Narrative:  COVID infection following COVID vaccine series 08/12 Janssen, dose #1 08/28 SARS-COV-2 Variant Sequencing RESULT: pending 08/28 COVID swab, result: detected 08/28 pt cc: cough, dyspnea, exposure: unknown 08/28 pt admit to Medicine cc: dysspnea dx: COVID-19 complicated with multifocal pneumonia, acute hypoxemic respiratory failure LOS: 31 days discharged to SNF 08/28 FIBRINOGEN: 515 08/28 DDIMER: 0.94 08/12 CTA PE impression: mild motion, limiting detection of small pulmonary emboli particularly within the subsegmental pulmonary arteries. No evidence of pulmonary embolism identified. Areas of patchy groundglass opacities throughout bilateral lungs, nonspecific but consistent with Covid infection. No pleural effusion or pneumothorax. Few other findings as described above. 08/29 PROCALCITONIN 0.63 08/29 ESR 28 08/30 FIBRINOGEN: 469 08/30 DDIMER: 0.70 08/31 ESR results 14 08/31 FIBRINOGEN: 414 08/31 DDIMER: 0.66 09/01 ESR 44 09/01 FIBRINOGEN: 365 09/01 DDIMER: 0.73 09/01 CXR impression: Bilateral lung opacities, which may reflect the provided clinical history of COVID-19 pneumonia. Note that superimposed edema is difficult to exclude by radiography. Possible cardiomegaly. 09/02 ESR 33 09/02 FIBRINOGEN: 399 09/02 DDIMER: 0.83 09/03 FIBRINOGEN: 353 09/03 DDIMER: 0.98 09/03 ABG result: i-pH 7.47, i-PC02 38.6, i-P02 62, i-HCO3 28.3 09/03 TROPONIN I <0.016 09/03 LACTIC ACID 3.56 09/03 PROCALCITONIN <0.05 09/03 BNP 280.5 09/04 ESR 32 09/04 FIBRINOGEN: 331 09/04 DDIMER: 0.93 09/04 S.PNEUMONIAE AG Eval: result: NEGATIVE 09/04 LEGIONELLAAgUR Eval result: negative 9/07 US DOPPLER IMPRESSION: No evidence of DVT in the bilateral lower extremity. 09/08 ESR result: 19 09/08 FIBRINOGEN: 247 09/08 DDIMER: 1.15 09/15 DDIMER 0.73 09/16 DDIMER 0.56 09/17 DDIMER 0.51 09/18 DDIMER 0.49 09/19 CT ABD/PELVIS Impression: Interval consolidation of diffuse bilateral alveolar disease likely related to stated history of COVID-19 pneumonia. * Moderate colonic stool burden with hyperdense stool throughout the distal colon; this is nonspecific and is likely related to ingestion, but can represent old blood products in the appropriate clinical context. Further evaluation with fecal stool test is suggested. * Indeterminate left lower pole exophytic renal mass; inherent hyperdensity raises possibility of hemorrhagic cyst, though further evaluation with MRI/CT adrenal protocol is recommended to exclude renal neoplasm. * Splenomegaly. * Diverticulosis without evidence of acute diverticulosis. * Nonobstructive bilateral nephrolithiasis versus renal vascular calcifications. 09/19 CT Chest W/O impression: * Interval consolidation of diffuse bilateral alveolar disease likely related to stated history of COVID-19 pneumonia. * Moderate colonic stool burden with hyperdense stool throughout the distal colon; this is nonspecific and is likely related to ingestion, but can represent old blood products in the appropriate clinical context. Further evaluation with fecal stool test is suggested. * Indeterminate left lower pole exophytic renal mass; inherent hyperdensity raises possibility of hemorrhagic cyst, though further evaluation with MRI/CT adrenal protocol is recommended to exclude renal neoplasm. * Splenomegaly. * Diverticulosis without evidence of acute diverticulosis. * Nonobstructive bilateral nephrolithiasis versus real vascular calcifications. 09/23 RETICULOCYTES: 146.3 09/23 RETICULOCYTES: 5.50 09/23 RWT-He: 26.2 09/23 IRF: 22.1 09/23 clinically resolved 09/26 CVR impression: Multifocal opacities unchanged. 09/29 COVID swab, result: detected