chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Patient was given a monovalent Moderna Booster dose on 08/31/2022 around 2:00 PM. We were unaware the FDA had modified the EUA for booster doses until around 6:00PM that evening when we received a notification via email. When I became aware of the issue I submitted a request to the Covid-19 program for guidance. I was advised to fill out this form as I am doing now. The patient was contacted about the issue and advised that he would be eligible for a additional bi-valent booster dose 2 months from the previous dose.   Overall we only gave one booster dose that day and have given no others since the modification to the EUA. All staff were advised of the changes in protocol and advised that no other booster doses would be given until the bi-valent doses were delivered.
Age: 45.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram
Clinical narrative: General arm soreness at injection site within 12 hours. Approximately 30 hours after injection, chest pain and tightness developed, including shortness of breath. Chest pain and tightness lasted approximately 30 hours. Labored breathing lasted approximately 24 hours from onset.
Age: 45.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fibrin D dimer, Injection site pain, SARS-CoV-2 test negative, Troponin
Clinical narrative: General arm soreness at injection site within 12 hours. Approximately 30 hours after injection, chest pain and tightness developed, including shortness of breath. Chest pain and tightness lasted approximately 30 hours. Labored breathing lasted approximately 24 hours from onset.
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Facial pain, Nodule, Swelling face, Tenderness
Clinical narrative: About 24 hours after my 2nd Moderna Vaccine, I began to feel a small nodule inside my chin, 9am the following day 9/10/22 my whole entire chin is swollen. I received, Lip and Chin Fillers from Oct- December 2021. The Lip Filler was Restylane Kiss, my Lips are normal. The chin Filler was Belotero. My chin is swollen and pain level would be at a 4. It's tolerable but very sore to touch and while talking.
Age: 53.0
Sex: F
Vaccine: UNK
Symptoms: No adverse event, Wrong technique in product usage process
Clinical narrative: Pulled up 0.3 ml of air to inject into vial to pull up the vaccine. Instead of putting the needle in the vial, I never drew up the vaccine and injected 0.3 ml of air into patient's muscle. After realizing it felt different. Examined that there was an extra dose in the Pfizer bivalent vial, and no residue in the syringe used to inject pt. It was determined that she just received air. Talked with patient and explained the situation, she felt that she didn't receive the vaccine either so we proceeded to repeat the process and give the vaccine. Patient didn't have any symptoms, signs of symptoms.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Erythema, Skin warm, Swelling
Clinical narrative: Redness and swollen and warm to the touch
Age: 65.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dehydration, Dizziness, Dry mouth, Injection site pain, Pyrexia
Clinical narrative: fever of 100.2 degrees, slight dizziness, dry mouth and mild dehydration soreness at injection site
Age: 22.0
Sex: F
Vaccine: FLUC4
Symptoms: Injection site rash, Injection site urticaria
Clinical narrative: Rash and hives in left arm around injection site
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital.
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: CSF glucose normal, CSF lymphocyte count, CSF protein increased, Facial paresis, Guillain-Barre syndrome
Clinical narrative: Patient developed right sided facial weakness within one week that progressed to bifacial weakness (greater on L than R), numbness in hands and feet, and severe weakness in lower extremities (2/5 proximal muscle weakness).  Symptoms were consistent with Acute Inflammatory Demyelinating Polyradiculoneuropathy.
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoaesthesia, Lumbar puncture, Magnetic resonance imaging head normal, Magnetic resonance imaging spinal, Muscular weakness
Clinical narrative: Patient developed right sided facial weakness within one week that progressed to bifacial weakness (greater on L than R), numbness in hands and feet, and severe weakness in lower extremities (2/5 proximal muscle weakness).  Symptoms were consistent with Acute Inflammatory Demyelinating Polyradiculoneuropathy.
Age: 20.0
Sex: M
Vaccine: COVID19
Symptoms: Scan with contrast normal
Clinical narrative: Patient developed right sided facial weakness within one week that progressed to bifacial weakness (greater on L than R), numbness in hands and feet, and severe weakness in lower extremities (2/5 proximal muscle weakness).  Symptoms were consistent with Acute Inflammatory Demyelinating Polyradiculoneuropathy.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital.
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Headache
Clinical narrative: Headache starting evening of vaccination, continuing for 48+ hours
Age: 73.0
Sex: F
Vaccine: PPV
Symptoms: Expired product administered
Clinical narrative: Given past expiration date. Contacted manufacturer. Is within tolerance, patient does not need to retake shot. Notified patient. Notified VAERS.
Age: 72.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Arthralgia, Condition aggravated, Dry mouth, Fatigue, Headache
Clinical narrative: Headache, nausea. Myalgia nape and thighs, and arthralgia Tired but insomnia Urinary incontinence dry mouth.
Age: 72.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Insomnia, Myalgia, Nausea, Urinary incontinence
Clinical narrative: Headache, nausea. Myalgia nape and thighs, and arthralgia Tired but insomnia Urinary incontinence dry mouth.
