chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Pulmonary arterial pressure increased, Pulmonary arterial wedge pressure, Pulmonary hypertension, QRS axis, Right ventricular systolic pressure
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Right ventricular systolic pressure increased, Scan with contrast abnormal, Stress cardiomyopathy, Tachycardia, Tricuspid valve incompetence
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Troponin I increased, Vascular resistance systemic, Ventricular hypokinesia, Vomiting
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: Developed Tinnitus (mainly in left ear) approximately10 days after vaccine
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper storage (temperature).
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Breast pain, Pruritus
Clinical narrative: Itchy scalp and pain in left breast area.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vial was punctured at 12pm 11/17/21  left out overnight in the refrigerator. Staff member drew and administered dose from punctured vial at around 10am on 11/18/21
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pain in extremity
Clinical narrative: Patient's injection arm is still sore 4 days after the vaccine and now has pain going down the side of her body. No fever or chills. Only reporting continued pain with it radiating down the same vaccine arm side. Patient is reaching out to primary medical doctor to determine further steps for the pain.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Product administration error
Clinical narrative: Vaccine administered beyond the Best used date but before expiration date.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper Storage (temperature).
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: No adverse event, Underdose
Clinical narrative: Patient received a pediatric dose of Pfizer vaccine. No adverse reaction from patient.
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vial punctured at 12 pm 11/17/2021, and left overnight in the refrigerator. Staff member administered a dose from the punctured vial at around 10 am on 11/18/2021.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoaesthesia, Swelling face
Clinical narrative: Numbness and swelling to right side of face. Patient cannot smile on the right side. No pain. This started a little over 1 month after third dose (booster) of Moderna Covid vaccine.
Age: 25.0
Sex: F
Vaccine: UNK
Symptoms: Pruritus, Rash, Skin irritation
Clinical narrative: Right over 24 hours after administration of vaccine, severe itching began on both arms and quickly escalated to both legs, abdomen and back over the following days. Severe irritation with rash that is unrelieved with antihistamine cream occurred as the itching increased. I am still taking Benadryl and using topical creams to relieve the symptoms, but the rash has continued to worsen 6 days post vaccine.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Heavy menstrual bleeding, Menstruation irregular
Clinical narrative: My menstrual period began 3+ weeks early, beginning 51 hours after I received the Moderna booster. This period is extremely heavy, with a volume I have not experienced in 15+ years. It is wildly different from periods I have experienced since I birthed my only child nearly 12 years ago. I experienced a similar ultra-early period after my initial Pfizer vaccine on April 3, 2021, although it was not as heavy as that seen with the Moderna booster two days ago. I have not yet phoned my physician, but I will be calling my OB/GYN if the heavy period continues beyond my normal flow length.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Chest discomfort, Dyspnoea exertional
Clinical narrative: pt called 11-22-2021 and stated ever since this past weekend she was experiencing chest tightness and shortness of breath upon exertion after receiving her Pfizer booster shot 11-19-2021. pt unsure if caused by anxiety or side effect from vaccine. encouraged pt to follow up with her doctor.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Lymphadenopathy, Pyrexia
Clinical narrative: fever, chills, swollen lymph nodes in arm pits on injection side
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Sensory disturbance
Clinical narrative: Patient with parents and sibling in treatment space. Reports she had some transient sensation that her heart was beating faster~ 15 minutes after receiving the dose- sensation has now resolved. Denies chest pain, shortness of breath, pruritus, pre-syncope. Vital signs: BP 105/68 Pulse 87/min Sats 100% RR 20/min exam unremarkable- heart rate 87, regular rhythm, clear breath sounds, no respiratory distress noted. Provided reassurance to parents and child. Hydration provided by clinic staff. Discussed potential side effects of vaccine and supportive management at home.
