chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Headache, Musculoskeletal chest pain, Nausea, Pain
Clinical narrative: Patient is fully vaccinated.  COVID + at ed visit on 12/28/2021.  chief complaint vomiting, headache.  40-year-old female with history of extensive coronary artery disease presents to the emergency Department with complaints of 5 days of body aches, nausea, vomiting, headache, cough. does not have any specific sick contacts. Patient states she has been taking Tylenol and ibuprofen for her symptoms. Patient states she is not on blood thinners, has no numbness, weakness, syncope, no head trauma.BP 137/90  | Pulse 96  | Temp 99 °F (37.2 °C) (Oral)  | Resp 17  | Ht 170.2 cm (5' 7")  | Wt 95.3 kg (210 lb)  | LMP 12/14/2021  | SpO2 97%  | BMI 32.89 kg/m² Chest wall: Tenderness> Imaging: No definite fracture or pneumothorax.we'll refer patient to infusion clinic to see if she qualifies. Recommend patient Motrin, Zofran at home. Patient to return to emergency room if shortness of breath worsens. Discharged from ED.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary imaging procedure normal, Vomiting
Clinical narrative: Patient is fully vaccinated.  COVID + at ed visit on 12/28/2021.  chief complaint vomiting, headache.  40-year-old female with history of extensive coronary artery disease presents to the emergency Department with complaints of 5 days of body aches, nausea, vomiting, headache, cough. does not have any specific sick contacts. Patient states she has been taking Tylenol and ibuprofen for her symptoms. Patient states she is not on blood thinners, has no numbness, weakness, syncope, no head trauma.BP 137/90  | Pulse 96  | Temp 99 °F (37.2 °C) (Oral)  | Resp 17  | Ht 170.2 cm (5' 7")  | Wt 95.3 kg (210 lb)  | LMP 12/14/2021  | SpO2 97%  | BMI 32.89 kg/m² Chest wall: Tenderness> Imaging: No definite fracture or pneumothorax.we'll refer patient to infusion clinic to see if she qualifies. Recommend patient Motrin, Zofran at home. Patient to return to emergency room if shortness of breath worsens. Discharged from ED.
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Diagnosed and hospitalized with Covid while vaccinated.
Age: 23.0
Sex: M
Vaccine: COVID19
Symptoms: Acne, Dyspnoea
Clinical narrative: Pt. states that after receiving the 2nd dose of Phizer 11/23/2021, started experiencing symptoms 11/26/2021 of shortness of breath and "pimples" on the left arm. "Pimples" hive-like areas throughout the chest, both arms, and back area.  No noted Primary visit/communications. Pt. still continuing to experience symptoms.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Unknown.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, Feeling abnormal, Nausea, SARS-CoV-2 test positive
Clinical narrative: Patient diagnosed with COVID on 1/17/22 by her PCP.  She states she did pretty well initially but then began having n/v and started feeling poorly with worsening SOB and therefore presented to the ED.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Vomiting
Clinical narrative: Patient diagnosed with COVID on 1/17/22 by her PCP.  She states she did pretty well initially but then began having n/v and started feeling poorly with worsening SOB and therefore presented to the ED.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: General symptom
Clinical narrative: Onset of symptoms 8/2/21
Age: 33.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Cough, Headache, Vomiting
Clinical narrative: Pt has a history of Marfan's, aortic root repair, and a seizure disorder, and comes to the ED for vomiting, weakness, and cough.  Pt also  has a headache.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Bell's palsy, Facial paresis
Clinical narrative: 4 weeks after, right facial weakness (Bell's palsy-7th cranial nerve right).  steroid rx prednisone  for one week.  on 1-22-2022
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy lung abnormal, COVID-19, Electrocardiogram abnormal, Pneumothorax, Pulmonary mass
Clinical narrative: Patient received Pfizer COVID vaccine on 5/24/21 and 6/14/21. On 1/24/22, patient admitted to our inpatient med/surg unit with EKG changes s/p syncopal event during CT guided lung biopsy for RLL cavitary lesion, right apical pneumothorax, and incidental COVID positive status upon admission. As of today (1/26/22), patient is still admitted in our med/surg unit and patient did have fever on 1/25/22 (even though repeat COVID test was negative on 1/25/22).
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Syncope
Clinical narrative: Patient received Pfizer COVID vaccine on 5/24/21 and 6/14/21. On 1/24/22, patient admitted to our inpatient med/surg unit with EKG changes s/p syncopal event during CT guided lung biopsy for RLL cavitary lesion, right apical pneumothorax, and incidental COVID positive status upon admission. As of today (1/26/22), patient is still admitted in our med/surg unit and patient did have fever on 1/25/22 (even though repeat COVID test was negative on 1/25/22).
