chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 76.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Hypoxia, Respiratory failure
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE  ACUTE ON CHRONIC HYPOXEMIC RESPIRATORY FAILURE HYPOXEMIA
Age: 56.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood test abnormal, Rash, Vasculitis
Clinical narrative: I noticed a rash on my leg on 11APR2023 and then the next day it was considerably worse so I went to Hospital and saw Dr. and he diagnosed Vasculitis and sent me home saying to go see my PCP and a Dermatologist. I saw Dr. on13-APR-2023 and Dr. a Dermatologist on 19-APR-2023 all confirming Vasculitis.
Age: 58.0
Sex: M
Vaccine: DTAP, TYP
Symptoms: Fatigue, Headache, Hyperhidrosis, Pharyngeal swelling, Pyrexia
Clinical narrative: High fever after first dose, sweating, fatigue, headache. After second dose, severe rash, hives, throat swelling, extreme fatigue.  I'm on antibiotics and antihistimines, beginning to get better.
Age: 58.0
Sex: M
Vaccine: DTAP, TYP
Symptoms: Rash, Urticaria
Clinical narrative: High fever after first dose, sweating, fatigue, headache. After second dose, severe rash, hives, throat swelling, extreme fatigue.  I'm on antibiotics and antihistimines, beginning to get better.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, Blood insulin, Blood test, COVID-19, Condition aggravated
Clinical narrative: He was very disoriented and confused with a sore throat and cough. I gave him a COVID-19 test on 01/25/2023 which came back positive. I took him to the emergency room that same evening where they confirmed he had contracted COVID-19 as his confusion got worse. They admitted into the hospital for 5 days and gave them Remdesivir infusion for his infection. He was discharged after that; we went to his physician for a follow-up where we discovered his type 2 diabetes and dementia had worsened since contracting COVID-19. They increased his dosage for his diabetic medication and was recommended to see an occupational therapist and physical therapist to see and aid him for the next 2 months after his follow-up. The physicians helped improve his mobility and regain his strength. Since then, he's been home as I care and look after him.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Confusional state, Cough, Dementia, Disorientation, Mobility decreased
Clinical narrative: He was very disoriented and confused with a sore throat and cough. I gave him a COVID-19 test on 01/25/2023 which came back positive. I took him to the emergency room that same evening where they confirmed he had contracted COVID-19 as his confusion got worse. They admitted into the hospital for 5 days and gave them Remdesivir infusion for his infection. He was discharged after that; we went to his physician for a follow-up where we discovered his type 2 diabetes and dementia had worsened since contracting COVID-19. They increased his dosage for his diabetic medication and was recommended to see an occupational therapist and physical therapist to see and aid him for the next 2 months after his follow-up. The physicians helped improve his mobility and regain his strength. Since then, he's been home as I care and look after him.
Age: 78.0
Sex: M
Vaccine: COVID19-2
Symptoms: Oropharyngeal pain, SARS-CoV-2 test positive, Therapy change, Type 2 diabetes mellitus
Clinical narrative: He was very disoriented and confused with a sore throat and cough. I gave him a COVID-19 test on 01/25/2023 which came back positive. I took him to the emergency room that same evening where they confirmed he had contracted COVID-19 as his confusion got worse. They admitted into the hospital for 5 days and gave them Remdesivir infusion for his infection. He was discharged after that; we went to his physician for a follow-up where we discovered his type 2 diabetes and dementia had worsened since contracting COVID-19. They increased his dosage for his diabetic medication and was recommended to see an occupational therapist and physical therapist to see and aid him for the next 2 months after his follow-up. The physicians helped improve his mobility and regain his strength. Since then, he's been home as I care and look after him.
Age: 70.0
Sex: F
Vaccine: COVID19-2, FLUX
Symptoms: Bronchitis, Malaise, Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test negative
Clinical narrative: I did not have an adverse reaction to the vaccine. I began not feeling well on 03/26/2023 with a sore throat and with cold symptoms. I went to the doctor and was bronchitis on 04/03/2023 and I got prescription for an antibiotic.  I was tested for COVID-19, and it was negative.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Influenza like illness, Malaise, Oropharyngeal pain, Pain
Clinical narrative: I woke up in the middle of the night and noticed that I had a really sore throat. I thought that wasn't a good sign. I went back to bed and when I got up in the morning, I felt crappy. I felt flu like symptoms and my throat was pretty raw. I went and got an at home COVID-19 test and brought it home and it was positive. I called the doctor; I was running a fever of 100 degrees at that point. I was feeling achy. It got worse a few days after that. The fever did get up to 102.9 degrees. That lasted for three days before I started feeling better. The doctor didn't feel comfortable giving me Paxlovid because of my current medications. He told me to take vitamins and Tylenol. He did prescribe a cough medicine that I never took. I don't feel one hundred percent, but I don't feel like I did before COVID-19.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Sleep disorder, Throat irritation
Clinical narrative: I woke up in the middle of the night and noticed that I had a really sore throat. I thought that wasn't a good sign. I went back to bed and when I got up in the morning, I felt crappy. I felt flu like symptoms and my throat was pretty raw. I went and got an at home COVID-19 test and brought it home and it was positive. I called the doctor; I was running a fever of 100 degrees at that point. I was feeling achy. It got worse a few days after that. The fever did get up to 102.9 degrees. That lasted for three days before I started feeling better. The doctor didn't feel comfortable giving me Paxlovid because of my current medications. He told me to take vitamins and Tylenol. He did prescribe a cough medicine that I never took. I don't feel one hundred percent, but I don't feel like I did before COVID-19.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Blood copper decreased, Blood test normal, Blood testosterone normal, Carcinoid syndrome
