This is VAERS ID 1437352
First Appeared on 7/2/2021
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA
||- / UNK
||- / -
Administered by: Private Purchased by: ??
Symptoms: Acute respiratory failure, Aggression, Agitation, Ammonia increased, Arteriosclerosis, Blood culture negative, Blood lactic acid, Chest X-ray abnormal, Confusional state, Cough, Delirium, Electrocardiogram, Hepatic cirrhosis, Hepatic encephalopathy, Hepatic failure, Lactic acidosis, Malaise, Neuropathy peripheral, Non-Hodgkin's lymphoma, Portal hypertension, Thrombocytopenia, Sputum culture, Respiratory tract congestion, Brain natriuretic peptide, Transaminases increased, Computerised tomogram abdomen abnormal, Lung hyperinflation, Troponin, Paracentesis, Scan with contrast abnormal, Portal hypertensive colopathy, Computerised tomogram pelvis abnormal, Lung opacity, COVID-19, SARS-CoV-2 test positive, COVID-19 pneumonia
Life Threatening? No
Birth Defect? No
Permanent Disability? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:
| Extended hospital stay? No|
Preexisting Conditions: past medical history of liver cirrhosis, esophageal and gastric varices, alcohol abuse, atrial fibrillation, CHF, coronary artery disease (last stent placed in 12/7/2012), type 2 diabetes, GERD, hyperlipidemia, hypertension, peripheral neuropathy, hypothyroidism, non-Hodgkin lymphoma and obstructive sleep apnea.
Allergies: atorvastatin hydroCHLOROthiazide lisinopril meloxicam propafenone
Diagnostic Lab Data: Pt. is a 67-year-old male with a past medical history of liver cirrhosis, esophageal and gastric varices, alcohol abuse, atrial fibrillation, CHF, coronary artery disease (last stent placed in 12/7/2012), type 2 diabetes, GERD, hyperlipidemia, hypertension, peripheral neuropathy, hypothyroidism, non-Hodgkin lymphoma and obstructive sleep apnea. Patient currently has been undergoing dexamethasone and remdesivir since 6/27. Patient has not yet received a dose of Tocilizumab. Patient has also been encephalopathic most likely due to liver failure. We will continue patient rifaximin. We will use Haldol for agitation and restraints. If patient continues to be agitated patient may need intubation to continue to maintain his saturations appropriately. Neuro/Psych Hepatic encephalopathy Agitation Delirium Peripheral neuropathy OSH Ammonia 72 Haldol 5 mg as needed for agitation Continue gabapentin 3 mg 3 times daily Continue rifaximin Pulmonary Acute hypoxic respiratory failure requiring MV 6/20-P COVID 19 pneumonia, non-vaccinated Chest x-ray at outside facility on 627 showed progressive pulmonary opacities suggestive of COVID-19, hyperinflated lungs and arthrosclerotic vascular disease process -dexamethasone 6mg IV daily 6/27-p -remdesivir 6/27-p -Patient does not seem to have received a dose of tocilizumab at outside facility Cardiovascular History of CHF History of CAD A.Fib BNP at OSH 155 EKG pending Troponin pending BNP pending Endocrine History of DM2 Hyperglycemia home regimen: Tresiba 75U BID, Reg insulin 50U TID AC and metformin Started insulin drip Renal Lactic acidosis Lactate at OSH was 6.2 Lactate upon arrival was 2.8 repeat 2hr later GI Liver cirrhosis Transaminitis ?CT of the abdomen and pelvis with contrast showed findings compatible with hepatic cirrhosis and portal hypertension, metallic density in the upper gastric body most likely due to surgical changes, high density material within the dependent portion of the body of the stomach that could represent gastric bleeding, thickening of the ascending and transverse colon likely represented a portal colopathy and lungs consistent with inflammatory process like Covid. ?Last paracentesis performed on 6/27/2021. Aspirated 5.2 L and was given 25 g of albumin IV Heme/oncology Thrombocytopenia Non-Hodgkin lymphoma We will continue to monitor We will hold DVT prophylaxis due to thrombocytopenia ID COVID 19 - tx as above ?Blood cultures 6/29?no growth to date ?Respiratory culture 6/29-Pending ?Vancomycin 6/27-p -zosyn 6/27-p - Azithromycin- 6/27-p Code: FULL okay with intubation Diet: NPO Lines/Tubes/Drains: DVT Prophylaxis: hold due to thrombocytopenia Patient staffed with attending Dr.
CDC 'Split Type':
Write-up: Patient presented to the outside hospital on 6/27 due to having congestion and feeling much worse. Patient symptoms started on Friday (6/25) with congestion and cough. This was not able to be remedied by Mucinex. Patient then went to an urgent care clinic on Saturday and after listening to his lungs was sent to the emergency room. While in the emergency patient received a CT scan of his abdomen and pelvis which showed signs of liver cirrhosis and Covid. Patient then had a rapid Covid test that came back positive. They then obtained a confirmatory test but that is still pending. Patient then had agitation while he was in the hospital to the point where he almost struck a nurse. Patient''s confusion got a little bit better but was found to have an elevated ammonia which was thought to be the cause of his delirium.
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