chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Epigastric discomfort, Fatigue, Hypophagia, Hypoxia, Inappropriate schedule of product administration
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/19/21 (EN6208) Pfizer Dose 2 4/14/21 (EW0153) COVID Positive 11/28/21 Discharged home 11/30/31 Hospitalized 11/28/21-11/30/21  12/8/21: The patient vaccinated for COVID-19, diagnosed with COVID-19 pneumonitis on November 28 and she was admitted to the hospital and observed and discharged home, for the last 3 days she had progressive shortness of breath with sputum productive cough and episodes of chills with epigastric discomfort and nausea and occasional vomiting and unable to tolerate p.o. intake last 24 hours with generalized weakness and fatigue, she does have dyspnea with minimal exertion while she is walking within her room and her home.  She is known to be asthmatic and was using her inhalers at home 2-3 times within  24 hours within the last 3 days without resolution in her cough and shortness of breath.  No wheezing noted test.  At baseline she does not use any oxygen.   At emergency she was hypoxic and require 3 L of oxygen to maintain SpO2 above 94%, her EKG show sinus rhythm with old left bundle branch block, troponin unremarkable, proBNP mildly elevated.  Chest x-ray reviewed personally and show vascular congestion and linear opacities.   At emergency she received Zofran and IV fluid.  12/10/21: She is a 79-year-old female recently admitted to hospital for severe COVID-19 infection complicated with pneumonia and hypoxia was discharged on 3 L of oxygen but came back to the emergency room on 12/08/2021 because of persistent SOB, nausea and poor appetite.  She was admitted and commenced on usual management for COVID-19 infection including restarting remdesivir, dexamethasone, IV antibiotics in addition to other supportive management.  On re-evaluation this morning she feels much better except for mild nausea.  She has a good appetite.  Her Sao2 on room air is 100%.  She will be discharged home on pre-admission medications.  She will follow-up with the PCP in 1-2 weeks.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Lung opacity, Nausea, Pneumonia, Productive cough, Prohormone brain natriuretic peptide increased
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/19/21 (EN6208) Pfizer Dose 2 4/14/21 (EW0153) COVID Positive 11/28/21 Discharged home 11/30/31 Hospitalized 11/28/21-11/30/21  12/8/21: The patient vaccinated for COVID-19, diagnosed with COVID-19 pneumonitis on November 28 and she was admitted to the hospital and observed and discharged home, for the last 3 days she had progressive shortness of breath with sputum productive cough and episodes of chills with epigastric discomfort and nausea and occasional vomiting and unable to tolerate p.o. intake last 24 hours with generalized weakness and fatigue, she does have dyspnea with minimal exertion while she is walking within her room and her home.  She is known to be asthmatic and was using her inhalers at home 2-3 times within  24 hours within the last 3 days without resolution in her cough and shortness of breath.  No wheezing noted test.  At baseline she does not use any oxygen.   At emergency she was hypoxic and require 3 L of oxygen to maintain SpO2 above 94%, her EKG show sinus rhythm with old left bundle branch block, troponin unremarkable, proBNP mildly elevated.  Chest x-ray reviewed personally and show vascular congestion and linear opacities.   At emergency she received Zofran and IV fluid.  12/10/21: She is a 79-year-old female recently admitted to hospital for severe COVID-19 infection complicated with pneumonia and hypoxia was discharged on 3 L of oxygen but came back to the emergency room on 12/08/2021 because of persistent SOB, nausea and poor appetite.  She was admitted and commenced on usual management for COVID-19 infection including restarting remdesivir, dexamethasone, IV antibiotics in addition to other supportive management.  On re-evaluation this morning she feels much better except for mild nausea.  She has a good appetite.  Her Sao2 on room air is 100%.  She will be discharged home on pre-admission medications.  She will follow-up with the PCP in 1-2 weeks.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary congestion, SARS-CoV-2 test positive, Sinus rhythm, Troponin normal, Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/19/21 (EN6208) Pfizer Dose 2 4/14/21 (EW0153) COVID Positive 11/28/21 Discharged home 11/30/31 Hospitalized 11/28/21-11/30/21  12/8/21: The patient vaccinated for COVID-19, diagnosed with COVID-19 pneumonitis on November 28 and she was admitted to the hospital and observed and discharged home, for the last 3 days she had progressive shortness of breath with sputum productive cough and episodes of chills with epigastric discomfort and nausea and occasional vomiting and unable to tolerate p.o. intake last 24 hours with generalized weakness and fatigue, she does have dyspnea with minimal exertion while she is walking within her room and her home.  She is known to be asthmatic and was using her inhalers at home 2-3 times within  24 hours within the last 3 days without resolution in her cough and shortness of breath.  No wheezing noted test.  At baseline she does not use any oxygen.   At emergency she was hypoxic and require 3 L of oxygen to maintain SpO2 above 94%, her EKG show sinus rhythm with old left bundle branch block, troponin unremarkable, proBNP mildly elevated.  Chest x-ray reviewed personally and show vascular congestion and linear opacities.   At emergency she received Zofran and IV fluid.  12/10/21: She is a 79-year-old female recently admitted to hospital for severe COVID-19 infection complicated with pneumonia and hypoxia was discharged on 3 L of oxygen but came back to the emergency room on 12/08/2021 because of persistent SOB, nausea and poor appetite.  