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Chest X-ray, Chest pain, Respiratory symptom, SARS-CoV-2 test positive
Clinical narrative: Patient presented to the ED with chest pain on 1/15/22.  Patient found to be COVID + but denies SOB, palpitations, lightheadedness, dizziness, fever or chills.  Had upper respiratory symptoms several days before coming to hospital.  Chest x-ray without obvious pneumonia, patient did not experience any respiratory distress.  Discharged 1/20/22.    Pfizer vaccine 2/17/21,  3/11/21, & 10/26/21.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac stress test, Catheterisation cardiac, Chest pain, Dyspnoea, Heart rate increased
Clinical narrative: I got 3 doses of the Pfizer vaccine: 3/20/2021 Lot # EN6207; 4/10/2021 Lot #ER8729; 10/29/2021 Lot #301308A. About a week later after the booster, my heart started to race on and off. By the third week of (November 17th, 2021, I started to have chest pain, shortness of breath and fast heart beat) On November 18th I went to hospital. My heart enzymes were at 84. I spent the night in hospital. They did a number of tests on me and discharged me having Myocarditis. I am better, however I still do get the fast heart beat.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Myocarditis, Palpitations, X-ray
Clinical narrative: I got 3 doses of the Pfizer vaccine: 3/20/2021 Lot # EN6207; 4/10/2021 Lot #ER8729; 10/29/2021 Lot #301308A. About a week later after the booster, my heart started to race on and off. By the third week of (November 17th, 2021, I started to have chest pain, shortness of breath and fast heart beat) On November 18th I went to hospital. My heart enzymes were at 84. I spent the night in hospital. They did a number of tests on me and discharged me having Myocarditis. I am better, however I still do get the fast heart beat.
Age: 62.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Nerve injury
Clinical narrative: LEFT SHOULDER PAIN SINCE 01/05/2022. PER THE  NURSE AT THE PATIENT'S PRIMARY CARE PROVIDER, IT WAS STATED THAT HE IS EXPERIEING NERVE DAMAGE AND THIS TEMPORARY.
Age: 16.0
Sex: F
Vaccine: VARCEL, VARCEL
Symptoms: Expired product administered, No adverse event
Clinical narrative: Expired varicella vaccine administered and was noted immediately.  Patient was recalled and non expired dose of varicella was administered the same day. When patient was seen in follow up three days later, she was asymptomatic with no evidence of an adverse outcome
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Unknown
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain, Pyrexia, Vomiting
Clinical narrative: person received Covid 19 Booster (Dose #3) of Pfizer on 01/03/2022. She reported  Body aches, fever of 104, N/V, and no other symptoms stated.
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Blood test, Chest pain, Decreased appetite, Fibrin D dimer increased
Clinical narrative: Chest Pain, since vaccination Trouble sleeping, several weeks Loss of appetite for one week after vaccination
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Insomnia, Laboratory test, Pulmonary fibrosis, Soft tissue disorder
Clinical narrative: Chest Pain, since vaccination Trouble sleeping, several weeks Loss of appetite for one week after vaccination
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: General symptom
Clinical narrative: Onset of symptoms 7/28/21
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No adverse event, Underdose
Clinical narrative: Pt received first pediatric dose on 12/10/2021.  Turned 12 on 12/22/21 and was schedule to return for 2nd dose in the series on 1/3.  This appointment was then rescheduled by patients parent to 1/10/2022.  Office called the hospital pharmacist to confirm which dose the patient should get with regards to the dose she had previously and the dose she aged into during the span between doses.  Pharmacist recommended completing the pediatric dose to ensure fulfillment of the series, and recommended that the booster dose be the adult formulation.  Office member then gave the pediatric dose based on this recommendation.  Pt had no adverse reaction to the vaccine.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: covid-19 illness
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Diagnosed and hospitalized with Covid while vaccinated.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Arthritis reactive, Bone pain, Joint swelling
Clinical narrative: This same reaction has occurred before:  after receiving covid vaccine, approx 12 hours later, had onset of deep bone aches, but also got a swollen, painful 4th MCP joint of left hand.  This reactive arthritis lasts weeks afterwards and comes and goes.  It hadn't recurred for awhile before she got her booster dose on 1-13-22 which triggered it again.
Age: 79.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Asthenia, Cough, Dyspnoea, Pneumonia bacterial, Pyrexia
Clinical narrative: Recently 2 admissions for bacterial pna.  He comes to ED for one week of cough and weakness and dyspnea.  He has had mild fevers and a good appetite.   In the ED, he is requiring oxygen at 4L nc.  He feels better on this.  He denies chest pain, but the cough has been troublesome.
Age: 55.0
Sex: F
Vaccine: UNK
Symptoms: Injected limb mobility decreased, Joint range of motion decreased
Clinical narrative: Limited ROM LUE since time of injection to left deltoid
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: covid-19 illness
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Breast swelling, Breast tenderness, Heavy menstrual bleeding, Lymph node pain, Lymphadenopathy
Clinical narrative: Swollen/tender lymph nodes under arm.  Swollen/tender breasts.  Very heavy menstrual flow. Took Tylenol, which didn't help much. Symptoms lasted approximately 2 weeks.
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, Needle issue
Clinical narrative: LVN attempted to administer the vaccine on the client's right deltoid. LVN noted the needle bent and did not penetrate the client's skin. LVN the needle away from the client. The plunger was not activated and no medication was administered in or on the skin of the client. Client received COVID vaccine Pfizer Lot#FL3209 on the left arm at 3:10PM. The client did not report any symptoms during the 15 minute observation period. With Interpreter translating between languages, RN educated client on possible adverse reactions and when to seek medical care. The client voiced understanding of this education. The client left the vaccination site unassisted with a steady gait.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Amylase increased, Asthenia, Computerised tomogram abdomen abnormal, Hypoaesthesia
Clinical narrative: Blurred Vision, weakness, sleepy, tingling head, arms and legs. Numbness of limbs at night, increased muscle pain more in the legs, legs stiffness. Stomach discomfort with a later diagnosis of pancreatitis.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Lipase increased, Musculoskeletal stiffness, Myalgia, Pain in extremity, Pancreatitis
Clinical narrative: Blurred Vision, weakness, sleepy, tingling head, arms and legs. Numbness of limbs at night, increased muscle pain more in the legs, legs stiffness. Stomach discomfort with a later diagnosis of pancreatitis.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia, Somnolence, Vision blurred
Clinical narrative: Blurred Vision, weakness, sleepy, tingling head, arms and legs. Numbness of limbs at night, increased muscle pain more in the legs, legs stiffness. Stomach discomfort with a later diagnosis of pancreatitis.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Diagnosed and hospitalized with COVID-19 despite fully vaccinated.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: covid-19 illness
Age: 47.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Hypoacusis, Insomnia, Tinnitus
Clinical narrative: Developed very loud tinnitus on both sides 10 days after first dose  struggled for two weeks with no signs of improvement.  Basically got little to no sleep for those two weeks without the help of sleeping medication.  ENT cleaned my ears, did a hearing test, prescribed 7 day prednisone treatment and Xanax for sleep  Noise has still not gone away and has not gotten any better  Wish this would have been listed as a possible side effect.  I might have changed my mind.
