Table 1.
Demographics, Medical and Vaping History, and Clinical Course of the Adolescents Affected with E-Cigarette, or Vaping, Product Use-Associated Lung Injury
| Case | Age | M/F | Vaping substance | Length | Other drugs | Presenting symptoms | Comorbidities | Highest respiratory support | Steroids | Pertinent laboratories | Clinical outcome on follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 16 | F | THC nicotine | 2 years | Marijuana | Fever, nausea, vomiting, cough, weight loss, malaise | Anxiety, ADHD | Intubated | Methylprednisolone IV 1 g × 3 days | THC+; BAL− | Symptoms resolved; stopped vaping |
| 2 | 17 | M | THC nicotine | 1 week | Marijuana cigarettes | Fever, nausea, vomiting, cough, weight loss, malaise, dyspnea | ADHD | BPAP | Methylprednisolone IV 1 g × 3 days | THC+, methamphetamine+ | Remained vaping nicotine, symptoms resolved |
| 3 | 16 | M | THC | 3 years | Marijuana | Fever, nausea, vomiting, cough, dyspnea | None | BPAP | Methylprednisolone IV 80 mg then prednisone PO taper; total 24 days | THC+; Clostridium difficile+ | Symptoms resolved; stopped vaping |
| 4 | 18 | M | THC nicotine | 2 years | Marijuana | Fever, nausea, vomiting, cough, weight loss, malaise, back pain, abdominal pain | PMH of neurocardiogenic syncope | HFNC | Prednisone PO 60 mg × 5 days | THC+, methamphetamine+ | Symptoms resolved; stopped vaping |
| 5 | 15 | F | THC | 3 weeks | None | Fever, nausea, vomiting, cough, dyspnea, malaise | Obesity, ADHD | HFNC | Methylprednisolone IV 120 mg × 3 days | THC+, methamphetamine+, elevated liver enzymes | Stopped vaping; mild exercise-induced dyspnea after 1 month |
| 6 | 16 | M | THC nicotine | 3–4 months | Marijuana | Fever, nausea, vomiting, tachypnea | Mild OSA | HFNC | Prednisone PO 60 mg × 3 days | THC+, elevated D-dimer, CRP, ESR, liver enzymes | Symptoms resolved; stopped vaping |
| 7 | 15 | M | THC | >1 year | Marijuana cocaine benzodiazepine promethazine | Fever, diarrhea, abdominal pain, myalgia, cough, weight loss | Behavioral issues, anxiety, RIJ vein thrombus on enoxaparin | Intubated, hypotensive shock on norepinephrine | Methylprednisolone IV 500 mg × 8 days then prednisone PO taper × 3 weeks; total 29 days | THC+, stool adenovirus+, elevated ESR, CRP, Mycoplasma IgM+ IgG+ | Stopped vaping, continued drugs and cigarettes |
| 8 | 17 | F | Nicotine | 1.5 years | Marijuana | Fever, nausea, vomiting, cough, myalgia, headache | ADHD, allergic rhinitis on immunotherapy | Room air | Prednisone PO 80 mg × 5 days | Elevated D-dimer | Symptoms resolved; stopped vaping |
ADHD, attention deficit hyperactivity disorde; BAL, bronchoalveolar lavage; BPAP, bilevel positive airway pressure; CRP, C reactive protein; HFNC, high flow nasal cannula; IV, intravenous; OSA, obstructive sleep apnea; PMH, past medical history; PO, per os; RIJ, right internal jugular; THC, tetrahydrocannabinol.