Age: 75.0
Sex: M
Vaccine: PPV
Symptoms: Expired product administered
Clinical narrative: Given past expiration date. Contacted manufacturer. Is within tolerance, patient does not need to retake shot. Notified patient. Notified VAERS.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Induration, Mass, Skin warm
Clinical narrative: Very. Large, hard lump; hot to touch, slightly red
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital.
Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Angina pectoris, Blood pressure increased, Cardiac stress test normal, Catheterisation cardiac abnormal, Chest pain
Clinical narrative: 10/31/2021 Sharp pain in lower right pubic area. Throbbing on right side of chest. 12/10/2021-1/23/2022 Multiple (12) occurrences - Heart pain, burning chest and lower part of throat, struggling to               keep steady flow of oxygen, face is hot. Occurs for 5-10 minutes with lingering numbness in face and chest.  Elevated blood pressure, dizziness, heart pain, burning chest, tiredness, jaw and face numbness for month and ongoing. Pericarditis diagnosed in February 2022, Medication prescribed. High blood pressure diagnosed in April 2022 Medication prescribed. Blocked artery diagnosed June 2022, Emergency Room Visit- worsened symptoms Heart Catheterization - Stent inserted, 6/24/2022, Blockage had erupted. Ongoing symptoms- Same as above Heart Catheterization- 8/9/2022. Microvascular disease a possibility - on medications
Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Coronary artery occlusion, Dizziness, Echocardiogram abnormal, Fatigue, Feeling hot
Clinical narrative: 10/31/2021 Sharp pain in lower right pubic area. Throbbing on right side of chest. 12/10/2021-1/23/2022 Multiple (12) occurrences - Heart pain, burning chest and lower part of throat, struggling to               keep steady flow of oxygen, face is hot. Occurs for 5-10 minutes with lingering numbness in face and chest.  Elevated blood pressure, dizziness, heart pain, burning chest, tiredness, jaw and face numbness for month and ongoing. Pericarditis diagnosed in February 2022, Medication prescribed. High blood pressure diagnosed in April 2022 Medication prescribed. Blocked artery diagnosed June 2022, Emergency Room Visit- worsened symptoms Heart Catheterization - Stent inserted, 6/24/2022, Blockage had erupted. Ongoing symptoms- Same as above Heart Catheterization- 8/9/2022. Microvascular disease a possibility - on medications
Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hypoaesthesia, Pain, Pericarditis, Pubic pain, Scan with contrast abnormal
Clinical narrative: 10/31/2021 Sharp pain in lower right pubic area. Throbbing on right side of chest. 12/10/2021-1/23/2022 Multiple (12) occurrences - Heart pain, burning chest and lower part of throat, struggling to               keep steady flow of oxygen, face is hot. Occurs for 5-10 minutes with lingering numbness in face and chest.  Elevated blood pressure, dizziness, heart pain, burning chest, tiredness, jaw and face numbness for month and ongoing. Pericarditis diagnosed in February 2022, Medication prescribed. High blood pressure diagnosed in April 2022 Medication prescribed. Blocked artery diagnosed June 2022, Emergency Room Visit- worsened symptoms Heart Catheterization - Stent inserted, 6/24/2022, Blockage had erupted. Ongoing symptoms- Same as above Heart Catheterization- 8/9/2022. Microvascular disease a possibility - on medications
Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Stent placement, Throat irritation
Clinical narrative: 10/31/2021 Sharp pain in lower right pubic area. Throbbing on right side of chest. 12/10/2021-1/23/2022 Multiple (12) occurrences - Heart pain, burning chest and lower part of throat, struggling to               keep steady flow of oxygen, face is hot. Occurs for 5-10 minutes with lingering numbness in face and chest.  Elevated blood pressure, dizziness, heart pain, burning chest, tiredness, jaw and face numbness for month and ongoing. Pericarditis diagnosed in February 2022, Medication prescribed. High blood pressure diagnosed in April 2022 Medication prescribed. Blocked artery diagnosed June 2022, Emergency Room Visit- worsened symptoms Heart Catheterization - Stent inserted, 6/24/2022, Blockage had erupted. Ongoing symptoms- Same as above Heart Catheterization- 8/9/2022. Microvascular disease a possibility - on medications
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Asthenia, Chills, Decreased appetite, Feeling abnormal, Feeling cold
Clinical narrative: real cold chills for over nite . inmorning feeling strange. went to restroom, walking back got real weak, next thing i woke up on the floor about an hour later got up, had the dry heavesthrowing only a small amount of fluid.came up weak all day ,food was not appealing.
