chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Dyspnoea, Full blood count, Gastrooesophageal reflux disease, Hyperlipidaemia, Hypertension
Clinical narrative: Patient is a pleasant 84-year-old male who presents to the emergency department today for chief complaint of shortness of breath.  He reports his symptoms have been ongoing for approximately 1 week.  He reports he was taken to home COVID test both of which have been negative.  He presented to urgent care this morning for evaluation at which time he was prompted to come to the emergency department as he was found to be hypoxic.  He reports that he normally walks approximately 2 miles per day, on his normal route he is noted that he is becoming increasingly dyspneic when normally he would not be.  He does endorse a dry cough, that is elicited with deep inspiration.  He denies any fever or chills.  He denies any current pulmonary dysfunction, denies any smoking history.  Patient states that he is fully vaccinated for COVID-19.  Denies any chest pain, palpitations, fever/chills, abdominal pain, nausea/vomiting, diarrhea/constipation ED work-up: Chest x-ray shows multifocal pneumonia with both lungs, with positive COVID-19 swab.  Does meet sepsis criteria.  CT of the chest shows no acute PE, but does note new 9 mm nodule in the left upper lung which is concerning for malignancy and is new from previous CT in 2006.  CBC and metabolic panel significant for WBC of 18.68, CRP 120, sodium 129.  Patient is hemodynamically stable at this time.  He is on 2 L nasal cannula with O2 saturation of approximately 93%.  He does have a T-max of 100.9 degrees while in the ED.  He was given 6 mg IV Decadron.  He is admitted under the hospitalist service for further work-up and continuation of care   Clinical Summary Patient did not qualify for remdesivir but did receive steroids.  Patient never required intubation, only NC and will be discharged home with oxygen.  Patient was noted to have a left upper lobe nodule and an ascending aortic aneurysm and patient is instructed to follow up with PCP.  Patient will be discharged with dexamethasone for a total of 10 days.  Patient did not require oxygen based on the 6 minute walk test prior to discharge.   Discharge diagnosis Acute hypoxic respiratory failure Sepsis, secondary to COVID-19 pneumonitis 9 mm left upper lobe nodule Hyponatremia Hypertension Hyperlipidemia GERD BPH OSA
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Hyponatraemia, Hypoxia, Metabolic function test, Obstructive sleep apnoea syndrome, Pulmonary mass
Clinical narrative: Patient is a pleasant 84-year-old male who presents to the emergency department today for chief complaint of shortness of breath.  He reports his symptoms have been ongoing for approximately 1 week.  He reports he was taken to home COVID test both of which have been negative.  He presented to urgent care this morning for evaluation at which time he was prompted to come to the emergency department as he was found to be hypoxic.  He reports that he normally walks approximately 2 miles per day, on his normal route he is noted that he is becoming increasingly dyspneic when normally he would not be.  He does endorse a dry cough, that is elicited with deep inspiration.  He denies any fever or chills.  He denies any current pulmonary dysfunction, denies any smoking history.  Patient states that he is fully vaccinated for COVID-19.  Denies any chest pain, palpitations, fever/chills, abdominal pain, nausea/vomiting, diarrhea/constipation ED work-up: Chest x-ray shows multifocal pneumonia with both lungs, with positive COVID-19 swab.  Does meet sepsis criteria.  CT of the chest shows no acute PE, but does note new 9 mm nodule in the left upper lung which is concerning for malignancy and is new from previous CT in 2006.  CBC and metabolic panel significant for WBC of 18.68, CRP 120, sodium 129.  Patient is hemodynamically stable at this time.  He is on 2 L nasal cannula with O2 saturation of approximately 93%.  He does have a T-max of 100.9 degrees while in the ED.  He was given 6 mg IV Decadron.  He is admitted under the hospitalist service for further work-up and continuation of care   Clinical Summary Patient did not qualify for remdesivir but did receive steroids.  Patient never required intubation, only NC and will be discharged home with oxygen.  Patient was noted to have a left upper lobe nodule and an ascending aortic aneurysm and patient is instructed to follow up with PCP.  Patient will be discharged with dexamethasone for a total of 10 days.  Patient did not require oxygen based on the 6 minute walk test prior to discharge.   Discharge diagnosis Acute hypoxic respiratory failure Sepsis, secondary to COVID-19 pneumonitis 9 mm left upper lobe nodule Hyponatremia Hypertension Hyperlipidemia GERD BPH OSA
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Sepsis, Walking distance test normal, White blood cell count increased
Clinical narrative: Patient is a pleasant 84-year-old male who presents to the emergency department today for chief complaint of shortness of breath.  He reports his symptoms have been ongoing for approximately 1 week.  He reports he was taken to home COVID test both of which have been negative.  He presented to urgent care this morning for evaluation at which time he was prompted to come to the emergency department as he was found to be hypoxic.  He reports that he normally walks approximately 2 miles per day, on his normal route he is noted that he is becoming increasingly dyspneic when normally he would not be.  He does endorse a dry cough, that is elicited with deep inspiration.  He denies any fever or chills.  He denies any current pulmonary dysfunction, denies any smoking history.  Patient states that he is fully vaccinated for COVID-19.  Denies any chest pain, palpitations, fever/chills, abdominal pain, nausea/vomiting, diarrhea/constipation ED work-up: Chest x-ray shows multifocal pneumonia with both lungs, with positive COVID-19 swab.  Does meet sepsis criteria.  