chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Chlamydia test negative, Chondrocalcinosis, Coronavirus test negative, Cystitis, Enterovirus test negative
Clinical narrative: 9/13/2021 - 9/20/2021 (7 days)     Last attending ? Treatment team Acute cystitis without hematuria  Principal problem     * (Principal) Acute cystitis without hematuria Yes       Non-ST elevation MI (NSTEMI)  Yes       Acute on chronic kidney failure Yes       COVID-19 virus infection Yes       Generalized weakness Yes       Coronary artery disease Yes       Anemia Yes       Status post fall Not Applicable            Medical Problems        Plan: 84-year-old gentleman presents with multiple's complaints and he has non-ST elevation MI, acute on chronic kidney failure COVID-19 infection with hypoxemia and generalized weakness.  At this point he is going to be admitted, I will give him IV heparin aspirin beta blockers and nitrates.  We will cycle his troponins and he will be seen by cardiology.  Cardiologist was informed from emergency room and since there are no beds available in the surrounding hospitals he will be kept here.  I will hold off on his statin and check patient's CPK.  If CPK is acceptable we will continue statin.  At the same time urine will be cultured and patient be on Rocephin.  For the Covid patient will be supplied with oxygen, will put home on dexamethasone.  Until kidney function improves remdesivir is not indicated.  Will give cautious IV hydration especially with underlying MI.  I reviewed his records in February his EF was normal.  Will continue IV fluid and monitor kidney function. I discussed patient's CODE STATUS with him given with all this medical active issues.  He wants to be full code.  Eventually PT OT for placement. Note, patient's knee x-rays are not read by radiologist.  Grossly there not showing any fracture.  If there is any issues orthopedic services should be involved.   VTE prophylaxis: IV heparin Full Code
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Exostosis, Human metapneumovirus test, Human rhinovirus test, Influenza A virus test negative, Influenza B virus test
Clinical narrative: 9/13/2021 - 9/20/2021 (7 days)     Last attending ? Treatment team Acute cystitis without hematuria  Principal problem     * (Principal) Acute cystitis without hematuria Yes       Non-ST elevation MI (NSTEMI)  Yes       Acute on chronic kidney failure Yes       COVID-19 virus infection Yes       Generalized weakness Yes       Coronary artery disease Yes       Anemia Yes       Status post fall Not Applicable            Medical Problems        Plan: 84-year-old gentleman presents with multiple's complaints and he has non-ST elevation MI, acute on chronic kidney failure COVID-19 infection with hypoxemia and generalized weakness.  At this point he is going to be admitted, I will give him IV heparin aspirin beta blockers and nitrates.  We will cycle his troponins and he will be seen by cardiology.  Cardiologist was informed from emergency room and since there are no beds available in the surrounding hospitals he will be kept here.  I will hold off on his statin and check patient's CPK.  If CPK is acceptable we will continue statin.  At the same time urine will be cultured and patient be on Rocephin.  For the Covid patient will be supplied with oxygen, will put home on dexamethasone.  Until kidney function improves remdesivir is not indicated.  Will give cautious IV hydration especially with underlying MI.  I reviewed his records in February his EF was normal.  Will continue IV fluid and monitor kidney function. I discussed patient's CODE STATUS with him given with all this medical active issues.  He wants to be full code.  Eventually PT OT for placement. Note, patient's knee x-rays are not read by radiologist.  Grossly there not showing any fracture.  If there is any issues orthopedic services should be involved.   VTE prophylaxis: IV heparin Full Code
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Influenza virus test negative, Injury, Intensive care, Interstitial lung disease, Joint effusion
Clinical narrative: 9/13/2021 - 9/20/2021 (7 days)     Last attending ? Treatment team Acute cystitis without hematuria  Principal problem     * (Principal) Acute cystitis without hematuria Yes       Non-ST elevation MI (NSTEMI)  Yes       Acute on chronic kidney failure Yes       COVID-19 virus infection Yes       Generalized weakness Yes       Coronary artery disease Yes       Anemia Yes       Status post fall Not Applicable            Medical Problems        Plan: 84-year-old gentleman presents with multiple's complaints and he has non-ST elevation MI, acute on chronic kidney failure COVID-19 infection with hypoxemia and generalized weakness.  At this point he is going to be admitted, I will give him IV heparin aspirin beta blockers and nitrates.  We will cycle his troponins and he will be seen by cardiology.  Cardiologist was informed from emergency room and since there are no beds available in the surrounding hospitals he will be kept here.  I will hold off on his statin and check patient's CPK.  If CPK is acceptable we will continue statin.  At the same time urine will be cultured and patient be on Rocephin.  For the Covid patient will be supplied with oxygen, will put home on dexamethasone.  Until kidney function improves remdesivir is not indicated.  Will give cautious IV hydration especially with underlying MI.  I reviewed his records in February his EF was normal.  Will continue IV fluid and monitor kidney function. I discussed patient's CODE STATUS with him given with all this medical active issues.  He wants to be full code.  Eventually PT OT for placement. Note, patient's knee x-rays are not read by radiologist.  Grossly there not showing any fracture.  If there is any issues orthopedic services should be involved.   VTE prophylaxis: IV heparin Full Code
