Shifting demographics of patients diagnosed with E-cigarette or vaping associated lung injury (EVALI)

Abstract

<b>Background:</b> E-cigarette or vaping associated lung injury (EVALI) was first recognized in the summer of 2019. Vitamin E acetate (VEA), an additive in tetrahydrocannabinol (THC) products, was identified as one cause of the outbreak in the United States by November 8, 2019. Whether demographics of patients diagnosed with EVALI since then differ is unknown. <b>Methods:</b> We evaluated all patients diagnosed with EVALI in two health systems in Utah between March 1, 2019 and February 9, 2021. We evaluated the demographics of the first part of the cohort diagnosed in 2019 (before VEA was known to be a cause of EVALI) and compared them to the demographics of the second part of the cohort (EVALI diagnosed in 2020-2021). <b>Results:</b> 223 patients were diagnosed with EVALI. 48% were diagnosed in 2019 and 52% were diagnosed 2020-2021. Compared to the first part of the cohort, patients who were diagnosed with EVALI in 2020 and 2021 were older (mean age 29.7+/- 9.9 vs. 33.4 +/- 13.1, p = 0.05) and more likely to be female (23.4% women vs. 49.1%, p&lt;0.001). We evaluated employment status and marijuana use in 75 of the patients at 12 months after EVALI diagnosis. The majority (57%, 43) reported they were employed for wages and 13% (10) reported they were out of work for less than a year while 11% (8) reported they were unable to work. Most patients reported they had used marijuana or cannabis in the previous 30 days (52%, 39) however 44% (33) reported they had not. <b>Conclusion:</b> The demographics of patients with EVALI have shifted with more female and older patients diagnosed. Despite the EVALI diagnosis, many patients continue to use marijuana and most are able to return to work.