chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Wheezing
Clinical narrative: Patient Is a 54-year-old female with a past medical history of COPD on 2 L nasal cannula chronically, HFpEF, hypertension, hyperlipidemia, hypothyroidism, GERD, IBS who presents with shortness of breath and wheezing. Patient states that last week her mother was admitted to the hospital with COVID-19.  She picked her mother up from the hospital upon discharge and had to spend some time with her to help care for her.  She received a DuoNeb as well as Decadron in the ED, ultimately able to be weaned down to 2 L however she still had significant wheezing.  She had a CT chest which is negative for PE though she does have right middle lobe attenuation of the bronchial tree consistent with a superimposed pneumonia.  Lab work in ED is otherwise unremarkable.  She did test positive for COVID-19.  Patient states she is vaccinated and has received 2/3 boosters.  Patient is admitted to surgical unit for acute on chronic hypoxia, COPD exacerbation and COVID-19 infection.     Clinical Summary Patient was treated with decadron and remdesivir for COVID-19 as well as Azithro.  Patient's breathing improved to where she no longer needed oxygen and wasn't wheezing.    I discussed with the patient, she should receive 3 doses of Remdesivir to prevent progression of COVID since she is at high risk.  Patient states though she has to get home to take care of her husband.   Will DC with short decadron taper and 2 more days of Azythromycin.  Patient has inhalers at home.  Patient instructed to return if she wheezes and to isolate for 10 days.   Discharge diagnosis COVID-19 Infection
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Fatigue, Herpes virus test abnormal, Herpes zoster, Influenza like illness
Clinical narrative: I had my vaccination on 10/07/2022. I woke up on 02/10/2023 with flu like symptoms and extreme fatigue. I went to the walk in clinic and had a COVID-19 test. I was COVID-19 positive and prescribed PAXLOVID. On 02/17/2023 I contracted Shingles. I stayed in quarantine until 02/23/2023. I still presently have the fatigue on 04/11/2023.
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: I had my vaccination on 10/07/2022. I woke up on 02/10/2023 with flu like symptoms and extreme fatigue. I went to the walk in clinic and had a COVID-19 test. I was COVID-19 positive and prescribed PAXLOVID. On 02/17/2023 I contracted Shingles. I stayed in quarantine until 02/23/2023. I still presently have the fatigue on 04/11/2023.
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLUX
Symptoms: Atrial fibrillation, COVID-19, Condition aggravated, Cough, Dyspnoea
Clinical narrative: My son was in the hospital and we visited him. We feel that we had come down with COVID-19 due to the hospital visit. I had a fever of 102 when we checked it and I was coughing and unable to breath. I couldn't catch my breath. I was not nauseous. I did have body aches and I felt terrible. I did get tested and was not sure if I had it however I was given PAXLOVID. After taking it right away, we started to feel back to normal. As of now I am feeling fine and I don't have any COVID-19 after symptoms. March 25th I did have an A-Fib episode however I do not suspect it being caused by COVID-19.
Age: 73.0
Sex: M
Vaccine: COVID19-2, FLUX
Symptoms: Feeling abnormal, Pain, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: My son was in the hospital and we visited him. We feel that we had come down with COVID-19 due to the hospital visit. I had a fever of 102 when we checked it and I was coughing and unable to breath. I couldn't catch my breath. I was not nauseous. I did have body aches and I felt terrible. I did get tested and was not sure if I had it however I was given PAXLOVID. After taking it right away, we started to feel back to normal. As of now I am feeling fine and I don't have any COVID-19 after symptoms. March 25th I did have an A-Fib episode however I do not suspect it being caused by COVID-19.
Age: 44.0
Sex: F
Vaccine: COVID19-2
Symptoms: Brain fog, COVID-19, Cardiovascular disorder, Chills, Cough
Clinical narrative: Tuesday awoke with sore throat and some sinus drainage.  As day progressed developed headache, congestion, fever, chills, body aches, shortness of breath and brain fog.  By next day I had developed a dry cough, and had an elevated pulse rate (about 130 - 140 resting) and high blood pressure (155/100). Continued to Thursday evening when I took a covid test which came back positive.   Called Friday morning to make telemedicine appt with dr to see if I should seek further treatment.  Dr said rest, should be ok. I called off sick from work and rested.  All symptoms largely resolved except for shortness of breath and cough.  Those have since improved around mid-March but still notice my cardio/breath is not 100%.
Age: 44.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dyspnoea, Headache, Heart rate increased, Hypertension, Impaired work ability
Clinical narrative: Tuesday awoke with sore throat and some sinus drainage.  As day progressed developed headache, congestion, fever, chills, body aches, shortness of breath and brain fog.  By next day I had developed a dry cough, and had an elevated pulse rate (about 130 - 140 resting) and high blood pressure (155/100). Continued to Thursday evening when I took a covid test which came back positive.   Called Friday morning to make telemedicine appt with dr to see if I should seek further treatment.  Dr said rest, should be ok. I called off sick from work and rested.  All symptoms largely resolved except for shortness of breath and cough.  Those have since improved around mid-March but still notice my cardio/breath is not 100%.
Age: 44.0
Sex: F
Vaccine: COVID19-2
Symptoms: Oropharyngeal pain, Pain, Paranasal sinus hypersecretion, Pyrexia, Respiratory tract congestion
Clinical narrative: Tuesday awoke with sore throat and some sinus drainage.  As day progressed developed headache, congestion, fever, chills, body aches, shortness of breath and brain fog.  By next day I had developed a dry cough, and had an elevated pulse rate (about 130 - 140 resting) and high blood pressure (155/100). Continued to Thursday evening when I took a covid test which came back positive.   Called Friday morning to make telemedicine appt with dr to see if I should seek further treatment.  Dr said rest, should be ok. I called off sick from work and rested.  All symptoms largely resolved except for shortness of breath and cough.  Those have since improved around mid-March but still notice my cardio/breath is not 100%.
