chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Cognitive disorder, Condition aggravated, Diabetic neuropathy, Gait disturbance
Clinical narrative: Patient is a 71 y.o. male with a history of T2DM, HTN, depression, who presented to hospital on 10/16/2023 for nausea/vomiting, severe generalized weakness. Found COVID+ without respiratory distress or hypoxia, symptoms improved with supportive care and Paxlovid initiated given high-risk with age/co-morbidities.   1. COVID-19 infection: Test positive 10/16/23, with symptoms starting 10/14/23. High-risk with age and co-morbidities. Last bivalent booster 12/2022. Not hypoxic. CXR on admit without significant infiltrates. ID followed via e-consult: recommended Paxlovid course initiated 10/17/23 (held atorvastatin for now, restart when Paxlovid complete). Rest of course prescribed at discharge. 2. Nausea/vomiting: Suspect related to COVID infection as reportedly similar to prior presentation in 2020. Gastroparesis could be considered. Improved with PRN anti-emetics and supportive care. Tolerated diet prior to discharge.  3. Generalized weakness: Likely due to COVID and poor PO. PT/OT evaluated. 4. Lactic acidosis: Lactate 2.7 on admit. Suspect from hypovolemia due to N/V. Resolved. 5. T2DM: Last A1C 7.5% in 7/2023. Home regimen Lantus alone at 50 units at bedtime. Continued reduced basal dose while acutely ill with poor PO intake, plus SSI. Back to home regimen at discharge with reduced basal insulin dosing until back to regular PO intake.  6. HTN: Reports on home amlodipine, lisinopril, Toprol (fill history without amlodipine or lisinopril). Continued home meds.  7. Peripheral neuropathy: Suspected due to diabetes. Saw Neuro 8/29/23, felt that neuropathy was contributing to his ongoing gait imbalance. 8. Cognitive impairment: Recently also saw Neuro for memory issues. MRI brain 9/2/2023 showed global cerebral volume loss, chronic microvascular changes. Pending outpatient Neuropsych eval.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Glycosylated haemoglobin increased, Hypophagia, Hypovolaemia, Lactic acidosis, Magnetic resonance imaging head abnormal
Clinical narrative: Patient is a 71 y.o. male with a history of T2DM, HTN, depression, who presented to hospital on 10/16/2023 for nausea/vomiting, severe generalized weakness. Found COVID+ without respiratory distress or hypoxia, symptoms improved with supportive care and Paxlovid initiated given high-risk with age/co-morbidities.   1. COVID-19 infection: Test positive 10/16/23, with symptoms starting 10/14/23. High-risk with age and co-morbidities. Last bivalent booster 12/2022. Not hypoxic. CXR on admit without significant infiltrates. ID followed via e-consult: recommended Paxlovid course initiated 10/17/23 (held atorvastatin for now, restart when Paxlovid complete). Rest of course prescribed at discharge. 2. Nausea/vomiting: Suspect related to COVID infection as reportedly similar to prior presentation in 2020. Gastroparesis could be considered. Improved with PRN anti-emetics and supportive care. Tolerated diet prior to discharge.  3. Generalized weakness: Likely due to COVID and poor PO. PT/OT evaluated. 4. Lactic acidosis: Lactate 2.7 on admit. Suspect from hypovolemia due to N/V. Resolved. 5. T2DM: Last A1C 7.5% in 7/2023. Home regimen Lantus alone at 50 units at bedtime. Continued reduced basal dose while acutely ill with poor PO intake, plus SSI. Back to home regimen at discharge with reduced basal insulin dosing until back to regular PO intake.  6. HTN: Reports on home amlodipine, lisinopril, Toprol (fill history without amlodipine or lisinopril). Continued home meds.  7. Peripheral neuropathy: Suspected due to diabetes. Saw Neuro 8/29/23, felt that neuropathy was contributing to his ongoing gait imbalance. 8. Cognitive impairment: Recently also saw Neuro for memory issues. MRI brain 9/2/2023 showed global cerebral volume loss, chronic microvascular changes. Pending outpatient Neuropsych eval.
Age: 70.0
Sex: M
Vaccine: COVID19-2
Symptoms: Memory impairment, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Patient is a 71 y.o. male with a history of T2DM, HTN, depression, who presented to hospital on 10/16/2023 for nausea/vomiting, severe generalized weakness. Found COVID+ without respiratory distress or hypoxia, symptoms improved with supportive care and Paxlovid initiated given high-risk with age/co-morbidities.   1. COVID-19 infection: Test positive 10/16/23, with symptoms starting 10/14/23. High-risk with age and co-morbidities. Last bivalent booster 12/2022. Not hypoxic. CXR on admit without significant infiltrates. ID followed via e-consult: recommended Paxlovid course initiated 10/17/23 (held atorvastatin for now, restart when Paxlovid complete). Rest of course prescribed at discharge. 2. Nausea/vomiting: Suspect related to COVID infection as reportedly similar to prior presentation in 2020. Gastroparesis could be considered. Improved with PRN anti-emetics and supportive care. Tolerated diet prior to discharge.  3. Generalized weakness: Likely due to COVID and poor PO. PT/OT evaluated. 4. Lactic acidosis: Lactate 2.7 on admit. Suspect from hypovolemia due to N/V. Resolved. 5. T2DM: Last A1C 7.5% in 7/2023. Home regimen Lantus alone at 50 units at bedtime. Continued reduced basal dose while acutely ill with poor PO intake, plus SSI. Back to home regimen at discharge with reduced basal insulin dosing until back to regular PO intake.  6. HTN: Reports on home amlodipine, lisinopril, Toprol (fill history without amlodipine or lisinopril). Continued home meds.  7. Peripheral neuropathy: Suspected due to diabetes. Saw Neuro 8/29/23, felt that neuropathy was contributing to his ongoing gait imbalance. 8. Cognitive impairment: Recently also saw Neuro for memory issues. MRI brain 9/2/2023 showed global cerebral volume loss, chronic microvascular changes. Pending outpatient Neuropsych eval.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Adult failure to thrive, Angiogram pulmonary abnormal, Asthenia, Blood lactic acid increased