She was admitted and commenced on usual management for COVID-19 infection including restarting remdesivir, dexamethasone, IV antibiotics in addition to other supportive management.  On re-evaluation this morning she feels much better except for mild nausea.  She has a good appetite.  Her Sao2 on room air is 100%.  She will be discharged home on pre-admission medications.  She will follow-up with the PCP in 1-2 weeks.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/19/21 (EN6208) Pfizer Dose 2 4/14/21 (EW0153) COVID Positive 11/28/21 Discharged home 11/30/31 Hospitalized 11/28/21-11/30/21  12/8/21: The patient vaccinated for COVID-19, diagnosed with COVID-19 pneumonitis on November 28 and she was admitted to the hospital and observed and discharged home, for the last 3 days she had progressive shortness of breath with sputum productive cough and episodes of chills with epigastric discomfort and nausea and occasional vomiting and unable to tolerate p.o. intake last 24 hours with generalized weakness and fatigue, she does have dyspnea with minimal exertion while she is walking within her room and her home.  She is known to be asthmatic and was using her inhalers at home 2-3 times within  24 hours within the last 3 days without resolution in her cough and shortness of breath.  No wheezing noted test.  At baseline she does not use any oxygen.   At emergency she was hypoxic and require 3 L of oxygen to maintain SpO2 above 94%, her EKG show sinus rhythm with old left bundle branch block, troponin unremarkable, proBNP mildly elevated.  Chest x-ray reviewed personally and show vascular congestion and linear opacities.   At emergency she received Zofran and IV fluid.  12/10/21: She is a 79-year-old female recently admitted to hospital for severe COVID-19 infection complicated with pneumonia and hypoxia was discharged on 3 L of oxygen but came back to the emergency room on 12/08/2021 because of persistent SOB, nausea and poor appetite.  She was admitted and commenced on usual management for COVID-19 infection including restarting remdesivir, dexamethasone, IV antibiotics in addition to other supportive management.  On re-evaluation this morning she feels much better except for mild nausea.  She has a good appetite.  Her Sao2 on room air is 100%.  She will be discharged home on pre-admission medications.  She will follow-up with the PCP in 1-2 weeks.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Blood pressure increased, Blood test, COVID-19, Chest X-ray, Cough
Clinical narrative: I was at the airport getting ready to fly home so I had to take a test to get on my flight home. I tested positive but had no symptoms at the time. I  went back to my host's apartment and the next day I was taken to the quarantine center the next day. I developed a sore throat and was very fatigued. I have a chronic cough so I did have a cough but I do not notice it from covid. The next day I was so exhausted I could not walk and had to be in a wheel chair- I was fighting to breath. My pulse and blood pressure were both high. I had started the meds for treatment after I arrived to the treatment center. I had my first negative test on April 8th and I was then able to travel home.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Electrocardiogram, Fatigue, Gait disturbance, Heart rate increased
Clinical narrative: I was at the airport getting ready to fly home so I had to take a test to get on my flight home. I tested positive but had no symptoms at the time. I  went back to my host's apartment and the next day I was taken to the quarantine center the next day. I developed a sore throat and was very fatigued. I have a chronic cough so I did have a cough but I do not notice it from covid. The next day I was so exhausted I could not walk and had to be in a wheel chair- I was fighting to breath. My pulse and blood pressure were both high. I had started the meds for treatment after I arrived to the treatment center. I had my first negative test on April 8th and I was then able to travel home.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: I was at the airport getting ready to fly home so I had to take a test to get on my flight home. I tested positive but had no symptoms at the time. I  went back to my host's apartment and the next day I was taken to the quarantine center the next day. I developed a sore throat and was very fatigued. I have a chronic cough so I did have a cough but I do not notice it from covid. The next day I was so exhausted I could not walk and had to be in a wheel chair- I was fighting to breath. My pulse and blood pressure were both high. I had started the meds for treatment after I arrived to the treatment center. I had my first negative test on April 8th and I was then able to travel home.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anion gap, Anosmia, Aortic dilatation, Asthenia
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 1/17/21 (lot NA) Pfizer Dose 2 2/7/21 (lot NA) COVID Positive 12/4/21  12/4/21: Patient is a 76-year-old female with a past medical history significant for end-stage renal disease on hemodialysis Tuesday Thursday Saturday, hypertension, hyperparathyroidism.  The patient presents to the ED today with complaints body aches, generalized illness over the last 2 weeks.  The patient's accompanying symptoms include loss of taste, loss of smell, nasal congestion, headaches, nausea, vomiting, diarrhea.  The patient denies any fever, cough, shortness of breath, chest pain, abdominal pain. The patient states she has not gone to any of her dialysis treatments this week due to significant weakness.  The patient had a known ill contact with her daughter.  The patient states she has been taking over-the-counter medications with no relief of her symptoms.  The patient is vaccinated against COVID-19. The patient attempted to ambulate in the ED but became very tachypneic and tachycardic requiring oxygen supplementation.   