Age: 44.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Tuesday awoke with sore throat and some sinus drainage.  As day progressed developed headache, congestion, fever, chills, body aches, shortness of breath and brain fog.  By next day I had developed a dry cough, and had an elevated pulse rate (about 130 - 140 resting) and high blood pressure (155/100). Continued to Thursday evening when I took a covid test which came back positive.   Called Friday morning to make telemedicine appt with dr to see if I should seek further treatment.  Dr said rest, should be ok. I called off sick from work and rested.  All symptoms largely resolved except for shortness of breath and cough.  Those have since improved around mid-March but still notice my cardio/breath is not 100%.
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: Arthropathy, Back pain, Blood test abnormal, Joint space narrowing, Magnetic resonance imaging abnormal
Clinical narrative: I had a sudden dramatic increase of pain in my lower back and right leg. I went to the doctor and had a number of blood tests. MRI, and X-ray. The blood work showed a significant decrease in B-12. I've had B-12 injections, an increase in pain medication, and a nerve blockage. The pain has eased somewhat. I go to a physical therapy and a pain clinic. Last fall I had COVID-19, and the day before I tested positive for COVID-19 I started having pain in my leg which is similar to the pain that I'm feeling now.
Age: 55.0
Sex: F
Vaccine: COVID19-2
Symptoms: Nerve block, Pain in extremity, Vitamin B12 deficiency, X-ray abnormal
Clinical narrative: I had a sudden dramatic increase of pain in my lower back and right leg. I went to the doctor and had a number of blood tests. MRI, and X-ray. The blood work showed a significant decrease in B-12. I've had B-12 injections, an increase in pain medication, and a nerve blockage. The pain has eased somewhat. I go to a physical therapy and a pain clinic. Last fall I had COVID-19, and the day before I tested positive for COVID-19 I started having pain in my leg which is similar to the pain that I'm feeling now.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chronic sinusitis, Computerised tomogram head abnormal, Face and mouth X-ray abnormal, Headache, Magnetic resonance imaging normal
Clinical narrative: When the headaches started it was mostly brief on the back of my head to the right and sometimes moved around. The headaches started to get more frequent. I went to the doctor, and they did a CT scan and X-ray. I was diagnosed with Chronic Rhinosinusitis and Chronic ethanol sinusitis. She also sent me for an MRI, and everything was normal. They also prescribed me two rounds of antibiotics.  I am also taking another medication twice a day. I am also suppose to see a neurologist.
Age: 70.0
Sex: F
Vaccine: COVID19-2
Symptoms: Sinusitis
Clinical narrative: When the headaches started it was mostly brief on the back of my head to the right and sometimes moved around. The headaches started to get more frequent. I went to the doctor, and they did a CT scan and X-ray. I was diagnosed with Chronic Rhinosinusitis and Chronic ethanol sinusitis. She also sent me for an MRI, and everything was normal. They also prescribed me two rounds of antibiotics.  I am also taking another medication twice a day. I am also suppose to see a neurologist.
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Atelectasis, COVID-19, Chest X-ray abnormal, Chest tube removal
Clinical narrative: 1. Acute hypoxic respiratory failure: secondary to pneumothorax and atelectasis with underlying COPD. Seems less likely related to COVID-19. Weaned to RA today, normal work of breathing, no wheezing or rales on exam, and CXR with re-expanded lung with continued atelectasis. Continue IS. If remains stable on RA ok to discharge .   2. Spontaneous secondary pneumothorax: secondary to underlying COPD. CT surgery evaluated as this is the patients second pneumothorax related to emphysema. They are planning possible VATS mechanical and chemical pleurodesis after discharge when he is out of COVID-19 isolation. CXR ordered for two weeks after discharge and follow up with Dr. to be arranged. Pulmonary removed chest tube 3/1/23 and has now signed off.   3. COVID-19: vaccinated 5 x with most recent 10/2022. No clear covid specific symptoms PTA and no way to determine start of infection (cough started 2/27 - likely d/t pneumo ). S/p remdesivir 3 day course.    4. Pulmonary nodule: CXR noting possible right lower lung lesion. CT obtained before discharge due to prior smoking history and elevated cancer risk. Noted stable 7 mm RUL nodule.   5. Tobacco use disorder: cessation recommended
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal, Cough, Emphysema, Lung hypoinflation
Clinical narrative: 1. Acute hypoxic respiratory failure: secondary to pneumothorax and atelectasis with underlying COPD. Seems less likely related to COVID-19. Weaned to RA today, normal work of breathing, no wheezing or rales on exam, and CXR with re-expanded lung with continued atelectasis. Continue IS. If remains stable on RA ok to discharge .   2. Spontaneous secondary pneumothorax: secondary to underlying COPD. CT surgery evaluated as this is the patients second pneumothorax related to emphysema. They are planning possible VATS mechanical and chemical pleurodesis after discharge when he is out of COVID-19 isolation. CXR ordered for two weeks after discharge and follow up with Dr. to be arranged. Pulmonary removed chest tube 3/1/23 and has now signed off.   3. COVID-19: vaccinated 5 x with most recent 10/2022. No clear covid specific symptoms PTA and no way to determine start of infection (cough started 2/27 - likely d/t pneumo ). S/p remdesivir 3 day course.    4. Pulmonary nodule: CXR noting possible right lower lung lesion. CT obtained before discharge due to prior smoking history and elevated cancer risk. Noted stable 7 mm RUL nodule.   5. Tobacco use disorder: cessation recommended
