Three recent case studies show that breathing problems in teens could be a result of vaping or COVID, according to a UC Davis Health paediatric team.
Known as e-cigarette, or vaping, product use-associated lung injury (EVALI), it is present in large numbers. As of February 2020, 2758 cases of EVALI were hospitalised, with 64 deaths in the United States, and over half of those hospitalised were under 25 years old.
“EVALI and COVID-19 share many symptoms but have very different treatment plans,” said lead author Kiran Nandalike, associate professor of paediatrics. “For this reason, providers caring for pediatric patients with unexplained respiratory failure should consider EVALI and ask for relevant smoking/vaping history.”
EVALI and COVID patients often present with fever, cough, nausea, abdominal pain and diarrhoea. Bilateral ground glass opacities are seen in chest imaging in both conditions.
Adolescents often use vaping with marijuana obtained through friends, family and unlicenced dealers, with products often containing vitamin E acetate, an additive which is strongly associated with lung injury. Isolation and stress as a result of the COVID pandemic increased usage.
In the case studies, all of the patients had fever, nausea and cough, as well as a high heart rate, rapid breathing and low blood oxygen levels. Laboratory results showed higher white blood cells (WBC) count and elevated inflammation, pointing to COVID inflammation. Chest imaging revealed nonspecific ground glass opacities. Despite all other findings indicating COVID, SARS-CoV-2 testing was negative. The patients were successfully treated with steroids, a potentially life-saving treatment for EVALI.
“To help reduce risk of EVALI recurrence, providers would recommend vaping cessation counseling to patients and close outpatient monitoring,” advised Nandalike.
Source: Medical Xpress