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Moderna vial was punctured at 12pm 11/17/21  left out overnight in the refrigerator. Staff member and administered dose from punctured vial at around 10am on 11/18/21
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal discomfort, Chills, Diarrhoea, Fatigue, Headache
Clinical narrative: Gastrointestinal discomfort, diarrhea began approximately 7:00 PM and continued for at least 3 hours (initially attributed by patient to food-induced indigestion) Fatigue, body ache, headache began approximately 8:30 PM and continued for approximately 36 hours Chills, probable low-grade fever (not measured) began approximately 9:30 PM and continued for 12-24 hours
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: Gastrointestinal discomfort, diarrhea began approximately 7:00 PM and continued for at least 3 hours (initially attributed by patient to food-induced indigestion) Fatigue, body ache, headache began approximately 8:30 PM and continued for approximately 36 hours Chills, probable low-grade fever (not measured) began approximately 9:30 PM and continued for 12-24 hours
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Feeling cold, Headache, Myalgia, Pain
Clinical narrative: 02/24/2021 within 11-12 of receiving the vaccination at 09:00pm, high fever, chest pains, muscle aches, deep right calf pains to the point of being worried about blood clout, felt really hold had hard time regulating body temperature, spiked a high fever of 103.5 and very sever and throbbing headache for a week and d aches and took a week to get over. Tele visit over the phone with physician. Homeopath medicine. Pain was 9 out of 10. Lack of sleep due pain level. Took a full week to recover from the issues after dose 2.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Pyrexia, Sleep disorder
Clinical narrative: 02/24/2021 within 11-12 of receiving the vaccination at 09:00pm, high fever, chest pains, muscle aches, deep right calf pains to the point of being worried about blood clout, felt really hold had hard time regulating body temperature, spiked a high fever of 103.5 and very sever and throbbing headache for a week and d aches and took a week to get over. Tele visit over the phone with physician. Homeopath medicine. Pain was 9 out of 10. Lack of sleep due pain level. Took a full week to recover from the issues after dose 2.
Age: 15.0
Sex: F
Vaccine: COVID19
Symptoms: Anxiety, Urticaria
Clinical narrative: Apprehension, Whelps at Right side of neck
Age: 11.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: Patient received the adult dose of Pfizer (12+) but was just short of his 12th birthday (3 days). No adverse reaction occurred.
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Moderna vial was punctured at 12pm 11/17/21  left out overnight in the refrigerator. Staff member drew and administered dose from punctured vial at around 10am on 11/18/21
Age: 24.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Diarrhoea, Pain, Pyrexia
Clinical narrative: Fever/chills,  abdominal cramping, diarrhea,  body aches. Started at 930pm & lasted 2 days
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: BREAKTHROUGH COVID INFECTION. TESTED POSITIVE ON 11/12/2021. PATIENT FULLY VACCINATED ON 03/11/2021. PATIENT RECEIVED MONOCLONAL ANITBODY INFUSION ON 11/15/2021
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac flutter, Chest pain, Dyspnoea, Hypoaesthesia, Paraesthesia
Clinical narrative: sharp chest pains with heart flutter,   shortness of breath for about 2 weeks    tingling like pins and numbness in feet and hands  still continues on and off today
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Anovulatory cycle, Hypomenorrhoea, Intermenstrual bleeding, Menstruation irregular, Oligomenorrhoea
Clinical narrative: Changes in menstrual cycle to include longer cycle with premenstrual bleeding, longer periods, lighter flow, and lack of ovulatory signs. Irregular cycles. Sometimes a week longer than usual and sometimes a week shorter.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Diarrhoea, Erythema, Headache, Oral herpes
Clinical narrative: Client called 11-22-2021 and stated that after receiving the injection and left the clinic started having some redness on her face with swelling in her face and neck.  She had a headache the next day and fever and chills for about 48 hours.  She felt better over the weekend and then at 3 am this morning she had vomiting and diarrhea.  She also stated that she has multiple cold sores in her mouth.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Swelling, Swelling face, Vomiting
Clinical narrative: Client called 11-22-2021 and stated that after receiving the injection and left the clinic started having some redness on her face with swelling in her face and neck.  She had a headache the next day and fever and chills for about 48 hours.  She felt better over the weekend and then at 3 am this morning she had vomiting and diarrhea.  She also stated that she has multiple cold sores in her mouth.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Ear pain
Clinical narrative: Dull with occasional sharp pains behind the left ear.  Started on Sunday 11/21/2021 in the evening.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Axillary pain, Erythema, Headache, Injection site erythema
Clinical narrative: 11/18/2021 AM :Pain, itching, redness and swelling at injection site. Headache, muscle aches, malaise, low grade temp, nausea. PM: Pain, redness and swelling at injection site extending to left shoulder, supraclavicular, ROM difficult. Headache, muscle aches, malaise, low grade temp, nausea, emesis. Notified nurse manager/FHS. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/19/2021 -11/21/2021 AM/PM  Pain, redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/22/2021 AM/PM  Continued Pain itching and tenderness, area firm, decreasing redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Limited ROM left shoulder. Headache, malaise. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress as needed.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Injection site pruritus, Injection site swelling, Joint range of motion decreased, Lymphadenopathy