Upon arrival to ED patient's temperature is 97.1°, heart rate 87, respirations 16, pulse ox 99% on room air, blood pressure 163/99. CT chest reveals no evidence of PE, patchy opacities in the lungs would be compatible of viral pneumonitis, enlargement of the ascending aorta up to 4.2 cm in diameter.  Patient's laboratory findings are significant for chloride 95, a gap 22, glucose 102, BUN 78, creatinine 8.05, ALP 142, troponin 0.04, WBC 4.06, hemoglobin 7.8, hematocrit 25.1.  Patient received 500 mg IV azithromycin, 1 g IV Rocephin in ED.  12/7/21: Patient is admitted hospital, started on empirical IV antibiotics.  COVID-19 test is reported positive. Patient is not hypoxic.  Nephrology consult requested patient had hemodialysis on Monday and Tuesday back-to-back.  She did have drop in hemoglobin, was given 2 unit PRBC transfusion, H&H is stable now.  Patient is discharged to home on oral antibiotics in stable condition. She is discharged with Agency services.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Blood alkaline phosphatase increased, Blood chloride decreased, Blood creatinine increased, Blood glucose normal, Blood urea increased
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 1/17/21 (lot NA) Pfizer Dose 2 2/7/21 (lot NA) COVID Positive 12/4/21  12/4/21: Patient is a 76-year-old female with a past medical history significant for end-stage renal disease on hemodialysis Tuesday Thursday Saturday, hypertension, hyperparathyroidism.  The patient presents to the ED today with complaints body aches, generalized illness over the last 2 weeks.  The patient's accompanying symptoms include loss of taste, loss of smell, nasal congestion, headaches, nausea, vomiting, diarrhea.  The patient denies any fever, cough, shortness of breath, chest pain, abdominal pain. The patient states she has not gone to any of her dialysis treatments this week due to significant weakness.  The patient had a known ill contact with her daughter.  The patient states she has been taking over-the-counter medications with no relief of her symptoms.  The patient is vaccinated against COVID-19. The patient attempted to ambulate in the ED but became very tachypneic and tachycardic requiring oxygen supplementation.   Upon arrival to ED patient's temperature is 97.1°, heart rate 87, respirations 16, pulse ox 99% on room air, blood pressure 163/99. CT chest reveals no evidence of PE, patchy opacities in the lungs would be compatible of viral pneumonitis, enlargement of the ascending aorta up to 4.2 cm in diameter.  Patient's laboratory findings are significant for chloride 95, a gap 22, glucose 102, BUN 78, creatinine 8.05, ALP 142, troponin 0.04, WBC 4.06, hemoglobin 7.8, hematocrit 25.1.  Patient received 500 mg IV azithromycin, 1 g IV Rocephin in ED.  12/7/21: Patient is admitted hospital, started on empirical IV antibiotics.  COVID-19 test is reported positive. Patient is not hypoxic.  Nephrology consult requested patient had hemodialysis on Monday and Tuesday back-to-back.  She did have drop in hemoglobin, was given 2 unit PRBC transfusion, H&H is stable now.  Patient is discharged to home on oral antibiotics in stable condition. She is discharged with Agency services.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Computerised tomogram thorax abnormal, Diarrhoea, Exposure to communicable disease, Haematocrit decreased
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 1/17/21 (lot NA) Pfizer Dose 2 2/7/21 (lot NA) COVID Positive 12/4/21  12/4/21: Patient is a 76-year-old female with a past medical history significant for end-stage renal disease on hemodialysis Tuesday Thursday Saturday, hypertension, hyperparathyroidism.  The patient presents to the ED today with complaints body aches, generalized illness over the last 2 weeks.  The patient's accompanying symptoms include loss of taste, loss of smell, nasal congestion, headaches, nausea, vomiting, diarrhea.  The patient denies any fever, cough, shortness of breath, chest pain, abdominal pain. The patient states she has not gone to any of her dialysis treatments this week due to significant weakness.  The patient had a known ill contact with her daughter.  The patient states she has been taking over-the-counter medications with no relief of her symptoms.  The patient is vaccinated against COVID-19. The patient attempted to ambulate in the ED but became very tachypneic and tachycardic requiring oxygen supplementation.   Upon arrival to ED patient's temperature is 97.1°, heart rate 87, respirations 16, pulse ox 99% on room air, blood pressure 163/99. CT chest reveals no evidence of PE, patchy opacities in the lungs would be compatible of viral pneumonitis, enlargement of the ascending aorta up to 4.2 cm in diameter.  Patient's laboratory findings are significant for chloride 95, a gap 22, glucose 102, BUN 78, creatinine 8.05, ALP 142, troponin 0.04, WBC 4.06, hemoglobin 7.8, hematocrit 25.1.  Patient received 500 mg IV azithromycin, 1 g IV Rocephin in ED.  12/7/21: Patient is admitted hospital, started on empirical IV antibiotics.  COVID-19 test is reported positive. Patient is not hypoxic.  Nephrology consult requested patient had hemodialysis on Monday and Tuesday back-to-back.  She did have drop in hemoglobin, was given 2 unit PRBC transfusion, H&H is stable now.  Patient is discharged to home on oral antibiotics in stable condition. She is discharged with Agency services.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Haemodialysis, Haemoglobin decreased, Headache, Illness, Lung opacity