CT of the chest shows no acute PE, but does note new 9 mm nodule in the left upper lung which is concerning for malignancy and is new from previous CT in 2006.  CBC and metabolic panel significant for WBC of 18.68, CRP 120, sodium 129.  Patient is hemodynamically stable at this time.  He is on 2 L nasal cannula with O2 saturation of approximately 93%.  He does have a T-max of 100.9 degrees while in the ED.  He was given 6 mg IV Decadron.  He is admitted under the hospitalist service for further work-up and continuation of care   Clinical Summary Patient did not qualify for remdesivir but did receive steroids.  Patient never required intubation, only NC and will be discharged home with oxygen.  Patient was noted to have a left upper lobe nodule and an ascending aortic aneurysm and patient is instructed to follow up with PCP.  Patient will be discharged with dexamethasone for a total of 10 days.  Patient did not require oxygen based on the 6 minute walk test prior to discharge.   Discharge diagnosis Acute hypoxic respiratory failure Sepsis, secondary to COVID-19 pneumonitis 9 mm left upper lobe nodule Hyponatremia Hypertension Hyperlipidemia GERD BPH OSA
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, Blood culture, Dyspnoea, Electrolyte substitution therapy
Clinical narrative: Patient is a 54 y.o. female who is a patient of MD with significant medical history of GERD, migraines, anxiety and depression, now presented with shortness of breath.   Community-acquired bacterial pneumonia Sepsis POA? RR 25, leukocytosis 18 K Suggested by chest imaging, negative COVID-19 testing, and white blood cell count with left shift.  Started on Rocephin, azithromycin on admission, continued Follow Blood cultures, pneumonia urine antigens neg IV fluid resuscitation Discharge on Azithromycin to complete 5 days, Omnicef to complete 7 days   Acute kidney injury, resolved Creatinine 1.2 on admission Likely related to above Creatinine normalized with IV fluid resuscitation   Hypokalemia Replaced Monitor and continue to replace as needed   Migraine disorder Continue home as needed Imitrex. Patient had been on Topamax in the past, but was taken off of it by her doctors remotely.   GERD History of peptic ulcer disease Continue home omeprazole.   Anxiety and depression Continue home Wellbutrin, Abilify, Prozac and as needed Xanax.   Tobacco abuse Cessation strongly encouraged and advised NRT while inpatient
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Hypokalaemia, Imaging procedure, Leukocytosis, Pneumonia, Pneumonia bacterial
Clinical narrative: Patient is a 54 y.o. female who is a patient of MD with significant medical history of GERD, migraines, anxiety and depression, now presented with shortness of breath.   Community-acquired bacterial pneumonia Sepsis POA? RR 25, leukocytosis 18 K Suggested by chest imaging, negative COVID-19 testing, and white blood cell count with left shift.  Started on Rocephin, azithromycin on admission, continued Follow Blood cultures, pneumonia urine antigens neg IV fluid resuscitation Discharge on Azithromycin to complete 5 days, Omnicef to complete 7 days   Acute kidney injury, resolved Creatinine 1.2 on admission Likely related to above Creatinine normalized with IV fluid resuscitation   Hypokalemia Replaced Monitor and continue to replace as needed   Migraine disorder Continue home as needed Imitrex. Patient had been on Topamax in the past, but was taken off of it by her doctors remotely.   GERD History of peptic ulcer disease Continue home omeprazole.   Anxiety and depression Continue home Wellbutrin, Abilify, Prozac and as needed Xanax.   Tobacco abuse Cessation strongly encouraged and advised NRT while inpatient
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test negative, Sepsis, Urine antigen test, White blood cell count increased
Clinical narrative: Patient is a 54 y.o. female who is a patient of MD with significant medical history of GERD, migraines, anxiety and depression, now presented with shortness of breath.   Community-acquired bacterial pneumonia Sepsis POA? RR 25, leukocytosis 18 K Suggested by chest imaging, negative COVID-19 testing, and white blood cell count with left shift.  Started on Rocephin, azithromycin on admission, continued Follow Blood cultures, pneumonia urine antigens neg IV fluid resuscitation Discharge on Azithromycin to complete 5 days, Omnicef to complete 7 days   Acute kidney injury, resolved Creatinine 1.2 on admission Likely related to above Creatinine normalized with IV fluid resuscitation   Hypokalemia Replaced Monitor and continue to replace as needed   Migraine disorder Continue home as needed Imitrex. Patient had been on Topamax in the past, but was taken off of it by her doctors remotely.   GERD History of peptic ulcer disease Continue home omeprazole.   Anxiety and depression Continue home Wellbutrin, Abilify, Prozac and as needed Xanax.   Tobacco abuse Cessation strongly encouraged and advised NRT while inpatient
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Haematuria, Inflammatory marker test
Clinical narrative: Patient is a 75 y.o. male patient of PRIVATE MD with a history of dementia admitted for COVID-19 pneumonia repeat chest x-ray shows improvement patient clinically stable inflammatory markers have significantly improved remains afebrile oxygen saturation 98% most of the times we do not keep oxygen on.  Plan discharge   Discharge Diagnoses: * Pneumonia due to COVID-19 virus Assessment & Plan Patient clinically has improved   Chest x-ray shows improvement in infiltrates.   Has completed remdesivir   Dyslipidemia Assessment & Plan Continue home medication   Primary hypertension Assessment & Plan Blood pressure stable   Hematuria Assessment & Plan Needs outpatient follow-up with urology   Moderate early onset Alzheimer's dementia (HCC) Assessment & Plan Previous chart reviewed continue home medication   Rheumatoid arthritis involving multiple sites (HCC) Assessment & Plan Patient currently on methotrexate continue the same.
