New and Dangerous Illness Caused by Vaping: Details

The Rector of Yerevan State Medical University, Armen Muradyan, has made a note: "Doctors and specialists warn of a new and dangerous illness caused by vaping, known as EVALI (E-cigarette and Vaping use-Associated Lung Injury). EVALI is an acute inhalation injury to the lung tissue. 95% of patients with EVALI require hospitalization in a pulmonary or intensive care unit, while one-third require artificial ventilation of the lungs.

Experts estimate that the use of electronic nicotine-containing or nicotine-free products can lead not only to EVALI but also to heart, vascular, and respiratory system damage. The study of the disease has stalled since the onset of the coronavirus pandemic due to similarities with the symptoms, and its detection rate has ceased to rise, which does not reduce its danger for vaping users.

The disease has received the 'popcorn lung' nickname, as a popping sound similar to exploding popcorn can be heard from the patient's lungs. It is accompanied by respiratory difficulties, cough, pain, and hypoxia.

According to an article published on the Yale Medicine website, in the summer of 2019, the U.S. Centers for Disease Control and Prevention (CDC) began investigating a sharp increase in hospitalizations related to vaping. Patients complained of numerous respiratory symptoms, including shortness of breath, cough, and chest pain. All of them had one commonality: they had used vapes in the previous three months. As of February 2020, the CDC had recorded over 2,800 hospitalizations due to EVALI, and there were 68 reported deaths from the disease.

Researchers identified the chemical substance vitamin E acetate, which has been added to some THC-containing vaping products, as the primary possible cause of the disease. The outbreak of confirmed cases of the disease has occurred amid a continuing vaping epidemic among young people. According to CDC data, 15% of patients were under the age of 18.

Symptoms of EVALI can include:

• Shortness of breath
• Cough
• Chest pain
• Fever and chills
• Diarrhea, nausea, vomiting, and abdominal pain
• Palpitations
• Rapid and shallow breathing

What causes the onset of EVALI? Researchers have linked the onset of EVALI to vitamin E acetate - a synthetic form of vitamin E found in some THC-containing vaping products. When inhaled, this chemical can damage the lungs. In one study, vitamin E acetate was found in the lung fluid of 48 out of 51 patients whose samples were collected from 16 states. In contrast, lung fluid samples from healthy individuals did not contain vitamin E acetate. Due to this and other studies, vitamin E acetate is considered the primary cause of EVALI's onset. Other chemicals found in nicotine and THC-containing vaping products may also play a role in the development of this condition.

The diagnosis of EVALI is quite difficult, as the symptoms of this lung disease resemble those of other respiratory illnesses such as pneumonia and even seasonal flu. There is no specific test for diagnosing EVALI; the only option is what is termed "diagnosis by exclusion," wherein the doctor conducts numerous tests to rule out other potential illnesses and conditions.

Treatment can include:

• Corticosteroids—medications that reduce inflammation.
• Supportive therapy: patients may receive additional oxygen. In more severe cases, they may be connected to a ventilator.
• Antibiotics—these may be prescribed to patients while awaiting definitive diagnostic results, as EVALI can be challenging to distinguish from bacterial infections.
• Antiviral medications—since EVALI produces symptoms similar to certain viral infections, antiviral medications may be used, particularly during flu season.

As this health condition is quite new, it is impossible to predict how patients will feel after completing treatment and being discharged from the hospital. The above article notes that some people relapse after stopping steroid treatment, making consistency vital.