chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Oedema peripheral, Oxygen saturation decreased, Pain, Pleural effusion, Polyuria
Clinical narrative: Admission Date: 7/20/2022  PRESENTING PROBLEM: Gross hematuria [R31.0] Bilateral pleural effusion [J90] Acute cystitis with hematuria [N30.01] Acute diastolic CHF (congestive heart failure) (HCC) [I50.31] Renal carcinoma, right (HCC) [C64.1] Adenocarcinoma of left lung (HCC) [C34.92] Atrial flutter, unspecified type (HCC) [I48.92] Acute congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic blood loss anemia [D62]   HOSPITAL COURSE: Patient is an 86 year old male with PMHx of severe pulmonary hypertension, chronic right sided heart failure, CKD3, DM2, COPD on home 2L O2, renal carcinoma who presented to the hospital with acute on chronic right sided CHF exacerbation and acute on chronic hypoxic respiratory failure. The patient was diuresed as he had significant lower extremity edema. He had an ECHO that showed severe aortic stenosis. He was also found during eating and drinking to be coughing and choking. SLP was consulted and recommended a dysphagia diet. His renal function also continued to decline during his hospital stay. Given his multiple chronic medical conditions as well as the need for a chronic dysphagia diet to prevent aspiration pneumonia, the patient stated that he would rather live a shorter life with risk of aspiration than have to have his diet restricted. The patient had untreatable cancer, worsening renal dysfunction, severe aortic stenosis, as well as worsening right sided heart failure and pulmonary hypertension. After much discussion with the patient and family, the decision was made to consult hospice. Hospice consulted and there were plans for discharge from the hospital to a long term care facility with outpatient hospice services. Unfortunately when patient had a screening COVID-19 test prior to discharge, it was incidentally positive so this delayed the patient's discharge. The patient had no symptoms of COVID-19, so this was likely an asymptomatic or prior infection. Patient continued to aspirate with meals and liquids. He became progressively more hypoxic during his hospital stay and was becoming increasingly more uncomfortable. Patient was treated for his pain and shortness of breath with oral morphine with good improvement. On the morning of 7/28, the patient became very lethargic and his O2 dropped into the low 70's despite nasal cannula. The decision was made at that time to support the patient and withdrawal care in the hospital. Patient was provided medications for comfort, Oxygen was removed and the patient died peacefully on 7/28, family was present at the bedside.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary hypertension, Renal cancer, Renal impairment, Respiratory failure, Right ventricular failure
Clinical narrative: Admission Date: 7/20/2022  PRESENTING PROBLEM: Gross hematuria [R31.0] Bilateral pleural effusion [J90] Acute cystitis with hematuria [N30.01] Acute diastolic CHF (congestive heart failure) (HCC) [I50.31] Renal carcinoma, right (HCC) [C64.1] Adenocarcinoma of left lung (HCC) [C34.92] Atrial flutter, unspecified type (HCC) [I48.92] Acute congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic blood loss anemia [D62]   HOSPITAL COURSE: Patient is an 86 year old male with PMHx of severe pulmonary hypertension, chronic right sided heart failure, CKD3, DM2, COPD on home 2L O2, renal carcinoma who presented to the hospital with acute on chronic right sided CHF exacerbation and acute on chronic hypoxic respiratory failure. The patient was diuresed as he had significant lower extremity edema. He had an ECHO that showed severe aortic stenosis. He was also found during eating and drinking to be coughing and choking. SLP was consulted and recommended a dysphagia diet. His renal function also continued to decline during his hospital stay. Given his multiple chronic medical conditions as well as the need for a chronic dysphagia diet to prevent aspiration pneumonia, the patient stated that he would rather live a shorter life with risk of aspiration than have to have his diet restricted. The patient had untreatable cancer, worsening renal dysfunction, severe aortic stenosis, as well as worsening right sided heart failure and pulmonary hypertension. After much discussion with the patient and family, the decision was made to consult hospice. Hospice consulted and there were plans for discharge from the hospital to a long term care facility with outpatient hospice services. Unfortunately when patient had a screening COVID-19 test prior to discharge, it was incidentally positive so this delayed the patient's discharge. The patient had no symptoms of COVID-19, so this was likely an asymptomatic or prior infection. Patient continued to aspirate with meals and liquids. He became progressively more hypoxic during his hospital stay and was becoming increasingly more uncomfortable. Patient was treated for his pain and shortness of breath with oral morphine with good improvement. On the morning of 7/28, the patient became very lethargic and his O2 dropped into the low 70's despite nasal cannula. The decision was made at that time to support the patient and withdrawal care in the hospital. Patient was provided medications for comfort, Oxygen was removed and the patient died peacefully on 7/28, family was present at the bedside.