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Lung infiltration
Clinical narrative: Patient is a 75 y.o. male patient of PRIVATE MD with a history of dementia admitted for COVID-19 pneumonia repeat chest x-ray shows improvement patient clinically stable inflammatory markers have significantly improved remains afebrile oxygen saturation 98% most of the times we do not keep oxygen on.  Plan discharge   Discharge Diagnoses: * Pneumonia due to COVID-19 virus Assessment & Plan Patient clinically has improved   Chest x-ray shows improvement in infiltrates.   Has completed remdesivir   Dyslipidemia Assessment & Plan Continue home medication   Primary hypertension Assessment & Plan Blood pressure stable   Hematuria Assessment & Plan Needs outpatient follow-up with urology   Moderate early onset Alzheimer's dementia (HCC) Assessment & Plan Previous chart reviewed continue home medication   Rheumatoid arthritis involving multiple sites (HCC) Assessment & Plan Patient currently on methotrexate continue the same.
Age: 58.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Magnetic resonance imaging, Pain in extremity, X-ray
Clinical narrative: Chronic joint pain left elbow. right hand, both knees
Age: 66.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Cough, Fatigue, Headache, SARS-CoV-2 test positive
Clinical narrative: 12/20/22 presents to ED for "cough, headache, generalized fatigue". PMHx of "DM type II, HTN, anxiety/depression, HLD, history of OSA asthma, chronic back pain"
Age: 12.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Underdose
Clinical narrative: Child was 12 yrs 0 months and received the Pfizer vaccine for 5-11 year olds.  No adverse reactions were noted.
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Decreased appetite, Influenza virus test negative, Pain, Pyrexia
Clinical narrative: I was tested for COVID-19, RSV, and Flu and I ended up testing positive for RSV. I had loss of appetite, fever, cough, congestion, and body aches. My doctor told me that it should be gone in 5 days, but I still have a bad cough. It gets really bad when I lay down. I was prescribed benzonatate, 600mg ibuprofen, and a steroid injection while I was at the hospital.
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory syncytial virus test positive, Respiratory tract congestion, SARS-CoV-2 test negative
Clinical narrative: I was tested for COVID-19, RSV, and Flu and I ended up testing positive for RSV. I had loss of appetite, fever, cough, congestion, and body aches. My doctor told me that it should be gone in 5 days, but I still have a bad cough. It gets really bad when I lay down. I was prescribed benzonatate, 600mg ibuprofen, and a steroid injection while I was at the hospital.
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Ammonia normal, Angiogram pulmonary abnormal, Atelectasis, Blood folate normal
Clinical narrative: Patient is a 85 y.o. male admitted to the hospital on 12/20/2022 for AMS, hypoxia, found to have covid-19, s/p dexamethasone, also given paxlovid while here. Was unable to be weaned off oxygen, repeat chest imaging showed a new RLL consolidation c/w pneumonia, started on CAP coverage with some improvement in his oxygenation, but still requiring 1-2L NC.   Discharge Diagnosis and Associated Hospital Course   Acute metabolic encephalopathy  - secondary to COVID-19 infection, on a background mild cognitive impairment - BMP, CBC, B12/folate, ammonia, TSH, and HFP largely unremarkable. UA negative. CT Head unremarkable - Minimize central acting medications, recommend delirium precautions - PT/OT and case management consulted, initially PT/OT recs 2-3x weekly with plan to return to ILF, however now 5x weekly, rehab on dc   COVID-19 Abnormal CT imaging Acute hypoxic respiratory failure Lobar pneumonia - No clear exact symptom onset. - CTPA negative for PE, does show mild bilateral lower lobe patchy lung opacities (atelectasis vs aspiration vs infiltrates) - Mildly hypoxic, initially with sleep only, but now seems relatively persistent (rather unclear how much of COVID is contributing vs undiagnosed OSA); - Continue Decadron for 10 days or when off O2; e-consult to ID and Paxlovid completed here  - Wean O2 as able for goal saturation 90-92% - CXR obtained due to increasing O2 demands 12/26, noted RLL consolidation and mild effusions, worse from prior, CT chest with RLL consolidation with air bronchograms c/w pneumonia. Started CAP coverage 12/27 - will ask ST to evaluate given location of lobar pneumonia, had ST evaluate here who recommended chopped solids, ST at rehab   Thrombocytopenia, resolved - presumably from acute illness / covid, possibly alcohol abuse. PLTs nml march - monitor, so far stable   Alcohol abuse: Currently drinks 6 glasses of wine per night. B12/folate unremarkable. History of PE: Secondary to COVID-19 infection in 2020.  S/p IVC filter placement. Consider removal as outpatient History of SDH/SAH/IPH: S/p mechanical fall from alcohol intoxication.  CT head negative here. Essential hypertension: Previously on losartan.  Not currently. Dyslipidemia Coronary artery atherosclerosis: Continue statin.  Not currently on ASA due to above Hypothyroidism: Continue Synthroid Major depressive disorder, recurrent, in full remission: Continue Prozac BPH: S/p greenlight therapy in 2019.  Continue doxazosin, finasteride Mild cognitive impairment: Per PCP notes.Unable due to finances or higher functioning tasks.  Follow-up outpatient. Hematuria: noted previously. Outpatient fu recommended
