chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Swelling face, Tongue blistering, Viral infection
Clinical narrative: About a week after receiving the vaccine, my face swelled, I had blisters in mouth and on my tongue. My throat was also swollen. I went to my doctor and he told me it was a virus type infection. He prescribed Acyclovir. I was off work for about 7 days. I have recovered but I am still fatigued which was also a symptom I experienced.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Blood HIV RNA below assay limit, HIV antigen negative, HIV test false positive, Lymphocyte stimulation test negative, SARS-CoV-2 test negative
Clinical narrative: Patient went for preadmission testing for orthopedic surgery (spinal stenosis) and tested positive for HIV through routine testing. This was false positive test. Patient takes no medication and has no relevant history. Test done on IM HIV Ag_Ab Combo. History done with physicians resulted in highly unlikely HIV positive. Patient was not COVID positive at the time. According to the lab, test was repeatedly reactive but weak from 1.374 to 1.424. Differentiation assay was negative on PCR. T cell and viral load negative.
Age: 76.0
Sex: M
Vaccine: COVID19
Symptoms: Acute myocardial infarction, COVID-19, COVID-19 pneumonia, SARS-CoV-2 test positive
Clinical narrative: Hospitalized 1/13 COVID + that date collapsed 1-2 weeks post symptom onset, now with STEMI, COVID Pneumonia, treated with remdesivir and dexamethasone.
Age: 77.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Arthralgia, Hypoaesthesia, Immediate post-injection reaction, Pain in extremity
Clinical narrative: per patient experienced within seconds bilateral arm and shoulder pain immediately after receiving both moderna COVID vaccines. she continues to have bilateral arm/hand pain and numbness every night since vaccination.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: HOSPITALIZATION
Age: 39.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Acute myocardial infarction, Chest pain, Coronary angioplasty, Coronary artery thrombosis, Hypoaesthesia
Clinical narrative: S.T.E.M.I. In the right coronary artery due to multiple blood clots. Clots cleared via balloon angiogram, no stent required because artery was healthy. Pt will most likely recover fully however will need to remain on medication for extended time frame and likely to effect his career. Symptoms included, sudden onset chest pain accompanied by bi lateral arm numbness over the duration of 45 min prior to arrival of EMS. CP & arm numbness did not subside until after PT was cleared of the blockage.
Age: 39.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Thrombectomy
Clinical narrative: S.T.E.M.I. In the right coronary artery due to multiple blood clots. Clots cleared via balloon angiogram, no stent required because artery was healthy. Pt will most likely recover fully however will need to remain on medication for extended time frame and likely to effect his career. Symptoms included, sudden onset chest pain accompanied by bi lateral arm numbness over the duration of 45 min prior to arrival of EMS. CP & arm numbness did not subside until after PT was cleared of the blockage.
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: ?Pfizer lot #FJ6369 with temp excursion. Reported to Pfizer company and ok?d for use. Instructed by their staff to report each dose given in this system.?
Age: 96.0
Sex: F
Vaccine: COVID19
Symptoms: Anaemia, Asthenia, Cardiac arrest, Cough, Death
Clinical narrative: Within a day, Patient developed flu-like symptoms which grew more severe between the first dose of vaccine and the second dose six weeks later. As her daughter, I asked if it was advisable to administer the second dose while she was sick with severe congestion, constant coughing and restricted breathing (low O2 levels) and Doctor advised the staff at Nursing home to administer the second dose.  After the second dose, her symptoms grew more severe and she became weak. Dr. said she had life-threatening anemia, which she did not have before the first vaccination, and needed a blood transfusion. A week later, she was admitted to the Hospital Emergency Department where she was given a blood transfusion. Her flu-like symptoms did not improve. Dr.  prescribed an antibiotic Z-Pac (3 day course of treatment) which began to improve her symptoms after the second dose on 3-20-2021. However, she was too ill at that point and died on 03-21-2021. It took three days for Dr. to decide what to declare as her cause of death on the death certificate and he finally decided on Cardiac Arrest.  Despite the patient's age, she was healthy and not taking any medications at the time she received the Pfizer COVID-19 vaccine. Her health deteriorated rapidly after the first vaccine and she was not able to overcome the severe anemia that resulted after the second vaccine.
Age: 96.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Influenza like illness, Malaise, Oxygen saturation decreased, Respiratory tract congestion
Clinical narrative: Within a day, Patient developed flu-like symptoms which grew more severe between the first dose of vaccine and the second dose six weeks later. As her daughter, I asked if it was advisable to administer the second dose while she was sick with severe congestion, constant coughing and restricted breathing (low O2 levels) and Doctor advised the staff at Nursing home to administer the second dose.  After the second dose, her symptoms grew more severe and she became weak. Dr. said she had life-threatening anemia, which she did not have before the first vaccination, and needed a blood transfusion. A week later, she was admitted to the Hospital Emergency Department where she was given a blood transfusion. Her flu-like symptoms did not improve. Dr.  prescribed an antibiotic Z-Pac (3 day course of treatment) which began to improve her symptoms after the second dose on 3-20-2021. However, she was too ill at that point and died on 03-21-2021. It took three days for Dr. to decide what to declare as her cause of death on the death certificate and he finally decided on Cardiac Arrest.  Despite the patient's age, she was healthy and not taking any medications at the time she received the Pfizer COVID-19 vaccine. Her health deteriorated rapidly after the first vaccine and she was not able to overcome the severe anemia that resulted after the second vaccine.