Age: 71.0
Sex: M
Vaccine: COVID19-2
Symptoms: Pneumothorax, Pneumothorax spontaneous, Pulmonary mass, Tobacco abuse
Clinical narrative: 1. Acute hypoxic respiratory failure: secondary to pneumothorax and atelectasis with underlying COPD. Seems less likely related to COVID-19. Weaned to RA today, normal work of breathing, no wheezing or rales on exam, and CXR with re-expanded lung with continued atelectasis. Continue IS. If remains stable on RA ok to discharge .   2. Spontaneous secondary pneumothorax: secondary to underlying COPD. CT surgery evaluated as this is the patients second pneumothorax related to emphysema. They are planning possible VATS mechanical and chemical pleurodesis after discharge when he is out of COVID-19 isolation. CXR ordered for two weeks after discharge and follow up with Dr. to be arranged. Pulmonary removed chest tube 3/1/23 and has now signed off.   3. COVID-19: vaccinated 5 x with most recent 10/2022. No clear covid specific symptoms PTA and no way to determine start of infection (cough started 2/27 - likely d/t pneumo ). S/p remdesivir 3 day course.    4. Pulmonary nodule: CXR noting possible right lower lung lesion. CT obtained before discharge due to prior smoking history and elevated cancer risk. Noted stable 7 mm RUL nodule.   5. Tobacco use disorder: cessation recommended
Age: 13.0
Sex: M
Vaccine: COVID19-2
Symptoms: COVID-19, Fatigue, Headache, Lethargy, Oropharyngeal pain
Clinical narrative: Woke up with headache and sore throat, developed more lethargy/fatigue. Telehealth appt with dr on 2/10, said to rest. Stayed home from school, returned to school 2/21/23
Age: 13.0
Sex: M
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Woke up with headache and sore throat, developed more lethargy/fatigue. Telehealth appt with dr on 2/10, said to rest. Stayed home from school, returned to school 2/21/23
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Chronic left ventricular failure
Clinical narrative: Patient is a 81 y.o. female patient of, CNP with history of COPD, chronic diastolic heart failure, coronary artery disease status post stent in 2011, hypothyroidism, hypertension, hyperlipidemia history of TIA presented to local Hospital with shortness of breath. She was diagnosed with COVID 19 infection. Acute hypoxic respiratory failure Acute exacerbation of COPD Secondary to COVID-19 infection Uses 2L NC at bedtime; requiring 2L continuously on admission Albuterol and Symbicort ordered Continue decadron as below Weaned to RA Wheezing markedly improved on exam Will continue decadron to complete 10d course at discharge   COVID-19 viral pneumonia Covid-19 Virus Infection Chest x-ray shows right lower lobe infiltrates.  Will need follow-up chest x-ray in 6 to 8 weeks to ensure resolution. Date of onset of symptoms: 2/28/23 Symptoms present on admission: shortness of breath, cough Date of covid positive test: 3/1/23 Vaccination status: not known Imaging: CXR: sows right lower lobe infiltrates Oxygen requirements on admission: 2 L NC Current oxygen requirements: RA Medical therapy: completed 4d of remdesivir while hospitalized; complete remaining course of dexamethasone Consultants following: none No indication to continue abx   Chronic systolic heart failure Essential hypertension Does not appear fluid overloaded.   Continue home Lasix, lisinopril, Imdur and coreg   Coronary artery disease Hyperlipidemia EKG shows sinus brady. Patient is asymptomatic Continue Plavix, statin History of pulmonary embolus History of stroke Continue apixaban
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Coronary artery disease, Cough, Dyspnoea
Clinical narrative: Patient is a 81 y.o. female patient of, CNP with history of COPD, chronic diastolic heart failure, coronary artery disease status post stent in 2011, hypothyroidism, hypertension, hyperlipidemia history of TIA presented to local Hospital with shortness of breath. She was diagnosed with COVID 19 infection. Acute hypoxic respiratory failure Acute exacerbation of COPD Secondary to COVID-19 infection Uses 2L NC at bedtime; requiring 2L continuously on admission Albuterol and Symbicort ordered Continue decadron as below Weaned to RA Wheezing markedly improved on exam Will continue decadron to complete 10d course at discharge   COVID-19 viral pneumonia Covid-19 Virus Infection Chest x-ray shows right lower lobe infiltrates.  Will need follow-up chest x-ray in 6 to 8 weeks to ensure resolution. Date of onset of symptoms: 2/28/23 Symptoms present on admission: shortness of breath, cough Date of covid positive test: 3/1/23 Vaccination status: not known Imaging: CXR: sows right lower lobe infiltrates Oxygen requirements on admission: 2 L NC Current oxygen requirements: RA Medical therapy: completed 4d of remdesivir while hospitalized; complete remaining course of dexamethasone Consultants following: none No indication to continue abx   Chronic systolic heart failure Essential hypertension Does not appear fluid overloaded.   Continue home Lasix, lisinopril, Imdur and coreg   Coronary artery disease Hyperlipidemia EKG shows sinus brady. Patient is asymptomatic Continue Plavix, statin History of pulmonary embolus History of stroke Continue apixaban
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Essential hypertension, Hyperlipidaemia, Lung infiltration, SARS-CoV-2 test positive
