management   Migraines--doing better Tylenol and tramadol as needed Flexeril as needed
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal distension, Asthenia, Chills, Decreased appetite, Lethargy
Clinical narrative: I usually do not have severe reactions to vaccines. However, with the Pfizer COVID-19 vaccine I had severe reactions and a mild seizure with the fifth dose. I was too ill from the reactions to travel to my physician's office, but I did communicate there by e-mail and telephone. These prior reactions were reported.  This year, I had the dilemma of what to do about getting another COVID-19 vaccine. I could get little or no guidance. This time my physician told her assistant to tell me that it was my decision about getting the vaccine and she would enter the office after I decided what to do (ie, get the vaccine or not). Having been hospitalized with COVID-19 in 2021, I really did not want to have it again. So, I decided to try the Moderna Spikevax this time. The lot number was 208f23-29 with exp date of 5/17/24. Having had a partial mastectomy on the left side and a fractured right arm, it was given in the right buttock.  I hoped for the best, but unfortunately I again suffered a severe reaction with the Moderna. I did not have a seizure this time.  I again was too ill due to the vaqccine reaction to travel to the doctor's office. There was some communication by e-mail.  I feel very strongly that a warning needs to be issued for senior citizens and disabled individuals that they should be prepared to be fully incapacitated for up to several days after this vaccine and they should take necessary precautions. The degree of fever and chills that I experienced for several days after the vaccine is not normal and it is very debilitating. If this happened when I was older and more in more debiltated condition I believe that it would cause an even more severe stress upon my body with potentially worse outcomes. Some degree of fever and chills is reasonable, but not to the exagerated degree that it knocks you off your feet and you are incapable of normal functioning. The first day fever remained in the 102 range and it went up to 101 the second night. The third day my temperature was still not stable. I expereinced severe body aches, chills, nausea, loss of appetite, lethargy, weakness etc. The first day I was pretty much confined to bed. The seondary risks also need to be taken into consideration and should not be ignored. On the fifth day I was in a very weakened state with a very large swelling at the injection site. One week later I was still not fully recovered.   I am not opposed to vaccines, but I have great concern about my reactions to the COVID-19 vaccines. These have been severe reactions causing incapacitation and inability to function normally. It also raises the risk for fall, injury etc.  I am getting no reasonable guidance or explanation for these severe reactions. At this point I am questioning if I am having severe reactions because it is an mRNA vaccine. Until I can get some clear cut answers and guidance I am going to be forced to defer any future mRNA vaccines.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Mobility decreased, Pain, Pyrexia, Seizure
Clinical narrative: I usually do not have severe reactions to vaccines. However, with the Pfizer COVID-19 vaccine I had severe reactions and a mild seizure with the fifth dose. I was too ill from the reactions to travel to my physician's office, but I did communicate there by e-mail and telephone. These prior reactions were reported.  This year, I had the dilemma of what to do about getting another COVID-19 vaccine. I could get little or no guidance. This time my physician told her assistant to tell me that it was my decision about getting the vaccine and she would enter the office after I decided what to do (ie, get the vaccine or not). Having been hospitalized with COVID-19 in 2021, I really did not want to have it again. So, I decided to try the Moderna Spikevax this time. The lot number was 208f23-29 with exp date of 5/17/24. Having had a partial mastectomy on the left side and a fractured right arm, it was given in the right buttock.  I hoped for the best, but unfortunately I again suffered a severe reaction with the Moderna. I did not have a seizure this time.  I again was too ill due to the vaqccine reaction to travel to the doctor's office. There was some communication by e-mail.  I feel very strongly that a warning needs to be issued for senior citizens and disabled individuals that they should be prepared to be fully incapacitated for up to several days after this vaccine and they should take necessary precautions. The degree of fever and chills that I experienced for several days after the vaccine is not normal and it is very debilitating. If this happened when I was older and more in more debiltated condition I believe that it would cause an even more severe stress upon my body with potentially worse outcomes. Some degree of fever and chills is reasonable, but not to the exagerated degree that it knocks you off your feet and you are incapable of normal functioning. The first day fever remained in the 102 range and it went up to 101 the second night. The third day my temperature was still not stable. I expereinced severe body aches, chills, nausea, loss of appetite, lethargy, weakness etc. The first day I was pretty much confined to bed. The seondary risks also need to be taken into consideration and should not be ignored. On the fifth day I was in a very weakened state with a very large swelling at the injection site. One week later I was still not fully recovered.   I am not opposed to vaccines, but I have great concern about my reactions to the COVID-19 vaccines. These have been severe reactions causing incapacitation and inability to function normally. It also raises the risk for fall, injury etc.  I am getting no reasonable guidance or explanation for these severe reactions. At this point I am questioning if I am having severe reactions because it is an mRNA vaccine. Until I can get some clear cut answers and guidance I am going to be forced to defer any future mRNA vaccines.