Clinical narrative: Saw patient on 4/5/23. Moderna 12/20 and 1/21. "Biggest regret of my life."  Onset of symptoms 3/21 with flushing, tachycardia, sweats when lying down, tremors during the day.  Dr. at facility urged him to get the shots, denied the symptoms he was having were from vaccine.  Extensive workup by multiple physicians - none of them reported to the agency, tho neurologist did attribute the symptoms to the shots.  Had stress test, CT scans, PET scans, blood work, endoscopy of GI tract, 24 hour urine and extensive blood work.   Only positive results was high urinary histamine and PCP told him he had carcinoid syndrome.  Has been taking ambien to sleep because symptoms are worse at night, along with zyrtec and Benadryl.  During the day takes valium.  Hasn't tried a Beta-blocker for the tremors.  Saw neurologist, who found low copper level, EMG normal.  Seeing other Dr. who put him on IVM 6mg BID, nattokinase and a multitude of vitamins.  Also doing live O2.  Has lost significant muscle mass but apparently testosterone level is okay.  Has history of bladder reconstruction with bowel and has to self-cath through abdomen every 6 hours.  Energy level is better but having diarrhea, thinks its from the latest additions to vitamin regiment.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac stress test normal, Computerised tomogram normal, Diarrhoea, Electromyogram normal, Endoscopy gastrointestinal normal
Clinical narrative: Saw patient on 4/5/23. Moderna 12/20 and 1/21. "Biggest regret of my life."  Onset of symptoms 3/21 with flushing, tachycardia, sweats when lying down, tremors during the day.  Dr. at facility urged him to get the shots, denied the symptoms he was having were from vaccine.  Extensive workup by multiple physicians - none of them reported to the agency, tho neurologist did attribute the symptoms to the shots.  Had stress test, CT scans, PET scans, blood work, endoscopy of GI tract, 24 hour urine and extensive blood work.   Only positive results was high urinary histamine and PCP told him he had carcinoid syndrome.  Has been taking ambien to sleep because symptoms are worse at night, along with zyrtec and Benadryl.  During the day takes valium.  Hasn't tried a Beta-blocker for the tremors.  Saw neurologist, who found low copper level, EMG normal.  Seeing other Dr. who put him on IVM 6mg BID, nattokinase and a multitude of vitamins.  Also doing live O2.  Has lost significant muscle mass but apparently testosterone level is okay.  Has history of bladder reconstruction with bowel and has to self-cath through abdomen every 6 hours.  Energy level is better but having diarrhea, thinks its from the latest additions to vitamin regiment.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Flushing, Histamine normal, Hyperhidrosis, Immunisation reaction, Muscle atrophy
Clinical narrative: Saw patient on 4/5/23. Moderna 12/20 and 1/21. "Biggest regret of my life."  Onset of symptoms 3/21 with flushing, tachycardia, sweats when lying down, tremors during the day.  Dr. at facility urged him to get the shots, denied the symptoms he was having were from vaccine.  Extensive workup by multiple physicians - none of them reported to the agency, tho neurologist did attribute the symptoms to the shots.  Had stress test, CT scans, PET scans, blood work, endoscopy of GI tract, 24 hour urine and extensive blood work.   Only positive results was high urinary histamine and PCP told him he had carcinoid syndrome.  Has been taking ambien to sleep because symptoms are worse at night, along with zyrtec and Benadryl.  During the day takes valium.  Hasn't tried a Beta-blocker for the tremors.  Saw neurologist, who found low copper level, EMG normal.  Seeing other Dr. who put him on IVM 6mg BID, nattokinase and a multitude of vitamins.  Also doing live O2.  Has lost significant muscle mass but apparently testosterone level is okay.  Has history of bladder reconstruction with bowel and has to self-cath through abdomen every 6 hours.  Energy level is better but having diarrhea, thinks its from the latest additions to vitamin regiment.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Positron emission tomogram normal, Tachycardia, Tremor
Clinical narrative: Saw patient on 4/5/23. Moderna 12/20 and 1/21. "Biggest regret of my life."  Onset of symptoms 3/21 with flushing, tachycardia, sweats when lying down, tremors during the day.  Dr. at facility urged him to get the shots, denied the symptoms he was having were from vaccine.  Extensive workup by multiple physicians - none of them reported to the agency, tho neurologist did attribute the symptoms to the shots.  Had stress test, CT scans, PET scans, blood work, endoscopy of GI tract, 24 hour urine and extensive blood work.   Only positive results was high urinary histamine and PCP told him he had carcinoid syndrome.  Has been taking ambien to sleep because symptoms are worse at night, along with zyrtec and Benadryl.  During the day takes valium.  Hasn't tried a Beta-blocker for the tremors.  Saw neurologist, who found low copper level, EMG normal.  Seeing other Dr. who put him on IVM 6mg BID, nattokinase and a multitude of vitamins.  Also doing live O2.  Has lost significant muscle mass but apparently testosterone level is okay.  Has history of bladder reconstruction with bowel and has to self-cath through abdomen every 6 hours.  Energy level is better but having diarrhea, thinks its from the latest additions to vitamin regiment.
Age: 71.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Blood glucose abnormal, Blood pressure decreased, COVID-19, Diabetes mellitus, Diabetes mellitus inadequate control
Clinical narrative: On 9/17/22 I received the vaccine booster.  On 10/22/22 I tested positive for COVID.  I was prescribed Paxlovid.  It seemed to be a mild case.  On 12/08/22, my blood pressure began to drop.  On 12/09/22 I felt very lethargic and was advised to go to the emergency room.  I was diagnosed with new onset diabetes with diabetic ketoacidosis.  My blood sugar was brought under control and I was released on 12/14/22.  I do not know if my diabetes has anything to do with the vaccination, with my COVID illness or possibly getting COVID after the vaccination.  I have been participating in a program to monitor my health after vaccination and they suggested I report it here.