Clinical narrative: Patient is a 81 y.o. female patient of, CNP with history of COPD, chronic diastolic heart failure, coronary artery disease status post stent in 2011, hypothyroidism, hypertension, hyperlipidemia history of TIA presented to local Hospital with shortness of breath. She was diagnosed with COVID 19 infection. Acute hypoxic respiratory failure Acute exacerbation of COPD Secondary to COVID-19 infection Uses 2L NC at bedtime; requiring 2L continuously on admission Albuterol and Symbicort ordered Continue decadron as below Weaned to RA Wheezing markedly improved on exam Will continue decadron to complete 10d course at discharge   COVID-19 viral pneumonia Covid-19 Virus Infection Chest x-ray shows right lower lobe infiltrates.  Will need follow-up chest x-ray in 6 to 8 weeks to ensure resolution. Date of onset of symptoms: 2/28/23 Symptoms present on admission: shortness of breath, cough Date of covid positive test: 3/1/23 Vaccination status: not known Imaging: CXR: sows right lower lobe infiltrates Oxygen requirements on admission: 2 L NC Current oxygen requirements: RA Medical therapy: completed 4d of remdesivir while hospitalized; complete remaining course of dexamethasone Consultants following: none No indication to continue abx   Chronic systolic heart failure Essential hypertension Does not appear fluid overloaded.   Continue home Lasix, lisinopril, Imdur and coreg   Coronary artery disease Hyperlipidemia EKG shows sinus brady. Patient is asymptomatic Continue Plavix, statin History of pulmonary embolus History of stroke Continue apixaban
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Sinus bradycardia, Wheezing
Clinical narrative: Patient is a 81 y.o. female patient of, CNP with history of COPD, chronic diastolic heart failure, coronary artery disease status post stent in 2011, hypothyroidism, hypertension, hyperlipidemia history of TIA presented to local Hospital with shortness of breath. She was diagnosed with COVID 19 infection. Acute hypoxic respiratory failure Acute exacerbation of COPD Secondary to COVID-19 infection Uses 2L NC at bedtime; requiring 2L continuously on admission Albuterol and Symbicort ordered Continue decadron as below Weaned to RA Wheezing markedly improved on exam Will continue decadron to complete 10d course at discharge   COVID-19 viral pneumonia Covid-19 Virus Infection Chest x-ray shows right lower lobe infiltrates.  Will need follow-up chest x-ray in 6 to 8 weeks to ensure resolution. Date of onset of symptoms: 2/28/23 Symptoms present on admission: shortness of breath, cough Date of covid positive test: 3/1/23 Vaccination status: not known Imaging: CXR: sows right lower lobe infiltrates Oxygen requirements on admission: 2 L NC Current oxygen requirements: RA Medical therapy: completed 4d of remdesivir while hospitalized; complete remaining course of dexamethasone Consultants following: none No indication to continue abx   Chronic systolic heart failure Essential hypertension Does not appear fluid overloaded.   Continue home Lasix, lisinopril, Imdur and coreg   Coronary artery disease Hyperlipidemia EKG shows sinus brady. Patient is asymptomatic Continue Plavix, statin History of pulmonary embolus History of stroke Continue apixaban
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Anaemia, Asthenia, Blood lactic acid normal, Blood potassium decreased, COVID-19
Clinical narrative: Patient is a 75 y.o. female patient of MD with history of essential hypertension, hx of  gastric ulcer, remote leukemia in remission presented to local Hospital with complaints of nausea/vomiting. She was followed by surgery and s/p EGD with no acute finding. She got 2 units PRBCs transfusions and Hb 8.4 at discharge. When she progressed, she was discharged home with advice for OP f/u with her physicians as instructed   Nausea and vomiting-resolved Hx of peptic ulcer and NSAID use at home Etiology likely COVID19 infection COVID-19 test as positive  s/p IV fluids, antiemetics S/p negative EGD on 2/28 avoid NSAIDs Tolerating diet OP PCP f/u as instructed   Symptomatic anemia Iron deficiency anemia  Hemoglobin on admission 6.9, negative stool studies No history of melena, hematochezia or hematemesis MCV strikingly low consistent with IDA S/p 2 unit PRBC and Hb 8.4 at discharge S/p venofer IVPB x1 and oral iron sulfate S/p negative EGD on 2/28 Last C-scope over 10 yrs back C/w iron on discharge Appreciate general surgery input and management OP f/u with surgery for C-scope as instructed   Acute urinary tract infection Positive nitrates and leukocyte esterase Started on ceftriaxone, changed to keflex on discharge      Covid-19 Virus Infection Date of onset of symptoms: 48 hours Symptoms present on admission: Nausea vomiting Date of covid positive test: 2/20/2023 Vaccination status: vaccinated Imaging: Chest x-ray showed no acute pathology Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not a candidate Consultants following: None Anticipated special isolation end date: 3/10/2023 Elevated LFTs- improving Likely secondary to underlying viral infection History of cholecystectomy CT without evidence of acute pathology Supportive care, IV fluids     Hypokalemia K 3 >3.9 today Replaced  SIRS due to COVID 19 infection, POA-resolved Sepsis ruled out Suspect combination of viral infection, and nausea/vomiting Not in sepsis, normal lactic acid   Essential hypertension Resume home losartan Blood pressure fairly controlled monitor     Generalized weakness Physical deconditioning PT/OT followed here
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Haemoglobin decreased, Hypokalaemia, Iron deficiency anaemia, Liver function test increased