Clinical narrative: Pt. is a 79 y.o. male patient with history of asthma, COPD, hx sigmoid colectomy with colostomy in place, atrial fibrillation (no anticoagulation) presented with COPD exacerbation.   Covid-19 Virus Infection Date of onset of symptoms: 10/25 Symptoms present on admission: yes Date of covid positive test: 10/26 Vaccination status: vaccinated Imaging: PCXR-Stable chest x-ray compared to 10/15/2023.  Right apical thickening and loss of volume redemonstrated.  Underlying emphysema.  No evidence of new findings. CTPA-No CT evidence for acute pulmonary embolus. COPD with chronic right upper lobe consolidation Oxygen requirements on admission: 2L NC Current oxygen requirements: None Medical therapy: remdesivir and steroids x 5days Consultants following: Pulmonary Anticipated special isolation end date: 11/6 COVID order set placed   Acute hypoxemic and hypercarbic respiratory failure Acute exacerbation of COPD Asthma Tobacco abuse Does not wear oxygen at baseline Admitted 10/15-10/19 for COPD and Pseudomonas pneumonia, finished course of levaquin Worsening weakness and SOB; unable to get out of bed since discharge Now on 2L oxygen Afebrile, WBC 13k, normotensive (10/25) Influenza and COVID swab refused by patient Elevated lactate 2.8 (10/24) -- > 1.7 (10/25) CXR (10/24) similar to previous (10/15), CT PA (10/24) nonacute, no PE Sputum culture pending collection Of note, at discharge 10/15 slow prednisone taper recommended to start 10/28. 40mg given this morning before transfer, will continue with 40mg daily Pulmonary consulted-  On prednisone as per below.Continue Dulera and Spiriva.  Continue prednisone with plan to complete 5-day course.  Also on azithromycin Encouraged complete cessation tobacco ST consulted PT/OT/ case management consulted Continue prednisone, pulm hygiene, home inhalers, nebulizer Cont pulse ox   Paroxysmal atrial fibrillation Last Echo June 2018 with porr quality and EF of 55% No home rate control medications or anticoagulation History of GI bleed on Xarelto (2019) Currently NSR Cont tele   Urinary frequency Urinary frequency x 4 days No dysuria UA negative   Severe Malnutrition with cachexia POA Failure to thrive BMI 16.09 Nutrition consulted-Boost TID ordered ST consulted PT/OT consulted   H/o Diverticular perforation S/p ostomy Wound care consulted
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cachexia, Cardiac telemetry, Chest X-ray abnormal, Chronic obstructive pulmonary disease
Clinical narrative: Pt. is a 79 y.o. male patient with history of asthma, COPD, hx sigmoid colectomy with colostomy in place, atrial fibrillation (no anticoagulation) presented with COPD exacerbation.   Covid-19 Virus Infection Date of onset of symptoms: 10/25 Symptoms present on admission: yes Date of covid positive test: 10/26 Vaccination status: vaccinated Imaging: PCXR-Stable chest x-ray compared to 10/15/2023.  Right apical thickening and loss of volume redemonstrated.  Underlying emphysema.  No evidence of new findings. CTPA-No CT evidence for acute pulmonary embolus. COPD with chronic right upper lobe consolidation Oxygen requirements on admission: 2L NC Current oxygen requirements: None Medical therapy: remdesivir and steroids x 5days Consultants following: Pulmonary Anticipated special isolation end date: 11/6 COVID order set placed   Acute hypoxemic and hypercarbic respiratory failure Acute exacerbation of COPD Asthma Tobacco abuse Does not wear oxygen at baseline Admitted 10/15-10/19 for COPD and Pseudomonas pneumonia, finished course of levaquin Worsening weakness and SOB; unable to get out of bed since discharge Now on 2L oxygen Afebrile, WBC 13k, normotensive (10/25) Influenza and COVID swab refused by patient Elevated lactate 2.8 (10/24) -- > 1.7 (10/25) CXR (10/24) similar to previous (10/15), CT PA (10/24) nonacute, no PE Sputum culture pending collection Of note, at discharge 10/15 slow prednisone taper recommended to start 10/28. 40mg given this morning before transfer, will continue with 40mg daily Pulmonary consulted-  On prednisone as per below.Continue Dulera and Spiriva.  Continue prednisone with plan to complete 5-day course.  Also on azithromycin Encouraged complete cessation tobacco ST consulted PT/OT/ case management consulted Continue prednisone, pulm hygiene, home inhalers, nebulizer Cont pulse ox   Paroxysmal atrial fibrillation Last Echo June 2018 with porr quality and EF of 55% No home rate control medications or anticoagulation History of GI bleed on Xarelto (2019) Currently NSR Cont tele   Urinary frequency Urinary frequency x 4 days No dysuria UA negative   Severe Malnutrition with cachexia POA Failure to thrive BMI 16.09 Nutrition consulted-Boost TID ordered ST consulted PT/OT consulted   H/o Diverticular perforation S/p ostomy Wound care consulted
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Dyspnoea, Emphysema, Lung consolidation, Malaise