Age: 71.0
Sex: M
Vaccine: COVID19-2, FLUA4
Symptoms: Diabetic ketoacidosis, Lethargy, SARS-CoV-2 test positive
Clinical narrative: On 9/17/22 I received the vaccine booster.  On 10/22/22 I tested positive for COVID.  I was prescribed Paxlovid.  It seemed to be a mild case.  On 12/08/22, my blood pressure began to drop.  On 12/09/22 I felt very lethargic and was advised to go to the emergency room.  I was diagnosed with new onset diabetes with diabetic ketoacidosis.  My blood sugar was brought under control and I was released on 12/14/22.  I do not know if my diabetes has anything to do with the vaccination, with my COVID illness or possibly getting COVID after the vaccination.  I have been participating in a program to monitor my health after vaccination and they suggested I report it here.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Hypoxia, Respiratory failure, Symptom recurrence
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE  HYPOXEMIC RESPIRATORY FAILURE, UNSPECIFIED ACUITY HYPOXIA 12/13/2022 --  RECURRENCE OF SAME SYMPTOMS
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Fatigue, Feeling abnormal, Malaise, Pain
Clinical narrative: 8/22/2022 I felt like a truck hit me. Just felt awful, low grade fever. Tested with at Home COVID-19 test, positive. Reached out to doctor in the evening, who returned the call on 8/23. Doctor proscribed Paxlovid. Symptoms improved 8/24, though I experienced awful taste in my mouth while on the Paxlovid. Took about 5 days for symptoms to improve. I experienced mostly fatigue during that time. After 10 days, everything was back to normal.
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: 8/22/2022 I felt like a truck hit me. Just felt awful, low grade fever. Tested with at Home COVID-19 test, positive. Reached out to doctor in the evening, who returned the call on 8/23. Doctor proscribed Paxlovid. Symptoms improved 8/24, though I experienced awful taste in my mouth while on the Paxlovid. Took about 5 days for symptoms to improve. I experienced mostly fatigue during that time. After 10 days, everything was back to normal.
Age: 59.0
Sex: F
Vaccine: COVID19-2
Symptoms: Cough, Wheezing
Clinical narrative: I had my vaccination on 01/25/2023. I had a history of a cough on 10/2022 that lingered and I was treated with a steroid in 01/2023. After vaccination 01/25/2023 the cough and wheezing came back. I sought medical attention and I was provided a breathing treatment. I am still having the breathing treatments as of 04/27/2023.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Tinnitus
Clinical narrative: I went in for ringing in my ear and was referred to an ear nose and throat doctor. I went to the ENT and all they did was look and tell me that nothing looked infected. I am still dealing with this at this time. I was not prescribed medication.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chills, Dyspnoea, Headache, Nausea
Clinical narrative: I had a breakthrough case of Covid-19 it started with fever and chills I then became achy short of breath and had a headache I was nauseous. I was prescribed Paxlovid.
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pain, Pyrexia, Vaccine breakthrough infection
Clinical narrative: I had a breakthrough case of Covid-19 it started with fever and chills I then became achy short of breath and had a headache I was nauseous. I was prescribed Paxlovid.
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthralgia, Mobility decreased
Clinical narrative: extreme pain in shoulder and majorly reduced ability to move left arm
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE  ACUTE HYPOXEMIC RESPIRATORY FAILURE
Age: 4.0
Sex: M
Vaccine: DTAPIPV
Symptoms: Injection site pain, Injection site rash, Injection site reaction, Injection site warmth, Rash erythematous
Clinical narrative: Rash around injection site that is hot to the touch and red. Patient reports no itching just pain at injection site. Was instructed to take OTC anti-histamine
Age: 6.0
Sex: F
Vaccine: COVID19-2
Symptoms: Wrong product administered
Clinical narrative: Patients caregiver had consented to DTaP, but COVID-19 was inadvertently been given. Mother was called and made aware of error. Mother reported that "her father was going to be very upset. He did not want a COVID vaccine given". Author offered to call father, but mother declined, stating that she would call him. Ensured mother had authors phone number and she ensured that she did. Mother reported that she would call with anything further.
Age: 58.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Arthralgia, Arthropathy, Bone loss, Degenerative bone disease, Ligament rupture
Clinical narrative: I had been having severe pain in my wrist, having problems even picking up anything. It felt as if they were dislocating. I went to the doctor to have them looked at, to see if there was anything going on. A year ago, I had x-rays on my wrist to have them file for preemptive baseline for any possible changes as I have been having issues with other joints. The x-rays I had in the fall showed that I had already started to show I had ligament tears and denigrative bone loss. The x-ray that were taken in April showed that my right wrist has already collapsed. I have degenerative changes in my bones that are way worse than I showed have for someone my age. I am now awaiting an MRI to see how far the bone loss is to see if the there is a surgery that can repair my bones.