Clinical narrative: Patient is a 75 y.o. female patient of MD with history of essential hypertension, hx of  gastric ulcer, remote leukemia in remission presented to local Hospital with complaints of nausea/vomiting. She was followed by surgery and s/p EGD with no acute finding. She got 2 units PRBCs transfusions and Hb 8.4 at discharge. When she progressed, she was discharged home with advice for OP f/u with her physicians as instructed   Nausea and vomiting-resolved Hx of peptic ulcer and NSAID use at home Etiology likely COVID19 infection COVID-19 test as positive  s/p IV fluids, antiemetics S/p negative EGD on 2/28 avoid NSAIDs Tolerating diet OP PCP f/u as instructed   Symptomatic anemia Iron deficiency anemia  Hemoglobin on admission 6.9, negative stool studies No history of melena, hematochezia or hematemesis MCV strikingly low consistent with IDA S/p 2 unit PRBC and Hb 8.4 at discharge S/p venofer IVPB x1 and oral iron sulfate S/p negative EGD on 2/28 Last C-scope over 10 yrs back C/w iron on discharge Appreciate general surgery input and management OP f/u with surgery for C-scope as instructed   Acute urinary tract infection Positive nitrates and leukocyte esterase Started on ceftriaxone, changed to keflex on discharge      Covid-19 Virus Infection Date of onset of symptoms: 48 hours Symptoms present on admission: Nausea vomiting Date of covid positive test: 2/20/2023 Vaccination status: vaccinated Imaging: Chest x-ray showed no acute pathology Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not a candidate Consultants following: None Anticipated special isolation end date: 3/10/2023 Elevated LFTs- improving Likely secondary to underlying viral infection History of cholecystectomy CT without evidence of acute pathology Supportive care, IV fluids     Hypokalemia K 3 >3.9 today Replaced  SIRS due to COVID 19 infection, POA-resolved Sepsis ruled out Suspect combination of viral infection, and nausea/vomiting Not in sepsis, normal lactic acid   Essential hypertension Resume home losartan Blood pressure fairly controlled monitor     Generalized weakness Physical deconditioning PT/OT followed here
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Mean cell volume decreased, Nausea, Nitrite urine present, Oesophagogastroduodenoscopy normal, Physical deconditioning
Clinical narrative: Patient is a 75 y.o. female patient of MD with history of essential hypertension, hx of  gastric ulcer, remote leukemia in remission presented to local Hospital with complaints of nausea/vomiting. She was followed by surgery and s/p EGD with no acute finding. She got 2 units PRBCs transfusions and Hb 8.4 at discharge. When she progressed, she was discharged home with advice for OP f/u with her physicians as instructed   Nausea and vomiting-resolved Hx of peptic ulcer and NSAID use at home Etiology likely COVID19 infection COVID-19 test as positive  s/p IV fluids, antiemetics S/p negative EGD on 2/28 avoid NSAIDs Tolerating diet OP PCP f/u as instructed   Symptomatic anemia Iron deficiency anemia  Hemoglobin on admission 6.9, negative stool studies No history of melena, hematochezia or hematemesis MCV strikingly low consistent with IDA S/p 2 unit PRBC and Hb 8.4 at discharge S/p venofer IVPB x1 and oral iron sulfate S/p negative EGD on 2/28 Last C-scope over 10 yrs back C/w iron on discharge Appreciate general surgery input and management OP f/u with surgery for C-scope as instructed   Acute urinary tract infection Positive nitrates and leukocyte esterase Started on ceftriaxone, changed to keflex on discharge      Covid-19 Virus Infection Date of onset of symptoms: 48 hours Symptoms present on admission: Nausea vomiting Date of covid positive test: 2/20/2023 Vaccination status: vaccinated Imaging: Chest x-ray showed no acute pathology Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not a candidate Consultants following: None Anticipated special isolation end date: 3/10/2023 Elevated LFTs- improving Likely secondary to underlying viral infection History of cholecystectomy CT without evidence of acute pathology Supportive care, IV fluids     Hypokalemia K 3 >3.9 today Replaced  SIRS due to COVID 19 infection, POA-resolved Sepsis ruled out Suspect combination of viral infection, and nausea/vomiting Not in sepsis, normal lactic acid   Essential hypertension Resume home losartan Blood pressure fairly controlled monitor     Generalized weakness Physical deconditioning PT/OT followed here
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Red blood cell transfusion, SARS-CoV-2 test positive, Stool analysis normal, Systemic inflammatory response syndrome, Urinary tract infection
Clinical narrative: Patient is a 75 y.o. female patient of MD with history of essential hypertension, hx of  gastric ulcer, remote leukemia in remission presented to local Hospital with complaints of nausea/vomiting. She was followed by surgery and s/p EGD with no acute finding. She got 2 units PRBCs transfusions and Hb 8.4 at discharge. When she progressed, she was discharged home with advice for OP f/u with her physicians as instructed   Nausea and vomiting-resolved Hx of peptic ulcer and NSAID use at home Etiology likely COVID19 infection COVID-19 test as positive  s/p IV fluids, antiemetics S/p negative EGD on 2/28 avoid NSAIDs Tolerating diet OP PCP f/u as instructed   Symptomatic anemia Iron deficiency anemia  Hemoglobin on admission 6.9, negative stool studies No history of melena, hematochezia or hematemesis MCV strikingly low consistent with IDA S/p 2 unit PRBC and Hb 8.4 at discharge S/p venofer IVPB x1 and oral iron sulfate S/p negative EGD on 2/28 Last C-scope over 10 yrs back C/w iron on discharge Appreciate general surgery input and management OP f/u with surgery for C-scope as instructed   Acute urinary tract infection Positive nitrates and leukocyte esterase Started on ceftriaxone, changed to keflex on discharge      Covid-19 Virus Infection Date of onset of symptoms: 48 hours Symptoms present on admission: Nausea vomiting Date of covid positive test: 2/20/2023 Vaccination status: vaccinated Imaging: Chest x-ray showed no acute pathology Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not a candidate Consultants following: None Anticipated special isolation end date: 3/10/2023 Elevated LFTs- improving Likely secondary to underlying viral infection History of cholecystectomy CT without evidence of acute pathology Supportive care, IV fluids     Hypokalemia K 3 >3.9 today Replaced  SIRS due to COVID 19 infection, POA-resolved Sepsis ruled out Suspect combination of viral infection, and nausea/vomiting Not in sepsis, normal lactic acid   Essential hypertension Resume home losartan Blood pressure fairly controlled monitor     Generalized weakness Physical deconditioning PT/OT followed here
