With Covid-19 topping the headlines, it’s easy to let other pressing news stories fall by the wayside, but a US doctor is urging us not to forget the lessons learned about vaping-associated lung injury from last year. A paper published in the journal Laryngoscope Investigative Otolaryngology reflects on mounting evidence of e-cigarette, or vaping, product use-associated lung injury (EVALI) and why the "safer" smoking alternative is such a bad idea in the context of the Covid-19 outbreak.
EVALI began to receive a lot of media attention in 2019 as increasing cases emerged of unusual presentations of lung injury in vaping patients. The increase in cases across the US but also elsewhere in the globe demonstrated a substantial escalation of preventable co‐morbid risk in otherwise healthy patients, according to Willard C. Harrill MD, author of the study and physician for the Carolina Ear, Nose & Throat Sinus and Allergy Center.
This increase in co-morbid risk – that is, the onset of symptoms which can worsen the prognosis if someone falls sick – can have a negative and significant impact on someone’s chances of surviving Covid-19. The paper stresses that if vaping is not sufficiently discouraged under the influence of the disease, the pulmonary inflammation caused by EVALI could lead to higher rates of mortality in patients who would have, without vaping, been otherwise healthy.
Dr Harrill’s research has revealed that the geographical location of highest EVALI presentations in hospitals is similar to that of the highest rates of Covid-19 (see above graph). The trend doesn’t constitute causation on the part of vaping, and the number of reported cases of EVALI are far lower than that of Covid-19, but Dr Harrill believes this could indicate that vaping may be putting younger people at a greater risk of suffering worse disease from Covid-19. Vapers are often young, meaning they could feel less at risk from Covid-19 due to their age, when in fact they could be at more risk of severe disease than they realize due to their e-cigarette-linked EVALI.
In the paper, Dr Harrill expresses his concern that unless they give up vaping during the pandemic, they could be putting themselves at higher risk of suffering severe Covid-19 symptoms. Patients with compromised respiratory function, such as those with chronic obstructive pulmonary disease (COPD) or asthma, are known to suffer worse symptoms, and it’s possible EVALI could result in a similar increased risk of severe illness and even death.