Age: 74.0
Sex: F
Vaccine: RSV
Symptoms: Lip pruritus, Pruritus
Clinical narrative: Patient states experiencing itching of lips and face that is controlled with liquid Benadryl.
Age: 96.0
Sex: F
Vaccine: COVID19, FLUA4
Symptoms: Heart rate irregular
Clinical narrative: Patient stated she was at an MD appointment and they sent her directly to the hospital for an irregular heartbeat. Patient stated she was hospitalized for several days and is now being evaluated for a pacemaker. Patient stated she is contributing these events to receiving the Spikevax vaccine two weeks prior.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Blood thyroid stimulating hormone increased, COVID-19, Chest X-ray normal, Chronic obstructive pulmonary disease
Clinical narrative: Patient is a 68 y.o. female patient of No primary care provider on file. with a history of shortness of breath    Discharge Diagnoses:   1. Covid-19 Virus Infection Date of onset of symptoms: 11/20/23 Symptoms present on admission: cough, SOB, leg pain, back pain Date of covid positive test: 11/22/23 Vaccination status: vaccinated once with J&J Imaging: 11/22/23: CXR: nothing acute Oxygen requirements on admission: 2 L NC Current oxygen requirements: 2 L NC per home regimen Medical therapy: steroids started 11/23/23 Consultants following: not at this tiime Anticipated special isolation end date: 11/30/23    2. COPD exac 3. Chr resp failure; wears 2 L NC at home 4. Current smoker   For the above - duoneb tx q 6 hrs - goal o2 sat is 88-92 % - routine VS with pulse ox checks - encourage smoking cessation    5. Hypothyroid - July TSH 5.16 - will cont synthroid 75 mcg daily while here   6. Chr pain syndrome - will cont home Lyrica and Mobic while here   7. HTN - will cont home Norvasc while here - July 2023 normal STT     8. Multiple wounds left hand - left thumb, index, and middle fingers all with various wounds. Do not appear infected. Keep dressed with gauze.    Patient presented to hospital with shortness of breath on November 22.  As she has known COPD and is supposed to wear 2 L of oxygen at home although she reports that she does not even use it at night.  She was found to be COVID-positive.  Has previously been vaccinated.  Was initiated on dexamethasone.  Patient currently is doing well on 2 L here.  Does states she is uncertain of the oxygen she has set up home will consult care management to make sure that patient can get her 2 L continuous and discussed the importance of using this.   Patient feels back to her baseline and is requesting discharge.  Is to follow-up closely outpatient with primary care.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic respiratory failure, Condition aggravated, Cough, Dyspnoea, Hypertension
Clinical narrative: Patient is a 68 y.o. female patient of No primary care provider on file. with a history of shortness of breath    Discharge Diagnoses:   1. Covid-19 Virus Infection Date of onset of symptoms: 11/20/23 Symptoms present on admission: cough, SOB, leg pain, back pain Date of covid positive test: 11/22/23 Vaccination status: vaccinated once with J&J Imaging: 11/22/23: CXR: nothing acute Oxygen requirements on admission: 2 L NC Current oxygen requirements: 2 L NC per home regimen Medical therapy: steroids started 11/23/23 Consultants following: not at this tiime Anticipated special isolation end date: 11/30/23    2. COPD exac 3. Chr resp failure; wears 2 L NC at home 4. Current smoker   For the above - duoneb tx q 6 hrs - goal o2 sat is 88-92 % - routine VS with pulse ox checks - encourage smoking cessation    5. Hypothyroid - July TSH 5.16 - will cont synthroid 75 mcg daily while here   6. Chr pain syndrome - will cont home Lyrica and Mobic while here   7. HTN - will cont home Norvasc while here - July 2023 normal STT     8. Multiple wounds left hand - left thumb, index, and middle fingers all with various wounds. Do not appear infected. Keep dressed with gauze.    Patient presented to hospital with shortness of breath on November 22.  As she has known COPD and is supposed to wear 2 L of oxygen at home although she reports that she does not even use it at night.  She was found to be COVID-positive.  Has previously been vaccinated.  Was initiated on dexamethasone.  Patient currently is doing well on 2 L here.  Does states she is uncertain of the oxygen she has set up home will consult care management to make sure that patient can get her 2 L continuous and discussed the importance of using this.   Patient feels back to her baseline and is requesting discharge.  Is to follow-up closely outpatient with primary care.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Hypothyroidism, Limb injury, Pain, Pain in extremity, SARS-CoV-2 test positive