Clinical narrative: 11/18/2021 AM :Pain, itching, redness and swelling at injection site. Headache, muscle aches, malaise, low grade temp, nausea. PM: Pain, redness and swelling at injection site extending to left shoulder, supraclavicular, ROM difficult. Headache, muscle aches, malaise, low grade temp, nausea, emesis. Notified nurse manager/FHS. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/19/2021 -11/21/2021 AM/PM  Pain, redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/22/2021 AM/PM  Continued Pain itching and tenderness, area firm, decreasing redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Limited ROM left shoulder. Headache, malaise. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress as needed.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Myalgia, Nausea, Neck pain, Pyrexia
Clinical narrative: 11/18/2021 AM :Pain, itching, redness and swelling at injection site. Headache, muscle aches, malaise, low grade temp, nausea. PM: Pain, redness and swelling at injection site extending to left shoulder, supraclavicular, ROM difficult. Headache, muscle aches, malaise, low grade temp, nausea, emesis. Notified nurse manager/FHS. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/19/2021 -11/21/2021 AM/PM  Pain, redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/22/2021 AM/PM  Continued Pain itching and tenderness, area firm, decreasing redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Limited ROM left shoulder. Headache, malaise. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress as needed.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling, Vomiting
Clinical narrative: 11/18/2021 AM :Pain, itching, redness and swelling at injection site. Headache, muscle aches, malaise, low grade temp, nausea. PM: Pain, redness and swelling at injection site extending to left shoulder, supraclavicular, ROM difficult. Headache, muscle aches, malaise, low grade temp, nausea, emesis. Notified nurse manager/FHS. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/19/2021 -11/21/2021 AM/PM  Pain, redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress prn 11/22/2021 AM/PM  Continued Pain itching and tenderness, area firm, decreasing redness and swelling at injection site. Increased pain and swelling left: shoulder, neck, and armpit. Significant swelling left supraclavicular. Limited ROM left shoulder. Headache, malaise. Treatment: OTC Motrin, Tylenol, rest, elevate, ice pack or warm compress as needed.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: BREAKTHROUGH COVID INFECTION. TESTED POSITIVE ON 09/07/2021. PATIENT FULLY VACCINATED ON 06/09/2021.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Extra dose administered, Pruritus, Scab, Skin weeping
Clinical narrative: Developed Hives 3-4 days after the vaccine.  This also occurred after 2nd shot but several months after the time of vaccine.  The hives this time where located on chest, stomach, upper arm.  Welty in appearance but most looked like little line.  some weeped with developed of scabbing.  Itched.  Treated by dermatologist with two antihistamine (Pepcid AC and Zyrtec) and now using a cream and ice pack as well.  No improvement in hives and continues to have new flairs.
Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Developed Hives 3-4 days after the vaccine.  This also occurred after 2nd shot but several months after the time of vaccine.  The hives this time where located on chest, stomach, upper arm.  Welty in appearance but most looked like little line.  some weeped with developed of scabbing.  Itched.  Treated by dermatologist with two antihistamine (Pepcid AC and Zyrtec) and now using a cream and ice pack as well.  No improvement in hives and continues to have new flairs.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Chest discomfort, Chest pain, Dyspnoea, Electrocardiogram normal
Clinical narrative: The day after my booster Covid-19 vaccine, I started having pain/pressure in my left chest. It hurt more to take a deep breath in. After a few days it started getting better, then on 11-16-2021 the chest pain got a little worse and I started getting short of breath by walking around the house. I continued to have a hard time taking deep breaths and continued to feel chest pain and shortness of breath, so I called my doctor who was not able to see me on 11-17-21 but recommended I schedule to be seen that day or go to urgent care. I went to urgent care later in the day and they did a chest xray, labs, and an EKG, all came back normal. Today on 11-22-2021, I continue to have mild chest pain/pressure.
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Laboratory test normal
Clinical narrative: The day after my booster Covid-19 vaccine, I started having pain/pressure in my left chest. It hurt more to take a deep breath in. After a few days it started getting better, then on 11-16-2021 the chest pain got a little worse and I started getting short of breath by walking around the house. I continued to have a hard time taking deep breaths and continued to feel chest pain and shortness of breath, so I called my doctor who was not able to see me on 11-17-21 but recommended I schedule to be seen that day or go to urgent care. I went to urgent care later in the day and they did a chest xray, labs, and an EKG, all came back normal. Today on 11-22-2021, I continue to have mild chest pain/pressure.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Lymphadenopathy
Clinical narrative: Large lump under right arm, swollen lymph gland
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Choking sensation, Oedema
Clinical narrative: Patient C/O choking sensation and edema. No edema observed by responding RN. Alert and Orientated x 4, talkative. Patient given 25mg Diphenhydramine PO. Patient states she immediately felt better after the Diphenhydramine.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond the Best Used Date but before expiration date.