Clinical narrative: Pt. is a 79 y.o. male patient with history of asthma, COPD, hx sigmoid colectomy with colostomy in place, atrial fibrillation (no anticoagulation) presented with COPD exacerbation.   Covid-19 Virus Infection Date of onset of symptoms: 10/25 Symptoms present on admission: yes Date of covid positive test: 10/26 Vaccination status: vaccinated Imaging: PCXR-Stable chest x-ray compared to 10/15/2023.  Right apical thickening and loss of volume redemonstrated.  Underlying emphysema.  No evidence of new findings. CTPA-No CT evidence for acute pulmonary embolus. COPD with chronic right upper lobe consolidation Oxygen requirements on admission: 2L NC Current oxygen requirements: None Medical therapy: remdesivir and steroids x 5days Consultants following: Pulmonary Anticipated special isolation end date: 11/6 COVID order set placed   Acute hypoxemic and hypercarbic respiratory failure Acute exacerbation of COPD Asthma Tobacco abuse Does not wear oxygen at baseline Admitted 10/15-10/19 for COPD and Pseudomonas pneumonia, finished course of levaquin Worsening weakness and SOB; unable to get out of bed since discharge Now on 2L oxygen Afebrile, WBC 13k, normotensive (10/25) Influenza and COVID swab refused by patient Elevated lactate 2.8 (10/24) -- > 1.7 (10/25) CXR (10/24) similar to previous (10/15), CT PA (10/24) nonacute, no PE Sputum culture pending collection Of note, at discharge 10/15 slow prednisone taper recommended to start 10/28. 40mg given this morning before transfer, will continue with 40mg daily Pulmonary consulted-  On prednisone as per below.Continue Dulera and Spiriva.  Continue prednisone with plan to complete 5-day course.  Also on azithromycin Encouraged complete cessation tobacco ST consulted PT/OT/ case management consulted Continue prednisone, pulm hygiene, home inhalers, nebulizer Cont pulse ox   Paroxysmal atrial fibrillation Last Echo June 2018 with porr quality and EF of 55% No home rate control medications or anticoagulation History of GI bleed on Xarelto (2019) Currently NSR Cont tele   Urinary frequency Urinary frequency x 4 days No dysuria UA negative   Severe Malnutrition with cachexia POA Failure to thrive BMI 16.09 Nutrition consulted-Boost TID ordered ST consulted PT/OT consulted   H/o Diverticular perforation S/p ostomy Wound care consulted
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Malnutrition, Mobility decreased, Pleural thickening, Pneumonia pseudomonal, Pollakiuria
Clinical narrative: Pt. is a 79 y.o. male patient with history of asthma, COPD, hx sigmoid colectomy with colostomy in place, atrial fibrillation (no anticoagulation) presented with COPD exacerbation.   Covid-19 Virus Infection Date of onset of symptoms: 10/25 Symptoms present on admission: yes Date of covid positive test: 10/26 Vaccination status: vaccinated Imaging: PCXR-Stable chest x-ray compared to 10/15/2023.  Right apical thickening and loss of volume redemonstrated.  Underlying emphysema.  No evidence of new findings. CTPA-No CT evidence for acute pulmonary embolus. COPD with chronic right upper lobe consolidation Oxygen requirements on admission: 2L NC Current oxygen requirements: None Medical therapy: remdesivir and steroids x 5days Consultants following: Pulmonary Anticipated special isolation end date: 11/6 COVID order set placed   Acute hypoxemic and hypercarbic respiratory failure Acute exacerbation of COPD Asthma Tobacco abuse Does not wear oxygen at baseline Admitted 10/15-10/19 for COPD and Pseudomonas pneumonia, finished course of levaquin Worsening weakness and SOB; unable to get out of bed since discharge Now on 2L oxygen Afebrile, WBC 13k, normotensive (10/25) Influenza and COVID swab refused by patient Elevated lactate 2.8 (10/24) -- > 1.7 (10/25) CXR (10/24) similar to previous (10/15), CT PA (10/24) nonacute, no PE Sputum culture pending collection Of note, at discharge 10/15 slow prednisone taper recommended to start 10/28. 40mg given this morning before transfer, will continue with 40mg daily Pulmonary consulted-  On prednisone as per below.Continue Dulera and Spiriva.  Continue prednisone with plan to complete 5-day course.  Also on azithromycin Encouraged complete cessation tobacco ST consulted PT/OT/ case management consulted Continue prednisone, pulm hygiene, home inhalers, nebulizer Cont pulse ox   Paroxysmal atrial fibrillation Last Echo June 2018 with porr quality and EF of 55% No home rate control medications or anticoagulation History of GI bleed on Xarelto (2019) Currently NSR Cont tele   Urinary frequency Urinary frequency x 4 days No dysuria UA negative   Severe Malnutrition with cachexia POA Failure to thrive BMI 16.09 Nutrition consulted-Boost TID ordered ST consulted PT/OT consulted   H/o Diverticular perforation S/p ostomy Wound care consulted
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory failure, SARS-CoV-2 test positive, Sinus rhythm, Total lung capacity decreased, Urine analysis normal
Clinical narrative: Pt. is a 79 y.o. male patient with history of asthma, COPD, hx sigmoid colectomy with colostomy in place, atrial fibrillation (no anticoagulation) presented with COPD exacerbation.   Covid-19 Virus Infection Date of onset of symptoms: 10/25 Symptoms present on admission: yes Date of covid positive test: 10/26 Vaccination status: vaccinated Imaging: PCXR-Stable chest x-ray compared to 10/15/2023.  Right apical thickening and loss of volume redemonstrated.  Underlying emphysema.  No evidence of new findings. CTPA-No CT evidence for acute pulmonary embolus. COPD with chronic right upper lobe consolidation Oxygen requirements on admission: 2L NC Current oxygen requirements: None Medical therapy: remdesivir and steroids x 5days Consultants following: Pulmonary Anticipated special isolation end date: 11/6 COVID order set placed   Acute hypoxemic and hypercarbic respiratory failure Acute exacerbation of COPD Asthma Tobacco abuse Does not wear oxygen at baseline Admitted 10/15-10/19 for COPD and Pseudomonas pneumonia, finished course of levaquin Worsening weakness and SOB; unable to get out of bed since discharge Now on 2L oxygen Afebrile, WBC 13k, normotensive (10/25) Influenza and COVID swab refused by patient Elevated lactate 2.8 (10/24) -- > 1.7 (10/25) CXR (10/24) similar to previous (10/15), CT PA (10/24) nonacute, no PE Sputum culture pending collection Of note, at discharge 10/15 slow prednisone taper recommended to start 10/28. 40mg given this morning before transfer, will continue with 40mg daily Pulmonary consulted-  On prednisone as per below.Continue Dulera and Spiriva.  Continue prednisone with plan to complete 5-day course.  Also on azithromycin Encouraged complete cessation tobacco ST consulted PT/OT/ case management consulted Continue prednisone, pulm hygiene, home inhalers, nebulizer Cont pulse ox   Paroxysmal atrial fibrillation Last Echo June 2018 with porr quality and EF of 55% No home rate control medications or anticoagulation History of GI bleed on Xarelto (2019) Currently NSR Cont tele   Urinary frequency Urinary frequency x 4 days No dysuria UA negative   Severe Malnutrition with cachexia POA Failure to thrive BMI 16.09 Nutrition consulted-Boost TID ordered ST consulted PT/OT consulted   H/o Diverticular perforation S/p ostomy Wound care consulted
