이상반응 보고

VAERS ID 2578138
성별 여성
나이 89세
주 코드 MI
제약회사 PFIZER\BIONTECH
로트 번호 GH9693
예방접종 횟수 5
접종일 2022-10-12
발병일 2023-02-01
상태 입원 사망
증상
  • 혼란 상태(Confusional state)
  • 피로(Fatigue)
  • 설사(Diarrhoea)
  • 무력증(Asthenia)
  • 상태가 악화됨(Condition aggravated)
  • 졸음(Somnolence)
  • 저혈압(Hypotension)
  • 기침(Cough)
  • 떨어지다(Fall)
  • 흉부 엑스레이 이상(Chest X-ray abnormal)
  • 혈액 알칼리성 인산 가수 분해 효소 정상(Blood alkaline phosphatase normal)
  • 혈중 칼륨 감소(Blood potassium decreased)
  • 혈액 요소 증가(Blood urea increased)
  • 저칼륨혈증(Hypokalaemia)
  • SARS-CoV-2 테스트 양성(SARS-CoV-2 test positive)
  • 혈중 젖산 증가(Blood lactic acid increased)
  • 결절(Nodule)
  • 혈액 크레아티닌 증가(Blood creatinine increased)
  • 헤마토크릿 증가(Haematocrit increased)
  • 코로나 바이러스 감염증 -19 : 코로나 19(COVID-19)
  • 심방 세동(Atrial fibrillation)
  • 국제 표준화 비율 증가(International normalised ratio increased)
  • 혈액 배양(Blood culture)
  • 배양 소변(Culture urine)
  • 알라닌 아미노전이효소 증가(Alanine aminotransferase increased)
  • 프로트롬빈 시간(Prothrombin time)
  • 컴퓨터 단층 촬영 머리 이상(Computerised tomogram head abnormal)
  • 사구체 여과율(Glomerular filtration rate)
  • 심근 경색증(Myocardial infarction)
  • 급성 심근경색(Acute myocardial infarction)
  • 폐렴(Pneumonia)
  • 혈액 소변 존재(Blood urine present)
  • 급성 신장 손상(Acute kidney injury)
  • 전체 혈구 수 비정상(Full blood count abnormal)
  • 혈중 나트륨 증가(Blood sodium increased)
  • 만성 신장 질환(Chronic kidney disease)
  • 죽음(Death)
  • 저산소증(Hypoxia)
  • 아스파르테이트 아미노전이효소 증가(Aspartate aminotransferase increased)
  • 폐 불투명도(Lung opacity)
  • 고나트륨혈증(Hypernatraemia)
  • 소변 분석 비정상(Urine analysis abnormal)
  • 소변 백혈구 에스테라제 양성(Urine leukocyte esterase positive)
  • 간 효소 증가(Hepatic enzyme increased)
  • 관절병증(Arthropathy)
  • 세균 검사(Bacterial test)
  • 틈새 탈장(Hiatus hernia)
  • 백혈구 소변 양성(White blood cells urine positive)
  • 골반 및 고관절 비정상 엑스레이(X-ray of pelvis and hip abnormal)

이환 중 질병

None

지병

Unspecified essential hypertension Hyperlipidemia Osteoarthritis Anemia, iron deficiency Pessary maintenance Osteopenia DVT of lower extremity (deep venous thrombosis) (HCC) History of pulmonary embolism GERD (gastroesophageal reflux disease) Current use of long term anticoagulation Thickened endometrium History of DVT (deep vein thrombosis) Dementia without behavioral disturbance, psychotic disturbance, mood disturbance, or anxiety (HCC) Pelvic floor weakness in female Pneumonia due to infectious organism Urinary tract infection with hematuria Dehydration with hypernatremia Generalized weakness Supratherapeutic INR COVID-19 VTE (venous thromboembolism) Atrial fibrillation (HCC) Myocardial infarction (HCC)

기타 의료

Ascorbic Acid (VITAMIN C PO) atenolol (TENORMIN) 25 MG tablet Calcium Carbonate-Vit D-Min (CALCIUM 1200 PO) cholecalciferol (VITAMIN D3) 2000 units TABS Estrogens Conjugated 0.625 MG/GM CREA ferrous sulfate 325 (65 Fe) MG tablet loratadine

이전 예방접종

알레르기

None

임상 검사

증상 상세

Discharge Provider: MD Primary Care Provider : FNP Admission Date: 2/1/2023 Deceased Date: Date of Death: 2/4/23 Time of Death: 8:08 AM Preliminary Cause of Death: Myocardial infarction (HCC) Admitting Diagnoses: Pneumonia due to infectious organism HOSPITAL COURSE: Patient is a 89 y.
o.
female with past medical history significant for dementia, DVT and pulmonary embolism on Coumadin, hypertension hyperlipidemia, osteoarthritis, iron deficiency anemia, gastroesophageal reflux disease, presenting to an inpatient unit as a transfer from a local Emergency Department where she had presented with chief complaint of increased fatigue, multiple falls, cough, diarrhea, and increased confusion.
Patient lives with her daughter and the falls were happening as she was trying to get off the toilet, no history of head injury.
No history of fever.
It should be noted, that patient is a very poor historian and most of information is obtained from reviewing chart and speaking with the emergency physician In the emergency department, patient was hypotensive with blood pressure of 84/64 and hypoxic with oxygen saturation of 81% on room air.
Laboratory value with evidence of hypernatremia with sodium 147, hypokalemia with potassium of 3.
4, acute kidney injury superimposed on chronic kidney disease stage 3 with BUN of 42, creatinine 1.
12, and GFR of 47, liver enzymes elevated with ALT of 42, AST of 66, and alk phosphatase of 111.
Initial lactic acid 4.
6 decreased to 2.
9 after sepsis fluid bolus.
Complete blood count with no evidence of leukocytosis but hematocrit elevated at 48.
INR elevated at 6.
2 with PT of 56.
COVID-19 PCR detected.
Urinalysis positive for leukocyte esterase, large amount of blood, many bacteria, greater than 180 wbc's, many WBC clumps.
CT head without contrast with no acute intracranial abnormality.
A 3.
5 mm nodularity at the left middle cerebral artery trifurcation possible aneurysm.
Two-view chest x-ray with evidence of large hiatal hernia, right lung base opacity concerning for infection.
Left hip x-ray with no evidence of fracture or dislocation, evidence of severe right femoral acetabular joint degenerative changes.
In the emergency department, patient was fluid resuscitated per sepsis guidelines.
Peripheral blood cultures and urine culture were obtained.
Patient was started on IV ceftriaxone and IV doxycycline, and IVF.
She was not hypoxic and with volume resuscitation became hemodynamically stable.
She was confused with was her baseline but remained weak and fairly somnolent despite treatment of her pneumonia.
Since she was not hypoxic she was not given steroids or remdesivir for COVID.
Due to her weakness, SAR or ECF was recommended.
Family asked about hospice care and if they could take her home with hospice.
They did meet with hospice and planned on discharge to home on 2/5.
Unfortunately, the patient developed atrial fibrillation in the setting of a STEMI.
She became hypoxic and since hospice was already being planned no aggressive interventions were carried out.
She was started on a morphine drip and subsequently expired the morning of 2/4.