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Malaise, SARS-CoV-2 test positive
Clinical narrative: Pt was hospitalized  twice from 10/11/21 and once again admitted 11/20/21 with COVID related s/s
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
Clinical narrative: Chronic sharp pains at the second injection site, limited range of extension of right arm over head due to pain.  The pain has never fully subsided. After 4 months I consider it a permanent damage. Had 3 flu shots previously with no adverse effect.
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster
Clinical narrative: Developed shingles in the L2 dermatome
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Neck pain, Neuropathy peripheral, Pain, Pain in extremity
Clinical narrative: Left shoulder, neck and arm pain that started a few days after vaccination and have increased.  Each week his pain increased from a 2 to to an 8 now on the pain scale.  He reports neuropathy that started in week 3.  He was given some prednisone and it provided relief but the pain continued after the prescription was completed.  He is now taking Gabapentin, but reports pain so severe that he is unable to sleep much as he wakes up with the arm pin.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Sleep disorder
Clinical narrative: Left shoulder, neck and arm pain that started a few days after vaccination and have increased.  Each week his pain increased from a 2 to to an 8 now on the pain scale.  He reports neuropathy that started in week 3.  He was given some prednisone and it provided relief but the pain continued after the prescription was completed.  He is now taking Gabapentin, but reports pain so severe that he is unable to sleep much as he wakes up with the arm pin.
Age: 9.0
Sex: M
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: 5mins post vaccination pt had an episode of vomiting Vitals: 14:17 (sitting) 79/49, 64, 13, SpO2 100% Temp 98.2F -- > (supine) 89/48, 74, 12, 100%, 98.2 -- > 14:30 94/52, 76, 13, 100% 98.1 Pt stable and released from the vaccination clinic.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: BREAKTHROUGH COVID INFECTION. TESTED POSITIVE ON 08/27/2021. PATIENT FULLY VACCINATED ON 02/28/2021.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: patient hospitalized
Age: 47.0
Sex: U
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Asymptomatic tested COVID positive
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatinine, Blood culture, Brain natriuretic peptide increased, Breath sounds abnormal
Clinical narrative: Assessment/Plan      Pt is 100 y/o female with medical history of breast cancer, CAD s/p CABG in 1980s, CHF, HLD, HTN, CKD stage 2, OA, GERD, atrial fibrillation on Apixaban, recurrent diverticulitis s/p ostomy being admitted for respiratory distress 2/2 covid pneumonia. Pt at this time requiring 4L to continue with appropriate saturations. Will start pt on dexamethasone. Pt Crcl< 30 will hold off of remdesivir for now. Noted bilateral pleural effusions on CT will place pulmonary consult with plans to speak with them in the morning.  24 hour plan:  -Dexamethasone 6mg IV  -AM Covid labs  -Pulmonary consult; plan to speak with them in am  -doxycycline 100 mg qday  -Wean O2 as tolerated  Respiratory Distress  -etiology likely 2/2 to covid pneumoina w/ concurrent pleural effusions  -Pt on 4 L at this time  -Plan:      -See treatment below      -wean O2 as tolerated  Covid Pneumonia  -Pt vaccinated x2  -Pt on 4 L O2  -Plan:      -Dexamethasone 6 mg IV qday      -hold remdesivir due to Crcl<30      -continue to monitor O2 status      -AM covid labs  Bilateral Pleural Effusions  -etiology possibly 2/2 covid pna vs known CHF vs other inflammatory process  -Pt on 4L O2  -Plan:      -Consult Pulmonology; appreciate recommendations  CAP  -Ct with some possible consolidations with pleural effusion within lung fissure  -Pt afebrile with cough  -Plan:      -doxycycline 100 mg daily  AKI  -etiology likely 2/2 decreased oral intake with covid pna  -pt cr 1.2 (baseline roughly 1.1)  -Plan:      -hold home diuretics      -am CMP  HTN  -chronic  -Plan:      -monitor vitals      -hold BP meds due to AKI  A.Fib  -chronic  -Plan:      -apixaban 2.5 mg BID  CHF  -chronic  -Plan:      -continue to monitor fluid status      -holding home furosemide due to AKI    Disposition: Floor  Diet: NPO  DVT PPX: Apixaban  CODE: DNR/DNI   Pt discussed and examined with attending, Dr.