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Retching, Vomiting
Clinical narrative: real cold chills for over nite . inmorning feeling strange. went to restroom, walking back got real weak, next thing i woke up on the floor about an hour later got up, had the dry heavesthrowing only a small amount of fluid.came up weak all day ,food was not appealing.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Acute myocardial infarction, Angiogram pulmonary normal, Aortic valve incompetence, COVID-19, COVID-19 pneumonia
Clinical narrative: Admit Date: 8/14/2022  8:33 PM Discharge Date:  8/18/2022  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Pancytopenia   Severe protein-calorie malnutrition   Pacemaker   Mild aortic regurgitation   NSTEMI (non-ST elevated myocardial infarction)   Left ventricular systolic dysfunction   Hypomagnesemia   Essential hypertension   Mixed hyperlipidemia       HPI: "Patient is a 70 y.o. female with a onset of fever 2 days ago brought on by respiratory infection, has had cough and congestion. Nothing noted to make it worse. Not particularly short of breath.  Nausea and vomiting with this. To ED, has tested + for COVID. She is vaccinated. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.     * Pneumonia due to COVID-19 virus Description of the Problem/Progression:  Plan:  o Pneumonia due to Covid 19 virus. Improving on current treatment. Completed Remdesivir D 3/3. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient remained on room air. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Follow up daily lab.  o NSTEMI. Likely type II MI with supply/demand mismatch due to the above. Serum troponin peaked at 0.2. Was seen by cardiology. Echocardiogram was done showing ejection fraction of 40-45%. Cardiac stress test was done showing no ischemia. No further ischemic workup planned per cardiology. Follow-up outpatient. o Elevated d-dimer. Trending down back to normal. CTA of the chest done on admission showed no PE and venous ultrasound of the lower extremity shows no DVT. o Pancytopenia. Recurrent. Etiology is unclear. Gradually improved in the hospital Hematology consulted, follow-up on patient. o Severe protein calorie malnutrition. Chronic. Patient was encouraged by mouth intake. Seen by dietitian, consult appreciated. Started on supplements. Continue to monitor. o Hyperlipidemia. Continue statin therapy. Lipid profile ordered.         Physical Exam on the Date of Discharge: Stable and improved     Consults:   IP CONSULT TO CARDIOLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO ONCOLOGY/HEMATOLOGY   Significant Diagnostic Studies:    labs, microbiology, radiology, nuclear medicine, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac assistance device user, Cardiac stress test normal, Cough, Echocardiogram, Ejection fraction
Clinical narrative: Admit Date: 8/14/2022  8:33 PM Discharge Date:  8/18/2022  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Pancytopenia   Severe protein-calorie malnutrition   Pacemaker   Mild aortic regurgitation   NSTEMI (non-ST elevated myocardial infarction)   Left ventricular systolic dysfunction   Hypomagnesemia   Essential hypertension   Mixed hyperlipidemia       HPI: "Patient is a 70 y.o. female with a onset of fever 2 days ago brought on by respiratory infection, has had cough and congestion. Nothing noted to make it worse. Not particularly short of breath.  Nausea and vomiting with this. To ED, has tested + for COVID. She is vaccinated. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.     * Pneumonia due to COVID-19 virus Description of the Problem/Progression:  Plan:  o Pneumonia due to Covid 19 virus. Improving on current treatment. Completed Remdesivir D 3/3. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient remained on room air. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Follow up daily lab.  o NSTEMI. Likely type II MI with supply/demand mismatch due to the above. Serum troponin peaked at 0.2. Was seen by cardiology. Echocardiogram was done showing ejection fraction of 40-45%. Cardiac stress test was done showing no ischemia. No further ischemic workup planned per cardiology. Follow-up outpatient. o Elevated d-dimer. Trending down back to normal. CTA of the chest done on admission showed no PE and venous ultrasound of the lower extremity shows no DVT. o Pancytopenia. Recurrent. Etiology is unclear. Gradually improved in the hospital Hematology consulted, follow-up on patient. o Severe protein calorie malnutrition. Chronic. Patient was encouraged by mouth intake. Seen by dietitian, consult appreciated. Started on supplements. Continue to monitor. o Hyperlipidemia. Continue statin therapy. Lipid profile ordered.         Physical Exam on the Date of Discharge: Stable and improved     Consults:   IP CONSULT TO CARDIOLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO ONCOLOGY/HEMATOLOGY   Significant Diagnostic Studies:    labs, microbiology, radiology, nuclear medicine, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Essential hypertension, Fibrin D dimer increased, Hypomagnesaemia, Inflammatory marker test, Left ventricular dysfunction
