Angela K Werner1, Emilia H Koumans1, Kevin Chatham-Stephens1, Phillip P Salvatore1, Christina Armatas1, Paul Byers1, Charles R Clark1, Isaac Ghinai1, Stacy M Holzbauer1, Kristen A Navarette1, Melissa L Danielson1, Sascha Ellington1, Erin D Moritz1, Emily E Petersen1, Emily A Kiernan1, Grant T Baldwin1, Peter Briss1, Christopher M Jones1, Brian A King1, Vikram Krishnasamy1, Dale A Rose1, Sarah Reagan-Steiner1. 1. From the National Center for Environmental Health (A.K.W., E.D.M.), the National Center for Chronic Disease Prevention and Health Promotion (E.H.K., S.E., E.E.P., P. Briss, B.A.K.), the National Center on Birth Defects and Developmental Disabilities (K.C.-S., M.L.D.), the Epidemic Intelligence Service, Center for Surveillance, Epidemiology, and Laboratory Services (P.P.S., I.G.), the National Center for Injury Prevention and Control (P.P.S., G.T.B., C.M.J., V.K.), the Center for Preparedness and Response (S.M.H.), the Agency for Toxic Substances and Disease Registry (E.A.K.), and the National Center for Emerging and Zoonotic Infectious Diseases (D.A.R., S.R.-S.), Centers for Disease Control and Prevention, and Emory University School of Medicine (E.A.K.) - all in Atlanta; the California Department of Public Health, Sacramento (C.A.); the Mississippi State Department of Health, Jackson (P. Byers); the Indiana State Department of Health, Indianapolis (C.R.C.); the Illinois Department of Public Health, Springfield (I.G.); the Minnesota Department of Health, St. Paul (S.M.H.); and the New York State Department of Health, Albany (K.A.N.).
Abstract
BACKGROUND: As of January 7, 2020, a total of 2558 hospitalized patients with nonfatal cases and 60 patients with fatal cases of e-cigarette, or vaping, product use-associated lung injury (EVALI) had been reported to the Centers for Disease Control and Prevention (CDC). METHODS: In a national study, we compared the characteristics of patients with fatal cases of EVALI with those of patients with nonfatal cases to improve the ability of clinicians to identify patients at increased risk for death from the condition. Health departments reported cases of EVALI to the CDC and included, when available, data from medical-record abstractions and patient interviews. Analyses included all the patients with fatal or nonfatal cases of EVALI that were reported to the CDC as of January 7, 2020. We also present three case reports of patients who died from EVALI to illustrate the clinical characteristics common among such patients. RESULTS: Most of the patients with fatal or nonfatal cases of EVALI were male (32 of 60 [53%] and 1666 of 2498 [67%], respectively). The proportion of patients with fatal or nonfatal cases was higher among those who were non-Hispanic white (39 of 49 [80%] and 1104 of 1818 [61%], respectively) than among those in other race or ethnic groups. The proportion of patients with fatal cases was higher among those 35 years of age or older (44 of 60 [73%]) than among those younger than 35 years, but the proportion with nonfatal cases was lower among those 35 years of age or older (551 of 2514 [22%]). Among the patients who had an available medical history, a higher proportion of those with fatal cases than those with nonfatal cases had a history of asthma (13 of 57 [23%] vs. 102 of 1297 [8%]), cardiac disease (26 of 55 [47%] vs. 115 of 1169 [10%]), or a mental health condition (32 of 49 [65%] vs. 575 of 1398 [41%]). A total of 26 of 50 patients (52%) with fatal cases had obesity. Half the patients with fatal cases (25 of 54 [46%]) were seen in an outpatient setting before hospitalization or death. CONCLUSIONS: Chronic conditions, including cardiac and respiratory diseases and mental health conditions, were common among hospitalized patients with EVALI.
BACKGROUND: As of January 7, 2020, a total of 2558 hospitalized patients with nonfatal cases and 60 patients with fatal cases of e-cigarette, or vaping, product use-associated lung injury (EVALI) had been reported to the Centers for Disease Control and Prevention (CDC). METHODS: In a national study, we compared the characteristics of patients with fatal cases of EVALI with those of patients with nonfatal cases to improve the ability of clinicians to identify patients at increased risk for death from the condition. Health departments reported cases of EVALI to the CDC and included, when available, data from medical-record abstractions and patient interviews. Analyses included all the patients with fatal or nonfatal cases of EVALI that were reported to the CDC as of January 7, 2020. We also present three case reports of patients who died from EVALI to illustrate the clinical characteristics common among such patients. RESULTS: Most of the patients with fatal or nonfatal cases of EVALI were male (32 of 60 [53%] and 1666 of 2498 [67%], respectively). The proportion of patients with fatal or nonfatal cases was higher among those who were non-Hispanic white (39 of 49 [80%] and 1104 of 1818 [61%], respectively) than among those in other race or ethnic groups. The proportion of patients with fatal cases was higher among those 35 years of age or older (44 of 60 [73%]) than among those younger than 35 years, but the proportion with nonfatal cases was lower among those 35 years of age or older (551 of 2514 [22%]). Among the patients who had an available medical history, a higher proportion of those with fatal cases than those with nonfatal cases had a history of asthma (13 of 57 [23%] vs. 102 of 1297 [8%]), cardiac disease (26 of 55 [47%] vs. 115 of 1169 [10%]), or a mental health condition (32 of 49 [65%] vs. 575 of 1398 [41%]). A total of 26 of 50 patients (52%) with fatal cases had obesity. Half the patients with fatal cases (25 of 54 [46%]) were seen in an outpatient setting before hospitalization or death. CONCLUSIONS: Chronic conditions, including cardiac and respiratory diseases and mental health conditions, were common among hospitalized patients with EVALI.
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