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Cardiac failure, Cardiac failure congestive, Computerised tomogram thorax abnormal
Clinical narrative: Assessment/Plan      Pt is 100 y/o female with medical history of breast cancer, CAD s/p CABG in 1980s, CHF, HLD, HTN, CKD stage 2, OA, GERD, atrial fibrillation on Apixaban, recurrent diverticulitis s/p ostomy being admitted for respiratory distress 2/2 covid pneumonia. Pt at this time requiring 4L to continue with appropriate saturations. Will start pt on dexamethasone. Pt Crcl< 30 will hold off of remdesivir for now. Noted bilateral pleural effusions on CT will place pulmonary consult with plans to speak with them in the morning.  24 hour plan:  -Dexamethasone 6mg IV  -AM Covid labs  -Pulmonary consult; plan to speak with them in am  -doxycycline 100 mg qday  -Wean O2 as tolerated  Respiratory Distress  -etiology likely 2/2 to covid pneumoina w/ concurrent pleural effusions  -Pt on 4 L at this time  -Plan:      -See treatment below      -wean O2 as tolerated  Covid Pneumonia  -Pt vaccinated x2  -Pt on 4 L O2  -Plan:      -Dexamethasone 6 mg IV qday      -hold remdesivir due to Crcl<30      -continue to monitor O2 status      -AM covid labs  Bilateral Pleural Effusions  -etiology possibly 2/2 covid pna vs known CHF vs other inflammatory process  -Pt on 4L O2  -Plan:      -Consult Pulmonology; appreciate recommendations  CAP  -Ct with some possible consolidations with pleural effusion within lung fissure  -Pt afebrile with cough  -Plan:      -doxycycline 100 mg daily  AKI  -etiology likely 2/2 decreased oral intake with covid pna  -pt cr 1.2 (baseline roughly 1.1)  -Plan:      -hold home diuretics      -am CMP  HTN  -chronic  -Plan:      -monitor vitals      -hold BP meds due to AKI  A.Fib  -chronic  -Plan:      -apixaban 2.5 mg BID  CHF  -chronic  -Plan:      -continue to monitor fluid status      -holding home furosemide due to AKI    Disposition: Floor  Diet: NPO  DVT PPX: Apixaban  CODE: DNR/DNI   Pt discussed and examined with attending, Dr.
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Cough, Echocardiogram abnormal, Ejection fraction decreased, Hypocalcaemia
Clinical narrative: Assessment/Plan      Pt is 100 y/o female with medical history of breast cancer, CAD s/p CABG in 1980s, CHF, HLD, HTN, CKD stage 2, OA, GERD, atrial fibrillation on Apixaban, recurrent diverticulitis s/p ostomy being admitted for respiratory distress 2/2 covid pneumonia. Pt at this time requiring 4L to continue with appropriate saturations. Will start pt on dexamethasone. Pt Crcl< 30 will hold off of remdesivir for now. Noted bilateral pleural effusions on CT will place pulmonary consult with plans to speak with them in the morning.  24 hour plan:  -Dexamethasone 6mg IV  -AM Covid labs  -Pulmonary consult; plan to speak with them in am  -doxycycline 100 mg qday  -Wean O2 as tolerated  Respiratory Distress  -etiology likely 2/2 to covid pneumoina w/ concurrent pleural effusions  -Pt on 4 L at this time  -Plan:      -See treatment below      -wean O2 as tolerated  Covid Pneumonia  -Pt vaccinated x2  -Pt on 4 L O2  -Plan:      -Dexamethasone 6 mg IV qday      -hold remdesivir due to Crcl<30      -continue to monitor O2 status      -AM covid labs  Bilateral Pleural Effusions  -etiology possibly 2/2 covid pna vs known CHF vs other inflammatory process  -Pt on 4L O2  -Plan:      -Consult Pulmonology; appreciate recommendations  CAP  -Ct with some possible consolidations with pleural effusion within lung fissure  -Pt afebrile with cough  -Plan:      -doxycycline 100 mg daily  AKI  -etiology likely 2/2 decreased oral intake with covid pna  -pt cr 1.2 (baseline roughly 1.1)  -Plan:      -hold home diuretics      -am CMP  HTN  -chronic  -Plan:      -monitor vitals      -hold BP meds due to AKI  A.Fib  -chronic  -Plan:      -apixaban 2.5 mg BID  CHF  -chronic  -Plan:      -continue to monitor fluid status      -holding home furosemide due to AKI    Disposition: Floor  Diet: NPO  DVT PPX: Apixaban  CODE: DNR/DNI   Pt discussed and examined with attending, Dr.