Clinical narrative: Patient is a 68 y.o. female patient of No primary care provider on file. with a history of shortness of breath    Discharge Diagnoses:   1. Covid-19 Virus Infection Date of onset of symptoms: 11/20/23 Symptoms present on admission: cough, SOB, leg pain, back pain Date of covid positive test: 11/22/23 Vaccination status: vaccinated once with J&J Imaging: 11/22/23: CXR: nothing acute Oxygen requirements on admission: 2 L NC Current oxygen requirements: 2 L NC per home regimen Medical therapy: steroids started 11/23/23 Consultants following: not at this tiime Anticipated special isolation end date: 11/30/23    2. COPD exac 3. Chr resp failure; wears 2 L NC at home 4. Current smoker   For the above - duoneb tx q 6 hrs - goal o2 sat is 88-92 % - routine VS with pulse ox checks - encourage smoking cessation    5. Hypothyroid - July TSH 5.16 - will cont synthroid 75 mcg daily while here   6. Chr pain syndrome - will cont home Lyrica and Mobic while here   7. HTN - will cont home Norvasc while here - July 2023 normal STT     8. Multiple wounds left hand - left thumb, index, and middle fingers all with various wounds. Do not appear infected. Keep dressed with gauze.    Patient presented to hospital with shortness of breath on November 22.  As she has known COPD and is supposed to wear 2 L of oxygen at home although she reports that she does not even use it at night.  She was found to be COVID-positive.  Has previously been vaccinated.  Was initiated on dexamethasone.  Patient currently is doing well on 2 L here.  Does states she is uncertain of the oxygen she has set up home will consult care management to make sure that patient can get her 2 L continuous and discussed the importance of using this.   Patient feels back to her baseline and is requesting discharge.  Is to follow-up closely outpatient with primary care.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Tobacco user
Clinical narrative: Patient is a 68 y.o. female patient of No primary care provider on file. with a history of shortness of breath    Discharge Diagnoses:   1. Covid-19 Virus Infection Date of onset of symptoms: 11/20/23 Symptoms present on admission: cough, SOB, leg pain, back pain Date of covid positive test: 11/22/23 Vaccination status: vaccinated once with J&J Imaging: 11/22/23: CXR: nothing acute Oxygen requirements on admission: 2 L NC Current oxygen requirements: 2 L NC per home regimen Medical therapy: steroids started 11/23/23 Consultants following: not at this tiime Anticipated special isolation end date: 11/30/23    2. COPD exac 3. Chr resp failure; wears 2 L NC at home 4. Current smoker   For the above - duoneb tx q 6 hrs - goal o2 sat is 88-92 % - routine VS with pulse ox checks - encourage smoking cessation    5. Hypothyroid - July TSH 5.16 - will cont synthroid 75 mcg daily while here   6. Chr pain syndrome - will cont home Lyrica and Mobic while here   7. HTN - will cont home Norvasc while here - July 2023 normal STT     8. Multiple wounds left hand - left thumb, index, and middle fingers all with various wounds. Do not appear infected. Keep dressed with gauze.    Patient presented to hospital with shortness of breath on November 22.  As she has known COPD and is supposed to wear 2 L of oxygen at home although she reports that she does not even use it at night.  She was found to be COVID-positive.  Has previously been vaccinated.  Was initiated on dexamethasone.  Patient currently is doing well on 2 L here.  Does states she is uncertain of the oxygen she has set up home will consult care management to make sure that patient can get her 2 L continuous and discussed the importance of using this.   Patient feels back to her baseline and is requesting discharge.  Is to follow-up closely outpatient with primary care.