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cell count increased
Clinical narrative: Pt. is a 79 y.o. male patient with history of asthma, COPD, hx sigmoid colectomy with colostomy in place, atrial fibrillation (no anticoagulation) presented with COPD exacerbation.   Covid-19 Virus Infection Date of onset of symptoms: 10/25 Symptoms present on admission: yes Date of covid positive test: 10/26 Vaccination status: vaccinated Imaging: PCXR-Stable chest x-ray compared to 10/15/2023.  Right apical thickening and loss of volume redemonstrated.  Underlying emphysema.  No evidence of new findings. CTPA-No CT evidence for acute pulmonary embolus. COPD with chronic right upper lobe consolidation Oxygen requirements on admission: 2L NC Current oxygen requirements: None Medical therapy: remdesivir and steroids x 5days Consultants following: Pulmonary Anticipated special isolation end date: 11/6 COVID order set placed   Acute hypoxemic and hypercarbic respiratory failure Acute exacerbation of COPD Asthma Tobacco abuse Does not wear oxygen at baseline Admitted 10/15-10/19 for COPD and Pseudomonas pneumonia, finished course of levaquin Worsening weakness and SOB; unable to get out of bed since discharge Now on 2L oxygen Afebrile, WBC 13k, normotensive (10/25) Influenza and COVID swab refused by patient Elevated lactate 2.8 (10/24) -- > 1.7 (10/25) CXR (10/24) similar to previous (10/15), CT PA (10/24) nonacute, no PE Sputum culture pending collection Of note, at discharge 10/15 slow prednisone taper recommended to start 10/28. 40mg given this morning before transfer, will continue with 40mg daily Pulmonary consulted-  On prednisone as per below.Continue Dulera and Spiriva.  Continue prednisone with plan to complete 5-day course.  Also on azithromycin Encouraged complete cessation tobacco ST consulted PT/OT/ case management consulted Continue prednisone, pulm hygiene, home inhalers, nebulizer Cont pulse ox   Paroxysmal atrial fibrillation Last Echo June 2018 with porr quality and EF of 55% No home rate control medications or anticoagulation History of GI bleed on Xarelto (2019) Currently NSR Cont tele   Urinary frequency Urinary frequency x 4 days No dysuria UA negative   Severe Malnutrition with cachexia POA Failure to thrive BMI 16.09 Nutrition consulted-Boost TID ordered ST consulted PT/OT consulted   H/o Diverticular perforation S/p ostomy Wound care consulted
Age: 51.0
Sex: F
Vaccine: COVID19, COVID19, COVID19, UNK
Symptoms: Oropharyngeal pain, SARS-CoV-2 test
Clinical narrative: Sore throat
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Blood gases normal, COVID-19, Chest X-ray normal, Chills
Clinical narrative: Patient is a 65 y.o. female patient with history of ESRD, CAD presented to with dyspnea found to have hypoxia   Acute Hypoxic Respiratory Failure, resolved  Covid-19 Virus Infection Date of onset of symptoms: 10/16; positive test 10/17 Symptoms present on admission: dyspnea, chills Date of covid positive test: 10/17/23 Imaging: CXR negative; no e/o infection. VBG w/o hypercapnia  Oxygen requirements on admission: 6L; weaned to RA w/ significant improvement in symptoms  Medical therapy: steroids and planning to continue at DC to complete 10 day total course; held off on remdesevir given rapid improvement in symptoms  Consultants following: nephrology Rx albuterol inhaler at DC  Continue isolation x10 days since symptoms onset    ESRD Finished one hour of dialysis day of admission; completed 10/19 PM and additional session 10/20  Normal schedule M/T/Th/F  Nephrology consulted on admission Resume home schedule at DC    CAD Heart catheterization June 2018 Multivessel coronary disease poorly suited to PCI - procedure complicated by major retroperitoneal hematoma Continue home ASA, Plavix, Statin  Denies chest pain    Paroxysmal Afib Not on anticoagulation given history of anemia Continue home CCB   HTN Continue home Cardizem   Severe AS Severe AS per history and following with cardiology outpatient   Chronic Anemia Chronic thrombocytopenia At baseline - in the setting of ESRD Hgb 10.1, Plt 56 on admission and stable on repeat  Follows with hematology outpatient
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Dialysis, Dyspnoea, Haemoglobin decreased, Hypoxia, Platelet count decreased
Clinical narrative: Patient is a 65 y.o. female patient with history of ESRD, CAD presented to with dyspnea found to have hypoxia   Acute Hypoxic Respiratory Failure, resolved  Covid-19 Virus Infection Date of onset of symptoms: 10/16; positive test 10/17 Symptoms present on admission: dyspnea, chills Date of covid positive test: 10/17/23 Imaging: CXR negative; no e/o infection. VBG w/o hypercapnia  Oxygen requirements on admission: 6L; weaned to RA w/ significant improvement in symptoms  Medical therapy: steroids and planning to continue at DC to complete 10 day total course; held off on remdesevir given rapid improvement in symptoms  Consultants following: nephrology Rx albuterol inhaler at DC  Continue isolation x10 days since symptoms onset    ESRD Finished one hour of dialysis day of admission; completed 10/19 PM and additional session 10/20  Normal schedule M/T/Th/F  Nephrology consulted on admission Resume home schedule at DC    CAD Heart catheterization June 2018 Multivessel coronary disease poorly suited to PCI - procedure complicated by major retroperitoneal hematoma Continue home ASA, Plavix, Statin  Denies chest pain    Paroxysmal Afib Not on anticoagulation given history of anemia Continue home CCB   HTN Continue home Cardizem   Severe AS Severe AS per history and following with cardiology outpatient   Chronic Anemia Chronic thrombocytopenia At baseline - in the setting of ESRD Hgb 10.1, Plt 56 on admission and stable on repeat  Follows with hematology outpatient
