J Korean Med Sci.  2021 Dec;36(48):e331. 10.3346/jkms.2021.36.e331.

E-cigarette-associated Severe Pneumonia in Korea Using Data Linkage between the Korea National Health and Nutrition Examination Survey (KNHANES, 2013–2019) and the National Health Insurance Service (NHIS) Claims Database

• Kang HS
• Kim JY
• Park HJ
• Jung JW
• Choi HS
• Park JS
• Park JH
• Lee SH
• Chun EM
• Cho Y
• Rhee E
• Hwang BS
• on behalf of the Korean Smoking Cessation Study Group

• KMID: 2523308
• DOI: http://doi.org/10.3346/jkms.2021.36.e331

Abstract

Background
This study aimed to investigate the association between e-cigarette (EC) use and development of acute severe pneumonia in the Korean population using a national database.
Methods
We conducted a retrospective analysis using linkage of data between the Korean National Health and Nutrition Examination Survey (KNHANES) and the National Health Insurance Service (NHIS) administrative claims database. The primary endpoint of this study was development of severe pneumonia requiring hospital admission according to EC use during the study period. The secondary endpoints were in-hospital mortality, intensive care unit (ICU) admission, ventilator care, and days of hospital stay.
Results
The final analysis included 28,950 individuals, of which 578 (2.0%) were EC users. EC users were younger and more often male than non-EC users. The EC users showed higher level of education and household income and had fewer comorbidities. Severe pneumonia was noted in 37 of 28,372 non-EC users (0.13%), but there were no occurrences of severe pneumonia in EC users. The incidence of pneumonia occurrence was not different between the two groups (P = 1.000).
Conclusions
Since e-cigarette or vaping use-associated lung injury (EVALI) is most likely included in acute severe pneumonia occurring within 3 months of EC use, it is considered that there might be no EVALI patients in Korea during the investigation period. A large-scale, prospective study is necessary to evaluate the association between EC use and acute lung injury.

Keyword

E-cigarette Vapor; Pneumonia; Lung Injury

Figure

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  Fig. 1 Flow chart of the study population from KNHANES in the Republic of Korea.KNHANES = Korean National Health and Nutrition Examination Survey, CC = conventional cigarette, EC = e-cigarette.

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