Age: 10.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: 10 year old patient was vaccinated with Moderna Spikevax 12yr and up vaccine
Age: 74.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Back pain, Blood culture positive, Blood lactic acid increased, Bronchomalacia
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of COPD, chronic hypoxemic respiratory failure, HTN, HLD, PAF, GAD, who presented to Hospital with shortness of breath.   COVID 19 Infection Acute on chronic hypoxemic respiratory failure: COPD exacerbation Elevated lactic acid is clinically undetermined  Baseline oxygen 2 L Date of onset of symptoms: 11/18/2023 Symptoms present on admission: cough, SOB Date of covid positive test: 11/18/23 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: BiPAP now improving on baseline 02 , 2lts  Current oxygen requirements: 3 Lpm by NC Medical therapy: remdesivir and steroids; Dulera, Spiriva, Albuterol PRN Consultants following: ID and pulmonology Anticipated special isolation end date: 11/28/2023 Respiratory status back to baseline 2lt NC with adequate saturation    Severe Sepsis, POA, resolved Enterococcus faecium bacteremia VRE Blood cultures 11/18 positive for E faecium VRE , repeat blood cultures 11/20 NGTD CT scan of the chest abdomen and pelvis, with changes of COPD, right lower lobectomy noted.  Trachea bronchomalacia noted, and compression deformity of T6.  Diverticulosis of the colon with no obvious diverticu  Daptomycin added 11/19 Continue Zosyn Consult to infectious disease Follow-up echocardiogram 1. Limited transthoracic echocardiogram is performed to interrogate valves for endocarditis.Patient unable to tolerate study due to dyspnea and inability to lie flat. No pericardial effusion. Grossly normal right ventricular size and function. Remaining intracardiac structures incompletely visualized on this limited study. Midline will be placed and coordination of antibiotics as an OP with HHC  F/u with ID  Lower extremities edema bilaterally  TTE attempting to repeat since initial once poor quality  ProBNP 400 S/p lasix  F/u with PCP    Back pain due to compression deformity of T6  Cont pain control  Will consult orthopedic in AM  MRI- No evidence of infection in the lumbar spine. No central spinal stenosis or neural foraminal stenosis. Subacute mild compression fracture of the superior endplate of T6 with resultant about 25% decrease in vertebral height, marrow edema and minimal prevertebral edema. No evidence of infection in the thoracic spine.      Costochondritis Ultram as needed Flexeril as needed     HTN: Metoprolol   GAD: Trintellix Ativan PRN  PAF: Metoprolol and Eliquis   HLD: Atorvastatin
Age: 74.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Catheter placement, Chest X-ray, Chronic obstructive pulmonary disease, Computerised tomogram abdomen abnormal
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of COPD, chronic hypoxemic respiratory failure, HTN, HLD, PAF, GAD, who presented to Hospital with shortness of breath.   COVID 19 Infection Acute on chronic hypoxemic respiratory failure: COPD exacerbation Elevated lactic acid is clinically undetermined  Baseline oxygen 2 L Date of onset of symptoms: 11/18/2023 Symptoms present on admission: cough, SOB Date of covid positive test: 11/18/23 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: BiPAP now improving on baseline 02 , 2lts  Current oxygen requirements: 3 Lpm by NC Medical therapy: remdesivir and steroids; Dulera, Spiriva, Albuterol PRN Consultants following: ID and pulmonology Anticipated special isolation end date: 11/28/2023 Respiratory status back to baseline 2lt NC with adequate saturation    Severe Sepsis, POA, resolved Enterococcus faecium bacteremia VRE Blood cultures 11/18 positive for E faecium VRE , repeat blood cultures 11/20 NGTD CT scan of the chest abdomen and pelvis, with changes of COPD, right lower lobectomy noted.  