Age: 58.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Mobility decreased, X-ray abnormal
Clinical narrative: I had been having severe pain in my wrist, having problems even picking up anything. It felt as if they were dislocating. I went to the doctor to have them looked at, to see if there was anything going on. A year ago, I had x-rays on my wrist to have them file for preemptive baseline for any possible changes as I have been having issues with other joints. The x-rays I had in the fall showed that I had already started to show I had ligament tears and denigrative bone loss. The x-ray that were taken in April showed that my right wrist has already collapsed. I have degenerative changes in my bones that are way worse than I showed have for someone my age. I am now awaiting an MRI to see how far the bone loss is to see if the there is a surgery that can repair my bones.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, Benign prostatic hyperplasia, COVID-19, Catheter placement, Condition aggravated
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/26/2023 Discharge Date: Mar 29, 2023  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] Constipation, unspecified constipation type [K59.00]   HOSPITAL COURSE:  83 y.o. male with past medical history significant for  panhypopituitarism, dyslipidemia, anxiety and depression, hypertension, GERD, hypothyroidism who presented with complaints of generalized weakness, recurrent falls.  Previously living with wife who felt she could no longer care for him.  Fall on morning of presentation.  Patient admitted for further care.   Reviewing chart, patient has been seen for multiple visits in the movement Disorders Clinic.  Possible diagnosis of Parkinson's disease however testing returned intermediate on imaging.  Patient with noted lower extremity weakness.  In movement Disorder Clinic had been offered repeat electromyogram to better determine etiology and at that time patient refused.  PT/OT evaluated patient and recommended skilled nursing facility.  Patient has also been followed by Urology in the outpatient setting.  Noted urinary retention BPH and urinary urgency.  Patient initially cathed with 1 L urine removed.  Continue to require intermittent straight catheterization.  Urology consulted and recommended: Have pt up to void every 3-5 hours.  1. If the patients voids check bladder scan as PVR and if PVR greater than the amount voided, then st. Cath.  2. If the patient does not void, check bladder scan and if scan is greater than 350 ml, then st. Cath.   Try to keep total bladder volume (void + cath) less than 500 ml (between 350 and 500 ml).  If it is more than 500 ml, perform above more frequently. Follow-up in clinic.  Screening COVID test returned positive however patient had had recent COVID-19 infection at the beginning of the month that had resolved.     Patient strongly desires to return home and feels that he is able to manage at home with help of wife and walker unfortunately as family is unable to care for patient will be transferred to skilled nursing.  Consider returned to movement Disorders Clinic for rediscussion on electromyogram to determine if results would lead to any meaningful intervention.     Also noted patient has a baseline diagnosis of dysphagia and will be discharged on a dysphagia diet.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Constipation, Fall, Micturition urgency, Muscular weakness, SARS-CoV-2 test positive
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/26/2023 Discharge Date: Mar 29, 2023  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] Constipation, unspecified constipation type [K59.00]   HOSPITAL COURSE:  83 y.o. male with past medical history significant for  panhypopituitarism, dyslipidemia, anxiety and depression, hypertension, GERD, hypothyroidism who presented with complaints of generalized weakness, recurrent falls.  Previously living with wife who felt she could no longer care for him.  Fall on morning of presentation.  Patient admitted for further care.   Reviewing chart, patient has been seen for multiple visits in the movement Disorders Clinic.  Possible diagnosis of Parkinson's disease however testing returned intermediate on imaging.  Patient with noted lower extremity weakness.  In movement Disorder Clinic had been offered repeat electromyogram to better determine etiology and at that time patient refused.  PT/OT evaluated patient and recommended skilled nursing facility.  Patient has also been followed by Urology in the outpatient setting.  Noted urinary retention BPH and urinary urgency.  Patient initially cathed with 1 L urine removed.  Continue to require intermittent straight catheterization.  Urology consulted and recommended: Have pt up to void every 3-5 hours.  1. If the patients voids check bladder scan as PVR and if PVR greater than the amount voided, then st. Cath.  2. If the patient does not void, check bladder scan and if scan is greater than 350 ml, then st. Cath.   Try to keep total bladder volume (void + cath) less than 500 ml (between 350 and 500 ml).  If it is more than 500 ml, perform above more frequently. Follow-up in clinic.  Screening COVID test returned positive however patient had had recent COVID-19 infection at the beginning of the month that had resolved.     Patient strongly desires to return home and feels that he is able to manage at home with help of wife and walker unfortunately as family is unable to care for patient will be transferred to skilled nursing.  Consider returned to movement Disorders Clinic for rediscussion on electromyogram to determine if results would lead to any meaningful intervention.     Also noted patient has a baseline diagnosis of dysphagia and will be discharged on a dysphagia diet.
Age: 82.0
Sex: M
Vaccine: COVID19-2
Symptoms: Urinary retention
Clinical narrative: Discharge Provider: MD Primary Care Provider: MD Admission Date: 3/26/2023 Discharge Date: Mar 29, 2023  PRESENTING PROBLEM: Weakness [R53.1] Generalized weakness [R53.1] Constipation, unspecified constipation type [K59.00]   HOSPITAL COURSE:  83 y.o. male with past medical history significant for  panhypopituitarism, dyslipidemia, anxiety and depression, hypertension, GERD, hypothyroidism who presented with complaints of generalized weakness, recurrent falls.  Previously living with wife who felt she could no longer care for him.  Fall on morning of presentation.  Patient admitted for further care.   Reviewing chart, patient has been seen for multiple visits in the movement Disorders Clinic.  Possible diagnosis of Parkinson's disease however testing returned intermediate on imaging.  Patient with noted lower extremity weakness.  In movement Disorder Clinic had been offered repeat electromyogram to better determine etiology and at that time patient refused.  PT/OT evaluated patient and recommended skilled nursing facility.  Patient has also been followed by Urology in the outpatient setting.  Noted urinary retention BPH and urinary urgency.  Patient initially cathed with 1 L urine removed.  Continue to require intermittent straight catheterization.  Urology consulted and recommended: Have pt up to void every 3-5 hours.  1. If the patients voids check bladder scan as PVR and if PVR greater than the amount voided, then st. Cath.  2. If the patient does not void, check bladder scan and if scan is greater than 350 ml, then st. Cath.   Try to keep total bladder volume (void + cath) less than 500 ml (between 350 and 500 ml).  If it is more than 500 ml, perform above more frequently. Follow-up in clinic.  Screening COVID test returned positive however patient had had recent COVID-19 infection at the beginning of the month that had resolved.     Patient strongly desires to return home and feels that he is able to manage at home with help of wife and walker unfortunately as family is unable to care for patient will be transferred to skilled nursing.  Consider returned to movement Disorders Clinic for rediscussion on electromyogram to determine if results would lead to any meaningful intervention.     Also noted patient has a baseline diagnosis of dysphagia and will be discharged on a dysphagia diet.
