TABLE 1

Characteristics of Adolescent Patients Admitted With EVALI

CharacteristicsResults
No./total No. (%)13/13 (100)a
Mean age (range), y15.9 (13–18)
Female sex, No. (%)7 (54)
Race and/or ethnicity, No. (%)
 White7 (54)
 Hispanic6 (46)
E-cigarette or vaping history, No. (%)
 E-cigarette or vaping use in previous 90 d
  Δ-9-tetrahydrocannabinol12 (92)
  Nicotine8 (62)
  Both nicotine and Δ-9-tetrahydrocannabinol7 (54)
Nicotine vaping history, No./total No. (%)
 Duration
  3–6 mo1/8 (13)
  >12 mo5/8 (63)
  Unknown2/8 (25)
 Frequency
  Multiple times a wk or less1/8 (13)
  Daily1/8 (13)
  Multiple times per d5/8 (63)
  Unknown1/8 (13)
 Cartridges used per wk
  <12/8 (25)
  2–72/8 (25)
  Unknown4/8 (50)
 Source of cartridge
  Friend3/8 (38)
  Acquaintance or dealer1/8 (13)
  Unknown4/8 (50)
Δ-9-tetrahydrocannabinol vaping history, No./total No. (%)
 Duration
  3–6 mo3/12 (25)
  6–12 mo1/12 (8)
  >12 mo8/12 (67)
 Frequency
  Multiple times a wk or less5/12 (42)
  Daily1/12 (8)
  Multiple times per d6/12 (50)
 Cartridges used per wk
  ≤16/12 (50)
  2–71/12 (8)
  Unknown5/12 (42)
 Source of cartridge
  Friend5/12 (42)
  Acquaintance or dealer4/12 (33)
  Black market1/12 (8)
  Unknown2/12 (17)
Vaping brands reported, No./total No. (%)b
 Nicotine brands
  JUUL5/8 (63)
  NJoy2/8 (25)
  Suorin1/8 (13)
  Delosi1/8 (13)
 Δ-9-tetrahydrocannabinol brands
  Dank3/12 (25)
  Rove2/12 (17)
  Cali plug2/12 (17)
  Chronic carts1/12 (8)
  Runtz1/12 (8)
  Stig1/12 (8)
  EonSmoke1/12 (8)
  Brass knuckles1/12 (8)
  Dr Zodiac1/12 (8)
Reported length of e-cigarette use (range), d30–730
Psychosocial history, No. (%)
 Stressors identified from psychosocial history
  Home environment6 (46)
  Academic difficulty8 (62)
  Behavior problems6 (46)
  History of mood or anxiety disorder7 (54)
  History of suicidal or homicidal ideation5 (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), d3 (2–21)
 Constitutional symptoms, No. (%)13 (100)
  Subjective fever13 (100)
  Fatigue or malaise8 (62)
  Weight loss6 (46)
  Excessive sweating3 (23)
 Respiratory symptoms, No. (%)11 (85)
  Cough11 (85)
  Shortness of breath10 (77)
  Chest pain9 (69)
  Dyspnea on exertion6 (46)
  Wheezing3 (23)
 GI symptoms, No. (%)11 (85)
  Vomiting11 (85)
  Nausea10 (77)
  Diarrhea8 (62)
  Abdominal pain6 (46)
Abnormal vital signs at presentation, No. (%)
 Respiratory rate ≥20 breaths per min11 (85)
 Oxygen saturation ≤95% in ambient air11 (85)
 Temperature ≥38°C10 (77)
 Heart rate ≥120 beats per min9 (69)
 Blood pressure ≥135/850 (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. (%)
  Negative10/12 (83)
  Coronavirus1/12 (8)
  Rhinovirus1/12 (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 opacities13 (100)
  Lung bases greater than lung apices6 (46)
 Interlobular septal thickening2 (15)
 Pneumomediastinum2 (15)
 Crazy paving1 (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 ICU4 (31)
 Maximum respiratory support, No. (%)
  Room air1 (8)
  Nasal cannula8 (62)
  Bilevel positive airway pressure2 (15)
  Intubation with invasive mechanical ventilation1 (8)
  VV-ECMO1 (8)
 Duration of hospitalization, median (range), d7 (2–120)
Treatment course
 Antibiotics for lower respiratory tract infection, No. (%)
  Oral antibiotics before hospitalization6 (46)
  Intravenous antibiotics during hospitalization9 (69)
 Systemic glucocorticoids, No./total No. (%)
  Oral and intravenous glucocorticoids10/12 (83)
  Oral glucocorticoids alone1/12 (8)
  Intravenous glucocorticoids alone1/12 (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.