Trachea bronchomalacia noted, and compression deformity of T6.  Diverticulosis of the colon with no obvious diverticu  Daptomycin added 11/19 Continue Zosyn Consult to infectious disease Follow-up echocardiogram 1. Limited transthoracic echocardiogram is performed to interrogate valves for endocarditis.Patient unable to tolerate study due to dyspnea and inability to lie flat. No pericardial effusion. Grossly normal right ventricular size and function. Remaining intracardiac structures incompletely visualized on this limited study. Midline will be placed and coordination of antibiotics as an OP with HHC  F/u with ID  Lower extremities edema bilaterally  TTE attempting to repeat since initial once poor quality  ProBNP 400 S/p lasix  F/u with PCP    Back pain due to compression deformity of T6  Cont pain control  Will consult orthopedic in AM  MRI- No evidence of infection in the lumbar spine. No central spinal stenosis or neural foraminal stenosis. Subacute mild compression fracture of the superior endplate of T6 with resultant about 25% decrease in vertebral height, marrow edema and minimal prevertebral edema. No evidence of infection in the thoracic spine.      Costochondritis Ultram as needed Flexeril as needed     HTN: Metoprolol   GAD: Trintellix Ativan PRN  PAF: Metoprolol and Eliquis   HLD: Atorvastatin
Age: 74.0
Sex: M
Vaccine: COVID19-2
Symptoms: Condition aggravated, Costochondritis, Cough, Diverticulum intestinal, Dyspnoea
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of COPD, chronic hypoxemic respiratory failure, HTN, HLD, PAF, GAD, who presented to Hospital with shortness of breath.   COVID 19 Infection Acute on chronic hypoxemic respiratory failure: COPD exacerbation Elevated lactic acid is clinically undetermined  Baseline oxygen 2 L Date of onset of symptoms: 11/18/2023 Symptoms present on admission: cough, SOB Date of covid positive test: 11/18/23 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: BiPAP now improving on baseline 02 , 2lts  Current oxygen requirements: 3 Lpm by NC Medical therapy: remdesivir and steroids; Dulera, Spiriva, Albuterol PRN Consultants following: ID and pulmonology Anticipated special isolation end date: 11/28/2023 Respiratory status back to baseline 2lt NC with adequate saturation    Severe Sepsis, POA, resolved Enterococcus faecium bacteremia VRE Blood cultures 11/18 positive for E faecium VRE , repeat blood cultures 11/20 NGTD CT scan of the chest abdomen and pelvis, with changes of COPD, right lower lobectomy noted.  Trachea bronchomalacia noted, and compression deformity of T6.  Diverticulosis of the colon with no obvious diverticu  Daptomycin added 11/19 Continue Zosyn Consult to infectious disease Follow-up echocardiogram 1. Limited transthoracic echocardiogram is performed to interrogate valves for endocarditis.Patient unable to tolerate study due to dyspnea and inability to lie flat. No pericardial effusion. Grossly normal right ventricular size and function. Remaining intracardiac structures incompletely visualized on this limited study. Midline will be placed and coordination of antibiotics as an OP with HHC  F/u with ID  Lower extremities edema bilaterally  TTE attempting to repeat since initial once poor quality  ProBNP 400 S/p lasix  F/u with PCP    Back pain due to compression deformity of T6  Cont pain control  Will consult orthopedic in AM  MRI- No evidence of infection in the lumbar spine. No central spinal stenosis or neural foraminal stenosis. Subacute mild compression fracture of the superior endplate of T6 with resultant about 25% decrease in vertebral height, marrow edema and minimal prevertebral edema. No evidence of infection in the thoracic spine.      Costochondritis Ultram as needed Flexeril as needed     HTN: Metoprolol   GAD: Trintellix Ativan PRN  PAF: Metoprolol and Eliquis   HLD: Atorvastatin
Age: 74.0
Sex: M
Vaccine: COVID19-2
