After careful consideration, the American Thoracic Society canceled its annual meeting that was to take place in Philadelphia, Pennsylvania from May 15-20, because of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Although the live events will not proceed as planned, our readers can still find coverage of research that was scheduled to be presented at the meeting. A virtual event is being planned for later this year.

Cases of e-cigarette or vaping product use–associated lung injury (EVALI), a term coined by the Centers for Disease Control and Prevention (CDC) appear to have been overlooked in the past. Researchers conducted a retrospective analysis to explore this issue, using the Agency for Healthcare Research and Quality-Healthcare Cost and Utilization Project (AHRQ-HCUP) Nationwide Inpatient Sample for the 2016 calendar year.

Results of the analysis were intended to be presented at the American Thoracic Society (ATS) International Conference in Philadelphia, Pennsylvania, but now may be provided in a virtual format later this year.

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The primary study objective was the incidence of hospitalizations linked to EVALI and to the use of e-cigarettes. The secondary study objectives included patient characteristics, clinical symptoms, reason(s) for hospital admission, rates of in-hospital mortality, and health resource use (ie, length of hospital stay and total costs related to hospitalization).

A total of 68,149 nonelective hospital admissions associated with the use of e-cigarettes and 6 cases of EVALI were recognized in 2016. Of the patients with nonelective hospitalizations associated with e-cigarette use, the average age was 57.5 years, and 16.7% were women. The majority of these patients had a low income status, were admitted to urban teaching hospitals with a large bed capacity, and had a higher-than-average Charlson Comorbidity Index (CCI). In this group of patients, the average length of hospital stay was 4.7 days. Overall, the total cost of hospitalization was $12,217.

In individuals with EVALI (n=6), the average age was 54.6 years, and 33.3% were women. Most of these patients had a low CCI, had private insurance, had an income level of ≥$70,000, and also were admitted to urban teaching hospitals with a large bed capacity. In this small group of patients, the most common symptom associated with hospitalization was nonspecific abdominal pain. The average length of hospital stay was 11 days. Overall, the total cost of hospitalization was $18,938.

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The investigators concluded that the results of the current study, which was designed to assess the prevalence of EVALI cases prior to the “Vaping Crisis of 2019,” suggest that these cases might have been overlooked in the past and highlights the importance of asking patients about their use of e-cigarette and vaping products.


Ho K, Nasserifar S, Sheehan J, et al. E-cigarette-associated lung injury is not that new. Am J Respir Crit Care Med. 2020;201:A1070.  

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