chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Hiccups, Hyperglycaemia, Hypoxia, Impaired work ability, Mitral valve incompetence
Clinical narrative: HOSPITAL COURSE: Briefly, this is a 48-year-old with insulin-dependent type 2 diabetes, asthma, coming in with concerns of gradually worsening URI symptoms and chest tightness 1 week preceding hospitalization. For more detail, including PMH, PSH, PFH, Social Hx and further info please see admission H&P.  Hospital course dictated by problem:   Acute hypoxic respiratory failure, resolved Suspect Covid pneumonia He was admitted and provided supplemental oxygen, steroids, Lovenox based on D-dimer and our institutional protocol for anticoagulation, I-S and Aerobika for pulmonary toilet.  With a procalcitonin of 0.14 on admission lower clinical concern for superimposed bacterial pneumonia.  For greater than 24 hours now he has been off oxygen.  He subjectively feels improved, his acute phase reactants are improving, his vitals are stable.  I feel appropriate for discharge.  Advised on isolatory precautions at home, given I-S and Aerobika to go home with for continued use of pulmonary toileting there, close primary care follow-up no later than 7 days from now.  He was given a work note.  Strict return precautions reviewed.   Suspect myocardial injury Troponin around 130 on arrival, down trended.  Echo without focal wall motion abnormality.  He was without symptoms of angina or anginal equivalents on the floor.  He works a physically demanding job, preceding illness he states he was not having any chest pain or pressure tightness or exertional symptoms.  Suspicion is that this was demand ischemia in the setting of hypoxia and/or myocarditis from Covid injury.  Advised on PCP follow-up for consideration of CAD work-up and stress testing.   Insulin-dependent type 2 diabetes Suspect corticosteroid induced hyperglycemia He was managed on his long-acting Lantus and high-dose sliding scale insulin while here.  He was running high at times which I suspect was the because steroids were on board.  Patient reports that his blood sugars are very well controlled with his home regime and so he was advised to continue doing so.  Per his report he is overdue for an A1c, advised he have this rechecked with his PCP when he follows up for posthospitalization visit.   Mild MR Incidental finding on echo, told to discuss with PCP regarding monitoring.   Mild anemia Hemoglobin 12.7 today without subjective findings of blood loss such as hematemesis, coffee-ground emesis, melena, hematochezia, etc.  Vitals are otherwise stable.  Advised to have this rechecked by primary care and consider further evaluation and management depending on findings.   Hiccups, resolved Suspect this was iatrogenic induced from dexamethasone.  He was given 1 dose of PPI, few doses of Reglan and baclofen with resolution.   Asthma without findings of acute exacerbation Advised to continue with his as needed albuterol.
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: Myocardial injury, Myocardial ischaemia, Myocarditis, Procalcitonin, Respiratory symptom
Clinical narrative: HOSPITAL COURSE: Briefly, this is a 48-year-old with insulin-dependent type 2 diabetes, asthma, coming in with concerns of gradually worsening URI symptoms and chest tightness 1 week preceding hospitalization. For more detail, including PMH, PSH, PFH, Social Hx and further info please see admission H&P.  Hospital course dictated by problem:   Acute hypoxic respiratory failure, resolved Suspect Covid pneumonia He was admitted and provided supplemental oxygen, steroids, Lovenox based on D-dimer and our institutional protocol for anticoagulation, I-S and Aerobika for pulmonary toilet.  With a procalcitonin of 0.14 on admission lower clinical concern for superimposed bacterial pneumonia.  For greater than 24 hours now he has been off oxygen.  He subjectively feels improved, his acute phase reactants are improving, his vitals are stable.  I feel appropriate for discharge.  Advised on isolatory precautions at home, given I-S and Aerobika to go home with for continued use of pulmonary toileting there, close primary care follow-up no later than 7 days from now.  He was given a work note.  Strict return precautions reviewed.   Suspect myocardial injury Troponin around 130 on arrival, down trended.  Echo without focal wall motion abnormality.  He was without symptoms of angina or anginal equivalents on the floor.  He works a physically demanding job, preceding illness he states he was not having any chest pain or pressure tightness or exertional symptoms.  Suspicion is that this was demand ischemia in the setting of hypoxia and/or myocarditis from Covid injury.  Advised on PCP follow-up for consideration of CAD work-up and stress testing.   Insulin-dependent type 2 diabetes Suspect corticosteroid induced hyperglycemia He was managed on his long-acting Lantus and high-dose sliding scale insulin while here.  He was running high at times which I suspect was the because steroids were on board.  Patient reports that his blood sugars are very well controlled with his home regime and so he was advised to continue doing so.  Per his report he is overdue for an A1c, advised he have this rechecked with his PCP when he follows up for posthospitalization visit.   Mild MR Incidental finding on echo, told to discuss with PCP regarding monitoring.   Mild anemia Hemoglobin 12.7 today without subjective findings of blood loss such as hematemesis, coffee-ground emesis, melena, hematochezia, etc.  Vitals are otherwise stable.  Advised to have this rechecked by primary care and consider further evaluation and management depending on findings.   Hiccups, resolved Suspect this was iatrogenic induced from dexamethasone.  He was given 1 dose of PPI, few doses of Reglan and baclofen with resolution.   Asthma without findings of acute exacerbation Advised to continue with his as needed albuterol.