Age: 75.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Diarrhoea, Influenza, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: On 4/13, I started having diarrhea and vomiting that lasted until about 4/15. On 4/16, I started having a fever about 100.8 with flu symptoms that evening. On the 4/18, I did a COVID-19 test which was negative. On 4/20, my fever broke.  on 4/23, I tested again and it was positive.
Age: 75.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Vomiting
Clinical narrative: On 4/13, I started having diarrhea and vomiting that lasted until about 4/15. On 4/16, I started having a fever about 100.8 with flu symptoms that evening. On the 4/18, I did a COVID-19 test which was negative. On 4/20, my fever broke.  on 4/23, I tested again and it was positive.
Age: 71.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Influenza, Nasopharyngitis, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: Positive Covid test 11/28/2022, cold and flu like symptoms, chest congestion. Started Paxolvid treatment 11/29/2022
Age: 1.83
Sex: M
Vaccine: PNC13
Symptoms: Expired product administered
Clinical narrative: Expired vaccine administered. No adverse events noted. Expiration date of 2/2023
Age: 75.0
Sex: F
Vaccine: COVID19-2
Symptoms: Abdominal pain, Intestinal obstruction, Vomiting
Clinical narrative: I did not have an adverse reaction to the vaccine. On 04/21/2023, I had severe abdominal pain with vomiting. I went to the emergency room and was hospitalized for five days with a bowel obstruction. I am to avoid spicy foods for the next few weeks.
Age: 51.0
Sex: F
Vaccine: COVID19-2
Symptoms: Anticoagulant therapy, Electrocardiogram ambulatory, Supraventricular extrasystoles
Clinical narrative: developed sudden onset of "PAC" premature atrial contraction. Medication treatment plan: Metoprolol (Beta Blocker)
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Pulmonary embolism
Clinical narrative: ACUTE DVT OF RIGHT LEG, UNSPECIFIED VEIN PULMONARY EMBOLISM, UNSPECIFIED.
Age: 0.83
Sex: F
Vaccine: COVID19-2
Symptoms: Expired product administered
Clinical narrative: A child was given an expired vaccine.  The vaccine expired on 4/23/23, which was on a weekend.  The cold chain nurse inadvertently prepared the vaccine for administration and did not note the beyond use date "BUD" of 4/23/23 which was marked in several places on the box.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Abnormal loss of weight, Asthenia, COVID-19, Condition aggravated, Cough
Clinical narrative: Around the morning of 12/23/2022, I had a cough and cold like symptoms. It got continuously worse, and I had a lot of fatigue. I wound up sick in bed, which is unusual for me. The coughing was incredibly painful. It went on for about a week or a little bit longer. At one point, I tried to get out of bed, and I was so weak, that I couldn't stand up. After I had been through all of this, my body was really sore from all of the coughing. After all of that, I wound up going to the doctor. He said that it was COVID-19. He prescribed me some antibiotics. It took a week to 10 days for the cough to go away. The fatigue took a week or two to go away. I lost around 25 or 26 pounds because I wasn't eating. Eventually, I got my energy back and was able to eat again slowly. It was a few weeks before I could eat again. I did drink a lot of fluids during that time. The antibiotics seemed to knock out the cough and cold like symptoms. It was all over a course of 10 days to 2 weeks.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Dysstasia, Fatigue, Feeding disorder, Malaise, Mobility decreased
Clinical narrative: Around the morning of 12/23/2022, I had a cough and cold like symptoms. It got continuously worse, and I had a lot of fatigue. I wound up sick in bed, which is unusual for me. The coughing was incredibly painful. It went on for about a week or a little bit longer. At one point, I tried to get out of bed, and I was so weak, that I couldn't stand up. After I had been through all of this, my body was really sore from all of the coughing. After all of that, I wound up going to the doctor. He said that it was COVID-19. He prescribed me some antibiotics. It took a week to 10 days for the cough to go away. The fatigue took a week or two to go away. I lost around 25 or 26 pounds because I wasn't eating. Eventually, I got my energy back and was able to eat again slowly. It was a few weeks before I could eat again. I did drink a lot of fluids during that time. The antibiotics seemed to knock out the cough and cold like symptoms. It was all over a course of 10 days to 2 weeks.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Nasopharyngitis, Pain, SARS-CoV-2 test positive
Clinical narrative: Around the morning of 12/23/2022, I had a cough and cold like symptoms. It got continuously worse, and I had a lot of fatigue. I wound up sick in bed, which is unusual for me. The coughing was incredibly painful. It went on for about a week or a little bit longer. At one point, I tried to get out of bed, and I was so weak, that I couldn't stand up. After I had been through all of this, my body was really sore from all of the coughing. After all of that, I wound up going to the doctor. He said that it was COVID-19. He prescribed me some antibiotics. It took a week to 10 days for the cough to go away. The fatigue took a week or two to go away. I lost around 25 or 26 pounds because I wasn't eating. Eventually, I got my energy back and was able to eat again slowly. It was a few weeks before I could eat again. I did drink a lot of fluids during that time. The antibiotics seemed to knock out the cough and cold like symptoms. It was all over a course of 10 days to 2 weeks.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Neuropathy peripheral, Small intestinal obstruction
Clinical narrative: CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY, SEQUELA 8/11/2021 SMALL BOWEL OBSTRUCTION
Age: 69.0
Sex: F
Vaccine: PNC20, VARZOS
Symptoms: Injection site erythema, Malaise, Pain, Pyrexia, Skin warm
Clinical narrative: PATIENT HAVING REDNESS ABOUT THE SIZE OF A SOFTBALL ON LEFT ARM RIGHT BELOW INJECTION SITE OF SHINGRIX VACCINATION SHE RECEIVED 2 DAYS PRIOR. MILD SORENESS THAT HAS IMPROVED FROM INITIAL VACCINATION DATE AND WARM TO TOUCH BUT NO SWELLING/MALAISE/FEVER REPORTED.