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Urine leukocyte esterase positive, Vomiting
Clinical narrative: Patient is a 75 y.o. female patient of MD with history of essential hypertension, hx of  gastric ulcer, remote leukemia in remission presented to local Hospital with complaints of nausea/vomiting. She was followed by surgery and s/p EGD with no acute finding. She got 2 units PRBCs transfusions and Hb 8.4 at discharge. When she progressed, she was discharged home with advice for OP f/u with her physicians as instructed   Nausea and vomiting-resolved Hx of peptic ulcer and NSAID use at home Etiology likely COVID19 infection COVID-19 test as positive  s/p IV fluids, antiemetics S/p negative EGD on 2/28 avoid NSAIDs Tolerating diet OP PCP f/u as instructed   Symptomatic anemia Iron deficiency anemia  Hemoglobin on admission 6.9, negative stool studies No history of melena, hematochezia or hematemesis MCV strikingly low consistent with IDA S/p 2 unit PRBC and Hb 8.4 at discharge S/p venofer IVPB x1 and oral iron sulfate S/p negative EGD on 2/28 Last C-scope over 10 yrs back C/w iron on discharge Appreciate general surgery input and management OP f/u with surgery for C-scope as instructed   Acute urinary tract infection Positive nitrates and leukocyte esterase Started on ceftriaxone, changed to keflex on discharge      Covid-19 Virus Infection Date of onset of symptoms: 48 hours Symptoms present on admission: Nausea vomiting Date of covid positive test: 2/20/2023 Vaccination status: vaccinated Imaging: Chest x-ray showed no acute pathology Oxygen requirements on admission: Room air Current oxygen requirements: Room air Medical therapy: not a candidate Consultants following: None Anticipated special isolation end date: 3/10/2023 Elevated LFTs- improving Likely secondary to underlying viral infection History of cholecystectomy CT without evidence of acute pathology Supportive care, IV fluids     Hypokalemia K 3 >3.9 today Replaced  SIRS due to COVID 19 infection, POA-resolved Sepsis ruled out Suspect combination of viral infection, and nausea/vomiting Not in sepsis, normal lactic acid   Essential hypertension Resume home losartan Blood pressure fairly controlled monitor     Generalized weakness Physical deconditioning PT/OT followed here
Age: 72.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: COVID-19, Chills, Cough, Nasopharyngitis, Pain
Clinical narrative: I had a bad cough, a fever, chills, and body aches. I took a home COVID-19 and that was positive so I called my doctor.  He put me on Paxlovid. Within about two of starting the Paxlovid the symptoms started to decrease but I continued to test positive.  I then developed a bad cold.  It took a good 10 days before I got a negative test.
Age: 72.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive
Clinical narrative: I had a bad cough, a fever, chills, and body aches. I took a home COVID-19 and that was positive so I called my doctor.  He put me on Paxlovid. Within about two of starting the Paxlovid the symptoms started to decrease but I continued to test positive.  I then developed a bad cold.  It took a good 10 days before I got a negative test.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Bronchial secretion retention, Bronchospasm, COVID-19
Clinical narrative: Patient is a 57 y.o. female patient of, MD with a history of SOB   Discharge Diagnoses:   1. COVID PNA, symptoms 2/20, +2/24: -CT chest negative PE, mild mucous plugging, multifocal pneumonia -Home Eliquis DVT prophylaxis -Decadron completed    2.  Acute hypoxic respiratory failure: with post-infective bronchospasm due to recent COVID -remains on room air with satisfactory o2 sats - nebulizer set up for home    3.  AKI, hyponatremia: -resolved    4. Pulmonary nodules: -visualized on CT chest, noncalcified granulomas vs metastatic disease -pulm consulted   5. Hypokalemia; replacement given    5.  Other chronic medical conditions: History of asthma, chronic back pain, history of breast cancer, chronic pain, cognitive developmental delay, CAD, history DVT, depression, history factor V Leiden, hyperlipidemia, hypertension, hypothyroidism, morbid obesity, OSA, port wine stain to face, history of PE, history of renal cell carcinoma, history of seizure, history of stroke, Sturge-Weber disease     Patient was initially admitted to the hospital following COVID symptoms starting February 20.  Patient was discharged on the 27th.  She returned to the ER on 3 March return to the ED was found to have pneumonia initiated on Vanco and Zosyn in ED.  Patient was further evaluated by pulmonary who found on her CT PE study bronchopneumonia.  Discussed nebulizer treatments.  No further treatment necessary for COVID from the 20th   We will discharge to home with a course of doxycycline and have patient follow-up outpatient with her primary care provider; patient agreeable to plan
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Computerised tomogram thorax abnormal, Hypokalaemia, Hyponatraemia, Malaise