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Hypokalaemia, Hypomagnesaemia, Hypophagia, Hypoxia, Inflammation
Clinical narrative: Assessment/Plan      Pt is 100 y/o female with medical history of breast cancer, CAD s/p CABG in 1980s, CHF, HLD, HTN, CKD stage 2, OA, GERD, atrial fibrillation on Apixaban, recurrent diverticulitis s/p ostomy being admitted for respiratory distress 2/2 covid pneumonia. Pt at this time requiring 4L to continue with appropriate saturations. Will start pt on dexamethasone. Pt Crcl< 30 will hold off of remdesivir for now. Noted bilateral pleural effusions on CT will place pulmonary consult with plans to speak with them in the morning.  24 hour plan:  -Dexamethasone 6mg IV  -AM Covid labs  -Pulmonary consult; plan to speak with them in am  -doxycycline 100 mg qday  -Wean O2 as tolerated  Respiratory Distress  -etiology likely 2/2 to covid pneumoina w/ concurrent pleural effusions  -Pt on 4 L at this time  -Plan:      -See treatment below      -wean O2 as tolerated  Covid Pneumonia  -Pt vaccinated x2  -Pt on 4 L O2  -Plan:      -Dexamethasone 6 mg IV qday      -hold remdesivir due to Crcl<30      -continue to monitor O2 status      -AM covid labs  Bilateral Pleural Effusions  -etiology possibly 2/2 covid pna vs known CHF vs other inflammatory process  -Pt on 4L O2  -Plan:      -Consult Pulmonology; appreciate recommendations  CAP  -Ct with some possible consolidations with pleural effusion within lung fissure  -Pt afebrile with cough  -Plan:      -doxycycline 100 mg daily  AKI  -etiology likely 2/2 decreased oral intake with covid pna  -pt cr 1.2 (baseline roughly 1.1)  -Plan:      -hold home diuretics      -am CMP  HTN  -chronic  -Plan:      -monitor vitals      -hold BP meds due to AKI  A.Fib  -chronic  -Plan:      -apixaban 2.5 mg BID  CHF  -chronic  -Plan:      -continue to monitor fluid status      -holding home furosemide due to AKI    Disposition: Floor  Diet: NPO  DVT PPX: Apixaban  CODE: DNR/DNI   Pt discussed and examined with attending, Dr.
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Jugular vein distension, Oedema peripheral, Pleural effusion, Pneumonia bacterial, Refusal of treatment by patient
Clinical narrative: Assessment/Plan      Pt is 100 y/o female with medical history of breast cancer, CAD s/p CABG in 1980s, CHF, HLD, HTN, CKD stage 2, OA, GERD, atrial fibrillation on Apixaban, recurrent diverticulitis s/p ostomy being admitted for respiratory distress 2/2 covid pneumonia. Pt at this time requiring 4L to continue with appropriate saturations. Will start pt on dexamethasone. Pt Crcl< 30 will hold off of remdesivir for now. Noted bilateral pleural effusions on CT will place pulmonary consult with plans to speak with them in the morning.  24 hour plan:  -Dexamethasone 6mg IV  -AM Covid labs  -Pulmonary consult; plan to speak with them in am  -doxycycline 100 mg qday  -Wean O2 as tolerated  Respiratory Distress  -etiology likely 2/2 to covid pneumoina w/ concurrent pleural effusions  -Pt on 4 L at this time  -Plan:      -See treatment below      -wean O2 as tolerated  Covid Pneumonia  -Pt vaccinated x2  -Pt on 4 L O2  -Plan:      -Dexamethasone 6 mg IV qday      -hold remdesivir due to Crcl<30      -continue to monitor O2 status      -AM covid labs  Bilateral Pleural Effusions  -etiology possibly 2/2 covid pna vs known CHF vs other inflammatory process  -Pt on 4L O2  -Plan:      -Consult Pulmonology; appreciate recommendations  CAP  -Ct with some possible consolidations with pleural effusion within lung fissure  -Pt afebrile with cough  -Plan:      -doxycycline 100 mg daily  AKI  -etiology likely 2/2 decreased oral intake with covid pna  -pt cr 1.2 (baseline roughly 1.1)  -Plan:      -hold home diuretics      -am CMP  HTN  -chronic  -Plan:      -monitor vitals      -hold BP meds due to AKI  A.Fib  -chronic  -Plan:      -apixaban 2.5 mg BID  CHF  -chronic  -Plan:      -continue to monitor fluid status      -holding home furosemide due to AKI    Disposition: Floor  Diet: NPO  DVT PPX: Apixaban  CODE: DNR/DNI   Pt discussed and examined with attending, Dr.