Clinical narrative: Admit Date: 8/14/2022  8:33 PM Discharge Date:  8/18/2022  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Pancytopenia   Severe protein-calorie malnutrition   Pacemaker   Mild aortic regurgitation   NSTEMI (non-ST elevated myocardial infarction)   Left ventricular systolic dysfunction   Hypomagnesemia   Essential hypertension   Mixed hyperlipidemia       HPI: "Patient is a 70 y.o. female with a onset of fever 2 days ago brought on by respiratory infection, has had cough and congestion. Nothing noted to make it worse. Not particularly short of breath.  Nausea and vomiting with this. To ED, has tested + for COVID. She is vaccinated. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.     * Pneumonia due to COVID-19 virus Description of the Problem/Progression:  Plan:  o Pneumonia due to Covid 19 virus. Improving on current treatment. Completed Remdesivir D 3/3. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient remained on room air. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Follow up daily lab.  o NSTEMI. Likely type II MI with supply/demand mismatch due to the above. Serum troponin peaked at 0.2. Was seen by cardiology. Echocardiogram was done showing ejection fraction of 40-45%. Cardiac stress test was done showing no ischemia. No further ischemic workup planned per cardiology. Follow-up outpatient. o Elevated d-dimer. Trending down back to normal. CTA of the chest done on admission showed no PE and venous ultrasound of the lower extremity shows no DVT. o Pancytopenia. Recurrent. Etiology is unclear. Gradually improved in the hospital Hematology consulted, follow-up on patient. o Severe protein calorie malnutrition. Chronic. Patient was encouraged by mouth intake. Seen by dietitian, consult appreciated. Started on supplements. Continue to monitor. o Hyperlipidemia. Continue statin therapy. Lipid profile ordered.         Physical Exam on the Date of Discharge: Stable and improved     Consults:   IP CONSULT TO CARDIOLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO ONCOLOGY/HEMATOLOGY   Significant Diagnostic Studies:    labs, microbiology, radiology, nuclear medicine, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Malnutrition, Nausea, Pancytopenia, Pyrexia, Respiratory tract congestion
Clinical narrative: Admit Date: 8/14/2022  8:33 PM Discharge Date:  8/18/2022  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Pancytopenia   Severe protein-calorie malnutrition   Pacemaker   Mild aortic regurgitation   NSTEMI (non-ST elevated myocardial infarction)   Left ventricular systolic dysfunction   Hypomagnesemia   Essential hypertension   Mixed hyperlipidemia       HPI: "Patient is a 70 y.o. female with a onset of fever 2 days ago brought on by respiratory infection, has had cough and congestion. Nothing noted to make it worse. Not particularly short of breath.  Nausea and vomiting with this. To ED, has tested + for COVID. She is vaccinated. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.     * Pneumonia due to COVID-19 virus Description of the Problem/Progression:  Plan:  o Pneumonia due to Covid 19 virus. Improving on current treatment. Completed Remdesivir D 3/3. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient remained on room air. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Follow up daily lab.  o NSTEMI. Likely type II MI with supply/demand mismatch due to the above. Serum troponin peaked at 0.2. Was seen by cardiology. Echocardiogram was done showing ejection fraction of 40-45%. Cardiac stress test was done showing no ischemia. No further ischemic workup planned per cardiology. Follow-up outpatient. o Elevated d-dimer. Trending down back to normal. CTA of the chest done on admission showed no PE and venous ultrasound of the lower extremity shows no DVT. o Pancytopenia. Recurrent. Etiology is unclear. Gradually improved in the hospital Hematology consulted, follow-up on patient. o Severe protein calorie malnutrition. Chronic. Patient was encouraged by mouth intake. Seen by dietitian, consult appreciated. Started on supplements. Continue to monitor. o Hyperlipidemia. Continue statin therapy. Lipid profile ordered.         Physical Exam on the Date of Discharge: Stable and improved     Consults:   IP CONSULT TO CARDIOLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO ONCOLOGY/HEMATOLOGY   Significant Diagnostic Studies:    labs, microbiology, radiology, nuclear medicine, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory tract infection, SARS-CoV-2 test positive, Troponin, Type V hyperlipidaemia, Ultrasound Doppler normal
Clinical narrative: Admit Date: 8/14/2022  8:33 PM Discharge Date:  8/18/2022  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Pancytopenia   Severe protein-calorie malnutrition   Pacemaker   Mild aortic regurgitation   NSTEMI (non-ST elevated myocardial infarction)   Left ventricular systolic dysfunction   Hypomagnesemia   Essential hypertension   Mixed hyperlipidemia       HPI: "Patient is a 70 y.o. female with a onset of fever 2 days ago brought on by respiratory infection, has had cough and congestion. Nothing noted to make it worse. Not particularly short of breath.  Nausea and vomiting with this. To ED, has tested + for COVID. She is vaccinated. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.     * Pneumonia due to COVID-19 virus Description of the Problem/Progression:  Plan:  o Pneumonia due to Covid 19 virus. Improving on current treatment. Completed Remdesivir D 3/3. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient remained on room air. