TABLE 1.
Characteristics of Adolescent Patients Admitted With EVALI
| Characteristics | Results |
|---|---|
| No./total No. (%) | 13/13 (100)a |
| Mean age (range), y | 15.9 (13–18) |
| Female sex, No. (%) | 7 (54) |
| Race and/or ethnicity, No. (%) | |
| White | 7 (54) |
| Hispanic | 6 (46) |
| E-cigarette or vaping history, No. (%) | |
| E-cigarette or vaping use in previous 90 d | |
| Δ−9-tetrahydrocannabinol | 12 (92) |
| Nicotine | 8 (62) |
| Both nicotine and Δ−9-tetrahydrocannabinol | 7 (54) |
| Nicotine vaping history, No./total No. (%) | |
| Duration | |
| 3–6 mo | 1/8 (13) |
| >12 mo | 5/8 (63) |
| Unknown | 2/8 (25) |
| Frequency | |
| Multiple times a wk or less | 1/8 (13) |
| Daily | 1/8 (13) |
| Multiple times per d | 5/8 (63) |
| Unknown | 1/8 (13) |
| Cartridges used per wk | |
| <1 | 2/8 (25) |
| 2–7 | 2/8 (25) |
| Unknown | 4/8 (50) |
| Source of cartridge | |
| Friend | 3/8 (38) |
| Acquaintance or dealer | 1/8 (13) |
| Unknown | 4/8 (50) |
| Δ−9-tetrahydrocannabinol vaping history, No./total No. (%) | |
| Duration | |
| 3–6 mo | 3/12 (25) |
| 6–12 mo | 1/12 (8) |
| >12 mo | 8/12 (67) |
| Frequency | |
| Multiple times a wk or less | 5/12 (42) |
| Daily | 1/12 (8) |
| Multiple times per d | 6/12 (50) |
| Cartridges used per wk | |
| ≤1 | 6/12 (50) |
| 2–7 | 1/12 (8) |
| Unknown | 5/12 (42) |
| Source of cartridge | |
| Friend | 5/12 (42) |
| Acquaintance or dealer | 4/12 (33) |
| Black market | 1/12 (8) |
| Unknown | 2/12 (17) |
| Vaping brands reported, No./total No. (%)b | |
| Nicotine brands | |
| JUUL | 5/8 (63) |
| NJoy | 2/8 (25) |
| Suorin | 1/8 (13) |
| Delosi | 1/8 (13) |
| Δ−9-tetrahydrocannabinol brands | |
| Dank | 3/12 (25) |
| Rove | 2/12 (17) |
| Cali plug | 2/12 (17) |
| Chronic carts | 1/12 (8) |
| Runtz | 1/12 (8) |
| Stig | 1/12 (8) |
| EonSmoke | 1/12 (8) |
| Brass knuckles | 1/12 (8) |
| Dr Zodiac | 1/12 (8) |
| Reported length of e-cigarette use (range), d | 30–730 |
| Psychosocial history, No. (%) | |
| Stressors identified from psychosocial history | |
| Home environment | 6 (46) |
| Academic difficulty | 8 (62) |
| Behavior problems | 6 (46) |
| History of mood or anxiety disorder | 7 (54) |
| History of suicidal or homicidal ideation | 5 (38) |
| Nicotine use (other than e-cigarette or vaping) | 5 (38) |
| Substance use (other than e-cigarette or vaping) | 12 (92) |
| Symptoms reported at presentation | |
| Median duration of symptoms before presentation (range), d | 3 (2–21) |
| Constitutional symptoms, No. (%) | 13 (100) |
| Subjective fever | 13 (100) |
| Fatigue or malaise | 8 (62) |
| Weight loss | 6 (46) |
| Excessive sweating | 3 (23) |
| Respiratory symptoms, No. (%) | 11 (85) |
| Cough | 11 (85) |
| Shortness of breath | 10 (77) |
| Chest pain | 9 (69) |
| Dyspnea on exertion | 6 (46) |
| Wheezing | 3 (23) |
| GI symptoms, No. (%) | 11 (85) |
| Vomiting | 11 (85) |
| Nausea | 10 (77) |
| Diarrhea | 8 (62) |
| Abdominal pain | 6 (46) |
| Abnormal vital signs at presentation, No. (%) | |
| Respiratory rate ≥20 breaths per min | 11 (85) |
| Oxygen saturation ≤95% in ambient air | 11 (85) |
| Temperature ≥38°C | 10 (77) |
| Heart rate ≥120 beats per min | 9 (69) |
| Blood pressure ≥135/85 | 0 (0) |
| Initial laboratory evaluation | |
| White blood cell count >11 000 cells per mm3, No. (%) | 11 (85) |
| White blood cell count with >80% neutrophils, No./total No. (%) | 9/12 (75) |
| C-reactive protein level >1 mg/dL, No./total No. (%) | 12/12 (100) |
| Erythrocyte sedimentation rate >15 mm/h, No./total No. (%) | 10/11 (91) |
| Erythrocyte sedimentation rate >30 mm/h, No./total No. (%) | 8/11 (73) |
| Respiratory viral panel result, No./total No. (%) | |
| Negative | 10/12 (83) |
| Coronavirus | 1/12 (8) |
| Rhinovirus | 1/12 (8) |
| Urine drug screen positive for Δ−9-tetrahydrocannabinol, No./total No. (%) | 11/11 (100) |
| Imaging findings on chest CT scan, No. (%) | |
| Bilateral ground-glass opacities | 13 (100) |
| Lung bases greater than lung apices | 6 (46) |
| Interlobular septal thickening | 2 (15) |
| Pneumomediastinum | 2 (15) |
| Crazy paving | 1 (8) |
| Bronchoscopy findings | |
| Negative BAL bacterial culture result, No./total No. (%) | 6/6 (100) |
| Lymphocytes, mean (range), % | 13.3 (2–32) |
| Neutrophils, mean (range), % | 27.8 (2–81) |
| Macrophages, mean (range), % | 25.8 (15–69) |
| Eosinophils, mean (range), % | 14.0 (1–46) |
| Normal bronchial mucosa, No./total No. (%) | 1/6 (17) |
| Clinical course | |
| Hospitalization, No. (%) | 13 (100) |
| Admission to ICU | 4 (31) |
| Maximum respiratory support, No. (%) | |
| Room air | 1 (8) |
| Nasal cannula | 8 (62) |
| Bilevel positive airway pressure | 2 (15) |
| Intubation with invasive mechanical ventilation | 1 (8) |
| VV-ECMO | 1 (8) |
| Duration of hospitalization, median (range), d | 7 (2–120) |
| Treatment course | |
| Antibiotics for lower respiratory tract infection, No. (%) | |
| Oral antibiotics before hospitalization | 6 (46) |
| Intravenous antibiotics during hospitalization | 9 (69) |
| Systemic glucocorticoids, No./total No. (%) | |
| Oral and intravenous glucocorticoids | 10/12 (83) |
| Oral glucocorticoids alone | 1/12 (8) |
| Intravenous glucocorticoids alone | 1/12 (8) |
| Required supplemental oxygen at discharge, No. (%) | 4 (31) |
a
Denominator equals 13 unless otherwise specified.
b
Each patient may have reported multiple brands; 3 patients had unknown brands.