Age: 47.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood test, Immunisation reaction, Incomplete course of vaccination, Magnetic resonance imaging head, Tinnitus
Clinical narrative: Developed very loud tinnitus on both sides 10 days after first dose  struggled for two weeks with no signs of improvement.  Basically got little to no sleep for those two weeks without the help of sleeping medication.  ENT cleaned my ears, did a hearing test, prescribed 7 day prednisone treatment and Xanax for sleep  Noise has still not gone away and has not gotten any better  Wish this would have been listed as a possible side effect.  I might have changed my mind.
Age: 47.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Vertigo
Clinical narrative: Developed very loud tinnitus on both sides 10 days after first dose  struggled for two weeks with no signs of improvement.  Basically got little to no sleep for those two weeks without the help of sleeping medication.  ENT cleaned my ears, did a hearing test, prescribed 7 day prednisone treatment and Xanax for sleep  Noise has still not gone away and has not gotten any better  Wish this would have been listed as a possible side effect.  I might have changed my mind.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
Clinical narrative: Covid positive through school contact.  Not due booster
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray abnormal, Confusional state, Cough, Dyspnoea
Clinical narrative: Patient is fully vaccinated. Chief complaint is shortness of breath. 71y.o. male with a past medical history of arthritis, DM, HTN, sleep apnea presenting for cough. Patient was diagnosed with COVID on 12/22. confusion. In the ED, patient was hypoxic to 70s on 5L NC. He was placed on 15L NRB with improvement in saturations. D-Dimer 874.CXR demonstrated worsened diffuse bilateral pulmonary airspace opacities. Patient's BP was later noted to be 206/78 and he was given IV hydralazine. Treatment:  decadron, oxgyen. DVT prophyaxis, decadron, remdesivir. Discharged to skilled nursing facility.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Fibrin D dimer, Hypoxia, Lung opacity, Oxygen saturation abnormal
Clinical narrative: Patient is fully vaccinated. Chief complaint is shortness of breath. 71y.o. male with a past medical history of arthritis, DM, HTN, sleep apnea presenting for cough. Patient was diagnosed with COVID on 12/22. confusion. In the ED, patient was hypoxic to 70s on 5L NC. He was placed on 15L NRB with improvement in saturations. D-Dimer 874.CXR demonstrated worsened diffuse bilateral pulmonary airspace opacities. Patient's BP was later noted to be 206/78 and he was given IV hydralazine. Treatment:  decadron, oxgyen. DVT prophyaxis, decadron, remdesivir. Discharged to skilled nursing facility.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Erythema, Mechanical urticaria, Pruritus
Clinical narrative: A few weeks after the booster, I started itching all over my body. No dry skin spots. After scratching my skin, trails where my finger nails scratched turned red and puffy.  I contacted my PCP and I got a diagnosis of dermatographism. I was asked to take 10mg zyrtec daily and benedryl 25-50mg at night to help.  The zyrtec removes the itching sensation but I still do get red streaks (dermatographism), though they do not puff up.  We're now at the end of January and if I stop taking the zyrtec, I notice the itching coming back.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, Gait inability, Pain
Clinical narrative: She presented to the ED complaining of weakness that has worsened over the past 2 days. The patient normally ambulated with a walker at home but has not been able to walk for the past 2 days at all. She states her son called EMS, as she has called the fire department to come to her home and help her walk 3 times over the last few days. She states she has body aches and cough but denies shortness of air and chest pain. The patient is vaccinated for COVID-19. She was found to be positive for covid-19 in the ED
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Walking aid user
Clinical narrative: She presented to the ED complaining of weakness that has worsened over the past 2 days. The patient normally ambulated with a walker at home but has not been able to walk for the past 2 days at all. She states her son called EMS, as she has called the fire department to come to her home and help her walk 3 times over the last few days. She states she has body aches and cough but denies shortness of air and chest pain. The patient is vaccinated for COVID-19. She was found to be positive for covid-19 in the ED
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: covid-19 illness
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Diagnosed and hospitalized with Covid while vaccinated.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Cardiac monitoring, Echocardiogram, Electrocardiogram, Palpitations
Clinical narrative: HEART PAPATATIONS, RACING HEART
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
Clinical narrative: Covid positive through family contact.  Up to date on booster
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Nasal congestion, Oropharyngeal pain, Pyrexia
Clinical narrative: ST, FEVER, COUGH, RN, NC
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Rhinorrhoea, SARS-CoV-2 RNA, SARS-CoV-2 test positive
Clinical narrative: ST, FEVER, COUGH, RN, NC
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Wrong product administered
Clinical narrative: Patient was given 2nd dose covid vaccine but she wanted flu vaccine, she filled out covid registration form and was asked if this was her first dose and asked if she wanted Moderna or pfizer, she responded pfizer.  When administer Rph asked her again that this was her first pfizer and asked which arm. While waiting after dose administered she then said she had already gotten covid shot and was wanting flu shot.  We looked up records on database and she recieved a Janssen vaccine on 1/21/2022.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Paraesthesia
Clinical narrative: Numbness/tingling in leg, hand, and neck
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Diarrhoea, Exposure to SARS-CoV-2, Hypophagia
Clinical narrative: Recent COVID exposure in his house. Yesterday started feeling weak. He has had intermittent diarrhea and poor p.o. intake.