Clinical narrative: Patient is a 57 y.o. female patient of, MD with a history of SOB   Discharge Diagnoses:   1. COVID PNA, symptoms 2/20, +2/24: -CT chest negative PE, mild mucous plugging, multifocal pneumonia -Home Eliquis DVT prophylaxis -Decadron completed    2.  Acute hypoxic respiratory failure: with post-infective bronchospasm due to recent COVID -remains on room air with satisfactory o2 sats - nebulizer set up for home    3.  AKI, hyponatremia: -resolved    4. Pulmonary nodules: -visualized on CT chest, noncalcified granulomas vs metastatic disease -pulm consulted   5. Hypokalemia; replacement given    5.  Other chronic medical conditions: History of asthma, chronic back pain, history of breast cancer, chronic pain, cognitive developmental delay, CAD, history DVT, depression, history factor V Leiden, hyperlipidemia, hypertension, hypothyroidism, morbid obesity, OSA, port wine stain to face, history of PE, history of renal cell carcinoma, history of seizure, history of stroke, Sturge-Weber disease     Patient was initially admitted to the hospital following COVID symptoms starting February 20.  Patient was discharged on the 27th.  She returned to the ER on 3 March return to the ED was found to have pneumonia initiated on Vanco and Zosyn in ED.  Patient was further evaluated by pulmonary who found on her CT PE study bronchopneumonia.  Discussed nebulizer treatments.  No further treatment necessary for COVID from the 20th   We will discharge to home with a course of doxycycline and have patient follow-up outpatient with her primary care provider; patient agreeable to plan
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Metastatic neoplasm, Pneumonia, Pulmonary granuloma, Pulmonary mass, SARS-CoV-2 test positive
Clinical narrative: Patient is a 57 y.o. female patient of, MD with a history of SOB   Discharge Diagnoses:   1. COVID PNA, symptoms 2/20, +2/24: -CT chest negative PE, mild mucous plugging, multifocal pneumonia -Home Eliquis DVT prophylaxis -Decadron completed    2.  Acute hypoxic respiratory failure: with post-infective bronchospasm due to recent COVID -remains on room air with satisfactory o2 sats - nebulizer set up for home    3.  AKI, hyponatremia: -resolved    4. Pulmonary nodules: -visualized on CT chest, noncalcified granulomas vs metastatic disease -pulm consulted   5. Hypokalemia; replacement given    5.  Other chronic medical conditions: History of asthma, chronic back pain, history of breast cancer, chronic pain, cognitive developmental delay, CAD, history DVT, depression, history factor V Leiden, hyperlipidemia, hypertension, hypothyroidism, morbid obesity, OSA, port wine stain to face, history of PE, history of renal cell carcinoma, history of seizure, history of stroke, Sturge-Weber disease     Patient was initially admitted to the hospital following COVID symptoms starting February 20.  Patient was discharged on the 27th.  She returned to the ER on 3 March return to the ED was found to have pneumonia initiated on Vanco and Zosyn in ED.  Patient was further evaluated by pulmonary who found on her CT PE study bronchopneumonia.  Discussed nebulizer treatments.  No further treatment necessary for COVID from the 20th   We will discharge to home with a course of doxycycline and have patient follow-up outpatient with her primary care provider; patient agreeable to plan
Age: 42.0
Sex: F
Vaccine: COVID19-2
Symptoms: Rash, Urticaria
Clinical narrative: Unsure of vaccine lot information as the vaccine was given by the pharmacy and not the clinic.  Vaccine given at pharmacy at same address. Pt has diffuse urticarial rash on arms, chest, torso and legs
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: The vaccine given was an error. vaccine intended was the COVID-19 M-RNA Bivalent by Pfizer.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, COVID-19, Death, Dyspnoea, Hyperglycaemia
Clinical narrative: Patient is a 58 y.o. male patient of, CNP with history of ALS, HTN presented on 3/5/2023 with cc of respiratory failure. HMS consulted by Generic Hms Hospitalists for taking over as primary as patient is transferred out of ICU. HMS called to patient's bedside to pronounce.  ? Patient's time of death was 0117 AM ? Patient's date of death was 3/9/2023 ?     Acute respiratory failure with hypoxia COVID-19 infection Initially on BiPAP on admission, transitioned to nasal cannula Sepsis suspected, likely from COVID Required 6L O2 on exam, pt in distress using accessory muscles of the neck. Refusing to put on BiPAP. Called wife and updated over the phone. Pt acceptable of BiPAP on wifes request. Discussed case with neurology and pulmonary. Wife confirms code status of DNR CCA DNI Very poor prognosis and not much treatment options available. Palliative c/s, dicussed case with NP along with goals of care discussion and rec transition to hospice. Mtg with family with change in code status to DNR CC. Morphine started for SOB.   Recent myocardial injury Essential hypertension Continue metoprolol and atorvastatin, aspirin BP controlled   Hyperglycemic A1c at 4.7, likely hyperglycemia prednisone induced   ALS Nonverbal at baseline, in moderate respiratory distress on exam. Continue Nuedexta and rilusole, atropine drops prn TF bolus four times a day, hold for vomiting at present   Central sleep apnea BiPAP at night as tolerated
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Intensive care, Myocardial injury, Positive airway pressure therapy, Respiratory distress, Respiratory failure