Age: 47.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Troponin increased
Clinical narrative: HOSPITAL COURSE: Briefly, this is a 48-year-old with insulin-dependent type 2 diabetes, asthma, coming in with concerns of gradually worsening URI symptoms and chest tightness 1 week preceding hospitalization. For more detail, including PMH, PSH, PFH, Social Hx and further info please see admission H&P.  Hospital course dictated by problem:   Acute hypoxic respiratory failure, resolved Suspect Covid pneumonia He was admitted and provided supplemental oxygen, steroids, Lovenox based on D-dimer and our institutional protocol for anticoagulation, I-S and Aerobika for pulmonary toilet.  With a procalcitonin of 0.14 on admission lower clinical concern for superimposed bacterial pneumonia.  For greater than 24 hours now he has been off oxygen.  He subjectively feels improved, his acute phase reactants are improving, his vitals are stable.  I feel appropriate for discharge.  Advised on isolatory precautions at home, given I-S and Aerobika to go home with for continued use of pulmonary toileting there, close primary care follow-up no later than 7 days from now.  He was given a work note.  Strict return precautions reviewed.   Suspect myocardial injury Troponin around 130 on arrival, down trended.  Echo without focal wall motion abnormality.  He was without symptoms of angina or anginal equivalents on the floor.  He works a physically demanding job, preceding illness he states he was not having any chest pain or pressure tightness or exertional symptoms.  Suspicion is that this was demand ischemia in the setting of hypoxia and/or myocarditis from Covid injury.  Advised on PCP follow-up for consideration of CAD work-up and stress testing.   Insulin-dependent type 2 diabetes Suspect corticosteroid induced hyperglycemia He was managed on his long-acting Lantus and high-dose sliding scale insulin while here.  He was running high at times which I suspect was the because steroids were on board.  Patient reports that his blood sugars are very well controlled with his home regime and so he was advised to continue doing so.  Per his report he is overdue for an A1c, advised he have this rechecked with his PCP when he follows up for posthospitalization visit.   Mild MR Incidental finding on echo, told to discuss with PCP regarding monitoring.   Mild anemia Hemoglobin 12.7 today without subjective findings of blood loss such as hematemesis, coffee-ground emesis, melena, hematochezia, etc.  Vitals are otherwise stable.  Advised to have this rechecked by primary care and consider further evaluation and management depending on findings.   Hiccups, resolved Suspect this was iatrogenic induced from dexamethasone.  He was given 1 dose of PPI, few doses of Reglan and baclofen with resolution.   Asthma without findings of acute exacerbation Advised to continue with his as needed albuterol.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac discomfort, Cardiac monitoring, Chills, Condition aggravated, Depressed mood
Clinical narrative: I experienced extreme arm pain the night of the vaccine. When I woke up the next morning, my arm was extremely painful at the injection site (more than any other vaccine I have had). I had a 2 inch ring of swelling around the injection site and it was very red. My heart felt heavy like it was being crushed or wrapped in a weighted blanket, and I started developing heart palpitations. By about 2pm that day, I was bedridden with fever, chills and my heart felt like it was having a hard time beating. By that evening, I couldn't get out of bed, and I was considering going to the ER. Also, I felt "lightning zaps" throughout my body, especially in my legs, which I had not experienced before. The next day, I felt 50% better but still experienced the electrical zaps (especially in my legs), mild compression of my heart and mild fever. The 3rd day I was able to move around, fever was mostly improved and I just felt general malaise. The lightning strikes lasted for about 2 weeks (more so in the front of my legs). I went to my cardiologist 10-14 days later. They did an EKG  and halter monitor for 24 hours. They did an echocardiogram and saw some mild fluid around the heart. They said pace yourself as you return to normal, and after about 2 weeks I went back to exercise; however, I was still unable to do my normal level of exercise due to fatigue/irritability. About 6-8 weeks after the shot, I felt mostly normal and able to do my normal routines. During this entire episode, I felt a little "blue".
