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Improvement in Pulmonary Function Following Discontinuation of Vaping or E-cigarette Use in Adolescents with EVALI
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  • Stanley Lee,
  • Edouard Sayad,
  • Naga Jaya Yenduri,
  • Kevin Yuqi Wang,
  • Paul Guilleman,
  • Harold Farber
Stanley Lee
Baylor College of Medicine
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Edouard Sayad
Baylor College of Medicine
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Naga Jaya Yenduri
Texas Children's Hospital
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Kevin Yuqi Wang
Baylor College of Medicine
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Paul Guilleman
Texas Children's Hospital
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Harold Farber
Baylor College of Medicine
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Peer review status:UNDER REVIEW

28 Jul 2020Submitted to Pediatric Pulmonology
29 Jul 2020Assigned to Editor
29 Jul 2020Submission Checks Completed
30 Jul 2020Reviewer(s) Assigned

Abstract

Introduction: In 2019, an alarming number of cases coined as e-cigarette, or vaping, product use associated lung injury (EVALI) was described in adolescents ranging from mild respiratory distress to fulminant respiratory failure. Limited data has been published on outcomes at short term follow-up. We aimed to describe pulmonary manifestations, function and radiologic findings after corticosteroid therapy in a cohort of adolescent patients. Methods: A retrospective chart review of all patients presenting to our institution between July and December 2019 with EVALI was conducted. Patients who had pulmonary follow-up were included. Spirometry was performed prior to discharge from the hospital and during outpatient follow-up. A paired t-test was used to compare serial spirometry data between visits. Results: Eight patients (6 males) were included. Two patients required intubation with mechanical ventilation, 2 required bilevel positive airway pressure (BPAP), and 3 required oxygen supplementation. All patients received glucocorticoids (3 receiving pulse dosing). Initial spirometry revealed decreased forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) with clinically and statistically significant improvement at follow-up. Diffusing capacity of the lungs for carbon monoxide (DLCO) was decreased in 2/6 patients initially and in 4/5 at follow-up. Radiographic manifestations also improved after vaping was discontinued. Conclusion: In our cohort of patients with EVALI, at short term follow up, all normalized their spirometry parameters. However, most did not normalize their DLCO on follow up, raising concern for risk of developing chronic lung disease later in life.