chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered, Underdose
Clinical narrative: I was given a 0.25ml dose instead of a 0.5ml dose.  I am NOT immunocompromised, I am a health care professional.  I cannot get the facility to speak with me in regards to what I need to do now.
Age: 77.0
Sex: F
Vaccine: FLU4, FLU4
Symptoms: Erythema
Clinical narrative: inside of left arm redness 6 inches long . lasted 6 days
Age: 77.0
Sex: F
Vaccine: FLU4, FLU4
Symptoms: Injection site erythema, Injection site pain, Rash
Clinical narrative: inside of left arm redness 6 inches long . lasted 6 days
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray, Diarrhoea, Dyspnoea, Fibrin D dimer increased
Clinical narrative: Dyspnea, diarrhea.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Dyspnea, diarrhea.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of consciousness
Clinical narrative: At 09:30 am I passed out losing conscious for a few minutes. The next day I was fine made a virtual appt with a doctor(he wasn't sympathetic) stated that this is something that may happened after taken a experimental drug.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Admitted to Hospital on Date of Adverse Event [recorded in VAERS] for treatment of Covid-19 Positive following completion of Covid Vaccine Series
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy, Ear pain, Facial paralysis, Hypoaesthesia, Neck pain
Clinical narrative: The patient experience unilateral droopiness, numbness, and tingling in the face; neck and ear pain, one week after vaccine, and was rushed to ER. A diagnosis of Bells Palsy and treated with oral steroid x 6-7 days and acyclovir x 10 days.
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Paraesthesia
Clinical narrative: The patient experience unilateral droopiness, numbness, and tingling in the face; neck and ear pain, one week after vaccine, and was rushed to ER. A diagnosis of Bells Palsy and treated with oral steroid x 6-7 days and acyclovir x 10 days.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test normal, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal
Clinical narrative: Heart palpitations, light-headedness, feeling of being unable to get a full breath of air
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Palpitations
Clinical narrative: Heart palpitations, light-headedness, feeling of being unable to get a full breath of air
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Cellulitis, X-ray
Clinical narrative: I had cellulitis on knees, back of hands, elbows, bottoms of my feet, palms, my whole back and my whole arms. I contacted my doctor about this.  She referred to me to a dermatologist
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Alanine aminotransferase increased, Anion gap normal, Anti factor Xa assay normal, Anticoagulant therapy
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Aspartate aminotransferase increased, Asthenia, Atrioventricular block complete, Basophil count, Bilirubin conjugated increased
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Blood alkaline phosphatase normal, Blood bicarbonate decreased, Blood bilirubin increased, Blood calcium decreased, Blood chloride normal
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatine increased, Blood gases abnormal, Blood glucose normal, Blood magnesium normal, Blood pH decreased
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Blood phosphorus normal, Blood potassium normal, Blood pressure abnormal, Blood pressure systolic decreased, Blood sodium decreased
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Blood urea increased, Body temperature decreased, Brain natriuretic peptide increased, C-reactive protein increased, COVID-19
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Carbon dioxide normal, Cardiac arrest, Cardiac failure, Cardiac resynchronisation therapy
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac vein dissection, Chest X-ray abnormal, Condition aggravated, Cough, Death
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Delirium, Diarrhoea, Dyspnoea, Endotracheal intubation, Eosinophil count
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Fibrin D dimer increased, General physical health deterioration, Glomerular filtration rate, Haematocrit decreased, Haemoglobin decreased
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Haemoptysis, Hypotension, Hypoxia, Hypoxic-ischaemic encephalopathy, Immature granulocyte count
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Implantable defibrillator insertion, Intensive care, International normalised ratio normal, Ischaemic cardiomyopathy, Laboratory test abnormal
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Lymphocyte count decreased, Mean cell volume normal, Mental status changes, Metabolic acidosis, Metabolic encephalopathy
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Monocyte count, Neutrophil count increased, Neutrophil percentage increased, Oxygen saturation decreased, PCO2
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: PO2 decreased, Platelet count decreased, Prothrombin time prolonged, Pulseless electrical activity, Red blood cell count decreased
Clinical narrative: Reason for Hospital Admission (Admitting Diagnosis): Heart Block/COVID Pneumonia   Hospital Course and Significant Findings: 75 Y male with hx of HFrEF (EF: 20%), HTN, anemia, seizures (not on antiepileptics), hx of renal calculus s/p ureteral stents and subsequent removal who presented with shortness of breath, weakness and diarrhea and was found to have AKI, 3rd degree AV block which was diagnosed on 9/5/2021 and COVID diagnosed on 9/3/2021.   Dual chamber ICD placed on 9/9 by Dr. (couldn't get coronary sinus lead in so only RV pacing now).  Reattempt LV lead placement is scheduled on 10/18 with Dr. . Stopped heparin gtt and start BID Eliquis (2.5mg BID - discussed dosing with pharmacy) Weight up (standing weight 201lbs today and recorded 188lbs on 9/6), BNP is up, oxygen requirement up today.  CXR looked a little better (intermpretation complicated by recent COVID diagnosis).  BP is soft (SBP low 90s).  Cr and BUN up.   D/w Cardiology who recommended start hydralazine, start dopamine gtt, resume Lasix, and consider repeat echo giving finding of dissection of coronary sinus on recent pacemaker placement.     With regard to COVID, symptom onset 9/3/2021. COVID positive on 9/3/2021. He remained afebrile.  He completed 5 day course of remdesivir and was continued on daily decadron.   He was not requiring much oxygen, about 2 to 4LMP via NC and appears well without tachypnea. He had a mild dry cough. He is speaking in complete sentences without cough or tachypnea during my exam.  - No hypoxia on 9/11, even with activity, but on 9/12 was a bit hypoxic so was on supplemental oxygen.    NONTRAUMATIC AKI on CKD. BUN and Cr increasing.  BP was low and CXR looked better but other findings concerning for increasing heart failure.  See above for recommendations from cardiology.     AMS / Delirium.  Due to metabolic and hypoxemic encephalopathy.  Fluctuated and occurred the first couple of days during the night.        Overnight in the early hours of 9/13, his respiratory status deteriorated.  He required increasing oxygen, was seen by cross cover.  He started coughing up bloody frothy sputum.  Required high flow oxygen.  Unfortunately he went into PEA arrest in the morning on 9/13.  Required CPR, was resuscitated, intubated and transferred to the ICU.  Bedside echo showed diminished EF, no pericardial effusion or tamponade.   Per ICU note, "Significant metabolic acidemia an refractory PEA despite initial ROSC and complete resuscitation. Finally, patient was prounced dead at 11am on 9/13."   Cause of death: Hypoxic respiratory failure from COVID pneumonia and ischemic cardiomyopathy.  Primary Procedures:  Procedure(s): CARDIAC AICD TOTAL SYSTEM IMPLANTATION, BIVENTRICULAR CHAMBER