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 1/17/21 (lot NA) Pfizer Dose 2 2/7/21 (lot NA) COVID Positive 12/4/21  12/4/21: Patient is a 76-year-old female with a past medical history significant for end-stage renal disease on hemodialysis Tuesday Thursday Saturday, hypertension, hyperparathyroidism.  The patient presents to the ED today with complaints body aches, generalized illness over the last 2 weeks.  The patient's accompanying symptoms include loss of taste, loss of smell, nasal congestion, headaches, nausea, vomiting, diarrhea.  The patient denies any fever, cough, shortness of breath, chest pain, abdominal pain. The patient states she has not gone to any of her dialysis treatments this week due to significant weakness.  The patient had a known ill contact with her daughter.  The patient states she has been taking over-the-counter medications with no relief of her symptoms.  The patient is vaccinated against COVID-19. The patient attempted to ambulate in the ED but became very tachypneic and tachycardic requiring oxygen supplementation.   Upon arrival to ED patient's temperature is 97.1°, heart rate 87, respirations 16, pulse ox 99% on room air, blood pressure 163/99. CT chest reveals no evidence of PE, patchy opacities in the lungs would be compatible of viral pneumonitis, enlargement of the ascending aorta up to 4.2 cm in diameter.  Patient's laboratory findings are significant for chloride 95, a gap 22, glucose 102, BUN 78, creatinine 8.05, ALP 142, troponin 0.04, WBC 4.06, hemoglobin 7.8, hematocrit 25.1.  Patient received 500 mg IV azithromycin, 1 g IV Rocephin in ED.  12/7/21: Patient is admitted hospital, started on empirical IV antibiotics.  COVID-19 test is reported positive. Patient is not hypoxic.  Nephrology consult requested patient had hemodialysis on Monday and Tuesday back-to-back.  She did have drop in hemoglobin, was given 2 unit PRBC transfusion, H&H is stable now.  Patient is discharged to home on oral antibiotics in stable condition. She is discharged with Agency services.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Nasal congestion, Nausea, Pain, Pneumonia viral, Red blood cell transfusion
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 1/17/21 (lot NA) Pfizer Dose 2 2/7/21 (lot NA) COVID Positive 12/4/21  12/4/21: Patient is a 76-year-old female with a past medical history significant for end-stage renal disease on hemodialysis Tuesday Thursday Saturday, hypertension, hyperparathyroidism.  The patient presents to the ED today with complaints body aches, generalized illness over the last 2 weeks.  The patient's accompanying symptoms include loss of taste, loss of smell, nasal congestion, headaches, nausea, vomiting, diarrhea.  The patient denies any fever, cough, shortness of breath, chest pain, abdominal pain. The patient states she has not gone to any of her dialysis treatments this week due to significant weakness.  The patient had a known ill contact with her daughter.  The patient states she has been taking over-the-counter medications with no relief of her symptoms.  The patient is vaccinated against COVID-19. The patient attempted to ambulate in the ED but became very tachypneic and tachycardic requiring oxygen supplementation.   Upon arrival to ED patient's temperature is 97.1°, heart rate 87, respirations 16, pulse ox 99% on room air, blood pressure 163/99. CT chest reveals no evidence of PE, patchy opacities in the lungs would be compatible of viral pneumonitis, enlargement of the ascending aorta up to 4.2 cm in diameter.  Patient's laboratory findings are significant for chloride 95, a gap 22, glucose 102, BUN 78, creatinine 8.05, ALP 142, troponin 0.04, WBC 4.06, hemoglobin 7.8, hematocrit 25.1.  Patient received 500 mg IV azithromycin, 1 g IV Rocephin in ED.  12/7/21: Patient is admitted hospital, started on empirical IV antibiotics.  COVID-19 test is reported positive. Patient is not hypoxic.  Nephrology consult requested patient had hemodialysis on Monday and Tuesday back-to-back.  She did have drop in hemoglobin, was given 2 unit PRBC transfusion, H&H is stable now.  Patient is discharged to home on oral antibiotics in stable condition. She is discharged with Agency services.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Tachycardia, Tachypnoea, Troponin, Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 1/17/21 (lot NA) Pfizer Dose 2 2/7/21 (lot NA) COVID Positive 12/4/21  12/4/21: Patient is a 76-year-old female with a past medical history significant for end-stage renal disease on hemodialysis Tuesday Thursday Saturday, hypertension, hyperparathyroidism.  The patient presents to the ED today with complaints body aches, generalized illness over the last 2 weeks.  The patient's accompanying symptoms include loss of taste, loss of smell, nasal congestion, headaches, nausea, vomiting, diarrhea.  The patient denies any fever, cough, shortness of breath, chest pain, abdominal pain. The patient states she has not gone to any of her dialysis treatments this week due to significant weakness.  The patient had a known ill contact with her daughter.  The patient states she has been taking over-the-counter medications with no relief of her symptoms.  The patient is vaccinated against COVID-19. The patient attempted to ambulate in the ED but became very tachypneic and tachycardic requiring oxygen supplementation.   Upon arrival to ED patient's temperature is 97.1°, heart rate 87, respirations 16, pulse ox 99% on room air, blood pressure 163/99. CT chest reveals no evidence of PE, patchy opacities in the lungs would be compatible of viral pneumonitis, enlargement of the ascending aorta up to 4.2 cm in diameter.  Patient's laboratory findings are significant for chloride 95, a gap 22, glucose 102, BUN 78, creatinine 8.05, ALP 142, troponin 0.04, WBC 4.06, hemoglobin 7.8, hematocrit 25.1.  Patient received 500 mg IV azithromycin, 1 g IV Rocephin in ED.  12/7/21: Patient is admitted hospital, started on empirical IV antibiotics.  COVID-19 test is reported positive. Patient is not hypoxic.  Nephrology consult requested patient had hemodialysis on Monday and Tuesday back-to-back.  She did have drop in hemoglobin, was given 2 unit PRBC transfusion, H&H is stable now.  Patient is discharged to home on oral antibiotics in stable condition. She is discharged with Agency services.
