chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Blood bilirubin decreased, Blood calcium decreased, Blood chloride normal, Blood creatinine decreased, Blood glucose increased
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Blood potassium normal, Blood sodium decreased, Blood urea increased, Brain natriuretic peptide normal, Bronchospasm
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: C-reactive protein increased, COVID-19, Cardiovascular examination, Chills, Condition aggravated
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Creatinine renal clearance decreased, Culture positive, Device related infection, Differential white blood cell count abnormal, Dyspnoea
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea exertional, Eosinophil count normal, Eosinophil percentage increased, Fibrin D dimer increased, Full blood count abnormal
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Glomerular filtration rate, Haematocrit decreased, Haemoglobin decreased, Hypoxia, Immature granulocyte count increased
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Joint prosthesis user, Knee arthroplasty, Lung opacity, Lymphocyte count decreased, Lymphocyte percentage decreased
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Mean cell haemoglobin concentration decreased, Mean cell haemoglobin decreased, Mean cell volume decreased, Mean platelet volume normal, Metabolic function test
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Metabolic function test abnormal, Monocyte count increased, Monocyte percentage increased, Neutrophil count increased, Neutrophil percentage increased
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Platelet count increased, Procalcitonin normal, Productive cough, Protein total decreased, Red blood cell count decreased
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Red blood cell nucleated morphology, Red cell distribution width increased, SARS-CoV-2 test positive, Serratia infection, Staphylococcal sepsis
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cell count increased
Clinical narrative: Hospitalized (11.16.21 -discharged 11/20/21; COVID-19 positive (11.16.21); Fully vaccinated   HOSPITAL COURSE: Patient is a 69M  with a history of pulmonary fibrosis and right prosthetic knee infection with MSSA status post right total knee replacement in July.  He completed 6 weeks IV cefazolin then transition to cephalexin.  He had relapse infection with additional OR on October 20th.  Intraoperative cultures grew Serratia and patient currently is on cefepime through December 7th.  He follows with Dr. from pulmonary and currently is not on home oxygen or steroids due to underlying knee infection.     He presented to Emergency Department with 2 days of acute worsening in his shortness of breath.  Minimal exertion makes the symptoms worse.  He has productive cough with chills but no fever.  Patient has received full vaccinations for COVID-19 (J and J).  On arrival to emergency department he was found to be hypoxic with oxygen saturation 70% room air.  Supplemental oxygen was placed with improvement to mid 90s.  He did undergo CT angiogram thorax which was negative for pulmonary embolism but had new superimposed mosaic attenuation throughout both lung fields question developing pulmonary edema or infectious etiology.  His BNP was normal, COVID-19 was not detected, procalcitonin was normal.   He was given 20 mg IV Lasix and transferred to another facility for ongoing care.   Film array was ordered which eventually showed positive for COVID-19.  He was started on Decadron 6 mg daily with plan to complete a 10 day treatment course.  He also received Remdesivir for 5 days.  He was seen by infectious disease who recommended continuing cefepime through 12/07/2021.   Pulmonary medicine recommended to continue Symbicort inpatient and albuterol p.r.n..  He is scheduled for outpatient follow-up with the Pulmonary office on 12/28   He continues to remain stable and required 3 L of oxygen with rest and 4 L of O2 with ambulation.  He will be out of COVID isolation on 11/24/2021   He was discharged home in stable condition on 11/20/2020 CONSULTS / RECOMMENDATION:   Consult Orders (From admission, onward)    IP CONSULT TO INFECTIOUS DISEASES      Provider:  MD   IP CONSULT TO PULMONOLOGY      Provider:  MD
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered
Clinical narrative: Adult dose given to 10 year old
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Dyspnoea exertional, Fall, SARS-CoV-2 test positive
Clinical narrative: Patient admitted as observation on 11/5 due to pneumonia due to COVID-19 virus. Patient was tested for COVID-19 and was positive on 11/5.  Upgraded from Observation to Inpatient because he has a current diagnosis of COVID-19 pneumonia, which has not improved enough to allow for a medically safe discharge despite receiving appropriate treatment.  58-year-old male with known multiple sclerosis on ocrelizumab, OSA on CPAP presenting with increasing dyspnea on exertion and falls.  COVID positive 10/22/2021.  On admission no signs of secondary bacterial pneumonia or VTE.  Started on dexamethasone and remdesivir on admission.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal distension, Asthenia, Back pain, Computerised tomogram abdomen, Decreased appetite
Clinical narrative: Fever, dizziness, headaches, back pain, nausea, swelling of abdomen, extreme weakness, unable to eat whole foods (currently only eating yogurt and jello), constant UTI's and pancreatic issues, weight loss, rash, dehydration, unable to stand, random fainting, loss of consciousness, peeling of the skin(legs, feet, arms, hands).  Healthcare providers has not diagnosed patient.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Dehydration, Dizziness, Dysstasia, Full blood count, Headache
Clinical narrative: Fever, dizziness, headaches, back pain, nausea, swelling of abdomen, extreme weakness, unable to eat whole foods (currently only eating yogurt and jello), constant UTI's and pancreatic issues, weight loss, rash, dehydration, unable to stand, random fainting, loss of consciousness, peeling of the skin(legs, feet, arms, hands).  Healthcare providers has not diagnosed patient.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of consciousness, Nausea, Pancreatic disorder, Pyrexia, Rash
Clinical narrative: Fever, dizziness, headaches, back pain, nausea, swelling of abdomen, extreme weakness, unable to eat whole foods (currently only eating yogurt and jello), constant UTI's and pancreatic issues, weight loss, rash, dehydration, unable to stand, random fainting, loss of consciousness, peeling of the skin(legs, feet, arms, hands).  Healthcare providers has not diagnosed patient.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Skin exfoliation, Syncope, Ultrasound scan, Urinary tract infection, Weight decreased
Clinical narrative: Fever, dizziness, headaches, back pain, nausea, swelling of abdomen, extreme weakness, unable to eat whole foods (currently only eating yogurt and jello), constant UTI's and pancreatic issues, weight loss, rash, dehydration, unable to stand, random fainting, loss of consciousness, peeling of the skin(legs, feet, arms, hands).  Healthcare providers has not diagnosed patient.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Error: Improper storage (temperature).