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Blood thyroid stimulating hormone normal, Bronchogram abnormal, COVID-19, Chest X-ray abnormal, Computerised tomogram head normal
Clinical narrative: Patient is a 85 y.o. male admitted to the hospital on 12/20/2022 for AMS, hypoxia, found to have covid-19, s/p dexamethasone, also given paxlovid while here. Was unable to be weaned off oxygen, repeat chest imaging showed a new RLL consolidation c/w pneumonia, started on CAP coverage with some improvement in his oxygenation, but still requiring 1-2L NC.   Discharge Diagnosis and Associated Hospital Course   Acute metabolic encephalopathy  - secondary to COVID-19 infection, on a background mild cognitive impairment - BMP, CBC, B12/folate, ammonia, TSH, and HFP largely unremarkable. UA negative. CT Head unremarkable - Minimize central acting medications, recommend delirium precautions - PT/OT and case management consulted, initially PT/OT recs 2-3x weekly with plan to return to ILF, however now 5x weekly, rehab on dc   COVID-19 Abnormal CT imaging Acute hypoxic respiratory failure Lobar pneumonia - No clear exact symptom onset. - CTPA negative for PE, does show mild bilateral lower lobe patchy lung opacities (atelectasis vs aspiration vs infiltrates) - Mildly hypoxic, initially with sleep only, but now seems relatively persistent (rather unclear how much of COVID is contributing vs undiagnosed OSA); - Continue Decadron for 10 days or when off O2; e-consult to ID and Paxlovid completed here  - Wean O2 as able for goal saturation 90-92% - CXR obtained due to increasing O2 demands 12/26, noted RLL consolidation and mild effusions, worse from prior, CT chest with RLL consolidation with air bronchograms c/w pneumonia. Started CAP coverage 12/27 - will ask ST to evaluate given location of lobar pneumonia, had ST evaluate here who recommended chopped solids, ST at rehab   Thrombocytopenia, resolved - presumably from acute illness / covid, possibly alcohol abuse. PLTs nml march - monitor, so far stable   Alcohol abuse: Currently drinks 6 glasses of wine per night. B12/folate unremarkable. History of PE: Secondary to COVID-19 infection in 2020.  S/p IVC filter placement. Consider removal as outpatient History of SDH/SAH/IPH: S/p mechanical fall from alcohol intoxication.  CT head negative here. Essential hypertension: Previously on losartan.  Not currently. Dyslipidemia Coronary artery atherosclerosis: Continue statin.  Not currently on ASA due to above Hypothyroidism: Continue Synthroid Major depressive disorder, recurrent, in full remission: Continue Prozac BPH: S/p greenlight therapy in 2019.  Continue doxazosin, finasteride Mild cognitive impairment: Per PCP notes.Unable due to finances or higher functioning tasks.  Follow-up outpatient. Hematuria: noted previously. Outpatient fu recommended
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram thorax abnormal, Full blood count normal, Haematuria, Hypoxia, Liver function test normal
Clinical narrative: Patient is a 85 y.o. male admitted to the hospital on 12/20/2022 for AMS, hypoxia, found to have covid-19, s/p dexamethasone, also given paxlovid while here. Was unable to be weaned off oxygen, repeat chest imaging showed a new RLL consolidation c/w pneumonia, started on CAP coverage with some improvement in his oxygenation, but still requiring 1-2L NC.   Discharge Diagnosis and Associated Hospital Course   Acute metabolic encephalopathy  - secondary to COVID-19 infection, on a background mild cognitive impairment - BMP, CBC, B12/folate, ammonia, TSH, and HFP largely unremarkable. UA negative. CT Head unremarkable - Minimize central acting medications, recommend delirium precautions - PT/OT and case management consulted, initially PT/OT recs 2-3x weekly with plan to return to ILF, however now 5x weekly, rehab on dc   COVID-19 Abnormal CT imaging Acute hypoxic respiratory failure Lobar pneumonia - No clear exact symptom onset. - CTPA negative for PE, does show mild bilateral lower lobe patchy lung opacities (atelectasis vs aspiration vs infiltrates) - Mildly hypoxic, initially with sleep only, but now seems relatively persistent (rather unclear how much of COVID is contributing vs undiagnosed OSA); - Continue Decadron for 10 days or when off O2; e-consult to ID and Paxlovid completed here  - Wean O2 as able for goal saturation 90-92% - CXR obtained due to increasing O2 demands 12/26, noted RLL consolidation and mild effusions, worse from prior, CT chest with RLL consolidation with air bronchograms c/w pneumonia. Started CAP coverage 12/27 - will ask ST to evaluate given location of lobar pneumonia, had ST evaluate here who recommended chopped solids, ST at rehab   Thrombocytopenia, resolved - presumably from acute illness / covid, possibly alcohol abuse. PLTs nml march - monitor, so far stable   Alcohol abuse: Currently drinks 6 glasses of wine per night. B12/folate unremarkable. History of PE: Secondary to COVID-19 infection in 2020.  S/p IVC filter placement. Consider removal as outpatient History of SDH/SAH/IPH: S/p mechanical fall from alcohol intoxication.  CT head negative here. Essential hypertension: Previously on losartan.  Not currently. Dyslipidemia Coronary artery atherosclerosis: Continue statin.  Not currently on ASA due to above Hypothyroidism: Continue Synthroid Major depressive disorder, recurrent, in full remission: Continue Prozac BPH: S/p greenlight therapy in 2019.  Continue doxazosin, finasteride Mild cognitive impairment: Per PCP notes.Unable due to finances or higher functioning tasks.  Follow-up outpatient. Hematuria: noted previously. Outpatient fu recommended