Age: 70.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: covid-19 illness
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Dizziness, Fatigue, Pyrexia
Clinical narrative: Dizziness, Chills, Fever and tiredness.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Electrocardiogram, Electrocardiogram ambulatory, Heart rate increased, Hypertension
Clinical narrative: Got tachycardia and internal fever. Fast heart rate. High bp. It's been going on since the vaccine
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Tachycardia, X-ray
Clinical narrative: Got tachycardia and internal fever. Fast heart rate. High bp. It's been going on since the vaccine
Age: 27.0
Sex: M
Vaccine: COVID19
Symptoms: Rash, Urticaria
Clinical narrative: A week after getting it, I went into the clinic with hives and full body rash. The initially diagnosed it as a food allergy and sent me home with hydrocortisone and epinephrine. It did not improve so I went back. I was placed on oral Allegra with hydrocortisone cream to be taken twice daily until the symptoms improved. I am currently down to 1 every other day.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Axillary mass, Axillary pain
Clinical narrative: Pain under arm  Armpit area  egg size lump  constant pain
Age: 30.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Rash erythematous, Skin warm
Clinical narrative: RED RASH ON LOWER BACK AND CHEST, ITCHY AND WARM TO THE TOUCH
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Illness
Clinical narrative: covid-19 illness
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Parosmia
Clinical narrative: Diesel exhaust smell present without source present.
Age: 5.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: LVN attempted to administer the vaccine on the client's left deltoid. The client moved after insertion of the needle in the client's left arm. LVN removed the needle from the client's left arm. The plunger was not activated and no medication was administered in or on the skin of the client's left arm. Client received COVID vaccine Pfizer Lot#FL8095 on the right arm at 3:18 PM. The client did not report any symptoms during the 15 minute observation period. RN educated client's mother on possible adverse reactions and when to seek medical care. The client's mother voiced understanding of this education. The client left the vaccination site unassisted with a steady gait.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram, Dizziness, Nausea, Vertigo
Clinical narrative: Frequent dizziness, no nausea. Feeling like the room is spinning. I had a CT scan ordered by Dr., scanned Jan 25, 2022 at local Hospital.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
Clinical narrative: Covid positive through family contact. Up to date on booster
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Acute respiratory failure, COVID-19, Computerised tomogram abdomen normal, SARS-CoV-2 test positive
Clinical narrative: Patient is fully vaccinated. COVID + on admission 12/29/2021. Admitted for abdominal pain however that resolved and CT abdomen showed no active issues. Acute respiratory failure with hypoxemia, the patient on a 3 L oxygen supplement.  Treatment: no remdesivir, no baricitinib.  Decadron IV given.  Discharged with homes oxygen.
Age: 14.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Chills, Laboratory test, Pyrexia, Tachycardia
Clinical narrative: Chills, Fever, Tachycardia and raised blood pressure.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Inappropriate schedule of product administration, No adverse event
Clinical narrative: Booster dose given too early. No adverse effects noted.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Diagnosed and hospitalized with Covid while vaccinated.