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting, White blood cell count decreased
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 1/17/21 (lot NA) Pfizer Dose 2 2/7/21 (lot NA) COVID Positive 12/4/21  12/4/21: Patient is a 76-year-old female with a past medical history significant for end-stage renal disease on hemodialysis Tuesday Thursday Saturday, hypertension, hyperparathyroidism.  The patient presents to the ED today with complaints body aches, generalized illness over the last 2 weeks.  The patient's accompanying symptoms include loss of taste, loss of smell, nasal congestion, headaches, nausea, vomiting, diarrhea.  The patient denies any fever, cough, shortness of breath, chest pain, abdominal pain. The patient states she has not gone to any of her dialysis treatments this week due to significant weakness.  The patient had a known ill contact with her daughter.  The patient states she has been taking over-the-counter medications with no relief of her symptoms.  The patient is vaccinated against COVID-19. The patient attempted to ambulate in the ED but became very tachypneic and tachycardic requiring oxygen supplementation.   Upon arrival to ED patient's temperature is 97.1°, heart rate 87, respirations 16, pulse ox 99% on room air, blood pressure 163/99. CT chest reveals no evidence of PE, patchy opacities in the lungs would be compatible of viral pneumonitis, enlargement of the ascending aorta up to 4.2 cm in diameter.  Patient's laboratory findings are significant for chloride 95, a gap 22, glucose 102, BUN 78, creatinine 8.05, ALP 142, troponin 0.04, WBC 4.06, hemoglobin 7.8, hematocrit 25.1.  Patient received 500 mg IV azithromycin, 1 g IV Rocephin in ED.  12/7/21: Patient is admitted hospital, started on empirical IV antibiotics.  COVID-19 test is reported positive. Patient is not hypoxic.  Nephrology consult requested patient had hemodialysis on Monday and Tuesday back-to-back.  She did have drop in hemoglobin, was given 2 unit PRBC transfusion, H&H is stable now.  Patient is discharged to home on oral antibiotics in stable condition. She is discharged with Agency services.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Atrial flutter, COVID-19, Chronic obstructive pulmonary disease, Computerised tomogram head normal
Clinical narrative: COVID Vaccine Breakthrough Case  Moderna Dose 1 3/13/21 (002B21A) Moderna Dose 2 4/10/21 (041B21A) COVID Positive 12/12/21  12/13/21: -Patient is an 88 yo male with medical history of COPD not on home oxygen, DMT2, HLD, Obesity , Prostate and bladder cancer s/p TURP / TURBT  -History obtained from EMR and ER provider as patient is a poor historian and no family at bedside  -Per EMR he presented with SOB and was being managed for COPD exacerbation with improving symptoms after steroids, duoneb treatment and levaquin. He is on supplemental oxygen for comfort.  -CT chest showed small pleural effusions,possible mild interstitial pulmonary edema,indeterminate nodule left upper lung but ruled out pulmonary embolism  -He was also confused and weak on presentation but CT head did not show any acute infarct. Of note he is also being treated at home for UTI  -He was also noted to be in new onset atrial flutter RVR rates in 120s-130s and hypotensive with SBP 80-90s for which cardiology  was consulted by ER provider and recommends  anticoagulation with heparin gtt. Personally discussed with Dr and he also recommended digoxin 0.5 IV x 1 followed by 0.125 digoxin IV daily.  -Patient denies chest pain , SOB , nausea, vomiting , palpitation during my encounter but endorses weakness and lightheaded ness when he gets up from bed.  12/15/21: P.o. vitamin-C and zinc sulfate  Nebulizer treatments  P.o. prednisone course  P.o. theophylline per home dose  Hemodynamically stable for discharge  Will discharge home with heath care services  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Condition aggravated, Confusional state, Dizziness, Dyspnoea
Clinical narrative: COVID Vaccine Breakthrough Case  Moderna Dose 1 3/13/21 (002B21A) Moderna Dose 2 4/10/21 (041B21A) COVID Positive 12/12/21  12/13/21: -Patient is an 88 yo male with medical history of COPD not on home oxygen, DMT2, HLD, Obesity , Prostate and bladder cancer s/p TURP / TURBT  -History obtained from EMR and ER provider as patient is a poor historian and no family at bedside  -Per EMR he presented with SOB and was being managed for COPD exacerbation with improving symptoms after steroids, duoneb treatment and levaquin. He is on supplemental oxygen for comfort.  -CT chest showed small pleural effusions,possible mild interstitial pulmonary edema,indeterminate nodule left upper lung but ruled out pulmonary embolism  -He was also confused and weak on presentation but CT head did not show any acute infarct. Of note he is also being treated at home for UTI  -He was also noted to be in new onset atrial flutter RVR rates in 120s-130s and hypotensive with SBP 80-90s for which cardiology  was consulted by ER provider and recommends  anticoagulation with heparin gtt. Personally discussed with Dr and he also recommended digoxin 0.5 IV x 1 followed by 0.125 digoxin IV daily.  -Patient denies chest pain , SOB , nausea, vomiting , palpitation during my encounter but endorses weakness and lightheaded ness when he gets up from bed.  12/15/21: P.o. vitamin-C and zinc sulfate  Nebulizer treatments  P.o. prednisone course  P.o. theophylline per home dose  Hemodynamically stable for discharge  Will discharge home with heath care services  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Pleural effusion, Pulmonary mass, SARS-CoV-2 test positive, Urinary tract infection
