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From August 2019 to date, over 2,700 patients have been reported with e-cigarette, or vaping, associated lung injury (EVALI) in all the states of the US.

Study - Severe Lung Injury Associated With Use of e-Cigarette, or Vaping, Products—California, 2019. Image Credit: Shannon Laura / Shutterstock

The study results

The investigators found that among 160 patients with EVALI of whom approximately 60% were male, with a median age of 27 years, about half received intensive care, and a little less than a third had to be put on mechanical ventilation. Four of them died in hospital.

Of the 160 patients, 86 were subject to interview. Among this group, 83% said they vaped products containing tetrahydrocannabinol (THC), which is the psychoactive component of cannabis. 43% had vaped products containing cannabidiol (CBD), another principal constituent of the same plant. 47% had vaped products containing nicotine.

Implications

The authors emphasize, “These findings underscore the importance for all clinicians, including outpatient health care providers, to consider EVALI in patients with a history of vaping who present with typical findings of infection, as well as monitor their clinical course and respiratory status closely for decompensation, in accordance with CDC guidance.”...depression, and anxiety are the most common illnesses found in patients with EVALI in California, which could indicate that such patients vape at higher rates or that such patients are at higher risk of EVALI.

Again, vitamin E or vitamin E acetate proved to be present in most products containing THC.

The study concludes, “The California Department of Public Health recommends that individuals refrain from using any vaping or e-cigarette products, particularly THC-containing products from informal sources, while this investigation is ongoing.”

Journal reference: Heinzerling A, Armatas C, Karmarkar E, et al. Severe Lung Injury Associated With Use of e-Cigarette, or Vaping, Products—California, 2019. JAMA Intern Med. Published online March 06, 2020. doi:10.1001/jamainternmed.2020.0664