Age: 73.0
Sex: M
Vaccine: UNK
Symptoms: Chills, Fall, Feeling hot, Mobility decreased
Clinical narrative: Chills, body felt like it was burning  could not move arms legs and fell down when tried to go to the bathroom.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary normal, Bilirubin conjugated increased, Blood bilirubin increased, Blood potassium normal, Brain natriuretic peptide increased
Clinical narrative: 88 Y male with h/o HTN, HLD, MVR in 2014 with Carpentier-Edwards Physio Mitral Annulop 32 mm, A fib on pradaxa, BPH, mild COPD and history of TIA 2016 presenting with SOB and AMS from baseline, admitted for COVID pneumonia.    COVID Pneumonia Exposed at least 4 days PTA. Symptom onset on 12/30/21. Tested positive on 12/31/21. D-dimer was elevated. ED ordered CTA which was neg for PE. During the 36 hours of admission, he received Decadron 6mg x1 and remdesivir x2. He did not require supplemental oxygen and was able to ambulate without SpO2 desating prior to discharge. He was discharged with a COVID kit which includes a pulse ox to continue self-assessing at home, should symptoms worsen.     Fluid overload | Murmur | MVR 2008 | HFpEF 50-55% Mitral Valve Repair Annuloplasty Neochords (PTFE): 4 inserted Mitral Prosthesis (Annuloplasty device) : 4450## - Carpentier-Edwards Physio Mitral Annulop, 32mm Serial# 4365268 Has increased swelling, SOB/DOE and dizziness. Planned for VA workup for progressive heart disease but not done yet. Received Lasix 20 IV x3 while admitted with >5L UOP response and significant decrease in LE edema.  - TTE to be done at clinic, already scheduled - discharged on Lasix 20 po daily, titration per PCP, f/u K/Cr in 5 days   HTN | HLD | A fib -Continue PTA amlodipine, losartan, atorvastatin and carvediol and apixaban 5 BID.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cardiac disorder, Cardiac murmur, Chest X-ray abnormal
Clinical narrative: 88 Y male with h/o HTN, HLD, MVR in 2014 with Carpentier-Edwards Physio Mitral Annulop 32 mm, A fib on pradaxa, BPH, mild COPD and history of TIA 2016 presenting with SOB and AMS from baseline, admitted for COVID pneumonia.    COVID Pneumonia Exposed at least 4 days PTA. Symptom onset on 12/30/21. Tested positive on 12/31/21. D-dimer was elevated. ED ordered CTA which was neg for PE. During the 36 hours of admission, he received Decadron 6mg x1 and remdesivir x2. He did not require supplemental oxygen and was able to ambulate without SpO2 desating prior to discharge. He was discharged with a COVID kit which includes a pulse ox to continue self-assessing at home, should symptoms worsen.     Fluid overload | Murmur | MVR 2008 | HFpEF 50-55% Mitral Valve Repair Annuloplasty Neochords (PTFE): 4 inserted Mitral Prosthesis (Annuloplasty device) : 4450## - Carpentier-Edwards Physio Mitral Annulop, 32mm Serial# 4365268 Has increased swelling, SOB/DOE and dizziness. Planned for VA workup for progressive heart disease but not done yet. Received Lasix 20 IV x3 while admitted with >5L UOP response and significant decrease in LE edema.  - TTE to be done at clinic, already scheduled - discharged on Lasix 20 po daily, titration per PCP, f/u K/Cr in 5 days   HTN | HLD | A fib -Continue PTA amlodipine, losartan, atorvastatin and carvediol and apixaban 5 BID.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Dyspnoea exertional, Exposure to SARS-CoV-2, Fibrin D dimer increased
Clinical narrative: 88 Y male with h/o HTN, HLD, MVR in 2014 with Carpentier-Edwards Physio Mitral Annulop 32 mm, A fib on pradaxa, BPH, mild COPD and history of TIA 2016 presenting with SOB and AMS from baseline, admitted for COVID pneumonia.    COVID Pneumonia Exposed at least 4 days PTA. Symptom onset on 12/30/21. Tested positive on 12/31/21. D-dimer was elevated. ED ordered CTA which was neg for PE. During the 36 hours of admission, he received Decadron 6mg x1 and remdesivir x2. He did not require supplemental oxygen and was able to ambulate without SpO2 desating prior to discharge. He was discharged with a COVID kit which includes a pulse ox to continue self-assessing at home, should symptoms worsen.     Fluid overload | Murmur | MVR 2008 | HFpEF 50-55% Mitral Valve Repair Annuloplasty Neochords (PTFE): 4 inserted Mitral Prosthesis (Annuloplasty device) : 4450## - Carpentier-Edwards Physio Mitral Annulop, 32mm Serial# 4365268 Has increased swelling, SOB/DOE and dizziness. Planned for VA workup for progressive heart disease but not done yet. Received Lasix 20 IV x3 while admitted with >5L UOP response and significant decrease in LE edema.  - TTE to be done at clinic, already scheduled - discharged on Lasix 20 po daily, titration per PCP, f/u K/Cr in 5 days   HTN | HLD | A fib -Continue PTA amlodipine, losartan, atorvastatin and carvediol and apixaban 5 BID.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Hypervolaemia, International normalised ratio increased, Lung opacity, Mental status changes, Oedema peripheral
Clinical narrative: 88 Y male with h/o HTN, HLD, MVR in 2014 with Carpentier-Edwards Physio Mitral Annulop 32 mm, A fib on pradaxa, BPH, mild COPD and history of TIA 2016 presenting with SOB and AMS from baseline, admitted for COVID pneumonia.    COVID Pneumonia Exposed at least 4 days PTA. Symptom onset on 12/30/21. Tested positive on 12/31/21. D-dimer was elevated. ED ordered CTA which was neg for PE. During the 36 hours of admission, he received Decadron 6mg x1 and remdesivir x2. He did not require supplemental oxygen and was able to ambulate without SpO2 desating prior to discharge. He was discharged with a COVID kit which includes a pulse ox to continue self-assessing at home, should symptoms worsen.     Fluid overload | Murmur | MVR 2008 | HFpEF 50-55% Mitral Valve Repair Annuloplasty Neochords (PTFE): 4 inserted Mitral Prosthesis (Annuloplasty device) : 4450## - Carpentier-Edwards Physio Mitral Annulop, 32mm Serial# 4365268 Has increased swelling, SOB/DOE and dizziness. Planned for VA workup for progressive heart disease but not done yet. Received Lasix 20 IV x3 while admitted with >5L UOP response and significant decrease in LE edema.  - TTE to be done at clinic, already scheduled - discharged on Lasix 20 po daily, titration per PCP, f/u K/Cr in 5 days   HTN | HLD | A fib -Continue PTA amlodipine, losartan, atorvastatin and carvediol and apixaban 5 BID.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Pancytopenia, Platelet count decreased, SARS-CoV-2 test positive, Swelling, White blood cell count decreased
