SUBMIT Cas ase P e Presen entat ation COVID-19 Kurt DeVine, MD - PDF document

SUBMIT Cas ase P e Presen entat ation COVID-19 Kurt DeVine, MD and Heather Bell, MD Date: _______________ Submitted by (Your Name): ________________________________ Age: ______________ Gender: _______________ Date Symptoms Began: _______________________ COVID-19 Swab Date (if done): ___________ Results of Swab and Date Resulted: _________________ Presenting Symptoms: __________________________________________________________________ Height: ____________________ Weight: ____________________ Pertinent Comorbidities? Yes No HTN: _____ Stroke: _____ MI: _____ Diabetes: _____ Other Chronic Health Conditions: _________________________________________________________ Nicotine use: __________________________________________________________________________ Alcohol use: ___________________________________________________________________________ Recreational drug use: __________________________________________________________________ Medications (home): ___________________________________________________________________ Imaging CXR/Date: ___________________________________________________________________ CXR/Date: ___________________________________________________________________ CXR/Date: ___________________________________________________________________ CT/Date: ___________________________________________________________________

LABS Date Result Date Result Date Result Date Result Date Result Date Result Date Result Wbc PMN Lymph Hgb Platel Albumin LDH Ferritin CRP SED Procalcitonin Other Labs: Ventilator/Settings: ____________________________________________________________________ Hemodialysis: _________________________________________________________________________ Other Findings: Case Evolution:

Any healthcare encounters prior to hospitalization? Questions: SUBMIT