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Electric shock sensation, Electrocardiogram abnormal, Exercise tolerance decreased, Fatigue
Clinical narrative: I experienced extreme arm pain the night of the vaccine. When I woke up the next morning, my arm was extremely painful at the injection site (more than any other vaccine I have had). I had a 2 inch ring of swelling around the injection site and it was very red. My heart felt heavy like it was being crushed or wrapped in a weighted blanket, and I started developing heart palpitations. By about 2pm that day, I was bedridden with fever, chills and my heart felt like it was having a hard time beating. By that evening, I couldn't get out of bed, and I was considering going to the ER. Also, I felt "lightning zaps" throughout my body, especially in my legs, which I had not experienced before. The next day, I felt 50% better but still experienced the electrical zaps (especially in my legs), mild compression of my heart and mild fever. The 3rd day I was able to move around, fever was mostly improved and I just felt general malaise. The lightning strikes lasted for about 2 weeks (more so in the front of my legs). I went to my cardiologist 10-14 days later. They did an EKG  and halter monitor for 24 hours. They did an echocardiogram and saw some mild fluid around the heart. They said pace yourself as you return to normal, and after about 2 weeks I went back to exercise; however, I was still unable to do my normal level of exercise due to fatigue/irritability. About 6-8 weeks after the shot, I felt mostly normal and able to do my normal routines. During this entire episode, I felt a little "blue".
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate decreased, Injection site erythema, Injection site pain, Injection site swelling, Irritability
Clinical narrative: I experienced extreme arm pain the night of the vaccine. When I woke up the next morning, my arm was extremely painful at the injection site (more than any other vaccine I have had). I had a 2 inch ring of swelling around the injection site and it was very red. My heart felt heavy like it was being crushed or wrapped in a weighted blanket, and I started developing heart palpitations. By about 2pm that day, I was bedridden with fever, chills and my heart felt like it was having a hard time beating. By that evening, I couldn't get out of bed, and I was considering going to the ER. Also, I felt "lightning zaps" throughout my body, especially in my legs, which I had not experienced before. The next day, I felt 50% better but still experienced the electrical zaps (especially in my legs), mild compression of my heart and mild fever. The 3rd day I was able to move around, fever was mostly improved and I just felt general malaise. The lightning strikes lasted for about 2 weeks (more so in the front of my legs). I went to my cardiologist 10-14 days later. They did an EKG  and halter monitor for 24 hours. They did an echocardiogram and saw some mild fluid around the heart. They said pace yourself as you return to normal, and after about 2 weeks I went back to exercise; however, I was still unable to do my normal level of exercise due to fatigue/irritability. About 6-8 weeks after the shot, I felt mostly normal and able to do my normal routines. During this entire episode, I felt a little "blue".
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Malaise, Mobility decreased, Pain in extremity, Palpitations, Pericardial effusion
Clinical narrative: I experienced extreme arm pain the night of the vaccine. When I woke up the next morning, my arm was extremely painful at the injection site (more than any other vaccine I have had). I had a 2 inch ring of swelling around the injection site and it was very red. My heart felt heavy like it was being crushed or wrapped in a weighted blanket, and I started developing heart palpitations. By about 2pm that day, I was bedridden with fever, chills and my heart felt like it was having a hard time beating. By that evening, I couldn't get out of bed, and I was considering going to the ER. Also, I felt "lightning zaps" throughout my body, especially in my legs, which I had not experienced before. The next day, I felt 50% better but still experienced the electrical zaps (especially in my legs), mild compression of my heart and mild fever. The 3rd day I was able to move around, fever was mostly improved and I just felt general malaise. The lightning strikes lasted for about 2 weeks (more so in the front of my legs). I went to my cardiologist 10-14 days later. They did an EKG  and halter monitor for 24 hours. They did an echocardiogram and saw some mild fluid around the heart. They said pace yourself as you return to normal, and after about 2 weeks I went back to exercise; however, I was still unable to do my normal level of exercise due to fatigue/irritability. About 6-8 weeks after the shot, I felt mostly normal and able to do my normal routines. During this entire episode, I felt a little "blue".