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Patient is a 65 y.o. female patient with history of ESRD, CAD presented to with dyspnea found to have hypoxia   Acute Hypoxic Respiratory Failure, resolved  Covid-19 Virus Infection Date of onset of symptoms: 10/16; positive test 10/17 Symptoms present on admission: dyspnea, chills Date of covid positive test: 10/17/23 Imaging: CXR negative; no e/o infection. VBG w/o hypercapnia  Oxygen requirements on admission: 6L; weaned to RA w/ significant improvement in symptoms  Medical therapy: steroids and planning to continue at DC to complete 10 day total course; held off on remdesevir given rapid improvement in symptoms  Consultants following: nephrology Rx albuterol inhaler at DC  Continue isolation x10 days since symptoms onset    ESRD Finished one hour of dialysis day of admission; completed 10/19 PM and additional session 10/20  Normal schedule M/T/Th/F  Nephrology consulted on admission Resume home schedule at DC    CAD Heart catheterization June 2018 Multivessel coronary disease poorly suited to PCI - procedure complicated by major retroperitoneal hematoma Continue home ASA, Plavix, Statin  Denies chest pain    Paroxysmal Afib Not on anticoagulation given history of anemia Continue home CCB   HTN Continue home Cardizem   Severe AS Severe AS per history and following with cardiology outpatient   Chronic Anemia Chronic thrombocytopenia At baseline - in the setting of ESRD Hgb 10.1, Plt 56 on admission and stable on repeat  Follows with hematology outpatient
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Dizziness, Erythema, Fatigue, Headache
Clinical narrative: Giant red mark on arm, severe headache, vomiting, diarrhea, fatigue, that lasted 6 days.  Unable to leave house.  Tried to go to physical therapy and had to stop from severe dizziness.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of personal independence in daily activities, Vomiting
Clinical narrative: Giant red mark on arm, severe headache, vomiting, diarrhea, fatigue, that lasted 6 days.  Unable to leave house.  Tried to go to physical therapy and had to stop from severe dizziness.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Asthma, COVID-19, Chest X-ray normal
Clinical narrative: Patient is a 61 y.o. female patient of DO with history of Afib, COPD, mood disorder, hypothyroid,  presented to Hospital with increasing shortness of breath.  She was positive for COVID-19 infection.     Discharged in improved condition on room air with prescriptions to pharmacy   Covid-19 Virus Infection Acute hypoxic respiratory failure.   Asthma exacerbation with sever persistent asthma Date of onset of symptoms: 10/20/23 Symptoms present on admission: cough.   Date of covid positive test: 10/21/23 Vaccination status: vaccinated  No booster.   Imaging: CXR, no pne.   Oxygen requirements on admission: 2 liter Current oxygen requirements: 2L Medical therapy: remdesivir and steroids Consultants following: none.   Anticipated special isolation end date: 10/29/2023  Continue LABA+ICS MDI.   Albuterol MDI prn.  Weaned to RA upon D/C   Paroxysmal AFib In sinus on admission Continue diltiazem po for rate control.   Continue home sotalol with hold parameters  Eliquis for stroke prevention.     AKI Improved Monitor daily Encourage PO fluid intake   Mood disorder with anxiety.   Continue Lexapro.     GERD.   Obesity BMI 44.2.   Encourage life style modification.     Code Status   Full code.
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Dyspnoea, SARS-CoV-2 test positive, Sinus rhythm
Clinical narrative: Patient is a 61 y.o. female patient of DO with history of Afib, COPD, mood disorder, hypothyroid,  presented to Hospital with increasing shortness of breath.  She was positive for COVID-19 infection.     Discharged in improved condition on room air with prescriptions to pharmacy   Covid-19 Virus Infection Acute hypoxic respiratory failure.   Asthma exacerbation with sever persistent asthma Date of onset of symptoms: 10/20/23 Symptoms present on admission: cough.   Date of covid positive test: 10/21/23 Vaccination status: vaccinated  No booster.   Imaging: CXR, no pne.   Oxygen requirements on admission: 2 liter Current oxygen requirements: 2L Medical therapy: remdesivir and steroids Consultants following: none.   Anticipated special isolation end date: 10/29/2023  Continue LABA+ICS MDI.   Albuterol MDI prn.  Weaned to RA upon D/C   Paroxysmal AFib In sinus on admission Continue diltiazem po for rate control.   Continue home sotalol with hold parameters  Eliquis for stroke prevention.     AKI Improved Monitor daily Encourage PO fluid intake   Mood disorder with anxiety.   Continue Lexapro.     GERD.   Obesity BMI 44.2.   Encourage life style modification.     Code Status   Full code.
Age: 75.0
Sex: M
Vaccine: VARZOS
Symptoms: Atrial tachycardia, Back pain, Cardioversion, Electrocardiogram, Heart rate increased
Clinical narrative: Pain in back began on 12/14/2023 and increased to severe over next couple of days and on morning of 12/17/2023 experienced rapid heartrate around 125-135 bpm together with low blood pressure. Saw cardiologist on 12/18/2023, diagnosis atrial tachycardia, prescribed Eliquis 5 mg twice daily and ordered cardioversion on 12/20/2023. Back pain gradually decreased by this time and while at hospital being prepped for cardioversion heart rate converted back to normal sinus rhythm. I must remain on Eliquis because of this episode.