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Admission Date: 7/20/2022  PRESENTING PROBLEM: Gross hematuria [R31.0] Bilateral pleural effusion [J90] Acute cystitis with hematuria [N30.01] Acute diastolic CHF (congestive heart failure) (HCC) [I50.31] Renal carcinoma, right (HCC) [C64.1] Adenocarcinoma of left lung (HCC) [C34.92] Atrial flutter, unspecified type (HCC) [I48.92] Acute congestive heart failure, unspecified heart failure type (HCC) [I50.9] Acute on chronic blood loss anemia [D62]   HOSPITAL COURSE: Patient is an 86 year old male with PMHx of severe pulmonary hypertension, chronic right sided heart failure, CKD3, DM2, COPD on home 2L O2, renal carcinoma who presented to the hospital with acute on chronic right sided CHF exacerbation and acute on chronic hypoxic respiratory failure. The patient was diuresed as he had significant lower extremity edema. He had an ECHO that showed severe aortic stenosis. He was also found during eating and drinking to be coughing and choking. SLP was consulted and recommended a dysphagia diet. His renal function also continued to decline during his hospital stay. Given his multiple chronic medical conditions as well as the need for a chronic dysphagia diet to prevent aspiration pneumonia, the patient stated that he would rather live a shorter life with risk of aspiration than have to have his diet restricted. The patient had untreatable cancer, worsening renal dysfunction, severe aortic stenosis, as well as worsening right sided heart failure and pulmonary hypertension. After much discussion with the patient and family, the decision was made to consult hospice. Hospice consulted and there were plans for discharge from the hospital to a long term care facility with outpatient hospice services. Unfortunately when patient had a screening COVID-19 test prior to discharge, it was incidentally positive so this delayed the patient's discharge. The patient had no symptoms of COVID-19, so this was likely an asymptomatic or prior infection. Patient continued to aspirate with meals and liquids. He became progressively more hypoxic during his hospital stay and was becoming increasingly more uncomfortable. Patient was treated for his pain and shortness of breath with oral morphine with good improvement. On the morning of 7/28, the patient became very lethargic and his O2 dropped into the low 70's despite nasal cannula. The decision was made at that time to support the patient and withdrawal care in the hospital. Patient was provided medications for comfort, Oxygen was removed and the patient died peacefully on 7/28, family was present at the bedside.
Age: 12.0
Sex: M
Vaccine: COVID19, TYP
Symptoms: Expired product administered, Product storage error
Clinical narrative: The Covid Vaccine (Gray top) Pfizer given to patient was outside of the 12 hour at room temperature recommendation for vaccine. No symptoms, side effects, or other concerns at this time. Spoke with the Pfizer Safety team. Staff states that a punctured vial of the Covid vaccine gray top should not exceed 36 hours at room temp range of 46 - 84 F. Vaccine was given from the vial that was at 26 hours at room temp of 70 F.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Blood potassium decreased, COVID-19, COVID-19 pneumonia, Chest X-ray normal, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: medical doctor Admission Date: 7/25/2022 Discharge Date: 7/27/2022  PRESENTING PROBLEM: Hypoxemia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE:   Patient is a 68 y.o. female with a PMH chronic obstructive pulmonary disease, hypertension, and anxiety who presents to hospital on 7/25/2022 with cough and SOB.  The patient lives with her daughter who was recently diagnosed with COVID-19.  The patient developed symptoms on 07/24/2022.   Upon presentation to the emergency department she was noted to be satting 86% air and was placed on 2 L nasal cannula with improvement.  Chest x-ray was completed and negative for infiltrate.  While hospitalized the patient received remdesivir 3 days.  Also received Decadron for total of 3 days will transition to low-dose oral prednisone for 5 additional days to also treat the chronic obstructive pulmonary disease exacerbation.  The patient notes that she does have some mild jittering from the steroids.  At baseline the patient is not on a home inhaler for maintenance.  A prescription for 1 month Advair inhaler was given as well as an inhaler for albuterol.  Patient was instructed to take Mucinex for the next week to help facilitate mucus secretion.   While hospitalized the patient's home lisinopril was stopped due to complaint of dry cough.  Will switch over to Arb as there is less incidence of a dry cough.  Started losartan 50 mg daily during the hospital stay which she has tolerated.  Recommend outpatient follow-up with PCP in 1 week.  Due to hypokalemia while hospitalized would recommend follow-up BMP in 1 week.  The patient's potassium was optimized with oral replacement prior to discharge.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Dyspnoea, Hypokalaemia, Hypoxia
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: medical doctor Admission Date: 7/25/2022 Discharge Date: 7/27/2022  PRESENTING PROBLEM: Hypoxemia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE:   Patient is a 68 y.o. female with a PMH chronic obstructive pulmonary disease, hypertension, and anxiety who presents to hospital on 7/25/2022 with cough and SOB.  The patient lives with her daughter who was recently diagnosed with COVID-19.  The patient developed symptoms on 07/24/2022.   Upon presentation to the emergency department she was noted to be satting 86% air and was placed on 2 L nasal cannula with improvement.  Chest x-ray was completed and negative for infiltrate.  While hospitalized the patient received remdesivir 3 days.  Also received Decadron for total of 3 days will transition to low-dose oral prednisone for 5 additional days to also treat the chronic obstructive pulmonary disease exacerbation.  The patient notes that she does have some mild jittering from the steroids.  At baseline the patient is not on a home inhaler for maintenance.  A prescription for 1 month Advair inhaler was given as well as an inhaler for albuterol.  Patient was instructed to take Mucinex for the next week to help facilitate mucus secretion.   While hospitalized the patient's home lisinopril was stopped due to complaint of dry cough.  Will switch over to Arb as there is less incidence of a dry cough.  Started losartan 50 mg daily during the hospital stay which she has tolerated.  Recommend outpatient follow-up with PCP in 1 week.  Due to hypokalemia while hospitalized would recommend follow-up BMP in 1 week.  The patient's potassium was optimized with oral replacement prior to discharge.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise
Clinical narrative: Discharge Provider:  Primary Care Provider at Discharge: medical doctor Admission Date: 7/25/2022 Discharge Date: 7/27/2022  PRESENTING PROBLEM: Hypoxemia Pneumonia due to COVID-19 virus COVID-19   HOSPITAL COURSE:   Patient is a 68 y.o. female with a PMH chronic obstructive pulmonary disease, hypertension, and anxiety who presents to hospital on 7/25/2022 with cough and SOB.  The patient lives with her daughter who was recently diagnosed with COVID-19.  The patient developed symptoms on 07/24/2022.   Upon presentation to the emergency department she was noted to be satting 86% air and was placed on 2 L nasal cannula with improvement.  Chest x-ray was completed and negative for infiltrate.  While hospitalized the patient received remdesivir 3 days.  Also received Decadron for total of 3 days will transition to low-dose oral prednisone for 5 additional days to also treat the chronic obstructive pulmonary disease exacerbation.  The patient notes that she does have some mild jittering from the steroids.  At baseline the patient is not on a home inhaler for maintenance.  A prescription for 1 month Advair inhaler was given as well as an inhaler for albuterol.  Patient was instructed to take Mucinex for the next week to help facilitate mucus secretion.   While hospitalized the patient's home lisinopril was stopped due to complaint of dry cough.  Will switch over to Arb as there is less incidence of a dry cough.  Started losartan 50 mg daily during the hospital stay which she has tolerated.  Recommend outpatient follow-up with PCP in 1 week.  Due to hypokalemia while hospitalized would recommend follow-up BMP in 1 week.  The patient's potassium was optimized with oral replacement prior to discharge.
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: No adverse reaction.  Pt should have received  30mcg/0.3ml. Pt received 10 mcg/0.2ml
Age: 0.33
Sex: M
Vaccine: DTAPIPVHIB, PNC13, RV5
Symptoms: Cardiac arrest
Clinical narrative: Child seen for routine well child check on 7/27/22. He was brought to the ED the following morning 7/28/22 after cardiac arrest.
Age: 13.0
Sex: F
Vaccine: COVID19, TYP
Symptoms: No adverse event, Product storage error
Clinical narrative: The Covid Vaccine (Gray top) Pfizer given to patient was outside of the 12 hour at room temperature recommendation for vaccine. No symptoms, side effects, or other concerns at this time. Spoke with the Pfizer Safety team. Staff states that a punctured vial of the Covid vaccine gray top should not exceed 36 hours at room temp range of 46 - 84 F. Vaccine was given from the vial that was at 26 hours at room temp of 70 F.
Age: 34.0
Sex: F
Vaccine: COVID19, UNK, UNK
Symptoms: Antinuclear antibody, Bone pain, Fatigue, Myalgia, Pain
Clinical narrative: Bone and muscle ache, extremely fatigue pain all over body sensitive to sunlight
Age: 34.0
Sex: F
Vaccine: COVID19, UNK, UNK
Symptoms: Photophobia
Clinical narrative: Bone and muscle ache, extremely fatigue pain all over body sensitive to sunlight
Age: 8.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature increased, COVID-19, Chest X-ray normal, Heart disease congenital, Oxygen saturation decreased
Clinical narrative: Primary Care Physician at Discharge: MD  Admission Date: 7/23/2022 Discharge Date: 7/23/2022  PRESENTING PROBLEM: COVID [U07.1]   HOSPITAL COURSE: Miracle is a 9 year old female with history significant for HLHS s/p Norwood with BT shunt on 7/10/2013, s/p bidirectional Glenn on 12/18/2013, most recently s/p extracardiac fenestrated Fontan on 6/6/2018; she went for cardiac catheterization on 10/22/2020 and underwent device closure of fenestration. She also has history significant for seizures and multiple thromboses secondary to being homozygous for MTFHR.  Miracle presented to ED on 7/22 with concerns for desaturations while sleeping into the upper 80s, patient's family positive for COVID and Miracle also had positive COVID test in the ED. Upon arrival to the ED she remained in RA with appropriate saturations >90%, she was hemodynamically stable, CXR did not demonstrate consolidation, effusions or pneumo. Following discussion with cardiology team she was admitted for observation following COVID diagnosis in the setting of complex congenital heart disease. Overnight she remained in RA with no increased WOB or shortness of breath, no chest pain, she rested comfortably, low grade temperature was responsive to Tylenol, she continued to take in adequate fluids with no changes to appetite. Discussed patient with ID regarding possibility of antiviral medications, however, due to her reassuring clinical status she was not deemed candidate for this treatment.  She was discharged to home the following morning and will continue supportive care at home. Parents instructed to contact cardiology with any changes in respiratory status or if clinical status changes.   Discharge instructions reviewed with dad at bedside who verbalized understanding.