Symptoms: Echocardiogram, Enterococcal bacteraemia, Enterococcus test positive, Magnetic resonance imaging spinal abnormal, N-terminal prohormone brain natriuretic peptide increased
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of COPD, chronic hypoxemic respiratory failure, HTN, HLD, PAF, GAD, who presented to Hospital with shortness of breath.   COVID 19 Infection Acute on chronic hypoxemic respiratory failure: COPD exacerbation Elevated lactic acid is clinically undetermined  Baseline oxygen 2 L Date of onset of symptoms: 11/18/2023 Symptoms present on admission: cough, SOB Date of covid positive test: 11/18/23 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: BiPAP now improving on baseline 02 , 2lts  Current oxygen requirements: 3 Lpm by NC Medical therapy: remdesivir and steroids; Dulera, Spiriva, Albuterol PRN Consultants following: ID and pulmonology Anticipated special isolation end date: 11/28/2023 Respiratory status back to baseline 2lt NC with adequate saturation    Severe Sepsis, POA, resolved Enterococcus faecium bacteremia VRE Blood cultures 11/18 positive for E faecium VRE , repeat blood cultures 11/20 NGTD CT scan of the chest abdomen and pelvis, with changes of COPD, right lower lobectomy noted.  Trachea bronchomalacia noted, and compression deformity of T6.  Diverticulosis of the colon with no obvious diverticu  Daptomycin added 11/19 Continue Zosyn Consult to infectious disease Follow-up echocardiogram 1. Limited transthoracic echocardiogram is performed to interrogate valves for endocarditis.Patient unable to tolerate study due to dyspnea and inability to lie flat. No pericardial effusion. Grossly normal right ventricular size and function. Remaining intracardiac structures incompletely visualized on this limited study. Midline will be placed and coordination of antibiotics as an OP with HHC  F/u with ID  Lower extremities edema bilaterally  TTE attempting to repeat since initial once poor quality  ProBNP 400 S/p lasix  F/u with PCP    Back pain due to compression deformity of T6  Cont pain control  Will consult orthopedic in AM  MRI- No evidence of infection in the lumbar spine. No central spinal stenosis or neural foraminal stenosis. Subacute mild compression fracture of the superior endplate of T6 with resultant about 25% decrease in vertebral height, marrow edema and minimal prevertebral edema. No evidence of infection in the thoracic spine.      Costochondritis Ultram as needed Flexeril as needed     HTN: Metoprolol   GAD: Trintellix Ativan PRN  PAF: Metoprolol and Eliquis   HLD: Atorvastatin
Age: 74.0
Sex: M
Vaccine: COVID19-2
Symptoms: Oedema peripheral, Positive airway pressure therapy, Respiratory failure, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of COPD, chronic hypoxemic respiratory failure, HTN, HLD, PAF, GAD, who presented to Hospital with shortness of breath.   COVID 19 Infection Acute on chronic hypoxemic respiratory failure: COPD exacerbation Elevated lactic acid is clinically undetermined  Baseline oxygen 2 L Date of onset of symptoms: 11/18/2023 Symptoms present on admission: cough, SOB Date of covid positive test: 11/18/23 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: BiPAP now improving on baseline 02 , 2lts  Current oxygen requirements: 3 Lpm by NC Medical therapy: remdesivir and steroids; Dulera, Spiriva, Albuterol PRN Consultants following: ID and pulmonology Anticipated special isolation end date: 11/28/2023 Respiratory status back to baseline 2lt NC with adequate saturation    Severe Sepsis, POA, resolved Enterococcus faecium bacteremia VRE Blood cultures 11/18 positive for E faecium VRE , repeat blood cultures 11/20 NGTD CT scan of the chest abdomen and pelvis, with changes of COPD, right lower lobectomy noted.  Trachea bronchomalacia noted, and compression deformity of T6.  