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Lung consolidation, Lung infiltration, Lung opacity, Mental status changes, Metabolic encephalopathy
Clinical narrative: Patient is a 85 y.o. male admitted to the hospital on 12/20/2022 for AMS, hypoxia, found to have covid-19, s/p dexamethasone, also given paxlovid while here. Was unable to be weaned off oxygen, repeat chest imaging showed a new RLL consolidation c/w pneumonia, started on CAP coverage with some improvement in his oxygenation, but still requiring 1-2L NC.   Discharge Diagnosis and Associated Hospital Course   Acute metabolic encephalopathy  - secondary to COVID-19 infection, on a background mild cognitive impairment - BMP, CBC, B12/folate, ammonia, TSH, and HFP largely unremarkable. UA negative. CT Head unremarkable - Minimize central acting medications, recommend delirium precautions - PT/OT and case management consulted, initially PT/OT recs 2-3x weekly with plan to return to ILF, however now 5x weekly, rehab on dc   COVID-19 Abnormal CT imaging Acute hypoxic respiratory failure Lobar pneumonia - No clear exact symptom onset. - CTPA negative for PE, does show mild bilateral lower lobe patchy lung opacities (atelectasis vs aspiration vs infiltrates) - Mildly hypoxic, initially with sleep only, but now seems relatively persistent (rather unclear how much of COVID is contributing vs undiagnosed OSA); - Continue Decadron for 10 days or when off O2; e-consult to ID and Paxlovid completed here  - Wean O2 as able for goal saturation 90-92% - CXR obtained due to increasing O2 demands 12/26, noted RLL consolidation and mild effusions, worse from prior, CT chest with RLL consolidation with air bronchograms c/w pneumonia. Started CAP coverage 12/27 - will ask ST to evaluate given location of lobar pneumonia, had ST evaluate here who recommended chopped solids, ST at rehab   Thrombocytopenia, resolved - presumably from acute illness / covid, possibly alcohol abuse. PLTs nml march - monitor, so far stable   Alcohol abuse: Currently drinks 6 glasses of wine per night. B12/folate unremarkable. History of PE: Secondary to COVID-19 infection in 2020.  S/p IVC filter placement. Consider removal as outpatient History of SDH/SAH/IPH: S/p mechanical fall from alcohol intoxication.  CT head negative here. Essential hypertension: Previously on losartan.  Not currently. Dyslipidemia Coronary artery atherosclerosis: Continue statin.  Not currently on ASA due to above Hypothyroidism: Continue Synthroid Major depressive disorder, recurrent, in full remission: Continue Prozac BPH: S/p greenlight therapy in 2019.  Continue doxazosin, finasteride Mild cognitive impairment: Per PCP notes.Unable due to finances or higher functioning tasks.  Follow-up outpatient. Hematuria: noted previously. Outpatient fu recommended
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Metabolic function test, Platelet count normal, Pleural effusion, Pneumonia, Thrombocytopenia
Clinical narrative: Patient is a 85 y.o. male admitted to the hospital on 12/20/2022 for AMS, hypoxia, found to have covid-19, s/p dexamethasone, also given paxlovid while here. Was unable to be weaned off oxygen, repeat chest imaging showed a new RLL consolidation c/w pneumonia, started on CAP coverage with some improvement in his oxygenation, but still requiring 1-2L NC.   Discharge Diagnosis and Associated Hospital Course   Acute metabolic encephalopathy  - secondary to COVID-19 infection, on a background mild cognitive impairment - BMP, CBC, B12/folate, ammonia, TSH, and HFP largely unremarkable. UA negative. CT Head unremarkable - Minimize central acting medications, recommend delirium precautions - PT/OT and case management consulted, initially PT/OT recs 2-3x weekly with plan to return to ILF, however now 5x weekly, rehab on dc   COVID-19 Abnormal CT imaging Acute hypoxic respiratory failure Lobar pneumonia - No clear exact symptom onset. - CTPA negative for PE, does show mild bilateral lower lobe patchy lung opacities (atelectasis vs aspiration vs infiltrates) - Mildly hypoxic, initially with sleep only, but now seems relatively persistent (rather unclear how much of COVID is contributing vs undiagnosed OSA); - Continue Decadron for 10 days or when off O2; e-consult to ID and Paxlovid completed here  - Wean O2 as able for goal saturation 90-92% - CXR obtained due to increasing O2 demands 12/26, noted RLL consolidation and mild effusions, worse from prior, CT chest with RLL consolidation with air bronchograms c/w pneumonia. Started CAP coverage 12/27 - will ask ST to evaluate given location of lobar pneumonia, had ST evaluate here who recommended chopped solids, ST at rehab   Thrombocytopenia, resolved - presumably from acute illness / covid, possibly alcohol abuse. PLTs nml march - monitor, so far stable   Alcohol abuse: Currently drinks 6 glasses of wine per night. B12/folate unremarkable. History of PE: Secondary to COVID-19 infection in 2020.  S/p IVC filter placement. Consider removal as outpatient History of SDH/SAH/IPH: S/p mechanical fall from alcohol intoxication.  CT head negative here. Essential hypertension: Previously on losartan.  Not currently. Dyslipidemia Coronary artery atherosclerosis: Continue statin.  Not currently on ASA due to above Hypothyroidism: Continue Synthroid Major depressive disorder, recurrent, in full remission: Continue Prozac BPH: S/p greenlight therapy in 2019.  Continue doxazosin, finasteride Mild cognitive impairment: Per PCP notes.Unable due to finances or higher functioning tasks.  Follow-up outpatient. Hematuria: noted previously. Outpatient fu recommended
