VAERS ID: 1663204

AGE: 63| SEX: M|STATE: TX (United States)

Description

Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21.

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Symptoms

Headache, Dyspnoea, Abdominal pain, Pulmonary oedema, Cough, Hypoxia, Chest X-ray abnormal, Intensive care, Respiratory failure, Death, Endotracheal intubation, Appendicitis, Computerised tomogram thorax abnormal, Lung opacity, COVID-19, SARS-CoV-2 test positive, COVID-19 pneumonia

Vaccines

VAX DATE: 03-13-2021| ONSET DATE: 08-06-2021| DAYS TO ONSET: 146
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (JANSSEN)) 1 COVID19 JANSSEN 1805031 IM RA

RECVDATE:09-01-2021
RPT_DATE:
CAGE_YR:63
CAGE_MO:
DIED:Y
DATEDIED:08-24-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:18
X_STAY:U
DISABLE:U
RECOVD:N
LAB_DATA:Covid positive (8/6/21)
V_ADMINBY:PVT
OTHER_MEDS:amlodipine 5mg daily, aspirin 81mg daily, atorvastatin 40mg daily, basaglar inject up to 30 units daily, Os-cal 3tabs TID, ceterizine 10mg daily, Vitamin D3 4,000unit 2 tab daily, famotidine 20mg BID, folic acid 1mg daily, Norco 10-325mg q8
CUR_ILL:
HISTORY:Anemia, CAD, T2DM, GERD, HTN, RA, obesity, HLD, hypercalcemia, hyperparathyroidism s/p parathyroidectomy
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:08-30-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:NKDA
V_FUNDBY:

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