Age: 69.0
Sex: F
Vaccine: PNC20, VARZOS
Symptoms: Swelling
Clinical narrative: PATIENT HAVING REDNESS ABOUT THE SIZE OF A SOFTBALL ON LEFT ARM RIGHT BELOW INJECTION SITE OF SHINGRIX VACCINATION SHE RECEIVED 2 DAYS PRIOR. MILD SORENESS THAT HAS IMPROVED FROM INITIAL VACCINATION DATE AND WARM TO TOUCH BUT NO SWELLING/MALAISE/FEVER REPORTED.
Age: 51.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Hyperacusis, Magnetic resonance imaging head normal, Magnetic resonance imaging neck, Tinnitus
Clinical narrative: Prior to receiving the vaccine I had extremely mild tinnitus for about 10 years. It was barely noticeable and always at a constant level. Within 3 months of the second dose of the vaccine the tinnitus went from a 1 to a 10 on a scale of 1 to 10.  I could hear it over everything 24 hours a day. It was accompanied with severe hyperacusis which I had never experienced before. There was no other reason for this to occur but the vaccine. I have spent more than a year searching for the cause of this in hope that it could be reversed. I immediately went to see an ENT doctor in January 2022. They tried high dose steroids and allergy medicine which did not help. In December 2022 they had me get an MRI of the head and neck to rule out tumors and other ear related possibilities. No issues were discovered.  This tinnitus controls my entire life and I have ruled out everything else. I am convinced this vaccine caused this as the tinnitus grew worse not long after the second dose.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Anaemia of chronic disease, Embolic stroke, Hyperlipidaemia, Type 2 diabetes mellitus
Clinical narrative: Moderna vaccine was administered outside of source- reported by patient ? NO LOT NUMBER WERE SUPPLIED  I63.9 ACUTE STROKE DUE TO EMBOLISM OF UNSPECIFIED ARTERY 6/23/2021 DM 2 W HYPERLIPIDEMIA I63.9 ACUTE STROKE DUE TO EMBOLISM OF UNSPECIFIED ARTERY 6/23/2021 ANEMIA OF CHRONIC DISEASE
Age: 64.0
Sex: M
Vaccine: VARZOS
Symptoms: Extra dose administered
Clinical narrative: PATIENT WAS INITIATED ON A SECOND SERIES OF SHINGRIX ON 12/12/2020 AND COMPLETED IT ON 2/20/2021. PATIENT PREVIOUSLY COMPLETED SHINGRIX SERIES IN 2018. ERROR WAS DISCOVERED WHEN PATIENT REQUESTED VACCINE RECORDS FOR OTHER VACCINES.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Malaise, Nasal congestion, Pain
Clinical narrative: COVID-19 infection symptoms began on 01/29/2023 at night. My nose and head was stuffed up. I had a raspy throat, moderate cough and body aches. I did a home test on 01/30/2023 which was positive.  I called my doctor on 01/31/2023 and did a telehealth. He prescribe me Paxlovid for 5 days  but I didn't take it because I did ok without it.  He also prescribe me cough medication which I took for the cough I had. I tested negative on 02/05/2023.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Respiratory tract congestion, SARS-CoV-2 test positive, Throat irritation
Clinical narrative: COVID-19 infection symptoms began on 01/29/2023 at night. My nose and head was stuffed up. I had a raspy throat, moderate cough and body aches. I did a home test on 01/30/2023 which was positive.  I called my doctor on 01/31/2023 and did a telehealth. He prescribe me Paxlovid for 5 days  but I didn't take it because I did ok without it.  He also prescribe me cough medication which I took for the cough I had. I tested negative on 02/05/2023.
Age: 70.0
Sex: M
Vaccine: VARZOS
Symptoms: Injection site rash, Palpitations, Rash, Rash erythematous, Rash pruritic
Clinical narrative: Generalized erthyematous  and pruritic rash on left side of body (including injection site) which has persisted for one week. Treating with OTC loratidine 10mg. daily. Also, had a single brief episode of palpitations 5 days post vaccination. Unknown whether vaccination was responsible for this event,
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest X-ray normal, Cough, Headache, Respiratory tract congestion, Symptom recurrence
Clinical narrative: November 26, 2022, I had a headache that turned into coughing and congestion, and it went away after a couple of weeks.  But it came back in at the end of January it came back and would come and go for about 2 months.  I went to the doctor in March I had an X-Ray to check for pneumonia.