Age: 85.0
Sex: M
Vaccine: COVID19
Symptoms: Urine analysis normal, Vitamin B12 normal
Clinical narrative: Patient is a 85 y.o. male admitted to the hospital on 12/20/2022 for AMS, hypoxia, found to have covid-19, s/p dexamethasone, also given paxlovid while here. Was unable to be weaned off oxygen, repeat chest imaging showed a new RLL consolidation c/w pneumonia, started on CAP coverage with some improvement in his oxygenation, but still requiring 1-2L NC.   Discharge Diagnosis and Associated Hospital Course   Acute metabolic encephalopathy  - secondary to COVID-19 infection, on a background mild cognitive impairment - BMP, CBC, B12/folate, ammonia, TSH, and HFP largely unremarkable. UA negative. CT Head unremarkable - Minimize central acting medications, recommend delirium precautions - PT/OT and case management consulted, initially PT/OT recs 2-3x weekly with plan to return to ILF, however now 5x weekly, rehab on dc   COVID-19 Abnormal CT imaging Acute hypoxic respiratory failure Lobar pneumonia - No clear exact symptom onset. - CTPA negative for PE, does show mild bilateral lower lobe patchy lung opacities (atelectasis vs aspiration vs infiltrates) - Mildly hypoxic, initially with sleep only, but now seems relatively persistent (rather unclear how much of COVID is contributing vs undiagnosed OSA); - Continue Decadron for 10 days or when off O2; e-consult to ID and Paxlovid completed here  - Wean O2 as able for goal saturation 90-92% - CXR obtained due to increasing O2 demands 12/26, noted RLL consolidation and mild effusions, worse from prior, CT chest with RLL consolidation with air bronchograms c/w pneumonia. Started CAP coverage 12/27 - will ask ST to evaluate given location of lobar pneumonia, had ST evaluate here who recommended chopped solids, ST at rehab   Thrombocytopenia, resolved - presumably from acute illness / covid, possibly alcohol abuse. PLTs nml march - monitor, so far stable   Alcohol abuse: Currently drinks 6 glasses of wine per night. B12/folate unremarkable. History of PE: Secondary to COVID-19 infection in 2020.  S/p IVC filter placement. Consider removal as outpatient History of SDH/SAH/IPH: S/p mechanical fall from alcohol intoxication.  CT head negative here. Essential hypertension: Previously on losartan.  Not currently. Dyslipidemia Coronary artery atherosclerosis: Continue statin.  Not currently on ASA due to above Hypothyroidism: Continue Synthroid Major depressive disorder, recurrent, in full remission: Continue Prozac BPH: S/p greenlight therapy in 2019.  Continue doxazosin, finasteride Mild cognitive impairment: Per PCP notes.Unable due to finances or higher functioning tasks.  Follow-up outpatient. Hematuria: noted previously. Outpatient fu recommended
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Death
Clinical narrative: MODERNA VACCINE #3 - LOT # 042J21A. DATE: 02/23/2022  MODERNA VACCINE #4 - LOT # 056A22A. DATE: 07/20/2022  CAUSE OF DEATH ON 08/15/2022 = COVID-19
Age: 3.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Respiratory tract congestion, Rhinorrhoea, Secretion discharge, Sinusitis bacterial
Clinical narrative: At the time we brought her to the doctors office on 10/17/2022 due to mucous and a runny nose we had treated her with ZYRTEC and BENADRYL to relieve congestion. I had sent a message to her doctor regarding her bad cough and taking the OTC medications the doctor advised if no active infections proceed with vaccine. Since 10/13/2022 she had seen the doctor multiple times; 10/17/2022, 11/11/2022, 11/28/2022, 12/08/2022, 12/29/2022, 01/12/2022, and 01/16/2022.
Age: 88.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Agitation, COVID-19, Hypophagia, Mental status changes, SARS-CoV-2 test positive
Clinical narrative: 12/20/22 presents to ED for "Change in mental status, agitations, decrease PO intake". PMHx of "HTN, cardiomyopathy (EF 25%), LBBB, HLD, CAD s/p PCI/LAD"
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cough, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: I received my Covid- 19 vaccine in October18,2022. On 12/15/2022 I woke up with a cough and fever. Next day I contact my health provider and tested Positive for Covid-19.  I was prescribed Paxlovid. Symptoms Lasted 4 days.  Tested negative on the 4th day. However, I contacted Covid again on 12/24/2022. Symptoms  of cough is still on going
Age: 60.0
Sex: F
Vaccine: COVID19-2, FLU4, VARZOS
Symptoms: Arthralgia, Blood test, Bone pain, Headache
Clinical narrative: I never had any side effects before with the covid and flu vaccinations together. I got the flu, covid, and shingrix vaccination on December 16th, 2022. The shingles shot has my bones aching terribly. I have headaches, and joint aches. I have never been diagnosed with arthritis. I made 60 November 6, and I got the shingle shot with my covid booster and my flu shot. I am calling to report the Shingle shot.