Age: 75.0
Sex: M
Vaccine: VARZOS
Symptoms: Hypotension, Sinus rhythm
Clinical narrative: Pain in back began on 12/14/2023 and increased to severe over next couple of days and on morning of 12/17/2023 experienced rapid heartrate around 125-135 bpm together with low blood pressure. Saw cardiologist on 12/18/2023, diagnosis atrial tachycardia, prescribed Eliquis 5 mg twice daily and ordered cardioversion on 12/20/2023. Back pain gradually decreased by this time and while at hospital being prepped for cardioversion heart rate converted back to normal sinus rhythm. I must remain on Eliquis because of this episode.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Angiogram pulmonary normal, Asthenia, COVID-19, COVID-19 pneumonia
Clinical narrative: Patient is a 80 y.o. male patient of, DO with history of BPH, Barrett's esophagus, MDD, DM type II, glaucoma, HLD, HTN presented to Medical Center with chief complaint of a fall.  He was found to be positive for COVID?19 on 11/6 complicated by acute hypoxic respiratory failure, requiring 3 L NC on admission.   Covid-19 pneumonia (improving)  Date of onset of symptoms: 11/5 Symptoms present on admission: yes Date of covid positive test: 11/6 Vaccination status: vaccinated Imaging: CTA chest without acute process. No focal consolidation or pulmonary edema. Oxygen requirements on admission: 3L NC Current oxygen requirements: room air  Medical therapy: remdesivir and Decadron.  LFTs up-trended, but currently on a downtrend. Completes remdesivir as of 11/10. Consultants following: ID Anticipated special isolation end date: 11/15 Continue supportive care with Mucinex and PRN antitussives    Acute hypoxic respiratory failure (resolved) Likely 2/2 COVID-19, plan discussed above  Not on O2 at home, SPO2 90% in ED requiring 3 L NC on admit  No leukocytosis, HDS, normal RR CTA chest (11/6) negative, recent echo 9/8/23 at Facility normal, EF 55 to 60% Continue aggressive pulm hygiene, encourage IS, up to chair, maintain SPO2 greater than 92% Weaned off O2 (11/10)   Elevated troponin Initial trop 32 -> 24 -> 22 Likely due to demand ischemia in setting of COVID pneumonia EKG does not suggest acute ischemia, V1 inversions are present and seen in prior EKG Doubt ACS, no further workup necessary at this time   Generalized weakness Fall at home Patient with progressive confusion, history of falls Suspect 2/2 COVID?19 vs deconditioning  CT head w/ severe chronic microvascular white matter disease MRI brain negative for bleed or acute intracranial findings, chronic microvascular ischemic/aging changes. No interval changes from 2022 brain MRI.  PT/OT consulted; recs up to 5 days/week Continue fall precautions   Possible dysphagia Patient family concern for worsening cough shortly after drinking orange juice SLP consulted for swallowing eval.  No evidence of dysphagia.  Current recs are for regular solids, thin liquids   End-stage neovascular glaucoma bilateral Chronic, stable Resume home eyedrops   DM type II without current long-term insulin use  A1c 6.6% (11/9/23) Currently on Amaryl 1mg, held inpatient  Low-dose SSI, continue Accu-Cheks ACHS, diabetic diet while inpatient   HLD Continue home statin Essential hypertension On losartan at home, held in house given stable BP so far Resume on DC    History of Barrett's esophagus On Omeprazole 20 mg BID at home  Protonix 40 mg BID ordered in house    Thrombocytopenia (POA) Plt 140 on admission; 141 (11/9), previously normal Likely reactive to viral illness (COVID) Continue to monitor
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Cerebral small vessel ischaemic disease, Computerised tomogram head abnormal, Confusional state, Diabetic diet, Echocardiogram normal
Clinical narrative: Patient is a 80 y.o. male patient of, DO with history of BPH, Barrett's esophagus, MDD, DM type II, glaucoma, HLD, HTN presented to Medical Center with chief complaint of a fall.  He was found to be positive for COVID?19 on 11/6 complicated by acute hypoxic respiratory failure, requiring 3 L NC on admission.   Covid-19 pneumonia (improving)  Date of onset of symptoms: 11/5 Symptoms present on admission: yes Date of covid positive test: 11/6 Vaccination status: vaccinated Imaging: CTA chest without acute process. No focal consolidation or pulmonary edema. Oxygen requirements on admission: 3L NC Current oxygen requirements: room air  Medical therapy: remdesivir and Decadron.  LFTs up-trended, but currently on a downtrend. Completes remdesivir as of 11/10. Consultants following: ID Anticipated special isolation end date: 11/15 Continue supportive care with Mucinex and PRN antitussives    Acute hypoxic respiratory failure (resolved) Likely 2/2 COVID-19, plan discussed above  Not on O2 at home, SPO2 90% in ED requiring 3 L NC on admit  No leukocytosis, HDS, normal RR CTA chest (11/6) negative, recent echo 9/8/23 at Facility normal, EF 55 to 60% Continue aggressive pulm hygiene, encourage IS, up to chair, maintain SPO2 greater than 92% Weaned off O2 (11/10)   Elevated troponin Initial trop 32 -> 24 -> 22 Likely due to demand ischemia in setting of COVID pneumonia EKG does not suggest acute ischemia, V1 inversions are present and seen in prior EKG Doubt ACS, no further workup necessary at this time   Generalized weakness Fall at home Patient with progressive confusion, history of falls Suspect 2/2 COVID?19 vs deconditioning  CT head w/ severe chronic microvascular white matter disease MRI brain negative for bleed or acute intracranial findings, chronic microvascular ischemic/aging changes. No interval changes from 2022 brain MRI.  PT/OT consulted; recs up to 5 days/week Continue fall precautions   Possible dysphagia Patient family concern for worsening cough shortly after drinking orange juice SLP consulted for swallowing eval.  No evidence of dysphagia.  Current recs are for regular solids, thin liquids   End-stage neovascular glaucoma bilateral Chronic, stable Resume home eyedrops   DM type II without current long-term insulin use  A1c 6.6% (11/9/23) Currently on Amaryl 1mg, held inpatient  Low-dose SSI, continue Accu-Cheks ACHS, diabetic diet while inpatient   HLD Continue home statin Essential hypertension On losartan at home, held in house given stable BP so far Resume on DC    History of Barrett's esophagus On Omeprazole 20 mg BID at home  Protonix 40 mg BID ordered in house    Thrombocytopenia (POA) Plt 140 on admission; 141 (11/9), previously normal Likely reactive to viral illness (COVID) Continue to monitor