Age: 25.0
Sex: F
Vaccine: COVID19
Symptoms: Facial paresis
Clinical narrative: RIGHT FACIAL MUSCLE WEAKNESS
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Pelvic venous thrombosis
Clinical narrative: ACUTE DVT, UNSPECIFIED VEIN 12/8/2021 ACUTE DVT OF BILAT FEMORAL VEINS ACUTE DVT OF BILAT FEMORAL VEINS 12/9/2021 ACUTE DVT OF BILAT FEMORAL VEINS ACUTE DVT OF BILAT ILIAC VEINS 12/8/2021 ACUTE DVT OF BILAT FEMORAL VEINS
Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Hypotension
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE   HYPOTENSION
Age: 4.0
Sex: M
Vaccine: UNK
Symptoms: Injection site erythema, Injection site nodule, Injection site pain, Injection site reaction, Injection site warmth
Clinical narrative: Local reaction at injection site, warm/red/knoted and pain to Lt leg
Age: 59.0
Sex: F
Vaccine: PNC15
Symptoms: Ageusia, Anosmia, Injection site rash, Rash, SARS-CoV-2 test negative
Clinical narrative: following morning - lost taste and smell (covid test negative) and had rash at injection site and face  -- no other systemic symptoms -
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Epilepsy, Hypertension, Mental status changes
Clinical narrative: Moderna vaccine was administered outside of clinic- reported by patient ? NO LOT NUMBER WERE SUPPLIED   EPILEPSY, UNSPECIFIED 6/10/2021 HTN (HYPERTENSION)  EPILEPSY, UNSPECIFIED 6/10/2021 ALTERED MENTAL STATUS, UNSPECIFIED
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Deep vein thrombosis, Neuropathy peripheral
Clinical narrative: PATIENT RECEIVED VACCINE FROM OUTSIDE SOURCE  NEUROPATHY ACUTE DVT, UNSPECIFIED VEIN ACUTE DVT OF LEFT POPLITEAL VEIN
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Attention deficit hyperactivity disorder, Cellulitis, Central nervous system leukaemia, Chemotherapy
Clinical narrative: ACUTE RESPIRATORY FAILURE 4/3/2022 BRAIN MASS  ACUTE RESPIRATORY FAILURE 4/3/2022 HEADACHE         ACUTE RESPIRATORY FAILURE 4/3/2022 CHRONIC MYELOID LEUKEMIA  ACUTE RESPIRATORY FAILURE 4/3/2022 CHEMOTHERAPY  ACUTE RESPIRATORY FAILURE 4/3/2022 CHEMOTHERAPY  ACUTE RESPIRATORY FAILURE 4/3/2022 LEUKEMIC MENINGITIS, UNSPECIFIED         ACUTE RESPIRATORY FAILURE 4/3/2022 CHRONIC MYELOID LEUKEMIA  ACUTE RESPIRATORY FAILURE 4/3/2022 COGNITIVE DEFICIT IN ATTENTION OR CONCENTRATION  ACUTE RESPIRATORY FAILURE 4/3/2022 FACTOR V DEFICIENCY  ACUTE RESPIRATORY FAILURE 4/3/2022 RIGHT LEG CELLULITIS  ACUTE RESPIRATORY FAILURE 4/3/2022 CMV INFECTION  ACUTE RESPIRATORY FAILURE 4/3/2022 PANCYTOPENIA  ACUTE RESPIRATORY FAILURE 4/3/2022 ACUTE PYELONEPHRITIS  ACUTE RESPIRATORY FAILURE 4/3/2022 VISUAL DISTURBANCE
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic myeloid leukaemia, Cognitive disorder, Cytomegalovirus infection, Disturbance in attention, Factor V deficiency
Clinical narrative: ACUTE RESPIRATORY FAILURE 4/3/2022 BRAIN MASS  ACUTE RESPIRATORY FAILURE 4/3/2022 HEADACHE         ACUTE RESPIRATORY FAILURE 4/3/2022 CHRONIC MYELOID LEUKEMIA  ACUTE RESPIRATORY FAILURE 4/3/2022 CHEMOTHERAPY  ACUTE RESPIRATORY FAILURE 4/3/2022 CHEMOTHERAPY  ACUTE RESPIRATORY FAILURE 4/3/2022 LEUKEMIC MENINGITIS, UNSPECIFIED         ACUTE RESPIRATORY FAILURE 4/3/2022 CHRONIC MYELOID LEUKEMIA  ACUTE RESPIRATORY FAILURE 4/3/2022 COGNITIVE DEFICIT IN ATTENTION OR CONCENTRATION  ACUTE RESPIRATORY FAILURE 4/3/2022 FACTOR V DEFICIENCY  ACUTE RESPIRATORY FAILURE 4/3/2022 RIGHT LEG CELLULITIS  ACUTE RESPIRATORY FAILURE 4/3/2022 CMV INFECTION  ACUTE RESPIRATORY FAILURE 4/3/2022 PANCYTOPENIA  ACUTE RESPIRATORY FAILURE 4/3/2022 ACUTE PYELONEPHRITIS  ACUTE RESPIRATORY FAILURE 4/3/2022 VISUAL DISTURBANCE
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Intracranial mass, Pancytopenia, Pyelonephritis acute, Visual impairment
Clinical narrative: ACUTE RESPIRATORY FAILURE 4/3/2022 BRAIN MASS  ACUTE RESPIRATORY FAILURE 4/3/2022 HEADACHE         ACUTE RESPIRATORY FAILURE 4/3/2022 CHRONIC MYELOID LEUKEMIA  ACUTE RESPIRATORY FAILURE 4/3/2022 CHEMOTHERAPY  ACUTE RESPIRATORY FAILURE 4/3/2022 CHEMOTHERAPY  ACUTE RESPIRATORY FAILURE 4/3/2022 LEUKEMIC MENINGITIS, UNSPECIFIED         ACUTE RESPIRATORY FAILURE 4/3/2022 CHRONIC MYELOID LEUKEMIA  ACUTE RESPIRATORY FAILURE 4/3/2022 COGNITIVE DEFICIT IN ATTENTION OR CONCENTRATION  ACUTE RESPIRATORY FAILURE 4/3/2022 FACTOR V DEFICIENCY  ACUTE RESPIRATORY FAILURE 4/3/2022 RIGHT LEG CELLULITIS  ACUTE RESPIRATORY FAILURE 4/3/2022 CMV INFECTION  ACUTE RESPIRATORY FAILURE 4/3/2022 PANCYTOPENIA  ACUTE RESPIRATORY FAILURE 4/3/2022 ACUTE PYELONEPHRITIS  ACUTE RESPIRATORY FAILURE 4/3/2022 VISUAL DISTURBANCE
Age: 58.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Asplenia, Bacterial test positive, COVID-19, Chest X-ray abnormal, Condition aggravated
Clinical narrative: Discharge Physician: MD Primary Care Physician: MD  Date of Admission: 3/30/2023 Discharge Date: 03/31/2023 Room Number:   PRESENTING PROBLEM: Chronic ulcer of left foot with fat layer exposed (HCC) Sepsis due to pneumonia (HCC)  Pneumonia of left lower lobe due to infectious organism  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC)  COVID-19    HOSPITAL COURSE: 58-year-old man with past medical history of myelofibrosis status post stem cell transplant and splenectomy, severe sepsis from Streptococcus resulting in cardiomyopathy, CKD, loss of multiple digits from septic emboli who presented with fever and fatigue.  Patient had debridement of a left foot ulcer that probes to the bone on 03/28/2023 with Dr.  He also had skin grafting from his left anterior thigh to his right foot performed on the same day and now has a wound VAC in place.  Patient was found to be COVID positive and meeting severe sepsis criteria on presentation to the ER.  Chest x-ray concerning for developing secondary bacterial pneumonia procalcitonin was elevated.  Infectious Disease was consulted to help manage antibiotics in an asplenic patient, and noted results from prior wound culture growing multiple bacteria.  Current tissue culture growing Staph aureus.  Infectious Disease adjusted antibiotics and recommended wound care consultation to consider wound VAC placement on the left foot.  Transfer was requested to local Hospital for in-person wound care consultation as well as consultation for Dr.'s team.