Age: 81.0
Sex: F
Vaccine: COVID19-2
Symptoms: Mobility decreased, Product administered at inappropriate site
Clinical narrative: Member reports post covid shot inability use shoulder/arm for greater than one week beginning the day after administration. Member states the shot was given much higher in her arm than other covid shots
Age: 78.0
Sex: F
Vaccine: PNC20
Symptoms: Erythema, Peripheral swelling, Pruritus
Clinical narrative: swelling, redness, and itching of entire right arm, radiating across the upper back and shoulders
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Blood cholesterol increased, COVID-19, Cough, Fatigue, Hepatic enzyme increased
Clinical narrative: The next day after receiving the vaccine I had red itchy spots come up on my body.  I was given a prescription for a cream to help with the itching. I had this happen to me for each vaccine.  Since receiving my vaccines, my liver enzymes have increased, and my cholesterol has increased.  I tested positive for COVID-19 on 06/17/2022.  I had a cough, very tired and congested. I contacted my doctor and received a prescription for a benzonatate.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Rash erythematous, Rash pruritic, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: The next day after receiving the vaccine I had red itchy spots come up on my body.  I was given a prescription for a cream to help with the itching. I had this happen to me for each vaccine.  Since receiving my vaccines, my liver enzymes have increased, and my cholesterol has increased.  I tested positive for COVID-19 on 06/17/2022.  I had a cough, very tired and congested. I contacted my doctor and received a prescription for a benzonatate.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Atrial fibrillation, Chest X-ray normal, Electrocardiogram normal, Fibrin D dimer normal, Heart rate increased
Clinical narrative: Within 10 days of 2nd dose, I developed heart palpitations. For approximately 1 week, they were every night, lasting approximately 10 minutes. On about the 5th night, the palpitations lasted for an hour. The following night, they lasted the entire night. The following day, I saw the Dr. at local clinic. Several tests (EKG, chest X-ray, metabolic panel, D dimer) were performed (all negative) and the condition was not present at that moment. For about 20 months, this condition persisted in a manageable manner, about 2x per week, with durations of approx. 10 minutes. In December of '22, it started to worsen. The frequency increases to 3-4 times per week and the duration increased to 20-30 minutes. On January 8, 2023, the frequency and duration further increased to every night, with episodes lasting 30-60 minutes. On January 12th, the episode lasted 3 hours and my resting heart rate (normally in low 40s) reached 120 bpm. At this time, I went to the ER at local hospital.   Again, several tests (EKG, chest X-ray, metabolic panel, D dimer) were performed and all were negative. However, because the condition was present, they were able to diagnose (as): Paroxysmal atrial fibrillation with RVR (HRC). The condition subsided naturally after 3 hours. As I type this report, I had experienced this condition 5 consecutive nights, with January 17 ending the consecutive string. At about the time of the 2nd dose, my VO2max also decreased from about 58 mL/kg-min to about 52 mL/kg-min.
Age: 55.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Metabolic function test normal, Palpitations
Clinical narrative: Within 10 days of 2nd dose, I developed heart palpitations. For approximately 1 week, they were every night, lasting approximately 10 minutes. On about the 5th night, the palpitations lasted for an hour. The following night, they lasted the entire night. The following day, I saw the Dr. at local clinic. Several tests (EKG, chest X-ray, metabolic panel, D dimer) were performed (all negative) and the condition was not present at that moment. For about 20 months, this condition persisted in a manageable manner, about 2x per week, with durations of approx. 10 minutes. In December of '22, it started to worsen. The frequency increases to 3-4 times per week and the duration increased to 20-30 minutes. On January 8, 2023, the frequency and duration further increased to every night, with episodes lasting 30-60 minutes. On January 12th, the episode lasted 3 hours and my resting heart rate (normally in low 40s) reached 120 bpm. At this time, I went to the ER at local hospital.   Again, several tests (EKG, chest X-ray, metabolic panel, D dimer) were performed and all were negative. However, because the condition was present, they were able to diagnose (as): Paroxysmal atrial fibrillation with RVR (HRC). The condition subsided naturally after 3 hours. As I type this report, I had experienced this condition 5 consecutive nights, with January 17 ending the consecutive string. At about the time of the 2nd dose, my VO2max also decreased from about 58 mL/kg-min to about 52 mL/kg-min.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Extra dose administered, No adverse event, Pain in extremity
Clinical narrative: No adverse event- patient presented full vaccine card with last dose (monovalent) given 5-2022 and then received Bivalent booster 1-17-23. Hours later patient presented an additional vaccine card with a Bivalent booster given 10/22. Only symptom is sore arm today.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Acoustic stimulation tests normal, Tinnitus
Clinical narrative: TINITUS in both ears started on or about 1-1-2022.  Tinitus runs 24/7 and has never stopped.
Age: 26.0
Sex: M
Vaccine: COVID19-2, UNK
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive
Clinical narrative: I tested positive for Covid 19 on 1/4/23 and became symptomatic despite receiving 4 prior Pfizer covid vaccines including the bivalent booster listed above. I then even developed a rebound case of covid symptoms and tested positive on a rapid covid test again on 1/16/23 despite being fully vaccinated.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Exposure to SARS-CoV-2, Headache, Malaise
Clinical narrative: Was exposed to COVID-19 and started having a bad cough 2 days later; Took a home COVID-19 test and it was negative; Next day took another COVID-19 test and it was positive; Went to an urgent care and was given cough medicine with codeine and prescribed azithromycin; Started feeling better really soon then 3 days later I became really sick again with a severe cough, headache and fever; Went back to urgent care and was prescribed LAGEVRIO and took for 5 days; Retested for COVID-19 and was negative.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Was exposed to COVID-19 and started having a bad cough 2 days later; Took a home COVID-19 test and it was negative; Next day took another COVID-19 test and it was positive; Went to an urgent care and was given cough medicine with codeine and prescribed azithromycin; Started feeling better really soon then 3 days later I became really sick again with a severe cough, headache and fever; Went back to urgent care and was prescribed LAGEVRIO and took for 5 days; Retested for COVID-19 and was negative.
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: 12/20/22 presents to ED for "coronavirus concern". PMHx of "CVA, dementia, non-verbal, HTN, pulmonary embolism on Eliquis, dysphagia s/p peg tube on TF"
Age: 2.0
Sex: F
Vaccine: COVID19-2, DTAP, HEPA
Symptoms: No adverse event, Product administered at inappropriate site, Wrong product administered
Clinical narrative: Incorrect vaccine given for primary series and incorrect site. No reports of adverse reactions.