Clinical narrative: COVID Vaccine Breakthrough Case  Moderna Dose 1 3/13/21 (002B21A) Moderna Dose 2 4/10/21 (041B21A) COVID Positive 12/12/21  12/13/21: -Patient is an 88 yo male with medical history of COPD not on home oxygen, DMT2, HLD, Obesity , Prostate and bladder cancer s/p TURP / TURBT  -History obtained from EMR and ER provider as patient is a poor historian and no family at bedside  -Per EMR he presented with SOB and was being managed for COPD exacerbation with improving symptoms after steroids, duoneb treatment and levaquin. He is on supplemental oxygen for comfort.  -CT chest showed small pleural effusions,possible mild interstitial pulmonary edema,indeterminate nodule left upper lung but ruled out pulmonary embolism  -He was also confused and weak on presentation but CT head did not show any acute infarct. Of note he is also being treated at home for UTI  -He was also noted to be in new onset atrial flutter RVR rates in 120s-130s and hypotensive with SBP 80-90s for which cardiology  was consulted by ER provider and recommends  anticoagulation with heparin gtt. Personally discussed with Dr and he also recommended digoxin 0.5 IV x 1 followed by 0.125 digoxin IV daily.  -Patient denies chest pain , SOB , nausea, vomiting , palpitation during my encounter but endorses weakness and lightheaded ness when he gets up from bed.  12/15/21: P.o. vitamin-C and zinc sulfate  Nebulizer treatments  P.o. prednisone course  P.o. theophylline per home dose  Hemodynamically stable for discharge  Will discharge home with heath care services  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Moderna Dose 1 3/13/21 (002B21A) Moderna Dose 2 4/10/21 (041B21A) COVID Positive 12/12/21  12/13/21: -Patient is an 88 yo male with medical history of COPD not on home oxygen, DMT2, HLD, Obesity , Prostate and bladder cancer s/p TURP / TURBT  -History obtained from EMR and ER provider as patient is a poor historian and no family at bedside  -Per EMR he presented with SOB and was being managed for COPD exacerbation with improving symptoms after steroids, duoneb treatment and levaquin. He is on supplemental oxygen for comfort.  -CT chest showed small pleural effusions,possible mild interstitial pulmonary edema,indeterminate nodule left upper lung but ruled out pulmonary embolism  -He was also confused and weak on presentation but CT head did not show any acute infarct. Of note he is also being treated at home for UTI  -He was also noted to be in new onset atrial flutter RVR rates in 120s-130s and hypotensive with SBP 80-90s for which cardiology  was consulted by ER provider and recommends  anticoagulation with heparin gtt. Personally discussed with Dr and he also recommended digoxin 0.5 IV x 1 followed by 0.125 digoxin IV daily.  -Patient denies chest pain , SOB , nausea, vomiting , palpitation during my encounter but endorses weakness and lightheaded ness when he gets up from bed.  12/15/21: P.o. vitamin-C and zinc sulfate  Nebulizer treatments  P.o. prednisone course  P.o. theophylline per home dose  Hemodynamically stable for discharge  Will discharge home with heath care services  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Chemotherapy, Neutropenia, Pyrexia
Clinical narrative: Patient presented to facility with fever, currently on Chemo for Breast Cancer.  Admit for neutropenia.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood culture negative, COVID-19, Chemotherapy, Chest X-ray normal, Oesophageal carcinoma
Clinical narrative: Hospitalized 05/16/2022-05/18/2022; COVID-19 positive 05/16/2022; fully vaccinated plus booster  HOSPITAL COURSE Per H and P at the time of admission, this is 64-year-old male with a history of ischemic cardiomyopathy, coronary artery disease status post multiple stenting procedures, dyslipidemia, CVA, newly diagnosed metastatic esophageal small cell carcinoma, on active treatment, presented to the emergency room with upper respiratory symptoms and a fever for 3 days prior to his hospitalization, had 2 positive home COVID test, which was confirmed in the ED with a COVID PCR.  Chest x-ray was completed which was negative.  Blood cultures were obtained.  He was given 1 unit of packed red blood cells and 1 unit of platelets.  Denied any shortness of breath or chest pain.  He was admitted for further evaluation and treatment.  Blood cultures remained negative.  He was started on cefepime and vancomycin.  He was continued on cefepime while he was inpatient.  It was noted that the patient got Neulasta outpatient on May 6 as part of his chemo regimen.  He continues to be pancytopenic, which is likely secondary to recent chemo.  Discussed with Service as well which also agree likely secondary to the recent chemo.  Counts should recover, recommending close monitoring at this time.  The patient will be offered a dose of Zarxio before he leaves to help improve his counts further.  The patient was continued on his home medications.  Aspirin was held due to his thrombocytopenia, may resume when his counts are normal.  The patient declines to remain in the hospital to complete a 5-day course of remdesivir.  He did receive a second dose this morning.  Please see system for complete listing of discharge instructions, followup information.  Discussed discharge plans with the attending who is aware of the patient being discharged.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Pancytopenia, Platelet transfusion, Pyrexia, Red blood cell transfusion, Respiratory symptom