Diverticulosis of the colon with no obvious diverticu  Daptomycin added 11/19 Continue Zosyn Consult to infectious disease Follow-up echocardiogram 1. Limited transthoracic echocardiogram is performed to interrogate valves for endocarditis.Patient unable to tolerate study due to dyspnea and inability to lie flat. No pericardial effusion. Grossly normal right ventricular size and function. Remaining intracardiac structures incompletely visualized on this limited study. Midline will be placed and coordination of antibiotics as an OP with HHC  F/u with ID  Lower extremities edema bilaterally  TTE attempting to repeat since initial once poor quality  ProBNP 400 S/p lasix  F/u with PCP    Back pain due to compression deformity of T6  Cont pain control  Will consult orthopedic in AM  MRI- No evidence of infection in the lumbar spine. No central spinal stenosis or neural foraminal stenosis. Subacute mild compression fracture of the superior endplate of T6 with resultant about 25% decrease in vertebral height, marrow edema and minimal prevertebral edema. No evidence of infection in the thoracic spine.      Costochondritis Ultram as needed Flexeril as needed     HTN: Metoprolol   GAD: Trintellix Ativan PRN  PAF: Metoprolol and Eliquis   HLD: Atorvastatin
Age: 74.0
Sex: M
Vaccine: COVID19-2
Symptoms: Spinal compression fracture, Spinal deformity
Clinical narrative: Patient is a 75 y.o. male patient of MD with history of COPD, chronic hypoxemic respiratory failure, HTN, HLD, PAF, GAD, who presented to Hospital with shortness of breath.   COVID 19 Infection Acute on chronic hypoxemic respiratory failure: COPD exacerbation Elevated lactic acid is clinically undetermined  Baseline oxygen 2 L Date of onset of symptoms: 11/18/2023 Symptoms present on admission: cough, SOB Date of covid positive test: 11/18/23 Vaccination status: vaccinated Imaging: CXR Oxygen requirements on admission: BiPAP now improving on baseline 02 , 2lts  Current oxygen requirements: 3 Lpm by NC Medical therapy: remdesivir and steroids; Dulera, Spiriva, Albuterol PRN Consultants following: ID and pulmonology Anticipated special isolation end date: 11/28/2023 Respiratory status back to baseline 2lt NC with adequate saturation    Severe Sepsis, POA, resolved Enterococcus faecium bacteremia VRE Blood cultures 11/18 positive for E faecium VRE , repeat blood cultures 11/20 NGTD CT scan of the chest abdomen and pelvis, with changes of COPD, right lower lobectomy noted.  Trachea bronchomalacia noted, and compression deformity of T6.  Diverticulosis of the colon with no obvious diverticu  Daptomycin added 11/19 Continue Zosyn Consult to infectious disease Follow-up echocardiogram 1. Limited transthoracic echocardiogram is performed to interrogate valves for endocarditis.Patient unable to tolerate study due to dyspnea and inability to lie flat. No pericardial effusion. Grossly normal right ventricular size and function. Remaining intracardiac structures incompletely visualized on this limited study. Midline will be placed and coordination of antibiotics as an OP with HHC  F/u with ID  Lower extremities edema bilaterally  TTE attempting to repeat since initial once poor quality  ProBNP 400 S/p lasix  F/u with PCP    Back pain due to compression deformity of T6  Cont pain control  Will consult orthopedic in AM  MRI- No evidence of infection in the lumbar spine. No central spinal stenosis or neural foraminal stenosis. Subacute mild compression fracture of the superior endplate of T6 with resultant about 25% decrease in vertebral height, marrow edema and minimal prevertebral edema. No evidence of infection in the thoracic spine.      Costochondritis Ultram as needed Flexeril as needed     HTN: Metoprolol   GAD: Trintellix Ativan PRN  PAF: Metoprolol and Eliquis   HLD: Atorvastatin
Age: 63.0
Sex: F
Vaccine: RSV
Symptoms: Dizziness, Nausea, Vomiting
Clinical narrative: Had vaccine on a Wednesday. Two days of nausea and lightheadedness. Tried having dinner on Friday night, and completely threw it up.