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Follow up daily lab.  o NSTEMI. Likely type II MI with supply/demand mismatch due to the above. Serum troponin peaked at 0.2. Was seen by cardiology. Echocardiogram was done showing ejection fraction of 40-45%. Cardiac stress test was done showing no ischemia. No further ischemic workup planned per cardiology. Follow-up outpatient. o Elevated d-dimer. Trending down back to normal. CTA of the chest done on admission showed no PE and venous ultrasound of the lower extremity shows no DVT. o Pancytopenia. Recurrent. Etiology is unclear. Gradually improved in the hospital Hematology consulted, follow-up on patient. o Severe protein calorie malnutrition. Chronic. Patient was encouraged by mouth intake. Seen by dietitian, consult appreciated. Started on supplements. Continue to monitor. o Hyperlipidemia. Continue statin therapy. Lipid profile ordered.         Physical Exam on the Date of Discharge: Stable and improved     Consults:   IP CONSULT TO CARDIOLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO ONCOLOGY/HEMATOLOGY   Significant Diagnostic Studies:    labs, microbiology, radiology, nuclear medicine, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Admit Date: 8/14/2022  8:33 PM Discharge Date:  8/18/2022  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Pancytopenia   Severe protein-calorie malnutrition   Pacemaker   Mild aortic regurgitation   NSTEMI (non-ST elevated myocardial infarction)   Left ventricular systolic dysfunction   Hypomagnesemia   Essential hypertension   Mixed hyperlipidemia       HPI: "Patient is a 70 y.o. female with a onset of fever 2 days ago brought on by respiratory infection, has had cough and congestion. Nothing noted to make it worse. Not particularly short of breath.  Nausea and vomiting with this. To ED, has tested + for COVID. She is vaccinated. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.     * Pneumonia due to COVID-19 virus Description of the Problem/Progression:  Plan:  o Pneumonia due to Covid 19 virus. Improving on current treatment. Completed Remdesivir D 3/3. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient remained on room air. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Follow up daily lab.  o NSTEMI. Likely type II MI with supply/demand mismatch due to the above. Serum troponin peaked at 0.2. Was seen by cardiology. Echocardiogram was done showing ejection fraction of 40-45%. Cardiac stress test was done showing no ischemia. No further ischemic workup planned per cardiology. Follow-up outpatient. o Elevated d-dimer. Trending down back to normal. CTA of the chest done on admission showed no PE and venous ultrasound of the lower extremity shows no DVT. o Pancytopenia. Recurrent. Etiology is unclear. Gradually improved in the hospital Hematology consulted, follow-up on patient. o Severe protein calorie malnutrition. Chronic. Patient was encouraged by mouth intake. Seen by dietitian, consult appreciated. Started on supplements. Continue to monitor. o Hyperlipidemia. Continue statin therapy. Lipid profile ordered.         Physical Exam on the Date of Discharge: Stable and improved     Consults:   IP CONSULT TO CARDIOLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO ONCOLOGY/HEMATOLOGY   Significant Diagnostic Studies:    labs, microbiology, radiology, nuclear medicine, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 89.0
Sex: M
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Atrial fibrillation, Bradycardia, COVID-19, Cardiac stress test abnormal
Clinical narrative: Age: 79 y.o.  Admit Date: 8/15/2022 10:34 AM  Discharge Date: 8/18/2022  Admitting Physician:   Discharge Physician: M.D.     Discharge Diagnosis:  Principal Problem:    Chest pain  Active Problems:    Bradycardia    Lung nodules    S/P drug eluting coronary stent placement, Cx    Paroxysmal atrial fibrillation    COVID-19 virus infection    Abnormal stress test    Primary hypertension    Anxiety    Type 2 diabetes mellitus with hyperglycemia, without long-term current use of insulin           HPI: "Patient is a 79 y.o. female who presented to the ER due to chest pain and reported bradycardia at her PCP's office this morning.  Patient has hx Afib and has PPM in place.  She says she has been having left sided chest pain intermittently, short bursts of sharp pain and tightness, no exacerbating or relieving factors.  No dyspnea.  At her PCP's office she reportedly had HR in 30s.  She denies any dizziness".     Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.        * Chest pain  Description of the Problem/Progression:   Plan:   ?Chest pain. Patient admitted to hospital telemetry which remained essentially uneventful. Serial troponin remained negative. Echocardiogram was done showing normal ejection fraction. Was seen by cardiology and cardiac stress test was done showing evidence of ischemia. Left heart catheterization done s/p "stenting of the proximal circumflex artery." Was cleared for DC per cardiology to follow up outpatient and "refer to structural heart as outpatient for LAAO device given need for multiple blood thinners. "   ?Atrial fibrillation with Bradycardia. Bradycardia resolved. Permanent pacemaker present and interrogated showing occasional PVCs. Beta blocker and Tikosyn and OAC on hold. Cardiology resumed DOAC and increased Coreg dose. DC Tikosyn. Follow up outpatient.    ?Covid-19 virus infection. Remains symptomatic from respiratory standpoint. Remains on room air with normal saturation. No remdesivir ordered. Ambulatory care manager referral on DC.    ?Lung nodules by CT of the chest. Patient reports some other past history. Refer to pulmonary on discharge.   ?Diabetes mellitus type 2. Continue with same home regimen/equivalent. Monitor blood sugar and cover with insulin sliding scale.   ?Hypertension. Controlled. Continue same treatment. Follow up daily labs.    ?Anxiety/depression. Continue home medication.            Physical Exam on the Date of Discharge:  Stable and improved