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia
Clinical narrative: I experienced extreme arm pain the night of the vaccine. When I woke up the next morning, my arm was extremely painful at the injection site (more than any other vaccine I have had). I had a 2 inch ring of swelling around the injection site and it was very red. My heart felt heavy like it was being crushed or wrapped in a weighted blanket, and I started developing heart palpitations. By about 2pm that day, I was bedridden with fever, chills and my heart felt like it was having a hard time beating. By that evening, I couldn't get out of bed, and I was considering going to the ER. Also, I felt "lightning zaps" throughout my body, especially in my legs, which I had not experienced before. The next day, I felt 50% better but still experienced the electrical zaps (especially in my legs), mild compression of my heart and mild fever. The 3rd day I was able to move around, fever was mostly improved and I just felt general malaise. The lightning strikes lasted for about 2 weeks (more so in the front of my legs). I went to my cardiologist 10-14 days later. They did an EKG  and halter monitor for 24 hours. They did an echocardiogram and saw some mild fluid around the heart. They said pace yourself as you return to normal, and after about 2 weeks I went back to exercise; however, I was still unable to do my normal level of exercise due to fatigue/irritability. About 6-8 weeks after the shot, I felt mostly normal and able to do my normal routines. During this entire episode, I felt a little "blue".
Age: 32.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Alopecia, Amenorrhoea, Blood oestrogen decreased, Menstrual disorder, Vitamin D
Clinical narrative: Absent or irregularities in menstraul cycle   Hair loss
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Adult failure to thrive, Asthenia
Clinical narrative: Adult failure to thrive, weakness. ED visit to hospital admission. This visit was within 6 weeks of receiving the COVID vaccine.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Body temperature increased, Chills, Dizziness, Migraine, Muscle spasms
Clinical narrative: Chills, body soreness, Leg cramps, Temperature exceeding 101.7, migraines, and dizzyness. Excessive temperature lasted two days. Chills lasted three hours, Soreness lasted 3 days.
Age: 64.0
Sex: M
Vaccine: COVID19
Symptoms: Pain
Clinical narrative: Chills, body soreness, Leg cramps, Temperature exceeding 101.7, migraines, and dizzyness. Excessive temperature lasted two days. Chills lasted three hours, Soreness lasted 3 days.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Illness
Clinical narrative: covid-19 illness
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Bell's palsy, Facial nerve disorder, SARS-CoV-2 antibody test
Clinical narrative: Bell's Palsey left facial nerve, dense.  Treated with high dose oral steroids for 10 days.  Clinical diagnosis.  Resolving.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Flushing, Headache, Lymph node pain, Nausea
Clinical narrative: Headache, extreme body aches, nausea, chills, facial flushing, hives, and lymph node pain.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Urticaria
Clinical narrative: Headache, extreme body aches, nausea, chills, facial flushing, hives, and lymph node pain.
Age: 17.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: Pfizer vaccine expired 50 minutes prior to administration, NO adv rx for patient
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Inflammation, Multisystem inflammatory syndrome, Ultrasound scan, X-ray
Clinical narrative: Multisystem Inflammatory Syndrome - Persistent inflammation of the left foot and ankle.
Age: 50.0
Sex: M
Vaccine: COVID19
Symptoms: Adverse event
Clinical narrative: ER visit; patient left after triage. This visit was within 6 weeks of receiving the COVID vaccine.