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Joint space narrowing, Mycoplasma test negative, Neurological symptom, Osteoarthritis, Respiratory syncytial virus test negative
Clinical narrative: 9/13/2021 - 9/20/2021 (7 days)     Last attending ? Treatment team Acute cystitis without hematuria  Principal problem     * (Principal) Acute cystitis without hematuria Yes       Non-ST elevation MI (NSTEMI)  Yes       Acute on chronic kidney failure Yes       COVID-19 virus infection Yes       Generalized weakness Yes       Coronary artery disease Yes       Anemia Yes       Status post fall Not Applicable            Medical Problems        Plan: 84-year-old gentleman presents with multiple's complaints and he has non-ST elevation MI, acute on chronic kidney failure COVID-19 infection with hypoxemia and generalized weakness.  At this point he is going to be admitted, I will give him IV heparin aspirin beta blockers and nitrates.  We will cycle his troponins and he will be seen by cardiology.  Cardiologist was informed from emergency room and since there are no beds available in the surrounding hospitals he will be kept here.  I will hold off on his statin and check patient's CPK.  If CPK is acceptable we will continue statin.  At the same time urine will be cultured and patient be on Rocephin.  For the Covid patient will be supplied with oxygen, will put home on dexamethasone.  Until kidney function improves remdesivir is not indicated.  Will give cautious IV hydration especially with underlying MI.  I reviewed his records in February his EF was normal.  Will continue IV fluid and monitor kidney function. I discussed patient's CODE STATUS with him given with all this medical active issues.  He wants to be full code.  Eventually PT OT for placement. Note, patient's knee x-rays are not read by radiologist.  Grossly there not showing any fracture.  If there is any issues orthopedic services should be involved.   VTE prophylaxis: IV heparin Full Code
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory viral panel, SARS-CoV-2 test positive, Soft tissue swelling, Vascular calcification, Viral test negative
Clinical narrative: 9/13/2021 - 9/20/2021 (7 days)     Last attending ? Treatment team Acute cystitis without hematuria  Principal problem     * (Principal) Acute cystitis without hematuria Yes       Non-ST elevation MI (NSTEMI)  Yes       Acute on chronic kidney failure Yes       COVID-19 virus infection Yes       Generalized weakness Yes       Coronary artery disease Yes       Anemia Yes       Status post fall Not Applicable            Medical Problems        Plan: 84-year-old gentleman presents with multiple's complaints and he has non-ST elevation MI, acute on chronic kidney failure COVID-19 infection with hypoxemia and generalized weakness.  At this point he is going to be admitted, I will give him IV heparin aspirin beta blockers and nitrates.  We will cycle his troponins and he will be seen by cardiology.  Cardiologist was informed from emergency room and since there are no beds available in the surrounding hospitals he will be kept here.  I will hold off on his statin and check patient's CPK.  If CPK is acceptable we will continue statin.  At the same time urine will be cultured and patient be on Rocephin.  For the Covid patient will be supplied with oxygen, will put home on dexamethasone.  Until kidney function improves remdesivir is not indicated.  Will give cautious IV hydration especially with underlying MI.  I reviewed his records in February his EF was normal.  Will continue IV fluid and monitor kidney function. I discussed patient's CODE STATUS with him given with all this medical active issues.  He wants to be full code.  Eventually PT OT for placement. Note, patient's knee x-rays are not read by radiologist.  Grossly there not showing any fracture.  If there is any issues orthopedic services should be involved.   VTE prophylaxis: IV heparin Full Code
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: X-ray limb abnormal