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Ejection fraction normal, Electrocardiogram abnormal, Fall, Glycosylated haemoglobin normal, Liver function test increased
Clinical narrative: Patient is a 80 y.o. male patient of, DO with history of BPH, Barrett's esophagus, MDD, DM type II, glaucoma, HLD, HTN presented to Medical Center with chief complaint of a fall.  He was found to be positive for COVID?19 on 11/6 complicated by acute hypoxic respiratory failure, requiring 3 L NC on admission.   Covid-19 pneumonia (improving)  Date of onset of symptoms: 11/5 Symptoms present on admission: yes Date of covid positive test: 11/6 Vaccination status: vaccinated Imaging: CTA chest without acute process. No focal consolidation or pulmonary edema. Oxygen requirements on admission: 3L NC Current oxygen requirements: room air  Medical therapy: remdesivir and Decadron.  LFTs up-trended, but currently on a downtrend. Completes remdesivir as of 11/10. Consultants following: ID Anticipated special isolation end date: 11/15 Continue supportive care with Mucinex and PRN antitussives    Acute hypoxic respiratory failure (resolved) Likely 2/2 COVID-19, plan discussed above  Not on O2 at home, SPO2 90% in ED requiring 3 L NC on admit  No leukocytosis, HDS, normal RR CTA chest (11/6) negative, recent echo 9/8/23 at Facility normal, EF 55 to 60% Continue aggressive pulm hygiene, encourage IS, up to chair, maintain SPO2 greater than 92% Weaned off O2 (11/10)   Elevated troponin Initial trop 32 -> 24 -> 22 Likely due to demand ischemia in setting of COVID pneumonia EKG does not suggest acute ischemia, V1 inversions are present and seen in prior EKG Doubt ACS, no further workup necessary at this time   Generalized weakness Fall at home Patient with progressive confusion, history of falls Suspect 2/2 COVID?19 vs deconditioning  CT head w/ severe chronic microvascular white matter disease MRI brain negative for bleed or acute intracranial findings, chronic microvascular ischemic/aging changes. No interval changes from 2022 brain MRI.  PT/OT consulted; recs up to 5 days/week Continue fall precautions   Possible dysphagia Patient family concern for worsening cough shortly after drinking orange juice SLP consulted for swallowing eval.  No evidence of dysphagia.  Current recs are for regular solids, thin liquids   End-stage neovascular glaucoma bilateral Chronic, stable Resume home eyedrops   DM type II without current long-term insulin use  A1c 6.6% (11/9/23) Currently on Amaryl 1mg, held inpatient  Low-dose SSI, continue Accu-Cheks ACHS, diabetic diet while inpatient   HLD Continue home statin Essential hypertension On losartan at home, held in house given stable BP so far Resume on DC    History of Barrett's esophagus On Omeprazole 20 mg BID at home  Protonix 40 mg BID ordered in house    Thrombocytopenia (POA) Plt 140 on admission; 141 (11/9), previously normal Likely reactive to viral illness (COVID) Continue to monitor
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Magnetic resonance imaging head abnormal, Malaise, Myocardial ischaemia, Physical deconditioning, Platelet count decreased
Clinical narrative: Patient is a 80 y.o. male patient of, DO with history of BPH, Barrett's esophagus, MDD, DM type II, glaucoma, HLD, HTN presented to Medical Center with chief complaint of a fall.  He was found to be positive for COVID?19 on 11/6 complicated by acute hypoxic respiratory failure, requiring 3 L NC on admission.   Covid-19 pneumonia (improving)  Date of onset of symptoms: 11/5 Symptoms present on admission: yes Date of covid positive test: 11/6 Vaccination status: vaccinated Imaging: CTA chest without acute process. No focal consolidation or pulmonary edema. Oxygen requirements on admission: 3L NC Current oxygen requirements: room air  Medical therapy: remdesivir and Decadron.  LFTs up-trended, but currently on a downtrend. Completes remdesivir as of 11/10. Consultants following: ID Anticipated special isolation end date: 11/15 Continue supportive care with Mucinex and PRN antitussives    Acute hypoxic respiratory failure (resolved) Likely 2/2 COVID-19, plan discussed above  Not on O2 at home, SPO2 90% in ED requiring 3 L NC on admit  No leukocytosis, HDS, normal RR CTA chest (11/6) negative, recent echo 9/8/23 at Facility normal, EF 55 to 60% Continue aggressive pulm hygiene, encourage IS, up to chair, maintain SPO2 greater than 92% Weaned off O2 (11/10)   Elevated troponin Initial trop 32 -> 24 -> 22 Likely due to demand ischemia in setting of COVID pneumonia EKG does not suggest acute ischemia, V1 inversions are present and seen in prior EKG Doubt ACS, no further workup necessary at this time   Generalized weakness Fall at home Patient with progressive confusion, history of falls Suspect 2/2 COVID?19 vs deconditioning  CT head w/ severe chronic microvascular white matter disease MRI brain negative for bleed or acute intracranial findings, chronic microvascular ischemic/aging changes. No interval changes from 2022 brain MRI.  PT/OT consulted; recs up to 5 days/week Continue fall precautions   Possible dysphagia Patient family concern for worsening cough shortly after drinking orange juice SLP consulted for swallowing eval.  No evidence of dysphagia.  Current recs are for regular solids, thin liquids   End-stage neovascular glaucoma bilateral Chronic, stable Resume home eyedrops   DM type II without current long-term insulin use  A1c 6.6% (11/9/23) Currently on Amaryl 1mg, held inpatient  Low-dose SSI, continue Accu-Cheks ACHS, diabetic diet while inpatient   HLD Continue home statin Essential hypertension On losartan at home, held in house given stable BP so far Resume on DC    History of Barrett's esophagus On Omeprazole 20 mg BID at home  Protonix 40 mg BID ordered in house    Thrombocytopenia (POA) Plt 140 on admission; 141 (11/9), previously normal Likely reactive to viral illness (COVID) Continue to monitor