Age: 96.0
Sex: F
Vaccine: COVID19
Symptoms: Transfusion
Clinical narrative: Within a day, Patient developed flu-like symptoms which grew more severe between the first dose of vaccine and the second dose six weeks later. As her daughter, I asked if it was advisable to administer the second dose while she was sick with severe congestion, constant coughing and restricted breathing (low O2 levels) and Doctor advised the staff at Nursing home to administer the second dose.  After the second dose, her symptoms grew more severe and she became weak. Dr. said she had life-threatening anemia, which she did not have before the first vaccination, and needed a blood transfusion. A week later, she was admitted to the Hospital Emergency Department where she was given a blood transfusion. Her flu-like symptoms did not improve. Dr.  prescribed an antibiotic Z-Pac (3 day course of treatment) which began to improve her symptoms after the second dose on 3-20-2021. However, she was too ill at that point and died on 03-21-2021. It took three days for Dr. to decide what to declare as her cause of death on the death certificate and he finally decided on Cardiac Arrest.  Despite the patient's age, she was healthy and not taking any medications at the time she received the Pfizer COVID-19 vaccine. Her health deteriorated rapidly after the first vaccine and she was not able to overcome the severe anemia that resulted after the second vaccine.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: ?Pfizer lot #FJ6369 with temp excursion. Reported to Pfizer company and ok?d for use. Instructed by their staff to report each dose given in this system.?
Age: 90.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Acute kidney injury, Anticoagulant therapy, Atrioventricular block first degree, Blood creatinine increased, Blood lactic acid decreased
Clinical narrative: Hospitalized 1/9/2022; COVID-19 Positive 1/9/2022; fully vaccinated Admitting Service: Internal Medicine Service Admission Date: 1/9/2022 Discharge Date: 01/14/2022 PRESENTING PROBLEM:  Hypernatremia Upper GI bleed Dehydration, severe AKI (acute kidney injury) Acute cystitis without hematuria COVID-19 virus infection   HOSPITAL COURSE: Patient is a 90 y.o. female with past medical history significant for  chronic obstructive pulmonary disease, chronic hypoxia, CKD stage 3, anxiety, hypertension, recurrent pulmonary emboli dementia who presented emergency department for failure to thrive. Upon arrival to emergency department, patient was slightly tachycardia but other vitals were stable.  Baseline blood work was obtained which was remarkable for sodium of 153, and creatinine 1.84, WBC 23.6, lactic acid 2.8, INR 3.8, troponin of 51 with repeat of 42. UA was obtained which was positive for acute infection. COVID PCR was also positive. Patient was given a total of 1.5 L for severe dehydration. EKG showed sinus rhythm with first-degree AV block.  Patient was started on Rocephin. During the hospitalization she was treated with D5W which helped improved hypernatremia, sodium level improved, required oxygen intermittently during nighttime, received dexamethasone for couple of days, mental status improved back to baseline, evaluated by PT and OT initially recommended skilled nursing facility but later changed recommendation to home care, recommended continuing home dose of Coumadin, and INR checked with PCP in 1 week. Care Management arranged for home physical therapy and nursing, discharge home today in stable condition, instruction discussed in detail with patient's DPOA son over the phone he verbalized understanding.
Age: 90.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood sodium increased, Blood test abnormal, COVID-19, Cystitis, Dehydration
Clinical narrative: Hospitalized 1/9/2022; COVID-19 Positive 1/9/2022; fully vaccinated Admitting Service: Internal Medicine Service Admission Date: 1/9/2022 Discharge Date: 01/14/2022 PRESENTING PROBLEM:  Hypernatremia Upper GI bleed Dehydration, severe AKI (acute kidney injury) Acute cystitis without hematuria COVID-19 virus infection   HOSPITAL COURSE: Patient is a 90 y.o. female with past medical history significant for  chronic obstructive pulmonary disease, chronic hypoxia, CKD stage 3, anxiety, hypertension, recurrent pulmonary emboli dementia who presented emergency department for failure to thrive. Upon arrival to emergency department, patient was slightly tachycardia but other vitals were stable.  Baseline blood work was obtained which was remarkable for sodium of 153, and creatinine 1.84, WBC 23.6, lactic acid 2.8, INR 3.8, troponin of 51 with repeat of 42. UA was obtained which was positive for acute infection. COVID PCR was also positive. Patient was given a total of 1.5 L for severe dehydration. EKG showed sinus rhythm with first-degree AV block.  Patient was started on Rocephin. During the hospitalization she was treated with D5W which helped improved hypernatremia, sodium level improved, required oxygen intermittently during nighttime, received dexamethasone for couple of days, mental status improved back to baseline, evaluated by PT and OT initially recommended skilled nursing facility but later changed recommendation to home care, recommended continuing home dose of Coumadin, and INR checked with PCP in 1 week. Care Management arranged for home physical therapy and nursing, discharge home today in stable condition, instruction discussed in detail with patient's DPOA son over the phone he verbalized understanding.