Clinical narrative: 88 Y male with h/o HTN, HLD, MVR in 2014 with Carpentier-Edwards Physio Mitral Annulop 32 mm, A fib on pradaxa, BPH, mild COPD and history of TIA 2016 presenting with SOB and AMS from baseline, admitted for COVID pneumonia.    COVID Pneumonia Exposed at least 4 days PTA. Symptom onset on 12/30/21. Tested positive on 12/31/21. D-dimer was elevated. ED ordered CTA which was neg for PE. During the 36 hours of admission, he received Decadron 6mg x1 and remdesivir x2. He did not require supplemental oxygen and was able to ambulate without SpO2 desating prior to discharge. He was discharged with a COVID kit which includes a pulse ox to continue self-assessing at home, should symptoms worsen.     Fluid overload | Murmur | MVR 2008 | HFpEF 50-55% Mitral Valve Repair Annuloplasty Neochords (PTFE): 4 inserted Mitral Prosthesis (Annuloplasty device) : 4450## - Carpentier-Edwards Physio Mitral Annulop, 32mm Serial# 4365268 Has increased swelling, SOB/DOE and dizziness. Planned for VA workup for progressive heart disease but not done yet. Received Lasix 20 IV x3 while admitted with >5L UOP response and significant decrease in LE edema.  - TTE to be done at clinic, already scheduled - discharged on Lasix 20 po daily, titration per PCP, f/u K/Cr in 5 days   HTN | HLD | A fib -Continue PTA amlodipine, losartan, atorvastatin and carvediol and apixaban 5 BID.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Diarrhoea, SARS-CoV-2 RNA
Clinical narrative: DIARRHEA, "ALLERGY SYMPTOMS"
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Broke out in severe hives two days after the shot. It lasted several days and I was put on steriods for treatment.
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Bacterial test, Herpes simplex test, Vaccine positive rechallenge, Vulval ulceration
Clinical narrative: Patient has now had sores on vulva after 2 of her COVID vaccines.  Dose number two and dose number 3. The COVID vaccine 2nd dose was given on 6/11/21 and she developed the sores on 6/15/21.  The vaccine was Pfizer lot EW0183 and given IM  in left arm.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, Blood electrolytes abnormal, COVID-19, Chills, Confusional state
Clinical narrative: Spoke to daughter by phone and she reports tonight the patient called stating she hit her head and evidently pretty hard on two closet doors knocking them off track.  She continues to have diarrhea in which the daughter did give her two immodium tablets today.  Patient resides in an assisted living facility.  Staff reports that they had to help her back to her room due to increased weakness. Pt reports she feels poorly. She complained of severe weakness, chills and rigor at times.   Reports confusion.  Patient's daughter brought patient to the ED due to worsening confusion.  Patient also reports that she was found on the floor her living room at assisted living and had no memory how she got there.  Workup in the ED tonight revealed electrolyte imbalance along with positive COVID-19 PCR.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Diarrhoea, Electrolyte imbalance, Fall, Feeling abnormal, Head injury
Clinical narrative: Spoke to daughter by phone and she reports tonight the patient called stating she hit her head and evidently pretty hard on two closet doors knocking them off track.  She continues to have diarrhea in which the daughter did give her two immodium tablets today.  Patient resides in an assisted living facility.  Staff reports that they had to help her back to her room due to increased weakness. Pt reports she feels poorly. She complained of severe weakness, chills and rigor at times.   Reports confusion.  Patient's daughter brought patient to the ED due to worsening confusion.  Patient also reports that she was found on the floor her living room at assisted living and had no memory how she got there.  Workup in the ED tonight revealed electrolyte imbalance along with positive COVID-19 PCR.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Spoke to daughter by phone and she reports tonight the patient called stating she hit her head and evidently pretty hard on two closet doors knocking them off track.  She continues to have diarrhea in which the daughter did give her two immodium tablets today.  Patient resides in an assisted living facility.  Staff reports that they had to help her back to her room due to increased weakness. Pt reports she feels poorly. She complained of severe weakness, chills and rigor at times.   Reports confusion.  Patient's daughter brought patient to the ED due to worsening confusion.  Patient also reports that she was found on the floor her living room at assisted living and had no memory how she got there.  Workup in the ED tonight revealed electrolyte imbalance along with positive COVID-19 PCR.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Hyperhidrosis, Loss of consciousness, Pallor
Clinical narrative: On January 25, 2022 the patient presented himself at our pharmacy to administered the Pfizer Covid-19 vaccine booster. It was administered and while waiting 15 minutes in the recovery area patient passed out. He turned pale, began to sweat, and was unconscious for approximately 2 minutes. His blood pressure was taken and it was 133/97 and his pulse was 63. 911 was called, he was given oxygen, candy and drink to rule out hypoglycemia. When the ambulance arrived they took him on a stretcher to stabilize him.
