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VAERS Report 2157446

Case Report Section

Vaer Report Details

Age: 74 years old

Gender: Male

State: Michigan

Patient Died?
No
Vaccine information

Name: COVID19 (COVID19 (JANSSEN))

Type: Coronavirus 2019 vaccine

Manufacturer: JANSSEN

Lot: 1805018


Date report was received
2022-03-04
Date form completed
Date Vaccinated
2021-03-05
Date of Onset
346
Number of days (onset date – vaccination date)
346
Adverse Event Description

patient is fully vaccinated and boosted. covid positive on admission to the hospital. patient presented to the ed per complaints of fatigue, flank pain, bradycardia, hypotension & hypoxia from their pcp's office. work up was concerning for covid pneumonia, diverticulitis, aki, copd exacerbation, chf exacerbation or possible sepsis. broad spectrum antibiotics, iv fluid resuscitation, breathing treatments, rate control, & blood cultures were all initiated & drawn. patient improved quickly oxygenating appropriately on room air with appropriate vitals & responding appropriately to interventions. discharge plans were initiated with continued outpatient antibiotics to treat diverticulitis. medications: albuter, aspirin, bumetanide, carvedilol, fluticasone, furosemide, ipratropium, tamsulosin and warfarin. cr 1.62, plts 42-132, d dimer 759. discharged home

Lab Data
na
List of symptoms
bradycardia fatigue platelet count decreased blood creatinine increased hypoxia hypotension blood culture covid-19 sars-cov-2 test positive diverticulitis flank pain fibrin d dimer anticoagulant therapy interventional procedure
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Private
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
na