Age: 99.0
Sex: F
Vaccine: COVID19
Symptoms: Respiratory distress
Clinical narrative: Assessment/Plan      Pt is 100 y/o female with medical history of breast cancer, CAD s/p CABG in 1980s, CHF, HLD, HTN, CKD stage 2, OA, GERD, atrial fibrillation on Apixaban, recurrent diverticulitis s/p ostomy being admitted for respiratory distress 2/2 covid pneumonia. Pt at this time requiring 4L to continue with appropriate saturations. Will start pt on dexamethasone. Pt Crcl< 30 will hold off of remdesivir for now. Noted bilateral pleural effusions on CT will place pulmonary consult with plans to speak with them in the morning.  24 hour plan:  -Dexamethasone 6mg IV  -AM Covid labs  -Pulmonary consult; plan to speak with them in am  -doxycycline 100 mg qday  -Wean O2 as tolerated  Respiratory Distress  -etiology likely 2/2 to covid pneumoina w/ concurrent pleural effusions  -Pt on 4 L at this time  -Plan:      -See treatment below      -wean O2 as tolerated  Covid Pneumonia  -Pt vaccinated x2  -Pt on 4 L O2  -Plan:      -Dexamethasone 6 mg IV qday      -hold remdesivir due to Crcl<30      -continue to monitor O2 status      -AM covid labs  Bilateral Pleural Effusions  -etiology possibly 2/2 covid pna vs known CHF vs other inflammatory process  -Pt on 4L O2  -Plan:      -Consult Pulmonology; appreciate recommendations  CAP  -Ct with some possible consolidations with pleural effusion within lung fissure  -Pt afebrile with cough  -Plan:      -doxycycline 100 mg daily  AKI  -etiology likely 2/2 decreased oral intake with covid pna  -pt cr 1.2 (baseline roughly 1.1)  -Plan:      -hold home diuretics      -am CMP  HTN  -chronic  -Plan:      -monitor vitals      -hold BP meds due to AKI  A.Fib  -chronic  -Plan:      -apixaban 2.5 mg BID  CHF  -chronic  -Plan:      -continue to monitor fluid status      -holding home furosemide due to AKI    Disposition: Floor  Diet: NPO  DVT PPX: Apixaban  CODE: DNR/DNI   Pt discussed and examined with attending, Dr.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Abnormal behaviour, Blood pressure decreased, COVID-19, Dialysis, Hypoxia
Clinical narrative: The patient tells me that on Wednesday she presented to dialysis and tells me this was completed. She normally has Monday Wednesday Friday dialysis. States that after returning home she was thought to be acting differently in an ambulance was called which time she was brought in to the emergency department at an outside facility. Her patient is being seen in transfer from that outside facility.  Per secondhand report for being found hypoxic in dialysis in the 70s.  Of note the patient was diagnosed with COVID-19 11/16/2021 in her assisted living at what sounds to be a standard screening test. She is vaccinated.  She states she has had some mild congestion but otherwise is asymptomatic.  Tells me that 2 other resdents were also positive.  Also has pertinent history of GI bleeding, renal artery stenosis, peripheral artery disease, diabetes mellitus, history of stroke, history of NSTEMI.   Patient was on 2 L of nasal cannula at the outside facility and saturating in the mid 90s.  Patient's blood pressure initially was in the 140 systolic however dropped to 80s though asymptomatic.  The patient was given normal saline boluses which her blood pressure was responsive.  Due to elevated procalcitonin was started on 1 g of ceftriaxone and 500 mg of azithromycin.  Was briefly on norepinephrine however this was weaned off without difficulty.  Patient was initially to be transferred to the ICU however with improvement was transferred to General Medicine.   On arrival the patient is 100% on 2 L. blood pressures are appropriate in the 120s to 130s.  She is awake, alert, and pleasant.  Denies chest pain, shortness of breath, dyspnea on exertion, pleuritic pain, abdominal pain, nausea, vomiting, diarrhea.  States she has had some fevers at her facility.  Tells me that she typically has low blood pressures.  Her biggest complaint is the neuropathy in her feet.