Age: 25.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Hypoxia, Pneumonia, Pulmonary embolism, Tachycardia
Clinical narrative: tachycardia, hypoxia, shortness of breath, bilateral pneumonia,  left pulmonary embolism
Age: 0.08
Sex: F
Vaccine: DTAPIPVHIB
Symptoms: Product preparation issue
Clinical narrative: The Hib part was not mixed into the rest of combo immunization
Age: 46.0
Sex: M
Vaccine: COVID19
Symptoms: Product storage error
Clinical narrative: Moderna vial punctured at 12 pm 11/17/2021, and left overnight in the refrigerator. Staff member administered a dose from the punctured vial at around 10 am on 11/18/2021.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Headache, Lymph node pain, Lymphadenopathy, Myalgia
Clinical narrative: Symptoms: nausea, left arm pain, swollen and painful lymph nodes in left armpit, all over muscle pain, low grade fever, fatigue, headache; Treatment: acetaminophen, ibuprofen, cold packs, heating pad; Time course: worst symptoms started about 24 hours after injection and started to subside 48 hours after injection, most symptoms gone by 96 hours after injections, remaining symptoms are left arm pain (mostly gone), swollen and painful lymph nodes in left armpit (mostly gone), and nausea (mostly gone)
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pain in extremity, Pyrexia
Clinical narrative: Symptoms: nausea, left arm pain, swollen and painful lymph nodes in left armpit, all over muscle pain, low grade fever, fatigue, headache; Treatment: acetaminophen, ibuprofen, cold packs, heating pad; Time course: worst symptoms started about 24 hours after injection and started to subside 48 hours after injection, most symptoms gone by 96 hours after injections, remaining symptoms are left arm pain (mostly gone), swollen and painful lymph nodes in left armpit (mostly gone), and nausea (mostly gone)
Age: 39.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered
Clinical narrative: Vaccine administered beyond the best-used-date but before expiration date.
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus
Clinical narrative: Pt. had redness and itching beginning at the site and then moved down his arm about 4 inches below the site
Age: 67.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: I was diagnosed by PCR with Covid on 11/12/2021
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Abnormal behaviour, Akinesia, Anticoagulant therapy, Anxiety, Atrial fibrillation
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Bundle branch block left, Cardiac index decreased, Cardiac output, Catheterisation cardiac abnormal, Dyspnoea
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram QT interval, Electrocardiogram abnormal, Endotracheal intubation
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Hyperhidrosis, Hyporesponsive to stimuli, Hypotension, Left ventricular dilatation, Left ventricular dysfunction
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.
Age: 67.0
Sex: M
Vaccine: COVID19
Symptoms: Left ventricular hypertrophy, Mechanical ventilation, Nausea, Oxygen saturation decreased, Positive end-expiratory pressure
Clinical narrative: Pt appeared to have slight cough when presenting for vaccination. Patient was asked a series of questions before receiving Vaccine including the patient's current status and whether they are currently having any symptoms of Covid, Illness, or Infection. Patient denied any symptoms. Patient continued to have a slight but constant cough. Patient was given Pfizer Covid Vaccine First Dose 0.3mg. Within two minutes the patient began to show signs of anxious behavior. Patient suddenly said he "needs to walk" and got up from his chair. He walked down a small hallway with the LPN who administered the Vaccine following close behind. Patient was asked if he was SOB and he stated he was. Patient sat down in waiting room. Patient was asked to return to the Covid Vaccine Clinic for assessment. On his way back to the Clinic, the patient had to take many pauses to breath. Patient was asked if the SOB was sudden after receiving Vaccine and patient denied this and stated that he was feeling SOB prior to arriving. Upon return to the Covid Vaccine Clinic the patient had an SpO2 attached and patient's O2 was at 81% on room air.  Emergency Response Team was notified of situation. O2 was provided at 2L via cannula and patient SpO2 raised to 85%. Patient's PCP was notified and responded to the Covid Vaccine Clinic. Physician was informed of vitals and immediately had EMS called. 02 was increased to 4L and patient's levels raised to 89% but began to decline to 86%. Patient exhibited tachycardia and was diaphoretic. 02 was increased to 6L with patient declining to 84%. EMS arrived and took over control of care.   Upon arrival, he had complaints of nausea and vomited multiple times. He was placed on monitor and oxygen saturations were reading 53% and HR 120's with rhythm concerning for atrial fibiralltion. He became minimally responsive requiring BVM and was then emergently intubated for airway protection with etomidate, succinylcholine, 150 mcg of fentanyl and 3 mg of IV ativan. After intubation, he became profoundly hypotensive with SBP 50s and MAPs in the 30s. He was given 100 mcg of IVP phenylephrine and was initiated on Norepinephrine infusion to maintain MAPs > 65. His initial troponin-1 was 196 . He was started on a Heparin infusion and bedside ECHO with EF 35%.  Diagnosed with Stress-induced cardiomyopathy with  Takotsubo presentation.  Of note, since being diagnosed with COVID 19 in October 2020 he had worsening dyspnea with intermittent chest pain., but had not yet followed up with pulmonary and cardiology docs.