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cough, Dyspnoea, Wheezing
Clinical narrative: Pt has increased cough and wheezing and called EMS due to worsening shortness of breath.  Pt does have COPD and diabetes.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Acute respiratory failure, Ascites, Asthenia, Bacteraemia
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Bacterial test positive, Blood albumin decreased, Blood bicarbonate normal, Blood calcium decreased, Blood electrolytes normal
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Blood lactic acid normal, Blood magnesium normal, Blood pH, Blood pressure normal, COVID-19
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chemotherapy, Chest X-ray, Confusional state, Constipation
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Death, Deep vein thrombosis, Diarrhoea, Dysstasia
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Dysuria, Haemoglobin normal, Hepatic lesion, Hypoxia, Laboratory test
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Metastases to adrenals, PCO2 normal, PO2 decreased, Platelet count decreased, Pulmonary embolism
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive, Sepsis, Tachycardia, Tachypnoea
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Urinary tract infection, Urine analysis, Walking aid user, White blood cells urine positive
Clinical narrative: HPI Patient is a 72 y.o. female with a history of metastatic bladder cancer with currently in chemotherapy who presents to the ED via EMS for evaluation of abdominal pain. She stated that she had a round of chemo yesterday. She started to have abdominal pain which has continued and worsened.  Reports that she had abdominal pain for a long time but it seems to have been worse over the past couple days when they had thought that it was due to her being constipated. Patient also has been very weak and unable to stand on her own. At baseline she is able to get around with a walker. EMS was called and gave her 1.5 mg of IV dilaudid and 250 ml of saline while en route.   She describes it as diffuse abdominal pain but mostly in the lower part.  She also admits to dysuria but not frequency.  She also gave history to cough and constipation that turned into loose stools after she received enema today.  Per her grandson, she has been a bit more confused over the past week.  Denies sick contacts and COVID exposure.   In ED, febrile with T 102.6, hypoxic in mid 80s,  tachycardic and slightly tachypneic.  Saturation 96%.  Blood pressure within normal.  Labs revealed no leukocytosis, normal lactate hemoglobin 8.2, platelet 103, magnesium 1.3, calcium 7.6 otherwise electrolytes unremarkable, albumin 2.0.  VBG with pH of 7.4, PCO2 of 35, HCO3 of 22, PO2 34.  UA reveals no esterase, presence of bacteria, WBCs.  CXR no acute disease but CAP revealed bilateral pulmonary emboli and extensive bilateral common femoral and profunda femoris DVT extending into the superficial femoral veins bilaterally, adrenal metastasis that has progressed, perihepatic ascites, subtle lesions in the liver (cannot exclude metastasis).    HOSPITAL COURSE:   72 y.o., female, w a PMH of Bladder Ca with metastatic disease on chemo, who was admitted on 1/21/2022, with generalized weakness found to have bilateral pulmonary embolic, extensive bilateral DVT, COVID pneumonia with acute hypoxic respiratory failure and Sepsis, GPC bacteremia/UTI. After discussion with family/ patient, palliative care, heme/onc and hospital medicine decision was made to focus on comfort, patient died on 1/27.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Back pain, Chest discomfort, Condition aggravated, Fatigue
Clinical narrative: Heaviness in my chest, racing heart, back and shoulder pain, fatigue, and nausea.
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Palpitations
Clinical narrative: Heaviness in my chest, racing heart, back and shoulder pain, fatigue, and nausea.
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Epiploic appendagitis, Fatigue, Headache, Hyperhidrosis
Clinical narrative: Nausea, vomiting. fever, fatigue, body aches, swollen lymph nodes, dizziness, headaches, redness below injection site and sweating
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Lymphadenopathy, Nausea, Pain, Pyrexia
Clinical narrative: Nausea, vomiting. fever, fatigue, body aches, swollen lymph nodes, dizziness, headaches, redness below injection site and sweating
Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Vomiting
Clinical narrative: Nausea, vomiting. fever, fatigue, body aches, swollen lymph nodes, dizziness, headaches, redness below injection site and sweating
Age: 15.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against and then tested positive for COVID19
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Diarrhoea, Dyspnoea, Fatigue, SARS-CoV-2 test positive
Clinical narrative: Received an email from RN infection prevention with limited information stating "here is a hospitalized break through case"  agency form attached with symptoms checked:  Diarrhea, Fatigue, SOB.  No underlying medical conditions or systemic immunosuppressive therapy or medications was selected.  Report checked "yes" that patient was hospitalized for >1 night and that it was related to SARS- COV-2 infection.  Nothing is selected for admitted to ICU or if mechanical ventilation was required.  We also were not given info on how long the patient was hospitalized for.
Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Vaccine breakthrough infection
Clinical narrative: Received an email from RN infection prevention with limited information stating "here is a hospitalized break through case"  agency form attached with symptoms checked:  Diarrhea, Fatigue, SOB.  No underlying medical conditions or systemic immunosuppressive therapy or medications was selected.  Report checked "yes" that patient was hospitalized for >1 night and that it was related to SARS- COV-2 infection.  Nothing is selected for admitted to ICU or if mechanical ventilation was required.  We also were not given info on how long the patient was hospitalized for.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Asthenia, Asymptomatic COVID-19, Lethargy, Loss of personal independence in daily activities, Mental status changes
Clinical narrative: Hospitalized 01/23/2022; COVID-19 positive 01/23/2022; fully vaccinated plus booster  Discharge Provider:  Primary Care Provider:   Admission Date: 1/23/2022 Admitting Diagnoses: COVID PRESENTING PROBLEM: COVID   HOSPITAL COURSE: The patient is a 65 year old male with past medical history significant for dementia with behavioral disturbance. He presented to the ED for AMS and generalized weakness. And additionally found to be COVID positive although otherwise asymptomatic. The patient remained on room air during his hospitalization and did not require further medications in regards to COVID infection. The patient is now past the five days of isolation required by the CDC with his positive test 1/23. They patient should have a mask for the remainder of the follow five days. The patient has residual generalized weakness and was evaluated by PT/OT who recommended return with increased assistance and wheelchair.     The patient required haldol in ED and then was lethargic following administration. After talking with sister it was determined that is a typical reaction after receiving that medication. The patient became more interactive once the medication worse off and no longer required a posey bed as of 1/26. The patients home aricept, zyprexa, depakote and zoloft were continued at discharge. The patient was hemodynamically stable at time of discharge.
Age: 65.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Wheelchair user
Clinical narrative: Hospitalized 01/23/2022; COVID-19 positive 01/23/2022; fully vaccinated plus booster  Discharge Provider:  Primary Care Provider:   Admission Date: 1/23/2022 Admitting Diagnoses: COVID PRESENTING PROBLEM: COVID   HOSPITAL COURSE: The patient is a 65 year old male with past medical history significant for dementia with behavioral disturbance. He presented to the ED for AMS and generalized weakness. And additionally found to be COVID positive although otherwise asymptomatic. The patient remained on room air during his hospitalization and did not require further medications in regards to COVID infection. The patient is now past the five days of isolation required by the CDC with his positive test 1/23. They patient should have a mask for the remainder of the follow five days. The patient has residual generalized weakness and was evaluated by PT/OT who recommended return with increased assistance and wheelchair.     The patient required haldol in ED and then was lethargic following administration. After talking with sister it was determined that is a typical reaction after receiving that medication. The patient became more interactive once the medication worse off and no longer required a posey bed as of 1/26. The patients home aricept, zyprexa, depakote and zoloft were continued at discharge. The patient was hemodynamically stable at time of discharge.
Age: 9.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Patient vaccinated against and then tested positive for COVID19
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site bruising, Injection site induration, Injection site swelling, Pain in extremity, Peripheral swelling
Clinical narrative: The patient received their booster Moderna covid vaccine in clinic here on 1.26.22. Right arm was used. They indicated that they were on blood thinners and so pressure was applied to injection site post injection. Today the patient presented to clinic and complained of swelling and sore arm. They stated they had not contacted their primary physician and that the swelling had started the day after the shot.  On checking the arm there appeared a small bruise, mild swelling and firmness to the area. I advised the patient to contact their health care provider to see if they deemed any treatment besides those the patient had been doing ( cold compresses) and that I would complete a VAERS form.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain upper, Urticaria
Clinical narrative: Giant urticaria, epigastric pain, and continuous symptoms for past 4 days. Treatment - Pepcid, Allegra, prednisone- mild improvement, still severe widespread hives on entire body after treatment and worse at night.
Age: 53.0
Sex: M
Vaccine: COVID19
Symptoms: Blood test, Guillain-Barre syndrome, Lumbar puncture, Urine analysis
Clinical narrative: Guillain-Barre Syndrome.
Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Hypophagia, Lethargy, Loss of consciousness, Presyncope, Syncope
Clinical narrative: Pt was observed closing his eyes and becoming slightly lethargic approx. 5-10 min after receiving vaccine.  He removed in his chair and was evaluated.  Alert and oriented X3.  No trauma.  He stated that he "was afraid of needles and passed out".  Pulse 99. Resp rate 82. BP 130/80.  Responsive to commands.  able to follow finger with neuro assessment. He also stated that he had not had breakfast.  He was offered and accepted water and crackers.  He had planned to eat this morning but had food in his car.  Patient was observed for 30 more minutes and escorted to his car.  During this time, he called his wife to notify her that he was ok to drive home.  Pt released by his own measure @1:00 PM. Dx: Vasovagal response/Fainting