Age: 8.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Primary Care Physician at Discharge: MD  Admission Date: 7/23/2022 Discharge Date: 7/23/2022  PRESENTING PROBLEM: COVID [U07.1]   HOSPITAL COURSE: Miracle is a 9 year old female with history significant for HLHS s/p Norwood with BT shunt on 7/10/2013, s/p bidirectional Glenn on 12/18/2013, most recently s/p extracardiac fenestrated Fontan on 6/6/2018; she went for cardiac catheterization on 10/22/2020 and underwent device closure of fenestration. She also has history significant for seizures and multiple thromboses secondary to being homozygous for MTFHR.  Miracle presented to ED on 7/22 with concerns for desaturations while sleeping into the upper 80s, patient's family positive for COVID and Miracle also had positive COVID test in the ED. Upon arrival to the ED she remained in RA with appropriate saturations >90%, she was hemodynamically stable, CXR did not demonstrate consolidation, effusions or pneumo. Following discussion with cardiology team she was admitted for observation following COVID diagnosis in the setting of complex congenital heart disease. Overnight she remained in RA with no increased WOB or shortness of breath, no chest pain, she rested comfortably, low grade temperature was responsive to Tylenol, she continued to take in adequate fluids with no changes to appetite. Discussed patient with ID regarding possibility of antiviral medications, however, due to her reassuring clinical status she was not deemed candidate for this treatment.  She was discharged to home the following morning and will continue supportive care at home. Parents instructed to contact cardiology with any changes in respiratory status or if clinical status changes.   Discharge instructions reviewed with dad at bedside who verbalized understanding.
Age: 33.0
Sex: F
Vaccine: TYP, YF
Symptoms: Rash, Rash erythematous
Clinical narrative: She states she has developed a small non-pustule rash on her arms, legs, torso. She describes the rash as pale pink edges with white color in the middle. She states her injection site at YF developed same presentation several days after vaccination. She denies any itching, shortness of breath, hives, chest pain, swelling
Age: 69.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Headache, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Positive COVID test 6/28/22. Sore throat; congestion; headache; mild overall Paxlovid Rx Almost immediate relief from sympthons  I feel well today and restarted doing long (30 mile plus) bike rides
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac monitoring abnormal, Echocardiogram, Electrocardiogram, Hypertension, Hypotension
Clinical narrative: Began experiencing tachycardia approximately 11-14 days after 2nd booster along with low blood pressure with spikes of high blood pressure.  Electrocardiologist believes it is POTS syndrome.  I believe I could have had this for a few years but symptoms were made worse after the booster.  Blood pressure drops very low and tachycardia begins within 10 minutes of standing.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Supraventricular tachycardia, Tachycardia, Tilt table test
Clinical narrative: Began experiencing tachycardia approximately 11-14 days after 2nd booster along with low blood pressure with spikes of high blood pressure.  Electrocardiologist believes it is POTS syndrome.  I believe I could have had this for a few years but symptoms were made worse after the booster.  Blood pressure drops very low and tachycardia begins within 10 minutes of standing.
Age: 62.0
Sex: F
Vaccine: UNK
Symptoms: Feeling abnormal, Injection site erythema, Injection site pain, Injection site swelling, Nausea
Clinical narrative: Pain, redness and swelling at injection site.  I feel bad and a little nauseous.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebral palsy, Computerised tomogram head, Facial paralysis, Hypoaesthesia, Inappropriate schedule of product administration
Clinical narrative: Patient received 4th dose of covid vaccine (pfizer) on 7/7/22. On 7/20/22 she woke up up with left sided facial numbness, left facial drooping and unable to raise left eyebrow. Patient went to ED and diagnosed with cerebral palsy. Of note, patient received her 3rd dose (booster)  Moderna on 11/24/21.  Her first two covid vaccines were Pfizer on 3/17/21 and 4/10/21.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Patient received 4th dose of covid vaccine (pfizer) on 7/7/22. On 7/20/22 she woke up up with left sided facial numbness, left facial drooping and unable to raise left eyebrow. Patient went to ED and diagnosed with cerebral palsy. Of note, patient received her 3rd dose (booster)  Moderna on 11/24/21.  Her first two covid vaccines were Pfizer on 3/17/21 and 4/10/21.