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19
Clinical narrative: Diagnosed and hospitalized with Covid while vaccinated.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Arteriosclerosis, Atrial fibrillation, Blood culture, Blood lactic acid
Clinical narrative: Pt presented to the ED after suffering a fall, complains of dehydration, nausea, vomiting,high heart rate, and SOB for 2 days.  Daughter whom she lives with had tested positive for COVID,  -EKG on admission showed atrial fibrillation with RVR, independently reviewed.  Troponin 34, BNP 11182.  Chest x-ray showed nonspecific patchy bibasilar interstitial and airspace opacities, independently reviewed.  CT of the abdomen and pelvis without contrast on 01/15/2022 showed no acute abnormality, calcific atherosclerotic disease, severe stenosis at the origin of the superior mesenteric artery unchanged, no evidence of bowel ischemia, diverticulosis, cholelithiasis, ...  -Lasix IV b.i.d. strict intake and output, daily weights, cardiac diet, fluid restriction. will obtain a 2D echo and consult Cardiology.  Aspirin, statin. serial troponins and EKGs.  Lipid panel, TSH, HbA1c.  Morphine and sublingual nitroglycerin as needed for chest pain.    -amiodarone drip for rate control for atrial fibrillation.  Continue with Eliquis for anticoagulation.    -white count is 9, currently afebrile, blood pressure is acceptable, sepsis focused exam performed.  Sirs criteria positive including tachycardia and tachypnea.  Appropriate IV hydration given in the emergency room.  Avoid IV hydration due to volume overload and CHF.  Blood cultures done in the emergency room.  Lactic acid 1.3.  Atrovent inhaler around the clock, Robitussin DM as needed for cough, incentive spirometry, Decadron 6 mg IV daily for 10 days.  Consult pulmonology.  Patient with severe pulmonary hypertension and recurrent admission forearm interstitial lung disease.    -COVID-19 test is positive 1/16/22.   Pt vaccinated with Moderna 3/21/21 & 4/18/21. Patient discharged 1/21/22.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide increased, COVID-19, Cardiac failure congestive, Chest X-ray abnormal, Chest pain
Clinical narrative: Pt presented to the ED after suffering a fall, complains of dehydration, nausea, vomiting,high heart rate, and SOB for 2 days.  Daughter whom she lives with had tested positive for COVID,  -EKG on admission showed atrial fibrillation with RVR, independently reviewed.  Troponin 34, BNP 11182.  Chest x-ray showed nonspecific patchy bibasilar interstitial and airspace opacities, independently reviewed.  CT of the abdomen and pelvis without contrast on 01/15/2022 showed no acute abnormality, calcific atherosclerotic disease, severe stenosis at the origin of the superior mesenteric artery unchanged, no evidence of bowel ischemia, diverticulosis, cholelithiasis, ...  -Lasix IV b.i.d. strict intake and output, daily weights, cardiac diet, fluid restriction. will obtain a 2D echo and consult Cardiology.  Aspirin, statin. serial troponins and EKGs.  Lipid panel, TSH, HbA1c.  Morphine and sublingual nitroglycerin as needed for chest pain.    -amiodarone drip for rate control for atrial fibrillation.  Continue with Eliquis for anticoagulation.    -white count is 9, currently afebrile, blood pressure is acceptable, sepsis focused exam performed.  Sirs criteria positive including tachycardia and tachypnea.  Appropriate IV hydration given in the emergency room.  Avoid IV hydration due to volume overload and CHF.  Blood cultures done in the emergency room.  Lactic acid 1.3.  Atrovent inhaler around the clock, Robitussin DM as needed for cough, incentive spirometry, Decadron 6 mg IV daily for 10 days.  Consult pulmonology.  Patient with severe pulmonary hypertension and recurrent admission forearm interstitial lung disease.    -COVID-19 test is positive 1/16/22.   Pt vaccinated with Moderna 3/21/21 & 4/18/21. Patient discharged 1/21/22.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Chronic respiratory disease, Computerised tomogram abdomen abnormal, Condition aggravated, Cough, Dehydration
Clinical narrative: Pt presented to the ED after suffering a fall, complains of dehydration, nausea, vomiting,high heart rate, and SOB for 2 days.  Daughter whom she lives with had tested positive for COVID,  -EKG on admission showed atrial fibrillation with RVR, independently reviewed.  Troponin 34, BNP 11182.  Chest x-ray showed nonspecific patchy bibasilar interstitial and airspace opacities, independently reviewed.  CT of the abdomen and pelvis without contrast on 01/15/2022 showed no acute abnormality, calcific atherosclerotic disease, severe stenosis at the origin of the superior mesenteric artery unchanged, no evidence of bowel ischemia, diverticulosis, cholelithiasis, ...  -Lasix IV b.i.d. strict intake and output, daily weights, cardiac diet, fluid restriction. will obtain a 2D echo and consult Cardiology.  Aspirin, statin. serial troponins and EKGs.  Lipid panel, TSH, HbA1c.  Morphine and sublingual nitroglycerin as needed for chest pain.    -amiodarone drip for rate control for atrial fibrillation.  Continue with Eliquis for anticoagulation.    -white count is 9, currently afebrile, blood pressure is acceptable, sepsis focused exam performed.  Sirs criteria positive including tachycardia and tachypnea.  Appropriate IV hydration given in the emergency room.  Avoid IV hydration due to volume overload and CHF.  Blood cultures done in the emergency room.  Lactic acid 1.3.  Atrovent inhaler around the clock, Robitussin DM as needed for cough, incentive spirometry, Decadron 6 mg IV daily for 10 days.  Consult pulmonology.  Patient with severe pulmonary hypertension and recurrent admission forearm interstitial lung disease.    -COVID-19 test is positive 1/16/22.   Pt vaccinated with Moderna 3/21/21 & 4/18/21. Patient discharged 1/21/22.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea, Electrocardiogram abnormal, Exposure to SARS-CoV-2, Fall, Fluid intake restriction