Clinical narrative: Hospitalized 05/16/2022-05/18/2022; COVID-19 positive 05/16/2022; fully vaccinated plus booster  HOSPITAL COURSE Per H and P at the time of admission, this is 64-year-old male with a history of ischemic cardiomyopathy, coronary artery disease status post multiple stenting procedures, dyslipidemia, CVA, newly diagnosed metastatic esophageal small cell carcinoma, on active treatment, presented to the emergency room with upper respiratory symptoms and a fever for 3 days prior to his hospitalization, had 2 positive home COVID test, which was confirmed in the ED with a COVID PCR.  Chest x-ray was completed which was negative.  Blood cultures were obtained.  He was given 1 unit of packed red blood cells and 1 unit of platelets.  Denied any shortness of breath or chest pain.  He was admitted for further evaluation and treatment.  Blood cultures remained negative.  He was started on cefepime and vancomycin.  He was continued on cefepime while he was inpatient.  It was noted that the patient got Neulasta outpatient on May 6 as part of his chemo regimen.  He continues to be pancytopenic, which is likely secondary to recent chemo.  Discussed with Service as well which also agree likely secondary to the recent chemo.  Counts should recover, recommending close monitoring at this time.  The patient will be offered a dose of Zarxio before he leaves to help improve his counts further.  The patient was continued on his home medications.  Aspirin was held due to his thrombocytopenia, may resume when his counts are normal.  The patient declines to remain in the hospital to complete a 5-day course of remdesivir.  He did receive a second dose this morning.  Please see system for complete listing of discharge instructions, followup information.  Discussed discharge plans with the attending who is aware of the patient being discharged.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Thrombocytopenia
Clinical narrative: Hospitalized 05/16/2022-05/18/2022; COVID-19 positive 05/16/2022; fully vaccinated plus booster  HOSPITAL COURSE Per H and P at the time of admission, this is 64-year-old male with a history of ischemic cardiomyopathy, coronary artery disease status post multiple stenting procedures, dyslipidemia, CVA, newly diagnosed metastatic esophageal small cell carcinoma, on active treatment, presented to the emergency room with upper respiratory symptoms and a fever for 3 days prior to his hospitalization, had 2 positive home COVID test, which was confirmed in the ED with a COVID PCR.  Chest x-ray was completed which was negative.  Blood cultures were obtained.  He was given 1 unit of packed red blood cells and 1 unit of platelets.  Denied any shortness of breath or chest pain.  He was admitted for further evaluation and treatment.  Blood cultures remained negative.  He was started on cefepime and vancomycin.  He was continued on cefepime while he was inpatient.  It was noted that the patient got Neulasta outpatient on May 6 as part of his chemo regimen.  He continues to be pancytopenic, which is likely secondary to recent chemo.  Discussed with Service as well which also agree likely secondary to the recent chemo.  Counts should recover, recommending close monitoring at this time.  The patient will be offered a dose of Zarxio before he leaves to help improve his counts further.  The patient was continued on his home medications.  Aspirin was held due to his thrombocytopenia, may resume when his counts are normal.  The patient declines to remain in the hospital to complete a 5-day course of remdesivir.  He did receive a second dose this morning.  Please see system for complete listing of discharge instructions, followup information.  Discussed discharge plans with the attending who is aware of the patient being discharged.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Blood lactic acid, COVID-19, Cancer in remission, Chills
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/21/21 (ER8730) Pfizer Dose 2 4/11/21 (EW0153) COVID Positive 12/10/21  12/10/21: This is a 71-year-old male with history of tobacco use and prostate cancer status post radiation in remission who presented with shortness of breath and cough. Patient reports that his symptoms started 3 days ago. He has been having fever, chills, shortness of breath, cough, nausea, vomiting and diarrhea. He is vaccinated against COVID-19 and had 2 shots. He denies chest pain or dizziness. He has history of prostate cancer and underwent radiation therapy in the past and follows at the University of Iowa and was told that he is currently in remission.   In the emergency department, patient was found to be hypoxic and was put on 2 L of O2 via nasal cannula. Labs showed a lactic acid of 2.1, D-dimer of 1.15. Patient had a positive rapid COVID-19 antigen test. CT abdomen and pelvis with IV contrast showed mild small bowel dilatation suggesting enteritis. CT angiography of the chest was negative for pulmonary embolism but it showed bilateral patchy infiltrates and chronic granulomatous disease. Patient received nebulizer treatments and a dose of IV azithromycin, Rocephin and Solu-Medrol.  12/14/21: Albuterol HFA q.6 hours  P.o. azithromycin course  P.o. Decadron course P.o. vitamin-C, vitamin-D and zinc sulfate  Patient requires 1 L of O2 with activity  Hemodynamically stable for discharge  Will discharge home  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic granulomatous disease, Computerised tomogram abdomen abnormal, Cough, Diarrhoea, Dyspnoea
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/21/21 (ER8730) Pfizer Dose 2 4/11/21 (EW0153) COVID Positive 12/10/21  12/10/21: This is a 71-year-old male with history of tobacco use and prostate cancer status post radiation in remission who presented with shortness of breath and cough. Patient reports that his symptoms started 3 days ago. He has been having fever, chills, shortness of breath, cough, nausea, vomiting and diarrhea. He is vaccinated against COVID-19 and had 2 shots. He denies chest pain or dizziness. He has history of prostate cancer and underwent radiation therapy in the past and follows at the University of Iowa and was told that he is currently in remission.   In the emergency department, patient was found to be hypoxic and was put on 2 L of O2 via nasal cannula. Labs showed a lactic acid of 2.1, D-dimer of 1.15. Patient had a positive rapid COVID-19 antigen test. CT abdomen and pelvis with IV contrast showed mild small bowel dilatation suggesting enteritis. CT angiography of the chest was negative for pulmonary embolism but it showed bilateral patchy infiltrates and chronic granulomatous disease. Patient received nebulizer treatments and a dose of IV azithromycin, Rocephin and Solu-Medrol.  12/14/21: Albuterol HFA q.6 hours  P.o. azithromycin course  P.o. Decadron course P.o. vitamin-C, vitamin-D and zinc sulfate  Patient requires 1 L of O2 with activity  Hemodynamically stable for discharge  Will discharge home  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Enteritis, Fibrin D dimer, Hypoxia, Intestinal dilatation, Lung infiltration