Age: 12.0
Sex: U
Vaccine: COVID19
Symptoms: Extra dose administered, Product administered to patient of inappropriate age
Clinical narrative: pt rec'd a booster dose of moderna, he should not have, pt is under 18years old.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Confusional state, Fall, Hydronephrosis, Imaging procedure
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: Private Primary Care Provider: None Physician, DO Admission Date: 7/23/2022 Discharge Date:  07/26/2022  PRESENTING PROBLEM: Nephrostomy tube displaced (HCC) [T83.022A] Acute kidney injury (HCC) [N17.9] Fall, initial encounter [W19.XXXA]   HOSPITAL COURSE: 82 y.o. male with a PMHx of prostate cancer, PE, TIA, HTN, and recent COVID-19 diagnosis (requiring 2 L oxygen), reportedly contracted from staff at facility who presented after a fall at said facility.  Per hospice nursing staff, patient got out of bed and was tangled in devices.  Patient was confused and staff were concerned that he struck his head on the bedside table.  Hospice nursing staff was contacted by the assisted living facility and patient was discharged from hospice to transfer to the emergency department for treatment.  At presentation patient was confused and unable to corroborate, but patient's daughter corroborated the story she heard over the phone.     Regarding patient's prostate cancer, he was enrolled in hospice with local Hospice on 07/07/2022 as patient no longer wished to pursue treatment.  His prostate cancer is causing obstruction of his right ureter and resultant hydronephrosis.  He required nephrostomy tube placement in January of 2022 to relieve this obstruction. The tube was replaced in April per protocol, then developed a leak and was replaced again in May. In June, it became dislodged and needed to be replaced before becoming dislodged on 07/20/2022 and, yet again, being replaced.  While in hospital, basic laboratory work and imaging were performed.  Workup demonstrated worsening kidney function, ultimately found to be secondary to hydronephrosis from mal-positioned nephrostomy tube.  Imaging of the head was negative for acute process.  Patient was admitted to the hospital with subsequent repositioning of nephrostomy tube.  A goals of care discussion was held with family, and was determined that the patient would not want aggressive measures and would most prefer  return to hospice now that nephrostomy tube was causing no distress.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test, Nephrostomy, Renal impairment
Clinical narrative: BRIEF OVERVIEW: Discharge Provider: Private Primary Care Provider: None Physician, DO Admission Date: 7/23/2022 Discharge Date:  07/26/2022  PRESENTING PROBLEM: Nephrostomy tube displaced (HCC) [T83.022A] Acute kidney injury (HCC) [N17.9] Fall, initial encounter [W19.XXXA]   HOSPITAL COURSE: 82 y.o. male with a PMHx of prostate cancer, PE, TIA, HTN, and recent COVID-19 diagnosis (requiring 2 L oxygen), reportedly contracted from staff at facility who presented after a fall at said facility.  Per hospice nursing staff, patient got out of bed and was tangled in devices.  Patient was confused and staff were concerned that he struck his head on the bedside table.  Hospice nursing staff was contacted by the assisted living facility and patient was discharged from hospice to transfer to the emergency department for treatment.  At presentation patient was confused and unable to corroborate, but patient's daughter corroborated the story she heard over the phone.     Regarding patient's prostate cancer, he was enrolled in hospice with local Hospice on 07/07/2022 as patient no longer wished to pursue treatment.  His prostate cancer is causing obstruction of his right ureter and resultant hydronephrosis.  He required nephrostomy tube placement in January of 2022 to relieve this obstruction. The tube was replaced in April per protocol, then developed a leak and was replaced again in May. In June, it became dislodged and needed to be replaced before becoming dislodged on 07/20/2022 and, yet again, being replaced.  While in hospital, basic laboratory work and imaging were performed.  Workup demonstrated worsening kidney function, ultimately found to be secondary to hydronephrosis from mal-positioned nephrostomy tube.  Imaging of the head was negative for acute process.  Patient was admitted to the hospital with subsequent repositioning of nephrostomy tube.  A goals of care discussion was held with family, and was determined that the patient would not want aggressive measures and would most prefer  return to hospice now that nephrostomy tube was causing no distress.
Age: 31.0
Sex: F
Vaccine: COVID19, FLUC4, HEPAB
Symptoms: Angiogram pulmonary normal, COVID-19, Dyspnoea, Dyspnoea exertional, Gastrectomy
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 7/22/2022 Discharge Date: Jul 23, 2022  PRESENTING PROBLEM: Shortness of breath DOE (dyspnea on exertion) Hypoxia COVID-19   HOSPITAL COURSE: 32 year old female presented with history of transposition of the great vessels status post fontan procedure as an infant who underwent a laparoscopic gastric sleeve procedure on 5th July. She started having symptoms of covid on Tuesday followed by positive covid test. She was admitted to hospital on Saturday. She had CT angio done which was negative for PE though left pulmonary artery was non diagnostic. She is US venous duplex which was negative. She was evaluated by congenital heart. It was felt her symptoms were unlikely from PE. Her symptoms are felt from covid. She was not hypoxic even with exertion. She was discharged home with close follow up with PCP and congenital heart.
Age: 31.0
Sex: F
Vaccine: COVID19, FLUC4, HEPAB
Symptoms: Hypoxia, Laparoscopic surgery, Malaise, SARS-CoV-2 test positive, Ultrasound Doppler normal
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 7/22/2022 Discharge Date: Jul 23, 2022  PRESENTING PROBLEM: Shortness of breath DOE (dyspnea on exertion) Hypoxia COVID-19   HOSPITAL COURSE: 32 year old female presented with history of transposition of the great vessels status post fontan procedure as an infant who underwent a laparoscopic gastric sleeve procedure on 5th July. She started having symptoms of covid on Tuesday followed by positive covid test. She was admitted to hospital on Saturday. She had CT angio done which was negative for PE though left pulmonary artery was non diagnostic. She is US venous duplex which was negative. She was evaluated by congenital heart. It was felt her symptoms were unlikely from PE. Her symptoms are felt from covid. She was not hypoxic even with exertion. She was discharged home with close follow up with PCP and congenital heart.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Got Covid
Age: 0.5
Sex: M
Vaccine: COVID19
Symptoms: Rash
Clinical narrative: He got a rash on his trunk (stomach, chest, and back).  Rash looked like a pinpoint rash.