Age: 58.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Culture tissue specimen positive, Culture wound positive, Debridement, Fatigue, Pneumonia
Clinical narrative: Discharge Physician: MD Primary Care Physician: MD  Date of Admission: 3/30/2023 Discharge Date: 03/31/2023 Room Number:   PRESENTING PROBLEM: Chronic ulcer of left foot with fat layer exposed (HCC) Sepsis due to pneumonia (HCC)  Pneumonia of left lower lobe due to infectious organism  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC)  COVID-19    HOSPITAL COURSE: 58-year-old man with past medical history of myelofibrosis status post stem cell transplant and splenectomy, severe sepsis from Streptococcus resulting in cardiomyopathy, CKD, loss of multiple digits from septic emboli who presented with fever and fatigue.  Patient had debridement of a left foot ulcer that probes to the bone on 03/28/2023 with Dr.  He also had skin grafting from his left anterior thigh to his right foot performed on the same day and now has a wound VAC in place.  Patient was found to be COVID positive and meeting severe sepsis criteria on presentation to the ER.  Chest x-ray concerning for developing secondary bacterial pneumonia procalcitonin was elevated.  Infectious Disease was consulted to help manage antibiotics in an asplenic patient, and noted results from prior wound culture growing multiple bacteria.  Current tissue culture growing Staph aureus.  Infectious Disease adjusted antibiotics and recommended wound care consultation to consider wound VAC placement on the left foot.  Transfer was requested to local Hospital for in-person wound care consultation as well as consultation for Dr.'s team.
Age: 58.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Pneumonia bacterial, Procalcitonin increased, Pyrexia, SARS-CoV-2 test positive, Sepsis
Clinical narrative: Discharge Physician: MD Primary Care Physician: MD  Date of Admission: 3/30/2023 Discharge Date: 03/31/2023 Room Number:   PRESENTING PROBLEM: Chronic ulcer of left foot with fat layer exposed (HCC) Sepsis due to pneumonia (HCC)  Pneumonia of left lower lobe due to infectious organism  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC)  COVID-19    HOSPITAL COURSE: 58-year-old man with past medical history of myelofibrosis status post stem cell transplant and splenectomy, severe sepsis from Streptococcus resulting in cardiomyopathy, CKD, loss of multiple digits from septic emboli who presented with fever and fatigue.  Patient had debridement of a left foot ulcer that probes to the bone on 03/28/2023 with Dr.  He also had skin grafting from his left anterior thigh to his right foot performed on the same day and now has a wound VAC in place.  Patient was found to be COVID positive and meeting severe sepsis criteria on presentation to the ER.  Chest x-ray concerning for developing secondary bacterial pneumonia procalcitonin was elevated.  Infectious Disease was consulted to help manage antibiotics in an asplenic patient, and noted results from prior wound culture growing multiple bacteria.  Current tissue culture growing Staph aureus.  Infectious Disease adjusted antibiotics and recommended wound care consultation to consider wound VAC placement on the left foot.  Transfer was requested to local Hospital for in-person wound care consultation as well as consultation for Dr.'s team.
Age: 58.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Skin graft, Skin ulcer, Staphylococcus test positive, Wound closure
Clinical narrative: Discharge Physician: MD Primary Care Physician: MD  Date of Admission: 3/30/2023 Discharge Date: 03/31/2023 Room Number:   PRESENTING PROBLEM: Chronic ulcer of left foot with fat layer exposed (HCC) Sepsis due to pneumonia (HCC)  Pneumonia of left lower lobe due to infectious organism  Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC)  COVID-19    HOSPITAL COURSE: 58-year-old man with past medical history of myelofibrosis status post stem cell transplant and splenectomy, severe sepsis from Streptococcus resulting in cardiomyopathy, CKD, loss of multiple digits from septic emboli who presented with fever and fatigue.  Patient had debridement of a left foot ulcer that probes to the bone on 03/28/2023 with Dr.  He also had skin grafting from his left anterior thigh to his right foot performed on the same day and now has a wound VAC in place.  Patient was found to be COVID positive and meeting severe sepsis criteria on presentation to the ER.  Chest x-ray concerning for developing secondary bacterial pneumonia procalcitonin was elevated.  Infectious Disease was consulted to help manage antibiotics in an asplenic patient, and noted results from prior wound culture growing multiple bacteria.  Current tissue culture growing Staph aureus.  Infectious Disease adjusted antibiotics and recommended wound care consultation to consider wound VAC placement on the left foot.  Transfer was requested to local Hospital for in-person wound care consultation as well as consultation for Dr.'s team.