Clinical narrative: Patient is a 58 y.o. male patient of, CNP with history of ALS, HTN presented on 3/5/2023 with cc of respiratory failure. HMS consulted by Generic Hms Hospitalists for taking over as primary as patient is transferred out of ICU. HMS called to patient's bedside to pronounce.  ? Patient's time of death was 0117 AM ? Patient's date of death was 3/9/2023 ?     Acute respiratory failure with hypoxia COVID-19 infection Initially on BiPAP on admission, transitioned to nasal cannula Sepsis suspected, likely from COVID Required 6L O2 on exam, pt in distress using accessory muscles of the neck. Refusing to put on BiPAP. Called wife and updated over the phone. Pt acceptable of BiPAP on wifes request. Discussed case with neurology and pulmonary. Wife confirms code status of DNR CCA DNI Very poor prognosis and not much treatment options available. Palliative c/s, dicussed case with NP along with goals of care discussion and rec transition to hospice. Mtg with family with change in code status to DNR CC. Morphine started for SOB.   Recent myocardial injury Essential hypertension Continue metoprolol and atorvastatin, aspirin BP controlled   Hyperglycemic A1c at 4.7, likely hyperglycemia prednisone induced   ALS Nonverbal at baseline, in moderate respiratory distress on exam. Continue Nuedexta and rilusole, atropine drops prn TF bolus four times a day, hold for vomiting at present   Central sleep apnea BiPAP at night as tolerated
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Sepsis, Use of accessory respiratory muscles, Vomiting
Clinical narrative: Patient is a 58 y.o. male patient of, CNP with history of ALS, HTN presented on 3/5/2023 with cc of respiratory failure. HMS consulted by Generic Hms Hospitalists for taking over as primary as patient is transferred out of ICU. HMS called to patient's bedside to pronounce.  ? Patient's time of death was 0117 AM ? Patient's date of death was 3/9/2023 ?     Acute respiratory failure with hypoxia COVID-19 infection Initially on BiPAP on admission, transitioned to nasal cannula Sepsis suspected, likely from COVID Required 6L O2 on exam, pt in distress using accessory muscles of the neck. Refusing to put on BiPAP. Called wife and updated over the phone. Pt acceptable of BiPAP on wifes request. Discussed case with neurology and pulmonary. Wife confirms code status of DNR CCA DNI Very poor prognosis and not much treatment options available. Palliative c/s, dicussed case with NP along with goals of care discussion and rec transition to hospice. Mtg with family with change in code status to DNR CC. Morphine started for SOB.   Recent myocardial injury Essential hypertension Continue metoprolol and atorvastatin, aspirin BP controlled   Hyperglycemic A1c at 4.7, likely hyperglycemia prednisone induced   ALS Nonverbal at baseline, in moderate respiratory distress on exam. Continue Nuedexta and rilusole, atropine drops prn TF bolus four times a day, hold for vomiting at present   Central sleep apnea BiPAP at night as tolerated
Age: 0.33
Sex: M
Vaccine: HIBV
Symptoms: Expired product administered
Clinical narrative: Vaccine was expired when  administered on 4-11-2023. Vaccine expired 4-7-2023.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Chills, Diarrhoea, Disturbance in attention, Faeces soft
Clinical narrative: I had a headache, fever, elevated pulse, chills, slight nausea, and diarrhea on 3/6/2023. On 3/7/2023, I also had nasal congestion and night sweats. I continued to have intense night sweats for about a week. I was treated with PAXLOVID, and I took TYLENOL for my headache. On 3/7/2023, I tested positive on a PCR test. I was on a cruise at the time, and the ship's doctor prescribed me the PAXLOVID, which I began taking on 3/9/2023. I was advised to stop taking atorvastatin while I took PAXLOVID. The doctor did a blood test to check my kidney function before prescribing the PAXLOVID, and the results were normal. The headache subsided after maybe four or five days. The nausea was very mild, but it continued for three or four days. The diarrhea changed to frequent, solid, soft bowel movements; this lasted for about a week. The nasal congestion probably lasted for five days. Slowly, things subsided, and I was isolated at home for ten days. From day three to day seven, I was irritable and had difficulty concentrating and remembering. For example, I would get irritated whenever more than one person was talking at the same time. I raised five children, so I'm used to noise and confusion, but I was definitely more irritable than usual when I was sick, and my nerves were on edge. I couldn't stand myself! Thankfully, though, the symptoms subsided, and everything returned to normal.
Age: 71.0
Sex: F
Vaccine: COVID19-2
Symptoms: Headache, Heart rate increased, Irritability, Memory impairment, Nasal congestion
Clinical narrative: I had a headache, fever, elevated pulse, chills, slight nausea, and diarrhea on 3/6/2023. On 3/7/2023, I also had nasal congestion and night sweats. I continued to have intense night sweats for about a week. I was treated with PAXLOVID, and I took TYLENOL for my headache. On 3/7/2023, I tested positive on a PCR test. I was on a cruise at the time, and the ship's doctor prescribed me the PAXLOVID, which I began taking on 3/9/2023. I was advised to stop taking atorvastatin while I took PAXLOVID. The doctor did a blood test to check my kidney function before prescribing the PAXLOVID, and the results were normal. The headache subsided after maybe four or five days. The nausea was very mild, but it continued for three or four days. The diarrhea changed to frequent, solid, soft bowel movements; this lasted for about a week. The nasal congestion probably lasted for five days. Slowly, things subsided, and I was isolated at home for ten days. From day three to day seven, I was irritable and had difficulty concentrating and remembering. For example, I would get irritated whenever more than one person was talking at the same time. I raised five children, so I'm used to noise and confusion, but I was definitely more irritable than usual when I was sick, and my nerves were on edge. I couldn't stand myself! Thankfully, though, the symptoms subsided, and everything returned to normal.