Age: 7.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: patient was given adult dose at booster dose, instead of Pfizer 5-11 yr old dose no adverse side effects reported
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Feeling abnormal, Muscular weakness, Nausea, Pain
Clinical narrative: I experienced a fever of 103.3, body aches, weakness in my legs, brain fog, nausea, and fatigue. I was advised to treat my symptoms with over the counter medication. The symptoms began to resolve after 3 days. It took me 7 days to fully recover from the booster.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: I experienced a fever of 103.3, body aches, weakness in my legs, brain fog, nausea, and fatigue. I was advised to treat my symptoms with over the counter medication. The symptoms began to resolve after 3 days. It took me 7 days to fully recover from the booster.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Underdose
Clinical narrative: No adverse reaction.  Pt should have received  30mcg/0.3ml. Pt received 10 mcg/0.2ml.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Fatigue, Illness
Clinical narrative: I received my second Pfizer booster for COVID-19 on 4/28/2022. On 7/22/2022, I developed a cough. I also felt fatigued, but I thought it was possibly on account of the heat and because we had just gone hiking. We were abroad at the time, and we flew home on 7/27/2022. I took a home COVID-19 test that evening and got a positive result. I called my doctor, and he prescribed me a 5-day course of Paxlovid. We picked up the prescription on 7/28/2022, but I haven't taken it, since I didn't really feel sick and I haven't ever had a fever during the illness. My doctor told me about the side effects of the Paxlovid; since they sounded worse than the symptoms I was experiencing, that was another reason why I decided against taking it. At the time of this writing, I'm just a little bit congested, but other than that, I don't really feel ill. My wife also has COVID-19. She took a home test today and got a positive result. I haven't taken a test today, since I figure that I would probably also get a positive result, since we likely were exposed the virus at the same time.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: I received my second Pfizer booster for COVID-19 on 4/28/2022. On 7/22/2022, I developed a cough. I also felt fatigued, but I thought it was possibly on account of the heat and because we had just gone hiking. We were abroad at the time, and we flew home on 7/27/2022. I took a home COVID-19 test that evening and got a positive result. I called my doctor, and he prescribed me a 5-day course of Paxlovid. We picked up the prescription on 7/28/2022, but I haven't taken it, since I didn't really feel sick and I haven't ever had a fever during the illness. My doctor told me about the side effects of the Paxlovid; since they sounded worse than the symptoms I was experiencing, that was another reason why I decided against taking it. At the time of this writing, I'm just a little bit congested, but other than that, I don't really feel ill. My wife also has COVID-19. She took a home test today and got a positive result. I haven't taken a test today, since I figure that I would probably also get a positive result, since we likely were exposed the virus at the same time.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Acute pulmonary oedema, Acute respiratory failure, Blood creatinine increased, Brain natriuretic peptide increased, COVID-19
Clinical narrative: Discharge Provider:  Primary Care Provider:  Admission Date: 7/22/2022 Discharge Date: Jul 25, 2022   PRESENTING PROBLEM: Shortness of breath [R06.02] Acute pulmonary edema [J81.0] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: 84-year-old man with past medical history of chronic diastolic heart failure, hypertension, type 2 diabetes, peripheral artery disease who presented to the emergency department due to concern for worsening shortness of breath and wheezing.  His symptoms of shortness of breath and upper respiratory infection started 1 week prior to this presentation.  In the emergency department patient required BiPAP and on lab work his creatinine was consistent with 2.24.  His troponins were elevated along with elevated BNP.  COVID PCR was positive.  Chest x-ray was consistent with central vascular congestion and moderate CHF and pulmonary edema suspected foot bilateral small pleural effusions were seen. Patient symptoms improved significantly with IV Lasix diuresis.  He was eventually weaned off the roommate.  He was also started on Decadron as he was requiring oxygen but COVID positive status.  He was not a candidate for remdesivir due to the timing and creatinine at the time of presentation..  Echocardiogram was obtained which did not show any wall motion abnormalities.  Patient also felt significantly better just with diuresis however after performing multiple doses of IV Lasix patient's creatinine went back up to 2.0 hands Lasix was held at the time of discharge and patient was asked to follow with his PCP with repeat BMP within 3 days from discharge.  During this admission patient on to have gross hematuria for which he underwent renal ultrasound was negative for any abnormality.  Neurology was consulted who plans to follow up with patient as outpatient to perform cystoscopy.  Patient was encouraged to follow heart failure diet and follow up with his primary care physician after getting discharged.  Decadron was held at the time of discharge as patient is significantly improved in terms of symptoms.  Patient was offered to enroll acute care program at the time of discharge but patient refused this. Since daughter is very actively involved in his care I spoke to her and gave all the instructions at the time of discharge.  Patient was also instructed to check his blood sugars as they were slightly elevated in the setting of Decadron use in the hospital.  If his blood sugars remain elevated then he will benefit and increasing dose of his home medications.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac failure congestive, Chest X-ray abnormal, Condition aggravated, Dyspnoea, Echocardiogram normal