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac telemetry normal, Catheterisation cardiac abnormal, Chest discomfort, Chest pain, Computerised tomogram thorax abnormal
Clinical narrative: Age: 79 y.o.  Admit Date: 8/15/2022 10:34 AM  Discharge Date: 8/18/2022  Admitting Physician:   Discharge Physician: M.D.     Discharge Diagnosis:  Principal Problem:    Chest pain  Active Problems:    Bradycardia    Lung nodules    S/P drug eluting coronary stent placement, Cx    Paroxysmal atrial fibrillation    COVID-19 virus infection    Abnormal stress test    Primary hypertension    Anxiety    Type 2 diabetes mellitus with hyperglycemia, without long-term current use of insulin           HPI: "Patient is a 79 y.o. female who presented to the ER due to chest pain and reported bradycardia at her PCP's office this morning.  Patient has hx Afib and has PPM in place.  She says she has been having left sided chest pain intermittently, short bursts of sharp pain and tightness, no exacerbating or relieving factors.  No dyspnea.  At her PCP's office she reportedly had HR in 30s.  She denies any dizziness".     Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.        * Chest pain  Description of the Problem/Progression:   Plan:   ?Chest pain. Patient admitted to hospital telemetry which remained essentially uneventful. Serial troponin remained negative. Echocardiogram was done showing normal ejection fraction. Was seen by cardiology and cardiac stress test was done showing evidence of ischemia. Left heart catheterization done s/p "stenting of the proximal circumflex artery." Was cleared for DC per cardiology to follow up outpatient and "refer to structural heart as outpatient for LAAO device given need for multiple blood thinners. "   ?Atrial fibrillation with Bradycardia. Bradycardia resolved. Permanent pacemaker present and interrogated showing occasional PVCs. Beta blocker and Tikosyn and OAC on hold. Cardiology resumed DOAC and increased Coreg dose. DC Tikosyn. Follow up outpatient.    ?Covid-19 virus infection. Remains symptomatic from respiratory standpoint. Remains on room air with normal saturation. No remdesivir ordered. Ambulatory care manager referral on DC.    ?Lung nodules by CT of the chest. Patient reports some other past history. Refer to pulmonary on discharge.   ?Diabetes mellitus type 2. Continue with same home regimen/equivalent. Monitor blood sugar and cover with insulin sliding scale.   ?Hypertension. Controlled. Continue same treatment. Follow up daily labs.    ?Anxiety/depression. Continue home medication.            Physical Exam on the Date of Discharge:  Stable and improved
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Coronary arterial stent insertion, Depression, Echocardiogram normal, Ejection fraction normal, Essential hypertension
Clinical narrative: Age: 79 y.o.  Admit Date: 8/15/2022 10:34 AM  Discharge Date: 8/18/2022  Admitting Physician:   Discharge Physician: M.D.     Discharge Diagnosis:  Principal Problem:    Chest pain  Active Problems:    Bradycardia    Lung nodules    S/P drug eluting coronary stent placement, Cx    Paroxysmal atrial fibrillation    COVID-19 virus infection    Abnormal stress test    Primary hypertension    Anxiety    Type 2 diabetes mellitus with hyperglycemia, without long-term current use of insulin           HPI: "Patient is a 79 y.o. female who presented to the ER due to chest pain and reported bradycardia at her PCP's office this morning.  Patient has hx Afib and has PPM in place.  She says she has been having left sided chest pain intermittently, short bursts of sharp pain and tightness, no exacerbating or relieving factors.  No dyspnea.  At her PCP's office she reportedly had HR in 30s.  She denies any dizziness".     Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.        * Chest pain  Description of the Problem/Progression:   Plan:   ?Chest pain. Patient admitted to hospital telemetry which remained essentially uneventful. Serial troponin remained negative. Echocardiogram was done showing normal ejection fraction. Was seen by cardiology and cardiac stress test was done showing evidence of ischemia. Left heart catheterization done s/p "stenting of the proximal circumflex artery." Was cleared for DC per cardiology to follow up outpatient and "refer to structural heart as outpatient for LAAO device given need for multiple blood thinners. "   ?Atrial fibrillation with Bradycardia. Bradycardia resolved. Permanent pacemaker present and interrogated showing occasional PVCs. Beta blocker and Tikosyn and OAC on hold. Cardiology resumed DOAC and increased Coreg dose. DC Tikosyn. Follow up outpatient.    ?Covid-19 virus infection. Remains symptomatic from respiratory standpoint. Remains on room air with normal saturation. No remdesivir ordered. Ambulatory care manager referral on DC.    ?Lung nodules by CT of the chest. Patient reports some other past history. Refer to pulmonary on discharge.   ?Diabetes mellitus type 2. Continue with same home regimen/equivalent. Monitor blood sugar and cover with insulin sliding scale.   ?Hypertension. Controlled. Continue same treatment. Follow up daily labs.    ?Anxiety/depression. Continue home medication.            Physical Exam on the Date of Discharge:  Stable and improved