Age: 90.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Electrocardiogram abnormal, Failure to thrive, Hypernatraemia, Infection, International normalised ratio increased
Clinical narrative: Hospitalized 1/9/2022; COVID-19 Positive 1/9/2022; fully vaccinated Admitting Service: Internal Medicine Service Admission Date: 1/9/2022 Discharge Date: 01/14/2022 PRESENTING PROBLEM:  Hypernatremia Upper GI bleed Dehydration, severe AKI (acute kidney injury) Acute cystitis without hematuria COVID-19 virus infection   HOSPITAL COURSE: Patient is a 90 y.o. female with past medical history significant for  chronic obstructive pulmonary disease, chronic hypoxia, CKD stage 3, anxiety, hypertension, recurrent pulmonary emboli dementia who presented emergency department for failure to thrive. Upon arrival to emergency department, patient was slightly tachycardia but other vitals were stable.  Baseline blood work was obtained which was remarkable for sodium of 153, and creatinine 1.84, WBC 23.6, lactic acid 2.8, INR 3.8, troponin of 51 with repeat of 42. UA was obtained which was positive for acute infection. COVID PCR was also positive. Patient was given a total of 1.5 L for severe dehydration. EKG showed sinus rhythm with first-degree AV block.  Patient was started on Rocephin. During the hospitalization she was treated with D5W which helped improved hypernatremia, sodium level improved, required oxygen intermittently during nighttime, received dexamethasone for couple of days, mental status improved back to baseline, evaluated by PT and OT initially recommended skilled nursing facility but later changed recommendation to home care, recommended continuing home dose of Coumadin, and INR checked with PCP in 1 week. Care Management arranged for home physical therapy and nursing, discharge home today in stable condition, instruction discussed in detail with patient's DPOA son over the phone he verbalized understanding.
Age: 90.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Tachycardia, Troponin, Upper gastrointestinal haemorrhage, Urine analysis abnormal
Clinical narrative: Hospitalized 1/9/2022; COVID-19 Positive 1/9/2022; fully vaccinated Admitting Service: Internal Medicine Service Admission Date: 1/9/2022 Discharge Date: 01/14/2022 PRESENTING PROBLEM:  Hypernatremia Upper GI bleed Dehydration, severe AKI (acute kidney injury) Acute cystitis without hematuria COVID-19 virus infection   HOSPITAL COURSE: Patient is a 90 y.o. female with past medical history significant for  chronic obstructive pulmonary disease, chronic hypoxia, CKD stage 3, anxiety, hypertension, recurrent pulmonary emboli dementia who presented emergency department for failure to thrive. Upon arrival to emergency department, patient was slightly tachycardia but other vitals were stable.  Baseline blood work was obtained which was remarkable for sodium of 153, and creatinine 1.84, WBC 23.6, lactic acid 2.8, INR 3.8, troponin of 51 with repeat of 42. UA was obtained which was positive for acute infection. COVID PCR was also positive. Patient was given a total of 1.5 L for severe dehydration. EKG showed sinus rhythm with first-degree AV block.  Patient was started on Rocephin. During the hospitalization she was treated with D5W which helped improved hypernatremia, sodium level improved, required oxygen intermittently during nighttime, received dexamethasone for couple of days, mental status improved back to baseline, evaluated by PT and OT initially recommended skilled nursing facility but later changed recommendation to home care, recommended continuing home dose of Coumadin, and INR checked with PCP in 1 week. Care Management arranged for home physical therapy and nursing, discharge home today in stable condition, instruction discussed in detail with patient's DPOA son over the phone he verbalized understanding.
Age: 90.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: White blood cell count increased
Clinical narrative: Hospitalized 1/9/2022; COVID-19 Positive 1/9/2022; fully vaccinated Admitting Service: Internal Medicine Service Admission Date: 1/9/2022 Discharge Date: 01/14/2022 PRESENTING PROBLEM:  Hypernatremia Upper GI bleed Dehydration, severe AKI (acute kidney injury) Acute cystitis without hematuria COVID-19 virus infection   HOSPITAL COURSE: Patient is a 90 y.o. female with past medical history significant for  chronic obstructive pulmonary disease, chronic hypoxia, CKD stage 3, anxiety, hypertension, recurrent pulmonary emboli dementia who presented emergency department for failure to thrive. Upon arrival to emergency department, patient was slightly tachycardia but other vitals were stable.  Baseline blood work was obtained which was remarkable for sodium of 153, and creatinine 1.84, WBC 23.6, lactic acid 2.8, INR 3.8, troponin of 51 with repeat of 42. UA was obtained which was positive for acute infection. COVID PCR was also positive. Patient was given a total of 1.5 L for severe dehydration. EKG showed sinus rhythm with first-degree AV block.  Patient was started on Rocephin. During the hospitalization she was treated with D5W which helped improved hypernatremia, sodium level improved, required oxygen intermittently during nighttime, received dexamethasone for couple of days, mental status improved back to baseline, evaluated by PT and OT initially recommended skilled nursing facility but later changed recommendation to home care, recommended continuing home dose of Coumadin, and INR checked with PCP in 1 week. Care Management arranged for home physical therapy and nursing, discharge home today in stable condition, instruction discussed in detail with patient's DPOA son over the phone he verbalized understanding.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Angiogram normal, Blood test normal, Diplopia, Ophthalmological examination
Clinical narrative: Awoke with double vision
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: ?Pfizer lot #FJ6369 with temp excursion. Reported to Pfizer company and ok?d for use. Instructed by their staff to report each dose given in this system.?
