Clinical Presentation and Diagnostic Evaluation of Vaping Related Lung Injury in Youth

The vaping epidemic is a public health crisis worldwide. E-cigarette, or vaping product, use-associated lung injury (EVALI) was recognised in the summer of 2019 and resulted in more than 2800 hospitalizations and 60 deaths per the Centres for Disease Control and Prevention (CDC). Vaping refers to the use of E-cigarettes, which are electronic nicotine delivery systems (ENDS) and mimic smoking without combustion. Over 40 million people in the United States vape, of which youth and young adults represent over half. We describe the evaluation and pulmonary complications in a large cohort of adolescents and young adults referred to a Pulmonary Complications of Vaping Clinic.

Youth ages 10-35 with a vaping history and respiratory symptoms underwent a comprehensive diagnostic evaluation. All patients were counselled for vaping cessation. Patients who met criteria for EVALI or probable EVALI with concurrent infection were reported to the Department of Health.

One hundred and thirty patients were referred, and 103 patients underwent comprehensive diagnostic evaluation. Eighty-four percent of patients reported vaping both marijuana and nicotine products. Forty-six percent of patients were diagnosed with EVALI or probable EVALI.

The evolving vaping epidemic demonstrates a need for subject matter expertise in the evaluation and diagnosis of youth with vaping-related lung injury, including EVALI. We report a higher number of youth who met criteria for EVALI with the implementation of a standardised vaping questionnaire and evaluation inclusive of outpatients.