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperglycaemia, Hypertension, Ischaemia, Laboratory test, Malaise
Clinical narrative: Age: 79 y.o.  Admit Date: 8/15/2022 10:34 AM  Discharge Date: 8/18/2022  Admitting Physician:   Discharge Physician: M.D.     Discharge Diagnosis:  Principal Problem:    Chest pain  Active Problems:    Bradycardia    Lung nodules    S/P drug eluting coronary stent placement, Cx    Paroxysmal atrial fibrillation    COVID-19 virus infection    Abnormal stress test    Primary hypertension    Anxiety    Type 2 diabetes mellitus with hyperglycemia, without long-term current use of insulin           HPI: "Patient is a 79 y.o. female who presented to the ER due to chest pain and reported bradycardia at her PCP's office this morning.  Patient has hx Afib and has PPM in place.  She says she has been having left sided chest pain intermittently, short bursts of sharp pain and tightness, no exacerbating or relieving factors.  No dyspnea.  At her PCP's office she reportedly had HR in 30s.  She denies any dizziness".     Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.        * Chest pain  Description of the Problem/Progression:   Plan:   ?Chest pain. Patient admitted to hospital telemetry which remained essentially uneventful. Serial troponin remained negative. Echocardiogram was done showing normal ejection fraction. Was seen by cardiology and cardiac stress test was done showing evidence of ischemia. Left heart catheterization done s/p "stenting of the proximal circumflex artery." Was cleared for DC per cardiology to follow up outpatient and "refer to structural heart as outpatient for LAAO device given need for multiple blood thinners. "   ?Atrial fibrillation with Bradycardia. Bradycardia resolved. Permanent pacemaker present and interrogated showing occasional PVCs. Beta blocker and Tikosyn and OAC on hold. Cardiology resumed DOAC and increased Coreg dose. DC Tikosyn. Follow up outpatient.    ?Covid-19 virus infection. Remains symptomatic from respiratory standpoint. Remains on room air with normal saturation. No remdesivir ordered. Ambulatory care manager referral on DC.    ?Lung nodules by CT of the chest. Patient reports some other past history. Refer to pulmonary on discharge.   ?Diabetes mellitus type 2. Continue with same home regimen/equivalent. Monitor blood sugar and cover with insulin sliding scale.   ?Hypertension. Controlled. Continue same treatment. Follow up daily labs.    ?Anxiety/depression. Continue home medication.            Physical Exam on the Date of Discharge:  Stable and improved
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary mass, Troponin normal, Type 2 diabetes mellitus, Ventricular extrasystoles
Clinical narrative: Age: 79 y.o.  Admit Date: 8/15/2022 10:34 AM  Discharge Date: 8/18/2022  Admitting Physician:   Discharge Physician: M.D.     Discharge Diagnosis:  Principal Problem:    Chest pain  Active Problems:    Bradycardia    Lung nodules    S/P drug eluting coronary stent placement, Cx    Paroxysmal atrial fibrillation    COVID-19 virus infection    Abnormal stress test    Primary hypertension    Anxiety    Type 2 diabetes mellitus with hyperglycemia, without long-term current use of insulin           HPI: "Patient is a 79 y.o. female who presented to the ER due to chest pain and reported bradycardia at her PCP's office this morning.  Patient has hx Afib and has PPM in place.  She says she has been having left sided chest pain intermittently, short bursts of sharp pain and tightness, no exacerbating or relieving factors.  No dyspnea.  At her PCP's office she reportedly had HR in 30s.  She denies any dizziness".     Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.        * Chest pain  Description of the Problem/Progression:   Plan:   ?Chest pain. Patient admitted to hospital telemetry which remained essentially uneventful. Serial troponin remained negative. Echocardiogram was done showing normal ejection fraction. Was seen by cardiology and cardiac stress test was done showing evidence of ischemia. Left heart catheterization done s/p "stenting of the proximal circumflex artery." Was cleared for DC per cardiology to follow up outpatient and "refer to structural heart as outpatient for LAAO device given need for multiple blood thinners. "   ?Atrial fibrillation with Bradycardia. Bradycardia resolved. Permanent pacemaker present and interrogated showing occasional PVCs. Beta blocker and Tikosyn and OAC on hold. Cardiology resumed DOAC and increased Coreg dose. DC Tikosyn. Follow up outpatient.    ?Covid-19 virus infection. Remains symptomatic from respiratory standpoint. Remains on room air with normal saturation. No remdesivir ordered. Ambulatory care manager referral on DC.    ?Lung nodules by CT of the chest. Patient reports some other past history. Refer to pulmonary on discharge.   ?Diabetes mellitus type 2. Continue with same home regimen/equivalent. Monitor blood sugar and cover with insulin sliding scale.   ?Hypertension. Controlled. Continue same treatment. Follow up daily labs.    ?Anxiety/depression. Continue home medication.            Physical Exam on the Date of Discharge:  Stable and improved
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Asymptomatic COVID-19, Cellulitis, Computerised tomogram head, Computerised tomogram neck, Diabetic diet