Age: 33.0
Sex: F
Vaccine: FLUC4
Symptoms: Dizziness, Nausea
Clinical narrative: An hour after the vaccine I started to develop dizziness and lightheadedness and mild nausea while walking. After laying down i still had the symptoms. Ate a bowl of cereal and took a 2 hr nap. Symptoms we still persistent after waking. I spoke with a tele doc from my insurance were she recommended I go to the ER if symptoms got worse or I develop new ones. After a night sleep, slight nausea is still present but no more dizziness.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood creatinine increased, Blood potassium increased, COVID-19, Nausea, Renal impairment
Clinical narrative: Covid19 breakthrough.  1st vaccine received on 03/01/2021.  78y/o PMH HTN, DM, CKD stage 4, IVC Filter and bowel resection with colostomy presents to ED by EMS from NH for abnormal renal fx/lab values.  Upon arrival, noted liquid black stool in colostomy and pt with c/o N/V.  Elevated creatnine and potassium treated and pt on IV ABX.
Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Vaccine breakthrough infection, Vomiting
Clinical narrative: Covid19 breakthrough.  1st vaccine received on 03/01/2021.  78y/o PMH HTN, DM, CKD stage 4, IVC Filter and bowel resection with colostomy presents to ED by EMS from NH for abnormal renal fx/lab values.  Upon arrival, noted liquid black stool in colostomy and pt with c/o N/V.  Elevated creatnine and potassium treated and pt on IV ABX.
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: ?Pfizer lot #FJ6369 with temp excursion. Reported to Pfizer company and ok?d for use. Instructed by their staff to report each dose given in this system.?
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Haematemesis, Haematochezia
Clinical narrative: Hospitalized abdominal pain and hematemesis and hematochezia new O2 requirement
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Rash, Urticaria
Clinical narrative: Rash on right arm, rash/urticaria under Dexcom, rash on right side of face.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Abdominal pain, Acute respiratory failure, Adrenal mass, Anticoagulant therapy, Biliary dilatation
Clinical narrative: Hospitalized 1/7/2022; COVID-19 positive 1/7/2022; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 1/7/2022 Discharge Date: Jan 15, 2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Necrotizing pancreatitis [K85.91] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 62 y.o. male with PMHx including type II diabetes, hypertension, hypertriglyceridemia, obesity, and alcohol use disorder who was admitted for management of necrotizing pancreatitis. He presented to the ED on 1/8/22 with abdominal pain. He was incidentally found to be COVID positive on admission with minor opacities on CXR without hypoxia. CT-abdomen demonstrated pancreatitis, partial splenic vein thrombosis, and a left adrenal gland nodule. RUQ ultrasound showed gallstones and a mildly dilated common bile duct. However, an MRCP done several days later did not demonstrate a stone in the common bile duct. Additionally, patient admits to having 3 beers/day for 15 years. Pancreatitis likely due from gallstones vs alcohol use. Due to COVID positivity, surgery recommended to follow up with general surgery team for possible elective cholecystectomy. GI was consulted and patient was started on aggressive IV fluids and made NPO. Therapeutic Lovenox was given for his splenic vein thrombosis.    While being fluid resuscitated, he developed pulmonary edema leading to an acute hypoxic respiratory failure and IV fluids were stopped. He was then hypoxic requiring 6L NC. Lasix was give for fluid overload and decadron was started for COVID, first dose 1/10. He was able to be weaned off oxygen to room air.   There was some concern that he had blood in his urine, but UA found no RBCs. His diet was advanced and his oxygen was weaned as tolerated. Lovenox transitioned to DOAC therapy, but patient cannot cover cost of 3 months of DOAC therapy, and as discussed with patient would have inadequate follow up on coumadin with INR checks in coumadin clinic or with follow up with PCP weekly. Patient was given one month prescription for eliquis at time of DC for noted splenic vein thrombosis, and was given a coupon to cover one month of cost. Patient will need repeat CT to reevaluate splenic vein thrombosis and adrenal adenoma. In the outpatient setting. On day of discharge patient was tolerating a low fat diet, he had ate chicken, rice, and green beans. He stated his pain was a 2/10. He denied any nausea, vomiting, chills, fever, SOB. He was hemodynamically stable at time of discharge He was given Decadron prescription at discharge to complete a 10 day course.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Chest X-ray abnormal, Cholelithiasis, Computerised tomogram abdomen abnormal, Hypervolaemia
Clinical narrative: Hospitalized 1/7/2022; COVID-19 positive 1/7/2022; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 1/7/2022 Discharge Date: Jan 15, 2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Necrotizing pancreatitis [K85.91] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 62 y.o. male with PMHx including type II diabetes, hypertension, hypertriglyceridemia, obesity, and alcohol use disorder who was admitted for management of necrotizing pancreatitis. He presented to the ED on 1/8/22 with abdominal pain. He was incidentally found to be COVID positive on admission with minor opacities on CXR without hypoxia. CT-abdomen demonstrated pancreatitis, partial splenic vein thrombosis, and a left adrenal gland nodule. RUQ ultrasound showed gallstones and a mildly dilated common bile duct. However, an MRCP done several days later did not demonstrate a stone in the common bile duct. Additionally, patient admits to having 3 beers/day for 15 years. Pancreatitis likely due from gallstones vs alcohol use. Due to COVID positivity, surgery recommended to follow up with general surgery team for possible elective cholecystectomy. GI was consulted and patient was started on aggressive IV fluids and made NPO. Therapeutic Lovenox was given for his splenic vein thrombosis.    While being fluid resuscitated, he developed pulmonary edema leading to an acute hypoxic respiratory failure and IV fluids were stopped. He was then hypoxic requiring 6L NC. Lasix was give for fluid overload and decadron was started for COVID, first dose 1/10. He was able to be weaned off oxygen to room air.   