Age: 82.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Neuropathy peripheral, Procalcitonin increased, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: The patient tells me that on Wednesday she presented to dialysis and tells me this was completed. She normally has Monday Wednesday Friday dialysis. States that after returning home she was thought to be acting differently in an ambulance was called which time she was brought in to the emergency department at an outside facility. Her patient is being seen in transfer from that outside facility.  Per secondhand report for being found hypoxic in dialysis in the 70s.  Of note the patient was diagnosed with COVID-19 11/16/2021 in her assisted living at what sounds to be a standard screening test. She is vaccinated.  She states she has had some mild congestion but otherwise is asymptomatic.  Tells me that 2 other resdents were also positive.  Also has pertinent history of GI bleeding, renal artery stenosis, peripheral artery disease, diabetes mellitus, history of stroke, history of NSTEMI.   Patient was on 2 L of nasal cannula at the outside facility and saturating in the mid 90s.  Patient's blood pressure initially was in the 140 systolic however dropped to 80s though asymptomatic.  The patient was given normal saline boluses which her blood pressure was responsive.  Due to elevated procalcitonin was started on 1 g of ceftriaxone and 500 mg of azithromycin.  Was briefly on norepinephrine however this was weaned off without difficulty.  Patient was initially to be transferred to the ICU however with improvement was transferred to General Medicine.   On arrival the patient is 100% on 2 L. blood pressures are appropriate in the 120s to 130s.  She is awake, alert, and pleasant.  Denies chest pain, shortness of breath, dyspnea on exertion, pleuritic pain, abdominal pain, nausea, vomiting, diarrhea.  States she has had some fevers at her facility.  Tells me that she typically has low blood pressures.  Her biggest complaint is the neuropathy in her feet.
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: The patient was given her 3rd dose of moderna a booster dose on 11/10/2021. The family returned a second consent and a 4th dose of moderna a booster done was administered on 11/20/2021
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram, Deep vein thrombosis, Pulmonary embolism, Ultrasound Doppler
Clinical narrative: Left lower extremity DVT Acute on chronic PE
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: BREAKTHROUGH COVID INFECTION. TESTED POSITIVE ON 10/14/2021. PATIENT FULLY VACCINATED ON 04/14/2021.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Chest X-ray, Chest discomfort, Electrocardiogram
Clinical narrative: 24 hours after, began to notice a mild tightness in my chest ? on the left side.  Sensation came and went. Brief periods of being aware of the tightness followed by long intervals without sensation. Never painful, never distressing, just mildly there on and off.  After 24 hours sensation had not gone away. Decided to go to ER (~48 hours after the shot)  out of concern for heart. At the ER, EKG was normal, traponin levels were normal (tested it twice), chest x-ray was normal, CT with contrast showed no sign of a clot.  I did not have swelling in my legs, nor any difficulty breathing, so the doctor ruled out myocarditis.  I left ER without an explanation and with instructions to follow-up with a cardiologist.  I waited a few more days to see if the sensation would go away. It didn?t. During this time, the pattern was pretty much the same as before, but some new sensations  emerged.  A few times, I had a sharp ?lightning bolt? that lasted only a second but was like a zap.    Once it became clear that the problem was ongoing, I made an appointment with a cardiologist.  I had a tele-health appointment with her on Friday, 11/19. She believes that the shot induced mild inflammation.  She told me to take ibuprofen and within a day or so the symptoms (mostly) subsided.  I am continuing to take the ibuprofen and will stop after a full week.  The doctor ordered an echocardiogram and EKG, which I will have after the holiday.
Age: 11.0
Sex: M
Vaccine: MNQ, TDAP
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
Clinical narrative: Approx <24 hrs after vaccines, developed redness, warmth, itching at both injection sites. Worsened with spreading redness at 48 hours. No fever. Right vastus lateralis- Tdap with 7x7cm erythema.  Left vastus lateralis- Menactra with 9x10cm erythema
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Product administration error
Clinical narrative: Vaccine administered beyond the Best Used Date but before expiration date.
Age: 17.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Product administered to patient of inappropriate age
Clinical narrative: patient is age 17 , guardian reported client having a slight headache day after immunization which resolved itself, then no other side effects were encountered.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: C-reactive protein increased, Condition aggravated, Disease recurrence, Full blood count, Metabolic function test
Clinical narrative: After years of remission from RA, recurrence of disease which has become highly active and has been difficult to get under control even with prednisone and now adalimumab.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Rheumatoid arthritis
Clinical narrative: After years of remission from RA, recurrence of disease which has become highly active and has been difficult to get under control even with prednisone and now adalimumab.