Clinical narrative: Patient ID:  MRN:   Name:   Age: 49 y.o.  Birthday:  Admit Date: 8/15/2022  3:08 PM  Discharge Date:  8/18/2022  Unit: 3A125/3A125A  Admitting Physician:   Discharge Physician: M.D.     Discharge Diagnosis:  Principal Problem:    Facial cellulitis  Active Problems:    Type 2 diabetes mellitus, with long-term current use of insulin    Morbid obesity    Acute parotitis    COVID-19 virus infection           HPI: "The patient is a 49 y.o. female morbidly obese, with type 2 diabetes mellitus, fibromyalgia. Patient reported that for the past 2 days she noted worsening swelling and erythema on the right lower face associated with fever. Her significant pain especially when opening the mouth. She was seen at ER and was diagnosed with facial cellulitis and was advised admission but she refuses. She was treated with Augmentin. Her condition worsened today does she came to our emergency room. She was seen by ENT and diagnosis was parotitis with facial cellulitis. She is edentulous with no gum swelling. She was started on IV antibiotics and steroid and will be admitted."     Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.         * Facial cellulitis  ?Right Facial cellulitis/parotitis. Failed outpatient treatment with oral antibiotic therapy. CT of the head and neck results reviewed. Continue IV Unasyn and Decadron per ENT recommendations and start Decadron Taper. Patient admits to history of MRSA infections in the past. Vancomycin added. MRSA swab is negative, transitioned IV vancomycin to by mouth doxycycline. Continue supportive/symptomatic treatment and pain control. Continue hydration with IV fluids. Continues with leukocytosis likely due to IV steroids. Continue to monitor with daily Lab. Pro-calcitonin trending down. Advanced to soft diet and tolerated well. Leukocytosis trended down with steroids taper. Cleared for discharge per ENT to follow up on patient. Transition antibiotics and steroids to oral.   ?Covid 19 virus infection. Remains asymptomatic from respiratory standpoint. Oxygen saturation within normal limits on room air. No IV Remdesivir . Continued to monitor. Ambulatory care manager referral on discharge.   ?Diabetes mellitus type 2. Continue with same home regimen/equivalent and adjust Levemir dose. Monitor blood sugar and cover with insulin sliding scale. Diabetic diet and A1c ordered.                  Physical Exam on the Date of Discharge:  Stable and improved.            Consults:    IP CONSULT TO SEPSIS NURSE NAVIGATOR  IP CONSULT TO OTOLARYNGOLOGY  IP CONSULT TO SOCIAL WORK     Significant Diagnostic Studies:     labs, microbiology, radiology, and cardiac graphics: per chart.        Disposition:  home     Discharge Condition:  good
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Leukocytosis, Medical diet, Pain, Parotitis
Clinical narrative: Patient ID:  MRN:   Name:   Age: 49 y.o.  Birthday:  Admit Date: 8/15/2022  3:08 PM  Discharge Date:  8/18/2022  Unit: 3A125/3A125A  Admitting Physician:   Discharge Physician: M.D.     Discharge Diagnosis:  Principal Problem:    Facial cellulitis  Active Problems:    Type 2 diabetes mellitus, with long-term current use of insulin    Morbid obesity    Acute parotitis    COVID-19 virus infection           HPI: "The patient is a 49 y.o. female morbidly obese, with type 2 diabetes mellitus, fibromyalgia. Patient reported that for the past 2 days she noted worsening swelling and erythema on the right lower face associated with fever. Her significant pain especially when opening the mouth. She was seen at ER and was diagnosed with facial cellulitis and was advised admission but she refuses. She was treated with Augmentin. Her condition worsened today does she came to our emergency room. She was seen by ENT and diagnosis was parotitis with facial cellulitis. She is edentulous with no gum swelling. She was started on IV antibiotics and steroid and will be admitted."     Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.         * Facial cellulitis  ?Right Facial cellulitis/parotitis. Failed outpatient treatment with oral antibiotic therapy. CT of the head and neck results reviewed. Continue IV Unasyn and Decadron per ENT recommendations and start Decadron Taper. Patient admits to history of MRSA infections in the past. Vancomycin added. MRSA swab is negative, transitioned IV vancomycin to by mouth doxycycline. Continue supportive/symptomatic treatment and pain control. Continue hydration with IV fluids. Continues with leukocytosis likely due to IV steroids. Continue to monitor with daily Lab. Pro-calcitonin trending down. Advanced to soft diet and tolerated well. Leukocytosis trended down with steroids taper. Cleared for discharge per ENT to follow up on patient. Transition antibiotics and steroids to oral.   ?Covid 19 virus infection. Remains asymptomatic from respiratory standpoint. Oxygen saturation within normal limits on room air. No IV Remdesivir . Continued to monitor. Ambulatory care manager referral on discharge.   ?Diabetes mellitus type 2. Continue with same home regimen/equivalent and adjust Levemir dose. Monitor blood sugar and cover with insulin sliding scale. Diabetic diet and A1c ordered.                  Physical Exam on the Date of Discharge:  Stable and improved.            Consults:    IP CONSULT TO SEPSIS NURSE NAVIGATOR  IP CONSULT TO OTOLARYNGOLOGY  IP CONSULT TO SOCIAL WORK     Significant Diagnostic Studies:     labs, microbiology, radiology, and cardiac graphics: per chart.        Disposition:  home     Discharge Condition:  good