There was some concern that he had blood in his urine, but UA found no RBCs. His diet was advanced and his oxygen was weaned as tolerated. Lovenox transitioned to DOAC therapy, but patient cannot cover cost of 3 months of DOAC therapy, and as discussed with patient would have inadequate follow up on coumadin with INR checks in coumadin clinic or with follow up with PCP weekly. Patient was given one month prescription for eliquis at time of DC for noted splenic vein thrombosis, and was given a coupon to cover one month of cost. Patient will need repeat CT to reevaluate splenic vein thrombosis and adrenal adenoma. In the outpatient setting. On day of discharge patient was tolerating a low fat diet, he had ate chicken, rice, and green beans. He stated his pain was a 2/10. He denied any nausea, vomiting, chills, fever, SOB. He was hemodynamically stable at time of discharge He was given Decadron prescription at discharge to complete a 10 day course.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lung opacity, Magnetic resonance cholangiopancreatography, Pancreatitis, Pulmonary oedema, SARS-CoV-2 test positive
Clinical narrative: Hospitalized 1/7/2022; COVID-19 positive 1/7/2022; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 1/7/2022 Discharge Date: Jan 15, 2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Necrotizing pancreatitis [K85.91] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 62 y.o. male with PMHx including type II diabetes, hypertension, hypertriglyceridemia, obesity, and alcohol use disorder who was admitted for management of necrotizing pancreatitis. He presented to the ED on 1/8/22 with abdominal pain. He was incidentally found to be COVID positive on admission with minor opacities on CXR without hypoxia. CT-abdomen demonstrated pancreatitis, partial splenic vein thrombosis, and a left adrenal gland nodule. RUQ ultrasound showed gallstones and a mildly dilated common bile duct. However, an MRCP done several days later did not demonstrate a stone in the common bile duct. Additionally, patient admits to having 3 beers/day for 15 years. Pancreatitis likely due from gallstones vs alcohol use. Due to COVID positivity, surgery recommended to follow up with general surgery team for possible elective cholecystectomy. GI was consulted and patient was started on aggressive IV fluids and made NPO. Therapeutic Lovenox was given for his splenic vein thrombosis.    While being fluid resuscitated, he developed pulmonary edema leading to an acute hypoxic respiratory failure and IV fluids were stopped. He was then hypoxic requiring 6L NC. Lasix was give for fluid overload and decadron was started for COVID, first dose 1/10. He was able to be weaned off oxygen to room air.   There was some concern that he had blood in his urine, but UA found no RBCs. His diet was advanced and his oxygen was weaned as tolerated. Lovenox transitioned to DOAC therapy, but patient cannot cover cost of 3 months of DOAC therapy, and as discussed with patient would have inadequate follow up on coumadin with INR checks in coumadin clinic or with follow up with PCP weekly. Patient was given one month prescription for eliquis at time of DC for noted splenic vein thrombosis, and was given a coupon to cover one month of cost. Patient will need repeat CT to reevaluate splenic vein thrombosis and adrenal adenoma. In the outpatient setting. On day of discharge patient was tolerating a low fat diet, he had ate chicken, rice, and green beans. He stated his pain was a 2/10. He denied any nausea, vomiting, chills, fever, SOB. He was hemodynamically stable at time of discharge He was given Decadron prescription at discharge to complete a 10 day course.
Age: 62.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Splenic vein thrombosis, Ultrasound abdomen abnormal, Urine analysis normal
Clinical narrative: Hospitalized 1/7/2022; COVID-19 positive 1/7/2022; fully vaccinated  BRIEF OVERVIEW: Discharge Provider: MD Primary Care Provider: MD Admission Date: 1/7/2022 Discharge Date: Jan 15, 2022 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Necrotizing pancreatitis [K85.91] COVID-19 [U07.1]   HOSPITAL COURSE: The patient is a 62 y.o. male with PMHx including type II diabetes, hypertension, hypertriglyceridemia, obesity, and alcohol use disorder who was admitted for management of necrotizing pancreatitis. He presented to the ED on 1/8/22 with abdominal pain. He was incidentally found to be COVID positive on admission with minor opacities on CXR without hypoxia. CT-abdomen demonstrated pancreatitis, partial splenic vein thrombosis, and a left adrenal gland nodule. RUQ ultrasound showed gallstones and a mildly dilated common bile duct. However, an MRCP done several days later did not demonstrate a stone in the common bile duct. Additionally, patient admits to having 3 beers/day for 15 years. Pancreatitis likely due from gallstones vs alcohol use. Due to COVID positivity, surgery recommended to follow up with general surgery team for possible elective cholecystectomy. GI was consulted and patient was started on aggressive IV fluids and made NPO. Therapeutic Lovenox was given for his splenic vein thrombosis.    While being fluid resuscitated, he developed pulmonary edema leading to an acute hypoxic respiratory failure and IV fluids were stopped. He was then hypoxic requiring 6L NC. Lasix was give for fluid overload and decadron was started for COVID, first dose 1/10. He was able to be weaned off oxygen to room air.   There was some concern that he had blood in his urine, but UA found no RBCs. His diet was advanced and his oxygen was weaned as tolerated. Lovenox transitioned to DOAC therapy, but patient cannot cover cost of 3 months of DOAC therapy, and as discussed with patient would have inadequate follow up on coumadin with INR checks in coumadin clinic or with follow up with PCP weekly. Patient was given one month prescription for eliquis at time of DC for noted splenic vein thrombosis, and was given a coupon to cover one month of cost. Patient will need repeat CT to reevaluate splenic vein thrombosis and adrenal adenoma. In the outpatient setting. On day of discharge patient was tolerating a low fat diet, he had ate chicken, rice, and green beans. He stated his pain was a 2/10. He denied any nausea, vomiting, chills, fever, SOB. He was hemodynamically stable at time of discharge He was given Decadron prescription at discharge to complete a 10 day course.