Clinical narrative: Pt presented to the ED after suffering a fall, complains of dehydration, nausea, vomiting,high heart rate, and SOB for 2 days.  Daughter whom she lives with had tested positive for COVID,  -EKG on admission showed atrial fibrillation with RVR, independently reviewed.  Troponin 34, BNP 11182.  Chest x-ray showed nonspecific patchy bibasilar interstitial and airspace opacities, independently reviewed.  CT of the abdomen and pelvis without contrast on 01/15/2022 showed no acute abnormality, calcific atherosclerotic disease, severe stenosis at the origin of the superior mesenteric artery unchanged, no evidence of bowel ischemia, diverticulosis, cholelithiasis, ...  -Lasix IV b.i.d. strict intake and output, daily weights, cardiac diet, fluid restriction. will obtain a 2D echo and consult Cardiology.  Aspirin, statin. serial troponins and EKGs.  Lipid panel, TSH, HbA1c.  Morphine and sublingual nitroglycerin as needed for chest pain.    -amiodarone drip for rate control for atrial fibrillation.  Continue with Eliquis for anticoagulation.    -white count is 9, currently afebrile, blood pressure is acceptable, sepsis focused exam performed.  Sirs criteria positive including tachycardia and tachypnea.  Appropriate IV hydration given in the emergency room.  Avoid IV hydration due to volume overload and CHF.  Blood cultures done in the emergency room.  Lactic acid 1.3.  Atrovent inhaler around the clock, Robitussin DM as needed for cough, incentive spirometry, Decadron 6 mg IV daily for 10 days.  Consult pulmonology.  Patient with severe pulmonary hypertension and recurrent admission forearm interstitial lung disease.    -COVID-19 test is positive 1/16/22.   Pt vaccinated with Moderna 3/21/21 & 4/18/21. Patient discharged 1/21/22.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Heart rate increased, Hypervolaemia, Interstitial lung disease, Lung opacity, Mesenteric artery stenosis
Clinical narrative: Pt presented to the ED after suffering a fall, complains of dehydration, nausea, vomiting,high heart rate, and SOB for 2 days.  Daughter whom she lives with had tested positive for COVID,  -EKG on admission showed atrial fibrillation with RVR, independently reviewed.  Troponin 34, BNP 11182.  Chest x-ray showed nonspecific patchy bibasilar interstitial and airspace opacities, independently reviewed.  CT of the abdomen and pelvis without contrast on 01/15/2022 showed no acute abnormality, calcific atherosclerotic disease, severe stenosis at the origin of the superior mesenteric artery unchanged, no evidence of bowel ischemia, diverticulosis, cholelithiasis, ...  -Lasix IV b.i.d. strict intake and output, daily weights, cardiac diet, fluid restriction. will obtain a 2D echo and consult Cardiology.  Aspirin, statin. serial troponins and EKGs.  Lipid panel, TSH, HbA1c.  Morphine and sublingual nitroglycerin as needed for chest pain.    -amiodarone drip for rate control for atrial fibrillation.  Continue with Eliquis for anticoagulation.    -white count is 9, currently afebrile, blood pressure is acceptable, sepsis focused exam performed.  Sirs criteria positive including tachycardia and tachypnea.  Appropriate IV hydration given in the emergency room.  Avoid IV hydration due to volume overload and CHF.  Blood cultures done in the emergency room.  Lactic acid 1.3.  Atrovent inhaler around the clock, Robitussin DM as needed for cough, incentive spirometry, Decadron 6 mg IV daily for 10 days.  Consult pulmonology.  Patient with severe pulmonary hypertension and recurrent admission forearm interstitial lung disease.    -COVID-19 test is positive 1/16/22.   Pt vaccinated with Moderna 3/21/21 & 4/18/21. Patient discharged 1/21/22.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nausea, Pulmonary hypertension, SARS-CoV-2 test positive, Sepsis, Systemic inflammatory response syndrome
Clinical narrative: Pt presented to the ED after suffering a fall, complains of dehydration, nausea, vomiting,high heart rate, and SOB for 2 days.  Daughter whom she lives with had tested positive for COVID,  -EKG on admission showed atrial fibrillation with RVR, independently reviewed.  Troponin 34, BNP 11182.  Chest x-ray showed nonspecific patchy bibasilar interstitial and airspace opacities, independently reviewed.  CT of the abdomen and pelvis without contrast on 01/15/2022 showed no acute abnormality, calcific atherosclerotic disease, severe stenosis at the origin of the superior mesenteric artery unchanged, no evidence of bowel ischemia, diverticulosis, cholelithiasis, ...  -Lasix IV b.i.d. strict intake and output, daily weights, cardiac diet, fluid restriction. will obtain a 2D echo and consult Cardiology.  Aspirin, statin. serial troponins and EKGs.  Lipid panel, TSH, HbA1c.  Morphine and sublingual nitroglycerin as needed for chest pain.    -amiodarone drip for rate control for atrial fibrillation.  Continue with Eliquis for anticoagulation.    -white count is 9, currently afebrile, blood pressure is acceptable, sepsis focused exam performed.  Sirs criteria positive including tachycardia and tachypnea.  Appropriate IV hydration given in the emergency room.  Avoid IV hydration due to volume overload and CHF.  Blood cultures done in the emergency room.  Lactic acid 1.3.  Atrovent inhaler around the clock, Robitussin DM as needed for cough, incentive spirometry, Decadron 6 mg IV daily for 10 days.  Consult pulmonology.  Patient with severe pulmonary hypertension and recurrent admission forearm interstitial lung disease.    -COVID-19 test is positive 1/16/22.   Pt vaccinated with Moderna 3/21/21 & 4/18/21. Patient discharged 1/21/22.