Clinical narrative: Discharge Provider:  Primary Care Provider:  Admission Date: 7/22/2022 Discharge Date: Jul 25, 2022   PRESENTING PROBLEM: Shortness of breath [R06.02] Acute pulmonary edema [J81.0] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: 84-year-old man with past medical history of chronic diastolic heart failure, hypertension, type 2 diabetes, peripheral artery disease who presented to the emergency department due to concern for worsening shortness of breath and wheezing.  His symptoms of shortness of breath and upper respiratory infection started 1 week prior to this presentation.  In the emergency department patient required BiPAP and on lab work his creatinine was consistent with 2.24.  His troponins were elevated along with elevated BNP.  COVID PCR was positive.  Chest x-ray was consistent with central vascular congestion and moderate CHF and pulmonary edema suspected foot bilateral small pleural effusions were seen. Patient symptoms improved significantly with IV Lasix diuresis.  He was eventually weaned off the roommate.  He was also started on Decadron as he was requiring oxygen but COVID positive status.  He was not a candidate for remdesivir due to the timing and creatinine at the time of presentation..  Echocardiogram was obtained which did not show any wall motion abnormalities.  Patient also felt significantly better just with diuresis however after performing multiple doses of IV Lasix patient's creatinine went back up to 2.0 hands Lasix was held at the time of discharge and patient was asked to follow with his PCP with repeat BMP within 3 days from discharge.  During this admission patient on to have gross hematuria for which he underwent renal ultrasound was negative for any abnormality.  Neurology was consulted who plans to follow up with patient as outpatient to perform cystoscopy.  Patient was encouraged to follow heart failure diet and follow up with his primary care physician after getting discharged.  Decadron was held at the time of discharge as patient is significantly improved in terms of symptoms.  Patient was offered to enroll acute care program at the time of discharge but patient refused this. Since daughter is very actively involved in his care I spoke to her and gave all the instructions at the time of discharge.  Patient was also instructed to check his blood sugars as they were slightly elevated in the setting of Decadron use in the hospital.  If his blood sugars remain elevated then he will benefit and increasing dose of his home medications.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Haematuria, Medical diet, Pleural effusion, Polyuria, Positive airway pressure therapy
Clinical narrative: Discharge Provider:  Primary Care Provider:  Admission Date: 7/22/2022 Discharge Date: Jul 25, 2022   PRESENTING PROBLEM: Shortness of breath [R06.02] Acute pulmonary edema [J81.0] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: 84-year-old man with past medical history of chronic diastolic heart failure, hypertension, type 2 diabetes, peripheral artery disease who presented to the emergency department due to concern for worsening shortness of breath and wheezing.  His symptoms of shortness of breath and upper respiratory infection started 1 week prior to this presentation.  In the emergency department patient required BiPAP and on lab work his creatinine was consistent with 2.24.  His troponins were elevated along with elevated BNP.  COVID PCR was positive.  Chest x-ray was consistent with central vascular congestion and moderate CHF and pulmonary edema suspected foot bilateral small pleural effusions were seen. Patient symptoms improved significantly with IV Lasix diuresis.  He was eventually weaned off the roommate.  He was also started on Decadron as he was requiring oxygen but COVID positive status.  He was not a candidate for remdesivir due to the timing and creatinine at the time of presentation..  Echocardiogram was obtained which did not show any wall motion abnormalities.  Patient also felt significantly better just with diuresis however after performing multiple doses of IV Lasix patient's creatinine went back up to 2.0 hands Lasix was held at the time of discharge and patient was asked to follow with his PCP with repeat BMP within 3 days from discharge.  During this admission patient on to have gross hematuria for which he underwent renal ultrasound was negative for any abnormality.  Neurology was consulted who plans to follow up with patient as outpatient to perform cystoscopy.  Patient was encouraged to follow heart failure diet and follow up with his primary care physician after getting discharged.  Decadron was held at the time of discharge as patient is significantly improved in terms of symptoms.  Patient was offered to enroll acute care program at the time of discharge but patient refused this. Since daughter is very actively involved in his care I spoke to her and gave all the instructions at the time of discharge.  Patient was also instructed to check his blood sugars as they were slightly elevated in the setting of Decadron use in the hospital.  If his blood sugars remain elevated then he will benefit and increasing dose of his home medications.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary oedema, SARS-CoV-2 test positive, Troponin increased, Ultrasound kidney normal, Upper respiratory tract infection
Clinical narrative: Discharge Provider:  Primary Care Provider:  Admission Date: 7/22/2022 Discharge Date: Jul 25, 2022   PRESENTING PROBLEM: Shortness of breath [R06.02] Acute pulmonary edema [J81.0] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: 84-year-old man with past medical history of chronic diastolic heart failure, hypertension, type 2 diabetes, peripheral artery disease who presented to the emergency department due to concern for worsening shortness of breath and wheezing.  His symptoms of shortness of breath and upper respiratory infection started 1 week prior to this presentation.  In the emergency department patient required BiPAP and on lab work his creatinine was consistent with 2.24.  His troponins were elevated along with elevated BNP.  COVID PCR was positive.  Chest x-ray was consistent with central vascular congestion and moderate CHF and pulmonary edema suspected foot bilateral small pleural effusions were seen. Patient symptoms improved significantly with IV Lasix diuresis.  He was eventually weaned off the roommate.  He was also started on Decadron as he was requiring oxygen but COVID positive status.  He was not a candidate for remdesivir due to the timing and creatinine at the time of presentation..  Echocardiogram was obtained which did not show any wall motion abnormalities.  Patient also felt significantly better just with diuresis however after performing multiple doses of IV Lasix patient's creatinine went back up to 2.0 hands Lasix was held at the time of discharge and patient was asked to follow with his PCP with repeat BMP within 3 days from discharge.  During this admission patient on to have gross hematuria for which he underwent renal ultrasound was negative for any abnormality.  Neurology was consulted who plans to follow up with patient as outpatient to perform cystoscopy.  Patient was encouraged to follow heart failure diet and follow up with his primary care physician after getting discharged.  Decadron was held at the time of discharge as patient is significantly improved in terms of symptoms.  Patient was offered to enroll acute care program at the time of discharge but patient refused this. Since daughter is very actively involved in his care I spoke to her and gave all the instructions at the time of discharge.  Patient was also instructed to check his blood sugars as they were slightly elevated in the setting of Decadron use in the hospital.  If his blood sugars remain elevated then he will benefit and increasing dose of his home medications.