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Swallow study, Thrombocytopenia, Troponin increased, White matter lesion
Clinical narrative: Patient is a 80 y.o. male patient of, DO with history of BPH, Barrett's esophagus, MDD, DM type II, glaucoma, HLD, HTN presented to Medical Center with chief complaint of a fall.  He was found to be positive for COVID?19 on 11/6 complicated by acute hypoxic respiratory failure, requiring 3 L NC on admission.   Covid-19 pneumonia (improving)  Date of onset of symptoms: 11/5 Symptoms present on admission: yes Date of covid positive test: 11/6 Vaccination status: vaccinated Imaging: CTA chest without acute process. No focal consolidation or pulmonary edema. Oxygen requirements on admission: 3L NC Current oxygen requirements: room air  Medical therapy: remdesivir and Decadron.  LFTs up-trended, but currently on a downtrend. Completes remdesivir as of 11/10. Consultants following: ID Anticipated special isolation end date: 11/15 Continue supportive care with Mucinex and PRN antitussives    Acute hypoxic respiratory failure (resolved) Likely 2/2 COVID-19, plan discussed above  Not on O2 at home, SPO2 90% in ED requiring 3 L NC on admit  No leukocytosis, HDS, normal RR CTA chest (11/6) negative, recent echo 9/8/23 at Facility normal, EF 55 to 60% Continue aggressive pulm hygiene, encourage IS, up to chair, maintain SPO2 greater than 92% Weaned off O2 (11/10)   Elevated troponin Initial trop 32 -> 24 -> 22 Likely due to demand ischemia in setting of COVID pneumonia EKG does not suggest acute ischemia, V1 inversions are present and seen in prior EKG Doubt ACS, no further workup necessary at this time   Generalized weakness Fall at home Patient with progressive confusion, history of falls Suspect 2/2 COVID?19 vs deconditioning  CT head w/ severe chronic microvascular white matter disease MRI brain negative for bleed or acute intracranial findings, chronic microvascular ischemic/aging changes. No interval changes from 2022 brain MRI.  PT/OT consulted; recs up to 5 days/week Continue fall precautions   Possible dysphagia Patient family concern for worsening cough shortly after drinking orange juice SLP consulted for swallowing eval.  No evidence of dysphagia.  Current recs are for regular solids, thin liquids   End-stage neovascular glaucoma bilateral Chronic, stable Resume home eyedrops   DM type II without current long-term insulin use  A1c 6.6% (11/9/23) Currently on Amaryl 1mg, held inpatient  Low-dose SSI, continue Accu-Cheks ACHS, diabetic diet while inpatient   HLD Continue home statin Essential hypertension On losartan at home, held in house given stable BP so far Resume on DC    History of Barrett's esophagus On Omeprazole 20 mg BID at home  Protonix 40 mg BID ordered in house    Thrombocytopenia (POA) Plt 140 on admission; 141 (11/9), previously normal Likely reactive to viral illness (COVID) Continue to monitor
Age: 35.0
Sex: F
Vaccine: VARCEL
Symptoms: Inappropriate schedule of product administration
Clinical narrative: none noted, varicella vaccine given one day to soon, client was advised to return to clinic for a repeat vaccination to be completed in one month no show for appointment.
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray normal, Culture urine positive
Clinical narrative: DISCHARGE SUMMARY -- Medical Center   Patient MRN:                                Account Number:  Admitted: 10/23/2023 Discharge Date: 11/01/23    PCP Handoff    Recommended Outpatient Testing o Follow Up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 69 y.o. male patient of MD with history of blindness, deafness, intellectual disability, seizures, dysphagia and PEG tube dependent, Barrett's esophagus who was admitted with COVID-19 PNA.   Acute hypoxemic respiratory failure 2/2 COVID-19 infection Date of onset of symptoms: 10/21/23 Symptoms present on admission: hypoxia Date of COVID positive test: 10/23/23 Vaccination status: Vaccinated Imaging: CXR with no acute findings Oxygen requirements on admission: Non-rebreather Current oxygen requirements: Weaned to RA 10/31 Medical therapy: Completed remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/1/23 CM following for discharge planning  Intermittently requires low dose NC. DC with O2   Sepsis, resolved Lactic acidosis, resolved SIRS POA with COVID 19 and Possible UTI as source  Initially was on Vanc/Zosyn Now tailored to Cefepime 10/25-10/31 Remdesivir as above Mgmt of UTI as below    Pseudomonas UTI UA with signs of infection Ucx with Pseudomonas Completed cefepime 10/31   Elevated troponin Initial troponin 31 > 29 -- flat trend Initial EKG showed sinus tachycardia Suspect demand ischemia in setting of sepsis Management of sepsis above   Cerebral palsy Spastic quadriplegia in setting of cerebral palsy Blindness, Deafness Presented from SNF Has baclofen pump, managed  Is blind and deaf at baseline Continue home baclofen pump (settings verified by pharmacist)   PEG tube dependent History of dysphagia and aspiration--NPO Baseline tube feed settings (Jevity 1.5, 230 mL at 9 AM, 1 PM, 5 PM, 9 PM, with 300 free water flushes) Initiated tube feeds with Isosource Dietitian following   Seizures Continue home Keppra Precautions  Barrett's esophagus Continue home PPI   Iron deficiency anemia Initial Hgb 14.2 No obvious bleeding Continue home ferrous sulfate   Constipation Continue home MiraLAX and senna-docusate