TABLE 2. Clinical characteristics of patients with e-cigarette, or vaping, product use-associated lung injury (EVALI), by reported tetrahydrocannabinol (THC)-containing product use — Illinois, July–December 2019.
| Characteristic | No. (%) |
p-value¶ | No. (%) |
p-value¶ | |
|---|---|---|---|---|---|
| Reported THC-containing product use* (reference) | Reported no THC-containing product use† | No indication of any THC use§ | |||
|
Total (N = 121)**
|
104 (86)
|
17 (14)
|
—
|
9 (7)
|
—
|
|
Past medical history
| |||||
| Existing respiratory condition†† |
12/61 (20) |
3/14 (21) |
1.0 |
2/7 (29) |
0.6 |
| Existing cardiovascular condition§§ |
2/61 (3) |
1/14 (7) |
0.5 |
1/7 (14) |
0.3 |
|
Symptoms reported at presentation
| |||||
| Any respiratory symptom¶¶ |
99/100 (99) |
16/17 (94) |
0.3 |
8/9 (89) |
0.2 |
| Any gastrointestinal symptom*** |
88/100 (88) |
14/17 (82) |
0.5 |
7/9 (78) |
0.3 |
| Any constitutional symptom††† |
96/100 (96) |
13/17 (76) |
0.02 |
5/9 (56) |
0.001 |
|
Vital signs at presentation
| |||||
| Hypoxemia (O2 saturation ≤95% on room air) |
66/104 (63) |
10/17 (59) |
0.7 |
5/9 (56) |
0.7 |
| Tachypnea (RR >20 breaths per minute) |
25/66 (38) |
7/15 (47) |
0.5 |
3/8 (38) |
1.0 |
| Tachycardia (HR >100 beats per minute) |
40/68 (59) |
7/15 (47) |
0.7 |
4/8 (50) |
0.7 |
| Fever (temperature ≥100.4°F [38°C]) |
21/65 (32) |
3/14 (21) |
0.5 |
2/8 (25) |
1.0 |
|
Initial laboratory results
| |||||
| Leukocytosis (WBC count >11,000 per mm3) |
63/69 (91) |
9/16 (56) |
0.001 |
3/8 (38) |
0.001 |
| with >80% neutrophils |
53/63 (84) |
5/9 (56) |
0.07 |
1/3 (33) |
0.08 |
| Sodium <135 mmol/liter |
17/69 (25) |
3/16 (19) |
0.8 |
0/8 (0) |
0.2 |
| Potassium <3.5 mmol/liter |
18/68 (26) |
2/15 (13) |
0.5 |
2/7 (29) |
1.0 |
| AST or ALT >35 U/liter |
27/61 (44) |
9/13 (69) |
0.1 |
5/6 (83) |
0.1 |
|
Clinical course
| |||||
| Duration of symptoms before hospitalization (median days, range) |
7 (1–148) |
4 (0–205) |
0.04 |
3 (0–205) |
0.1 |
| Outpatient or ED visit before hospitalization |
51/64 (80) |
3/10 (30) |
0.003 |
1/4 (25) |
0.04 |
| Received glucocorticoids |
53/55 (96) |
8/10 (80) |
0.1 |
5/5 (100) |
1.0 |
| Clinical improvement documented after glucocorticoids |
16/53 (30) |
1/8 (13) |
0.4 |
0/5 (0) |
0.3 |
| Admitted to intensive care unit |
40/81 (49) |
9/17 (53) |
0.8 |
5/9 (56) |
1.0 |
| Severe outcome§§§ | 19/90 (21) | 7/17 (41) | 0.07 | 4/9 (44) | 0.2 |
Abbreviations: ALT = alanine aminotransferase; AST = aspartate aminotransferase; ED = emergency department; HR = heart rate; O2 = oxygen; RR = respiratory rate; WBC = white blood cell.
* Patients who reported using THC-containing e-cigarette, or vaping, products on initial structured questionnaire or follow-up interview.
† Patients who reported not using THC-containing e-cigarette, or vaping, products on initial structured questionnaire or follow-up interview.
§ Subgroup of those patients who reported not using THC-containing products who also had no indication of use of any other THC-containing substance (e.g., reported not smoking combustible marijuana, had negative toxicology testing, if performed).
¶ P-values for comparisons, using Pearson’s chi-squared test or Fisher’s exact test (for cells with <5 observations). Wilcoxon rank sum test used to compare medians. Statistical tests compared EVALI patients who reported THC-containing product use with EVALI patients who reported no THC-containing product use and with EVALI patients with no indication of any THC use.
** Data were not available for all patients. Differing denominators reflect missing data.
†† Existing respiratory conditions include asthma, chronic obstructive pulmonary disease, bronchitis, previous lung cancer and obstructive sleep apnea.
§§ Existing cardiovascular conditions include ischemic heart disease, congestive heart failure and congenital heart disease.
¶¶ Respiratory symptoms include shortness of breath, any cough, pleuritic chest pain.
*** Gastrointestinal symptoms include nausea, vomiting, diarrhea, abdominal pain.
††† Constitutional symptoms include subjective fever, chills, weight loss, fatigue/malaise.
§§§ Severe outcomes include death or respiratory failure requiring endotracheal intubation and mechanical ventilation.