SHORT-TERM PULMONARY FUNCTION TEST CHARACTERISTICS IN PATIENTS DIAGNOSED WITH E-CIGARETTE- OR VAPING-ASSOCIATED LUNG INJURY

Abstract

SESSION TITLE: Tobacco Cessation and Prevention Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The E-cigarette, or vaping, associated lung injury (EVALI) outbreak in 2019 caused many young people to be hospitalized with severe lung disease. What, if any, residual pulmonary abnormalities assessed by pulmonary function tests (PFTs) remain at short term follow-up in patients with EVALI is unknown. METHODS: We studied all patients who presented with EVALI at Intermountain Healthcare facilities between June 1, 2019 and January 13, 2020. We reviewed PFTs on all patients who were at least 30 days post discharge. We included PFTs with spirometry, lung volume, and/or diffusing capacity for carbon monoxide (DLCO) corrected for hemoglobin and reported patterns of abnormalities for all abnormal PFTs. RESULTS: 114 patients presented with EVALI and 111 were alive at least 30 days post-discharge. 28% (31/111) had at least one PFT performed at a median of 36 days (IQR 17 – 53) post-discharge. 52% (16/31) of patients with PFTs performed had abnormal PFTs. 2 of the 16 patients (13%) with abnormal PFTs at follow-up had abnormal PFTs at baseline. 65% (20/31) of patients had PFTs performed with spirometry, single-breath total lung capacity testing, and DLCO testing. 19% (6/31) had PFTs with spirometry, total lung capacity testing with plethysmography, and DLCO testing. 16% (5/31) had PFTs with spirometry only. There were six patterns of abnormalities. 19% (6/31) had obstruction only, 16% (5/31) had DLCO reduction only with normal spirometry, 6% (2/31) had obstruction with DLCO reduction. 3% (1/31) had restriction and DLCO reduction, 3% (1/31) had obstruction and suggested restriction, and 3% (1/31) had DLCO reduction and suggested restriction. The patients with suggested restriction had a low forced expiratory volume in one second (FEV1) and low forced vital capacity (FVC) without TLC plethysmography measurement. 44% of patients with abnormal PFTs (7/16) had a second, follow up PFT at a median of 135 days (IQR 79 - 145) post-discharge. None of these 7 patients had baseline PFTs prior to their EVALI diagnosis. 43% (3/7) of these follow up PFTs improved to normal, the other 4 had residual abnormalities. CONCLUSIONS: Many patients with EVALI had abnormal PFTs at least 30 days post-discharge with the most common abnormalities being obstruction only, DLCO reduction only, and obstruction with DLCO reduction. Patients who had PFT abnormalities continued to improve (some to normal predicted values) with subsequent testing. CLINICAL IMPLICATIONS: Many patients diagnosed with EVALI have persistent PFT abnormalities at follow up. Further study of the long-term effects of EVALI on pulmonary function is needed. DISCLOSURES: No relevant relationships by Braden Anderson, source=Web Response No relevant relationships by Denitza Blagev, source=Web Response No relevant relationships by Colin Grissom, source=Web Response No relevant relationships by David Guidry, source=Web Response No relevant relationships by Dixie Harris, source=Web Response No relevant relationships by Michael Lanspa, source=Web Response No relevant relationships by Susan Rea, source=Web Response