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/21/21 (ER8730) Pfizer Dose 2 4/11/21 (EW0153) COVID Positive 12/10/21  12/10/21: This is a 71-year-old male with history of tobacco use and prostate cancer status post radiation in remission who presented with shortness of breath and cough. Patient reports that his symptoms started 3 days ago. He has been having fever, chills, shortness of breath, cough, nausea, vomiting and diarrhea. He is vaccinated against COVID-19 and had 2 shots. He denies chest pain or dizziness. He has history of prostate cancer and underwent radiation therapy in the past and follows at the University of Iowa and was told that he is currently in remission.   In the emergency department, patient was found to be hypoxic and was put on 2 L of O2 via nasal cannula. Labs showed a lactic acid of 2.1, D-dimer of 1.15. Patient had a positive rapid COVID-19 antigen test. CT abdomen and pelvis with IV contrast showed mild small bowel dilatation suggesting enteritis. CT angiography of the chest was negative for pulmonary embolism but it showed bilateral patchy infiltrates and chronic granulomatous disease. Patient received nebulizer treatments and a dose of IV azithromycin, Rocephin and Solu-Medrol.  12/14/21: Albuterol HFA q.6 hours  P.o. azithromycin course  P.o. Decadron course P.o. vitamin-C, vitamin-D and zinc sulfate  Patient requires 1 L of O2 with activity  Hemodynamically stable for discharge  Will discharge home  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Nausea, Pyrexia, SARS-CoV-2 test positive, Scan with contrast abnormal, Vaccine breakthrough infection
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/21/21 (ER8730) Pfizer Dose 2 4/11/21 (EW0153) COVID Positive 12/10/21  12/10/21: This is a 71-year-old male with history of tobacco use and prostate cancer status post radiation in remission who presented with shortness of breath and cough. Patient reports that his symptoms started 3 days ago. He has been having fever, chills, shortness of breath, cough, nausea, vomiting and diarrhea. He is vaccinated against COVID-19 and had 2 shots. He denies chest pain or dizziness. He has history of prostate cancer and underwent radiation therapy in the past and follows at the University of Iowa and was told that he is currently in remission.   In the emergency department, patient was found to be hypoxic and was put on 2 L of O2 via nasal cannula. Labs showed a lactic acid of 2.1, D-dimer of 1.15. Patient had a positive rapid COVID-19 antigen test. CT abdomen and pelvis with IV contrast showed mild small bowel dilatation suggesting enteritis. CT angiography of the chest was negative for pulmonary embolism but it showed bilateral patchy infiltrates and chronic granulomatous disease. Patient received nebulizer treatments and a dose of IV azithromycin, Rocephin and Solu-Medrol.  12/14/21: Albuterol HFA q.6 hours  P.o. azithromycin course  P.o. Decadron course P.o. vitamin-C, vitamin-D and zinc sulfate  Patient requires 1 L of O2 with activity  Hemodynamically stable for discharge  Will discharge home  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: COVID Vaccine Breakthrough Case  Pfizer Dose 1 3/21/21 (ER8730) Pfizer Dose 2 4/11/21 (EW0153) COVID Positive 12/10/21  12/10/21: This is a 71-year-old male with history of tobacco use and prostate cancer status post radiation in remission who presented with shortness of breath and cough. Patient reports that his symptoms started 3 days ago. He has been having fever, chills, shortness of breath, cough, nausea, vomiting and diarrhea. He is vaccinated against COVID-19 and had 2 shots. He denies chest pain or dizziness. He has history of prostate cancer and underwent radiation therapy in the past and follows at the University of Iowa and was told that he is currently in remission.   In the emergency department, patient was found to be hypoxic and was put on 2 L of O2 via nasal cannula. Labs showed a lactic acid of 2.1, D-dimer of 1.15. Patient had a positive rapid COVID-19 antigen test. CT abdomen and pelvis with IV contrast showed mild small bowel dilatation suggesting enteritis. CT angiography of the chest was negative for pulmonary embolism but it showed bilateral patchy infiltrates and chronic granulomatous disease. Patient received nebulizer treatments and a dose of IV azithromycin, Rocephin and Solu-Medrol.  12/14/21: Albuterol HFA q.6 hours  P.o. azithromycin course  P.o. Decadron course P.o. vitamin-C, vitamin-D and zinc sulfate  Patient requires 1 L of O2 with activity  Hemodynamically stable for discharge  Will discharge home  Follow-up with PCP in 3-5 days  Patient agrees with plan of care
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was a refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Product storage error
Clinical narrative: On the clinic day, the vaccine was transported out from the pharmacy to the facility without a digital data logger. The packing used for transport was refrigerated packaging tote to maintain a temperature of 36 F - 46 F.  However, that is not approved by State for COVID-19 vaccine transportation. The total time (from when vaccine left the pharmacy to the clinic completion) was less than 6 hours. There were no adverse events.