Age: 83.0
Sex: M
Vaccine: COVID19
Symptoms: Wheezing
Clinical narrative: Discharge Provider:  Primary Care Provider:  Admission Date: 7/22/2022 Discharge Date: Jul 25, 2022   PRESENTING PROBLEM: Shortness of breath [R06.02] Acute pulmonary edema [J81.0] Acute respiratory failure with hypoxia [J96.01] COVID-19 [U07.1]   HOSPITAL COURSE: 84-year-old man with past medical history of chronic diastolic heart failure, hypertension, type 2 diabetes, peripheral artery disease who presented to the emergency department due to concern for worsening shortness of breath and wheezing.  His symptoms of shortness of breath and upper respiratory infection started 1 week prior to this presentation.  In the emergency department patient required BiPAP and on lab work his creatinine was consistent with 2.24.  His troponins were elevated along with elevated BNP.  COVID PCR was positive.  Chest x-ray was consistent with central vascular congestion and moderate CHF and pulmonary edema suspected foot bilateral small pleural effusions were seen. Patient symptoms improved significantly with IV Lasix diuresis.  He was eventually weaned off the roommate.  He was also started on Decadron as he was requiring oxygen but COVID positive status.  He was not a candidate for remdesivir due to the timing and creatinine at the time of presentation..  Echocardiogram was obtained which did not show any wall motion abnormalities.  Patient also felt significantly better just with diuresis however after performing multiple doses of IV Lasix patient's creatinine went back up to 2.0 hands Lasix was held at the time of discharge and patient was asked to follow with his PCP with repeat BMP within 3 days from discharge.  During this admission patient on to have gross hematuria for which he underwent renal ultrasound was negative for any abnormality.  Neurology was consulted who plans to follow up with patient as outpatient to perform cystoscopy.  Patient was encouraged to follow heart failure diet and follow up with his primary care physician after getting discharged.  Decadron was held at the time of discharge as patient is significantly improved in terms of symptoms.  Patient was offered to enroll acute care program at the time of discharge but patient refused this. Since daughter is very actively involved in his care I spoke to her and gave all the instructions at the time of discharge.  Patient was also instructed to check his blood sugars as they were slightly elevated in the setting of Decadron use in the hospital.  If his blood sugars remain elevated then he will benefit and increasing dose of his home medications.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Fatigue, Nasal congestion, Pyrexia
Clinical narrative: I had fever, cough, tired, I went to the doctor and gave me medicine for 5 days but after the 12 day I tested Positive again. On July 18 I had the first home test, and it was positive, on July 22 another test was negative and on July 28 the test was positive. I had stuffy nose and cough.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I had fever, cough, tired, I went to the doctor and gave me medicine for 5 days but after the 12 day I tested Positive again. On July 18 I had the first home test, and it was positive, on July 22 another test was negative and on July 28 the test was positive. I had stuffy nose and cough.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, COVID-19, Cough, Nasopharyngitis, Oropharyngeal pain
Clinical narrative: When I caught COVID-19 I had a slight sore throat. On 7/13/2022 I spoke to the doctor and she prescribed me with paxlovid. I had a low grade fever for 2 days, and I had the sniffles. The fever had went away. Then on the 2nd day of taking paxlovid the sore throat went away. I thought I was better until 7/22/2022. I had snidffles and a sore throat again. I had a rebound of Covid-19. I had a dry cough too. The fever didn't come back. I had those symptoms until yesterday or this morning. On Monday I felt my lower back ache. By the end of the day I had put heat on it, and I had horrible back pain. That lasted until yesterday. Today I feel much better. The rebound of COVID-19 lasted for about a week. I had a much stronger head cold the 2nd time around. I took Advil and Aleve.   2 and a half days.