Age: 56.0
Sex: M
Vaccine: COVID19
Symptoms: C-reactive protein, Fibrin D dimer, International normalised ratio, Prothrombin level, Thrombosis
Clinical narrative: Blood clots in toes on both feet (big toe then second and third).
Age: 30.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administered after deadline for use.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, COVID-19, Chest X-ray, Computerised tomogram, Full blood count
Clinical narrative: 54-year-old female who presents with nausea and vomiting since yesterday as well as a fever as high as 102° with generalized abdominal discomfort to palpation which is non-peritoneal. Vital signs reviewed on presentation to the ED and patient had a mild fever but no other significant findings were noted. Physical examination obese with mild diffuse abdominal tenderness. Otherwise she was on her home O2 requirement of 3 L saturating well with no other significant abnormalities. In light of patient's symptoms full cardiac workup was obtained including CBC, BMP, troponins, urinalysis, hepatic profile and chest x-ray. Patient was also ordered a CT of her abdomen and pelvis to rule out any intra-abdominal pathology. Patient was given Zofran and IV fluids which she tolerated well. Laboratory results show an unremarkable CBC and BMP, hepatic profile showed no acute findings urinalysis. Chest x-ray showed some mild atelectasis and her CT of her abdomen and pelvis was noncontributory. She was noted to be positive for Covid. She is a vaccinated individual. I had an extensive discussion with the patient upon her findings. She did state she was no longer nauseous and will discharge her with a short course of Zofran for her to follow up with her primary doctor gastroenterologist after quarantine period. Patient verbalized understanding of her discussion agreed for close follow-up with her primary doctor after quarantine. We will give her pulse ox on discharge as well as; body infusion referral. Patient verbalized nursing discussion agreed for close follow-up verbalized understanding of return precautions.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Hepatic enzyme, Metabolic function test, Nausea, Pyrexia, SARS-CoV-2 test positive
Clinical narrative: 54-year-old female who presents with nausea and vomiting since yesterday as well as a fever as high as 102° with generalized abdominal discomfort to palpation which is non-peritoneal. Vital signs reviewed on presentation to the ED and patient had a mild fever but no other significant findings were noted. Physical examination obese with mild diffuse abdominal tenderness. Otherwise she was on her home O2 requirement of 3 L saturating well with no other significant abnormalities. In light of patient's symptoms full cardiac workup was obtained including CBC, BMP, troponins, urinalysis, hepatic profile and chest x-ray. Patient was also ordered a CT of her abdomen and pelvis to rule out any intra-abdominal pathology. Patient was given Zofran and IV fluids which she tolerated well. Laboratory results show an unremarkable CBC and BMP, hepatic profile showed no acute findings urinalysis. Chest x-ray showed some mild atelectasis and her CT of her abdomen and pelvis was noncontributory. She was noted to be positive for Covid. She is a vaccinated individual. I had an extensive discussion with the patient upon her findings. She did state she was no longer nauseous and will discharge her with a short course of Zofran for her to follow up with her primary doctor gastroenterologist after quarantine period. Patient verbalized understanding of her discussion agreed for close follow-up with her primary doctor after quarantine. We will give her pulse ox on discharge as well as; body infusion referral. Patient verbalized nursing discussion agreed for close follow-up verbalized understanding of return precautions.
Age: 63.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin, Urine analysis, Vomiting
Clinical narrative: 54-year-old female who presents with nausea and vomiting since yesterday as well as a fever as high as 102° with generalized abdominal discomfort to palpation which is non-peritoneal. Vital signs reviewed on presentation to the ED and patient had a mild fever but no other significant findings were noted. Physical examination obese with mild diffuse abdominal tenderness. Otherwise she was on her home O2 requirement of 3 L saturating well with no other significant abnormalities. In light of patient's symptoms full cardiac workup was obtained including CBC, BMP, troponins, urinalysis, hepatic profile and chest x-ray. Patient was also ordered a CT of her abdomen and pelvis to rule out any intra-abdominal pathology. Patient was given Zofran and IV fluids which she tolerated well. Laboratory results show an unremarkable CBC and BMP, hepatic profile showed no acute findings urinalysis. Chest x-ray showed some mild atelectasis and her CT of her abdomen and pelvis was noncontributory. She was noted to be positive for Covid. She is a vaccinated individual. I had an extensive discussion with the patient upon her findings. She did state she was no longer nauseous and will discharge her with a short course of Zofran for her to follow up with her primary doctor gastroenterologist after quarantine period. Patient verbalized understanding of her discussion agreed for close follow-up with her primary doctor after quarantine. We will give her pulse ox on discharge as well as; body infusion referral. Patient verbalized nursing discussion agreed for close follow-up verbalized understanding of return precautions.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: ?Pfizer lot #FJ6369 with temp excursion. Reported to Pfizer company and ok?d for use. Instructed by their staff to report each dose given in this system.?