Clinical narrative: 9/13/2021 - 9/20/2021 (7 days)     Last attending ? Treatment team Acute cystitis without hematuria  Principal problem     * (Principal) Acute cystitis without hematuria Yes       Non-ST elevation MI (NSTEMI)  Yes       Acute on chronic kidney failure Yes       COVID-19 virus infection Yes       Generalized weakness Yes       Coronary artery disease Yes       Anemia Yes       Status post fall Not Applicable            Medical Problems        Plan: 84-year-old gentleman presents with multiple's complaints and he has non-ST elevation MI, acute on chronic kidney failure COVID-19 infection with hypoxemia and generalized weakness.  At this point he is going to be admitted, I will give him IV heparin aspirin beta blockers and nitrates.  We will cycle his troponins and he will be seen by cardiology.  Cardiologist was informed from emergency room and since there are no beds available in the surrounding hospitals he will be kept here.  I will hold off on his statin and check patient's CPK.  If CPK is acceptable we will continue statin.  At the same time urine will be cultured and patient be on Rocephin.  For the Covid patient will be supplied with oxygen, will put home on dexamethasone.  Until kidney function improves remdesivir is not indicated.  Will give cautious IV hydration especially with underlying MI.  I reviewed his records in February his EF was normal.  Will continue IV fluid and monitor kidney function. I discussed patient's CODE STATUS with him given with all this medical active issues.  He wants to be full code.  Eventually PT OT for placement. Note, patient's knee x-rays are not read by radiologist.  Grossly there not showing any fracture.  If there is any issues orthopedic services should be involved.   VTE prophylaxis: IV heparin Full Code
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Rash
Clinical narrative: Rash and itching all over body, patient took BENADRYL oral 50mg and improved.
Age: 18.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested positive for Covid on 09/30/2021
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Malaise, Pain, Pyrexia
Clinical narrative: I had headache and fever.  I feel like I am run down.  These symptoms has lasted about a 2 weeks.  I went to  the doctor about this.  I got a Covid-19 test, which came back negative.  On Friday, I started having achiness and fever.  I went back to the doctor.  She did another Covid-19 test, unknown result at this time.
Age: 51.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chills, Oropharyngeal pain, Pyrexia, Upper respiratory tract congestion
Clinical narrative: History of non-Hodgkin's lymphoma.  Has had a 4-day history of fever, chills, sore throat, and URI symptoms/congestion.
Age: 78.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Tremor
Clinical narrative: I was sitting out in my sun porch with my dogs in my lap, it started as a trembling and it just got worse and worse. I tried putting a blanket and jacket on and I could barely speak because I was trembling. I went to closest Hospital. We had a good 45 minute wait. The physician came in did vitals and i was getting exhausted from the shaking. They put heated blankets on and i was still shaking and then they gave me Tylenol and Motrin. I was told to follow up with my primary care doctor.
Age: 35.0
Sex: F
Vaccine: FLU4
Symptoms: Rash, Rash erythematous
Clinical narrative: pt developed a red rash on her chest. she states she gets like this with every flu shot. she normally takes benadryl beforehand but had forgotten to take some prior. I had her sit for 45 minutes to 1 hour and had given her benadryl. she felt much better after 10-15minutes after taking the benadryl and the rash/redness went away. followed up with pt the next day and she felt fine not concerns.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Abdominal pain lower, Decreased appetite, Diarrhoea, Dizziness
Clinical narrative: Irregular mensuration, spotting, chronic headache, dizziness, fatigue, loose bowl movements, upset stomach, hot flashes, loss of appetite, lower abdomen cramping.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Hot flush, Intermenstrual bleeding, Menstruation irregular
Clinical narrative: Irregular mensuration, spotting, chronic headache, dizziness, fatigue, loose bowl movements, upset stomach, hot flashes, loss of appetite, lower abdomen cramping.
Age: 29.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: Pt was administered Pfizer(for 2nd vaccination) instead of Moderna. Pt informed on 9-28-2021.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Impaired quality of life, Sleep disorder, Tinnitus
Clinical narrative: Severe loud tinnitus in my ears. It's a very loud ringing, hissing, squeaking continuous noise. It interferes with my sleep and quality of life. It's very annoying!
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Mobility decreased, Pain, Pain in extremity
Clinical narrative: Still have bad pain in left arm. Can?t raise my arm all the way up before more pain
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered, No adverse event
Clinical narrative: Patient was administered 3rd dose of Moderna vaccine, but it turns out he did not meet criteria for severely immunocompromised. He tolerated the dose well with no adverse reaction, but I am filling out this report as patient did not meet criteria outlined by FDA EUA and ACIP recommendations for 3rd dose Moderna vaccine.
