hospitalized 01/30/2022; covid-19 positive 01/30/2022; fully vaccinated plus booster discharge provider: private* primary care provider: do admission date: 1/30/2022 discharge date: jan 31, 2022 details of hospital stay: presenting problem: generalized weakness [r53.1] elevated troponin [r77.8] covid-19 [u07.1] hospital course: patient is a 90 y.o. male with h/o intermittent a-fib, htn, hld, ckd, copd (on 2l via nc nocturnally), gerd, bph and prior bladder and skin cancer, presenting to the er on 1/30 with increasing weakness over the past 3 weeks. in the er, he was afebrile (tmax 37.2), normotensive to borderline soft, transiently tachycardic, mildly tachypnic, and maintaining spo2 in low to mid 90?s on baseline ra. initial labs are notable for stable renal dysfunction, hypomagnesemia, elevated trops with negative delta, normocytic anemia. covid screen is positive without concurrent influenza or rsv positivity. ua is unremarkable. ekg initially showed a-flutter with rvr and non-specific st-t change, but repeat study shows conversion to nsr with pvc?s. cxr shows no acute process. cth shows no acute intracranial process, with note of probable microvascular ischemia and/or periventricular edema and disproportionate mild-to-moderate central volume loss and/or chronic nph. he was treated with iv mag sulfate. on admission mri of brain, ultrasound carotids, echocardiogram, pt and ot were ordered. mri of brain was negative for acute stroke senescent findings with probable central involution though nph is not excluded. echocardiogram showed ef of 48% and wall motion abnormalities. ultrasound was negative for significant carotid stenosis. these results were discussed with patient as well as his daughter at bedside. pt and ot recommended home health. daughter and patient deferred home health. patient and daughter also deferred inpatient cardiology workup and preferred outpatient follow-up