Age: 86.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Vaccine breakthrough infection
Clinical narrative: COVID BREAKTHROUGH CASE
Age: 65.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Fatigue, Headache
Clinical narrative: Headache, Fatigue . starting 1/13/22
Age: 28.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Headache, Pain, Pyrexia, Tremor
Clinical narrative: Fever 100.3, weakness, shakey, body aches, headache. After visiting with nurse went home to rest.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal distension, Abdominal pain upper, Blood test, Diarrhoea, Discomfort
Clinical narrative: About 7 months after receiving my vaccine, I had a case of severe diarrhea that lasted for about a month. I work in a hospital and they kept me home because GI symptoms are symptoms of COVID. I needed to be symptom free for 24 hours. I was able to get it under control with a very strict diet. After that, during August as well, I started to experience headaches, other GI issues, feeling full and uncomfortable, pain in my upper abdomen, fatigue and nausea which still exists today.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Gastric disorder, Gastric emptying study, Headache, Nausea
Clinical narrative: About 7 months after receiving my vaccine, I had a case of severe diarrhea that lasted for about a month. I work in a hospital and they kept me home because GI symptoms are symptoms of COVID. I needed to be symptom free for 24 hours. I was able to get it under control with a very strict diet. After that, during August as well, I started to experience headaches, other GI issues, feeling full and uncomfortable, pain in my upper abdomen, fatigue and nausea which still exists today.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Ultrasound abdomen
Clinical narrative: About 7 months after receiving my vaccine, I had a case of severe diarrhea that lasted for about a month. I work in a hospital and they kept me home because GI symptoms are symptoms of COVID. I needed to be symptom free for 24 hours. I was able to get it under control with a very strict diet. After that, during August as well, I started to experience headaches, other GI issues, feeling full and uncomfortable, pain in my upper abdomen, fatigue and nausea which still exists today.
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Confusional state, Dyspnoea, Fatigue, Hypoxia
Clinical narrative: Hospitalized with worsening fatigability, shortness of breath with hypoxia to 85%, increased confusion (covid + 1/8/2022)
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Hospitalized with worsening fatigability, shortness of breath with hypoxia to 85%, increased confusion (covid + 1/8/2022)
Age: 49.0
Sex: M
Vaccine: COVID19
Symptoms: Cardiac monitoring, Computerised tomogram, Flank pain, Laboratory test, Renal infarct
Clinical narrative: LEFT SIDE FLANK PAIN 10/10 KIDNEY INFARCT
Age: 38.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, FLU4
Symptoms: Sinusitis
Clinical narrative: Sinus infection
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Dyspnoea exertional, Pruritus, Rash, SARS-CoV-2 test positive
Clinical narrative: Patient arrives to be seen for tachycardia from the clinic.  Patient was actually there to get seen for hives that she gets occasionally with no known onset because.  Patient says that she gets these hives to go self-directed steroid pack and then go away.  When they were doing her vitals there they noticed that her heart rate was 150.  Patient has no known history of A. fib.  Patient arrives here and seen to be in A. fib on the monitor.  Patient denies chest pain or palpitations but notes that she has been more short of breath with activity recently.  Patient denies history of heart attack cardiac stent or CABG.  Associated Symptoms: itching, rash, shortness of breath
Age: 62.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Tachycardia, Urticaria
Clinical narrative: Patient arrives to be seen for tachycardia from the clinic.  Patient was actually there to get seen for hives that she gets occasionally with no known onset because.  Patient says that she gets these hives to go self-directed steroid pack and then go away.  When they were doing her vitals there they noticed that her heart rate was 150.  Patient has no known history of A. fib.  Patient arrives here and seen to be in A. fib on the monitor.  Patient denies chest pain or palpitations but notes that she has been more short of breath with activity recently.  Patient denies history of heart attack cardiac stent or CABG.  Associated Symptoms: itching, rash, shortness of breath
Age: 58.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Headache, Pyrexia
Clinical narrative: Chills, headache, feverish
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Blood magnesium normal, COVID-19, Chest X-ray normal, Chills, Cough
Clinical narrative: The patient is a 32 year old female with pmhx of HTN, HLD, DM-II who presents to the ED with fever, chills, dry cough, and body aches that started on 12/22/21. She came in today due to pleuritic chest pain, stating she has pain with deep inspiration. Her vitals on arrival are BP 143/90, temp 99.8, HR 96, SpO2 97%. Heart and lung exam is normal. The patient is alert and oriented, not in any acute distress. ECG is NSR. COVID test is positive. Tops neg. coags normal. CBC and CMP stable. Mag slightly low at 1.6. CXR shows NAP. The patient was given Ibuprofen with improvement in symptoms. The patient's well's criteria is 0. The patient was given supportive care instructions and recommend she do a follow up phone call with her PCP. She was given strict return precautions. She was given RX for pulmicort and Vit D. She was given pulse ox at discharge and order for MAB. The patient is stable for discharge home. She understands and agrees to the plan.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram normal, Full blood count normal, Metabolic function test, Pain, Pleuritic pain
Clinical narrative: The patient is a 32 year old female with pmhx of HTN, HLD, DM-II who presents to the ED with fever, chills, dry cough, and body aches that started on 12/22/21. She came in today due to pleuritic chest pain, stating she has pain with deep inspiration. Her vitals on arrival are BP 143/90, temp 99.8, HR 96, SpO2 97%. Heart and lung exam is normal. The patient is alert and oriented, not in any acute distress. ECG is NSR. COVID test is positive. Tops neg. coags normal. CBC and CMP stable. Mag slightly low at 1.6. CXR shows NAP. The patient was given Ibuprofen with improvement in symptoms. The patient's well's criteria is 0. The patient was given supportive care instructions and recommend she do a follow up phone call with her PCP. She was given strict return precautions. She was given RX for pulmicort and Vit D. She was given pulse ox at discharge and order for MAB. The patient is stable for discharge home. She understands and agrees to the plan.
