Adolescent E-cigarette or Vaping Use-Associated Lung Injury in the Delaware Valley: A Review of Hospital-Based Presentation, Management, and Outcomes.

Sarah Schaffer,Vijay Krishnan,David Saul,Abigail Strang,Aaron Chidekel

doi:10.7759/cureus.21988

Abstract

E-cigarette or vaping use-associated lung injury (EVALI) remains a major concern due to ongoing use of nicotine and/or cannabis-containing products and resulting acute lung injury. There are few published reports describing the clinical features, comorbidities, severity of disease, and outcomes of treatment in adolescents. This report describes the experience of a single tertiary care children’s hospital in the Delaware Valley and reviews data from all patients diagnosed with EVALI in the emergency department and inpatient setting from July 2019 to June 2021 at the Nemours Children’s Hospital in Wilmington, Delaware. Demographic, clinical, therapeutic, diagnostic features, and outcomes are presented. Abstinence and steroids improved outcomes in our population. Obtaining a vaping history, negative infectious testing, elevated inflammatory markers, and characteristic computed tomography findings were key to making the diagnosis of EVALI.

Highlights

The Centers for Disease Control and Prevention (CDC) defines e-cigarette or vaping product use-associated lung injury (EVALI) as an acute or subacute respiratory illness that can be severe and life-threatening
Negative infectious testing, elevated inflammatory markers, and characteristic computed tomography findings were key to making the diagnosis of E-cigarette or vaping use-associated lung injury (EVALI)
As of February 2020, there have been 2,807 EVALI cases and deaths reported to the CDC, 15% of whom were under the age of 18 years [2]

Summary

Introduction

The Centers for Disease Control and Prevention (CDC) defines e-cigarette or vaping product use-associated lung injury (EVALI) as an acute or subacute respiratory illness that can be severe and life-threatening. As of February 2020, there have been 2,807 EVALI cases and deaths reported to the CDC, 15% of whom were under the age of 18 years [2]. In 2016, about seven in 10 middle school and high school students (69.3%) said they had seen e-cigarette advertising [4]. This has led to nearly one in four high school students and one in 15 middle school students in the United States reporting use of any tobacco product in 2020. According to the 2017 Delaware Youth Risk Behavior Survey of public high school students conducted by the University of Delaware, 13.6% of students used e-cigarettes in the past month and 38% reported trying an electronic vapor product, which is significantly higher than the national average [7]

Methods

Results

Discussion

Conclusion