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Condition aggravated, Dyspnoea, Haemoglobin decreased, Iron deficiency anaemia
Clinical narrative: This case meets criteria for vaccine breakthrough review. Patient had SOB, no other COVID SxS.  Presented for low hgb/iron deficiency anemia.
Age: 39.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Tested Positive for Covid
Age: 19.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Interchange of vaccine products, No adverse event
Clinical narrative: Per provider, no adverse effects noted at this time from receiving Janssen Covid Vaccine 3/11/21 and then Moderna # 1 vaccine on 9/2/21.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Adenovirus test, Anaemia, Asthenia, Atelectasis, Atrioventricular block first degree
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine normal, Blood culture, Blood lactic acid normal, Blood pH normal, Blood urea normal
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Bordetella test negative, Bradycardia, Bundle branch block right, COVID-19, Cerebral small vessel ischaemic disease
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Chest pain, Chlamydia test negative, Chronic kidney disease, Clostridium test
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Computerised tomogram head normal, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Cough, Culture stool negative
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Culture urine, Decreased appetite, Dehydration, Diarrhoea, Dyspnoea
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Electrocardiogram abnormal, Enterovirus test negative, Full blood count, Glomerular filtration rate decreased, Haemoglobin decreased
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Human metapneumovirus test, Human rhinovirus test, Hyponatraemia, Hypoxia, Influenza A virus test negative
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Influenza B virus test, Influenza virus test negative, Metabolic function test, Mycoplasma test negative, PCO2 normal
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: PO2 increased, Positive airway pressure therapy, Rectal tube insertion, Respiratory syncytial virus test negative, SARS-CoV-2 test positive
Clinical narrative: ED to Hosp-Admission Discharged  9/15/2021 - 9/20/2021 (5 days) Hospital, MD Last attending ? Treatment team COVID-19   Hospital Problems          POA   * (Principal) COVID-19 Yes       Hypothyroidism Yes       Essential hypertension Yes       Chronic renal insufficiency, stage III (moderate) Yes       Hyponatremia Yes       Lab test positive for detection of COVID-19 virus Yes       Syncope and collapse Yes       Bradycardia Yes       PVC's (premature ventricular contractions) Yes          HPI:Patient is an 88 y.o. male.    Past medical history of chronic kidney disease stage III, hypertension, hypothyroidism, dyslipidemia, BPH, presented to the ER and was brought by an ambulance for evaluation of syncopal episode. Patient has been feeling pretty weak and having some mild cough.  He is also reporting some shortness of breath.  Patient also reported mild decrease in appetite.   Vitals in the ER showed mild bradycardia, lowest heart rate was 48, patient was started on BiPAP treatment but was not very hypoxemic.  Patient will obviously be started on oxygen treatment by nasal cannula Labs reviewed CBC and CMP and showed chronic anemia and hemoglobin was 11, acute hyponatremia, CKD stage III with GFR of 54.2 and normal BUN and creatinine. Troponin was minimally elevated.  Troponin was 0.03. ABG showed pH of 7.42 PCO2 of 37 and PO2 of 148 on current BiPAP treatment. COVID-19 was positive. Lactic acid was normal. UA was abnormal and urine and blood culture was obtained. Chest x-ray and CT chest was reviewed and was unremarkable.  CT chest showed possible bibasilar atelectasis versus early pneumonia.  CTA chest ruled out PE. CT head was unremarkable. EKG shows sinus bradycardia with first-degree AV block and right bundle branch block. Vitals was consulted   Hospital Course:   Patient was admitted after having a syncopal event at home.  He was found to be Covid positive, dehydrated and having profuse diarrhea.  Initially a rectal tube was placed however he stopped having diarrhea.  He did have stool studies including C. difficile performed and were negative.  It is thought that the diarrhea was solely related to his COVID-19.  He was treated with IV fluids and did not require any supplemental oxygen.  Echocardiogram was recommended due to his prior history of having moderately severe aortic stenosis and thought that this could be contributing to his syncopal episode especially if it had gotten worse.  Additionally he could have had his syncopal episode simply from being dehydrated and from being in a weakened state from being elderly and Covid positive.  PT and OT did work with the patient and it was felt that the patient was in a weakened state where rehab would be beneficial.  For that reason he was discharged to rehab where he and his wife will continue to improve their overall strength and functioning prior to returning home.  He does have hyponatremia and may need more liberalization of salt intake.