Age: 61.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dizziness, SARS-CoV-2 test positive
Clinical narrative: 12/20/22 presents to ED for "worsening dizziness". PMHx of "DM, HTN"
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID on 01/13/23
Age: 82.0
Sex: M
Vaccine: COVID19, COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: Pt tested positive for COVID on 01/13/23
Age: 61.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Pt tested positive for COVID-19 on 01/11/2023
Age: 60.0
Sex: M
Vaccine: COVID19-2
Symptoms: Extra dose administered, No adverse event
Clinical narrative: RN was informed by his primary care doctor that he needed to have his COVID bivalent booster. It was charted that he previously received 4 COVID vaccine doses (with the most recent one charted in 5/27/22). RN confirmed with patient that this was correct. RN gave COVID vaccine and charted this. When RN asked for COVID vaccine card, it was noted that he previously did receive a COVID bivalent vaccine at another pharmacy on 9/22/22. Since this was at another location, it was not in patient's chart yet and patient wasn't sure of what vaccines he previously received. I reached out to patient on 1/18/23 to discuss if he was feeling any side effects of vaccine administration the day after and he denies.
Age: 37.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Contusion, Laboratory test, Superficial vein thrombosis
Clinical narrative: Started having superficial thrombosis with severe bruising in my legs and arms
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Angiogram cerebral, Angiogram normal, Anticoagulant therapy, Biopsy bone marrow abnormal, Blood test
Clinical narrative: Severe, 2 week long right frontal headache, 2 ED visits, treatment for migraine, IV Meds, CTA, IV fluids, March 2022,    F/U MRI May 2022 showed right frontal intracranial hemorrhage, admitted to tertiary hospital, Cerebral angiogram completed, CT chest/abdoment/pelvis, normal , Angiogram no deformities.  D/C on BP medications, Atorvastatin, Baby aspirin.   MRI follow up x2 for resolution of bleed, diagnosis ischemic stroke that bleed.   Labs continuing to show high platelet count, Hematology visit with diagnosis of PolyCythemia Vera,  JAK2 mutation present.    Bone Marrow biopsy confirmation of Polycythemia Vera January 2023
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram abdomen normal, Computerised tomogram thorax normal, Haemorrhage intracranial, Headache, Ischaemic stroke
Clinical narrative: Severe, 2 week long right frontal headache, 2 ED visits, treatment for migraine, IV Meds, CTA, IV fluids, March 2022,    F/U MRI May 2022 showed right frontal intracranial hemorrhage, admitted to tertiary hospital, Cerebral angiogram completed, CT chest/abdoment/pelvis, normal , Angiogram no deformities.  D/C on BP medications, Atorvastatin, Baby aspirin.   MRI follow up x2 for resolution of bleed, diagnosis ischemic stroke that bleed.   Labs continuing to show high platelet count, Hematology visit with diagnosis of PolyCythemia Vera,  JAK2 mutation present.    Bone Marrow biopsy confirmation of Polycythemia Vera January 2023
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Janus kinase 2 mutation, Laboratory test, Magnetic resonance imaging head abnormal, Migraine, Platelet count increased
Clinical narrative: Severe, 2 week long right frontal headache, 2 ED visits, treatment for migraine, IV Meds, CTA, IV fluids, March 2022,    F/U MRI May 2022 showed right frontal intracranial hemorrhage, admitted to tertiary hospital, Cerebral angiogram completed, CT chest/abdoment/pelvis, normal , Angiogram no deformities.  D/C on BP medications, Atorvastatin, Baby aspirin.   MRI follow up x2 for resolution of bleed, diagnosis ischemic stroke that bleed.   Labs continuing to show high platelet count, Hematology visit with diagnosis of PolyCythemia Vera,  JAK2 mutation present.    Bone Marrow biopsy confirmation of Polycythemia Vera January 2023
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Polycythaemia vera
Clinical narrative: Severe, 2 week long right frontal headache, 2 ED visits, treatment for migraine, IV Meds, CTA, IV fluids, March 2022,    F/U MRI May 2022 showed right frontal intracranial hemorrhage, admitted to tertiary hospital, Cerebral angiogram completed, CT chest/abdoment/pelvis, normal , Angiogram no deformities.  D/C on BP medications, Atorvastatin, Baby aspirin.   MRI follow up x2 for resolution of bleed, diagnosis ischemic stroke that bleed.   Labs continuing to show high platelet count, Hematology visit with diagnosis of PolyCythemia Vera,  JAK2 mutation present.    Bone Marrow biopsy confirmation of Polycythemia Vera January 2023
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Headache, Hypertension, Hypoaesthesia, Nausea
Clinical narrative: headache, high blood pressure, nausea, dizzy,  vision ( white lingering flashes),  num toe for month TIA
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Photopsia, Transient ischaemic attack
Clinical narrative: headache, high blood pressure, nausea, dizzy,  vision ( white lingering flashes),  num toe for month TIA
Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Cardiac monitoring, Colonoscopy normal, Dizziness, Erythema
Clinical narrative: He got his vaccine, he felt like he was going to pass out, dizzy and woozy.  He got his neighbor to drive him to the Hospital to the ER.  He ended up sleeping in he ER.  He had numerous tests, put on  monitors, CT scans.  They let him go home, and tried to him it was his heart and wanting to do some sort of surgery.  He told him to FU with a cardiologist, and he told them it was a shot.  They wanted to do an ablation of his heart, which he refused to have done.  They said he had an irregular heart beat.  He repeated what they told him in the ER.  He was in the hospital for 3 days, which did not show anything after that from the monitor, just the one episode.  He did FU with his cardiologist who did not feel that he needed surgery.  He was not put on any new medicine.    He did not have any more episodes since that initial one, and dealing with radiation issues with his prostate cancer.  He had a colonoscopy in 2022 which was OK.   He has been having some problems with his legs and has been diagnosed with venous insufficiency, and says that they are not telling him anything.    He was diagnosed with a blood clot on 1/21/22 of his calf after it was warm to the touch, red and swollen.  They did an US in his leg and gave him an aspirin and told him to go to the vascular doctor.  His legs look lumpy since then, but they look different.