Age: 31.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: The patient is a 32 year old female with pmhx of HTN, HLD, DM-II who presents to the ED with fever, chills, dry cough, and body aches that started on 12/22/21. She came in today due to pleuritic chest pain, stating she has pain with deep inspiration. Her vitals on arrival are BP 143/90, temp 99.8, HR 96, SpO2 97%. Heart and lung exam is normal. The patient is alert and oriented, not in any acute distress. ECG is NSR. COVID test is positive. Tops neg. coags normal. CBC and CMP stable. Mag slightly low at 1.6. CXR shows NAP. The patient was given Ibuprofen with improvement in symptoms. The patient's well's criteria is 0. The patient was given supportive care instructions and recommend she do a follow up phone call with her PCP. She was given strict return precautions. She was given RX for pulmicort and Vit D. She was given pulse ox at discharge and order for MAB. The patient is stable for discharge home. She understands and agrees to the plan.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Dyspnoea, Headache
Clinical narrative: Pt. states that after receiving the 3rd dose of Phizer 01/14/2022, started experiencing symptoms shortly after of shortness of breath and dizziness. Transported to local Emergency Room where symptoms subsided with Hydration. Discharged with no recommendations for Follow-Up. Pt. states symptoms continue daily in "spells" with pain in the Left temple causing headaches.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Administered dose after use date.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Back pain, Blindness unilateral, Chest pain, Chills
Clinical narrative: Acute Covid Symptoms.  Headache, eye pain, neck pain, back pain, chest pain, vertigo, nausea, energy loss, throat irritation, cough.  102 fever for 8 hours, with chills, sweats, and delusional visions.  Elevated temperature 99.8 for 48hours with continued cough, eye pain, chest pain.  Continued swollen lymph nodes under arms, confused/ cloudy cognitive function, chest pain, energy loss, light sensitivity and measurable vision loss in right eye.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Cognitive disorder, Confusional state, Cough, Delusion, Eye pain
Clinical narrative: Acute Covid Symptoms.  Headache, eye pain, neck pain, back pain, chest pain, vertigo, nausea, energy loss, throat irritation, cough.  102 fever for 8 hours, with chills, sweats, and delusional visions.  Elevated temperature 99.8 for 48hours with continued cough, eye pain, chest pain.  Continued swollen lymph nodes under arms, confused/ cloudy cognitive function, chest pain, energy loss, light sensitivity and measurable vision loss in right eye.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Headache, Hyperhidrosis, Lymphadenopathy, Malaise, Nausea
Clinical narrative: Acute Covid Symptoms.  Headache, eye pain, neck pain, back pain, chest pain, vertigo, nausea, energy loss, throat irritation, cough.  102 fever for 8 hours, with chills, sweats, and delusional visions.  Elevated temperature 99.8 for 48hours with continued cough, eye pain, chest pain.  Continued swollen lymph nodes under arms, confused/ cloudy cognitive function, chest pain, energy loss, light sensitivity and measurable vision loss in right eye.
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Neck pain, Photophobia, Pyrexia, Throat irritation, Vertigo
Clinical narrative: Acute Covid Symptoms.  Headache, eye pain, neck pain, back pain, chest pain, vertigo, nausea, energy loss, throat irritation, cough.  102 fever for 8 hours, with chills, sweats, and delusional visions.  Elevated temperature 99.8 for 48hours with continued cough, eye pain, chest pain.  Continued swollen lymph nodes under arms, confused/ cloudy cognitive function, chest pain, energy loss, light sensitivity and measurable vision loss in right eye.
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: ?Pfizer lot #FJ6369 with temp excursion. Reported to Pfizer company and ok?d for use. Instructed by their staff to report each dose given in this system.?
Age: 52.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Motor dysfunction, Tinnitus
Clinical narrative: 1st dose Ears started ringing  3 week after 1 shot.     3rd dose 12/15/21  3day after the 3 booster I lost all motor control and went to the hospital for a TIA but that was ruled out.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Osteonecrosis, Pyrexia, X-ray abnormal
Clinical narrative: 24 hour fever after booster which did not happen after my first two shots Pain in right knee  started 3 weeks after booster shot. Diagnosed with osteonecrosis of medial condyle left femur of unknow cause. Was not there one year prior on another radiograph