Adverse Event Reporting
| VAERS ID | 2057853 |
|---|---|
| Gender | Female |
| Age | 53 |
| StateCode | |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | FC3184 |
| Number of vaccinations | 3 |
| Vaccinated | 2021-09-08 |
| Onset | 2022-01-08 |
| Condition | Hospitalized Life Threatening Permanent Disability |
Symptoms
- Malaise
- Chest X-ray abnormal
- Mental status changes
- Electrocardiogram abnormal
- White blood cell count normal
- Sinus tachycardia
- Urine analysis normal
- SARS-CoV-2 test positive
- Computerised tomogram head normal
- COVID-19
- Alanine aminotransferase increased
- Electroencephalogram
- Blood thyroid stimulating hormone
- Endotracheal intubation
- Initial insomnia
- Troponin increased
- Mechanical ventilation
- Coagulation test
- Pulmonary congestion
- Aspartate aminotransferase increased
- Liver function test increased
- Blood lactic acid
- Moaning
- Encephalopathy
- Blood gases
- Infection
- Transaminases increased
- Acute respiratory failure
- Vitamin B12
- Interstitial lung disease
- Antiphospholipid antibodies positive
- Blood folate
- Dependence on respirator
- Myocardial ischaemia
- Ammonia
Current Illness
Depression, Anxiety, HIT, OA, Seizure Disorder with status epilepticus, and HLD.
Preexisting Conditions
same
Other Medications
Previous Vaccinations
Allergies
Naproxen and Heparin
Laboratory Data
Write-up
Patient is a 53 y.
o.
female with a history of anxiety/depression, HLD, OA, PE/DVT 2020 (on Arixtra), seizure disorder with status epilepticus, autoimmune encephalitis, hypothyroidism, COVID-19 + 1/5/22 who presented to RMH 1/8/2022 with altered mental status.
Per patient's husband, patient took her evening medications, then patient did not fall asleep as usual and began repeatedly moaning, stated that she did not feel well.
Admit WBC WNL, CT head non-acute, UA unremarkable, Troponin 18.
1.
Acute encephalopathy: Presented as above.
Unclear etiology, possibly related to COVID-19 vs autoimmune encephalitis.
Admit CT head non-acute, VBG, lactate, WBC, TSH, UA unremarkable.
LFTs mildly elevated on admit, although pt denied abdominal pain, nausea/vomiting.
B12/folate, ammonia levels pending.
Neurology consulted.
2.
COVID-19: Presented as above.
Symptom onset 4 days PTA, positive test 1/5/22.
Pt required 2L on admit.
Admit CXR with interstitial prominence, possibly related to pulmonary vascular congestion vs interstitial pneumonia.
Supportive care, pulmonary hygiene.
Consider Decadron/Remdesivir if symptoms worsen and pending neurology recs.
CRP pending.
3.
Acute hypoxic respiratory failure: Secondary to COVID-19 as above.
Required 2L NC on admit.
Supportive care, pulmonary hygiene.
Management for COVID-19 as above.
Wean oxygen as able for SpO2 goal > 90%.
4.
Transaminitis: Admit AST 71, ALT 116.
Pt denied abdominal pain, possibly related to COVID-19 as above.
Ammonia level pending.
Trend daily CMP, consider RUQ if persists.
5.
Elevated troponin: Admit troponin 18.
Admit EKG with sinus tachycardia, HR 104, no ST changes.
Pt denied CP.
Likely demand ischemia related to infection as above.
Trend.
6.
Seizure disorder: Per history with prior status epilepticus, follows with (neurology).
Per husband, pt has 7-8 seizures per month, last seizure one week PTA.
Admit phenobarbital level 44.
2.
Continued home AED regimen on admit.
Seizure precautions.
7.
Autoimmune encephalitis: Per history, followed with (neurology).
S/p Rituximab treatment.
1.
History of PE/DVT: PE noted on 1/12/20 and DVT on 1/29/20, suspected provoked in setting of hospitalization but found to have abnormal lupus anticoagulant on prior hypercoag panel.
Eliquis discontinued previously due to questionable interaction with phenobarb.
Continued home Arixtra.
1.
History of HIT: diagnosed 01/2020 while in NCC.
Avoid all heparin-based products.
8.
Anxiety/depression: Per history.
Continued home meds.
9.
Code status: Full, discussed on admit 10.
DVT Prophylaxis: Arixtra Patient still intubated and on EEG on 1/23.
Patient likely will have a trach and PEG procedure due to inability to come off the Ventilator.