EVALI: Symptoms, Causes, Treatment

What are the symptoms of EVALI?

EVALI, or e-cigarette or vaping product use-associated lung injury, refers to a severe lung injury that has been associated with the use of e-cigarettes or vaping products. The symptoms of EVALI can vary but may include:

Respiratory symptoms: Such as cough, shortness of breath, chest pain, and difficulty breathing.
Gastrointestinal symptoms: Including nausea, vomiting, diarrhea, and abdominal pain.
Systemic symptoms: Such as fever, chills, and weight loss.
Other symptoms: Some people with EVALI may also experience fatigue, malaise, and symptoms similar to influenza or pneumonia.

The symptoms of EVALI can be similar to those of other respiratory illnesses, which can make diagnosis challenging. It’s important to seek medical attention if you develop any of these symptoms, especially if you have a history of vaping or using e-cigarettes.

What are the causes of EVALI?

EVALI, or e-cigarette or vaping product use-associated lung injury, is primarily caused by the use of e-cigarettes or vaping products. The exact cause of EVALI is not yet fully understood, but it is believed to be related to the inhalation of harmful substances or chemicals found in e-cigarettes or vaping products.

One of the key factors associated with EVALI is the use of vaping products containing tetrahydrocannabinol (THC), particularly those obtained from informal sources such as friends, family, or illicit dealers. Some of the potential causes or contributing factors to EVALI include:

Vitamin E acetate: This additive has been strongly linked to EVALI and is often used as a thickening agent in THC-containing vaping products.
Other harmful substances: E-cigarettes and vaping products can contain other harmful substances such as heavy metals, volatile organic compounds, and flavoring chemicals, which may contribute to lung injury.
Product contamination: Contaminated or counterfeit vaping products may contain additional harmful substances that can contribute to lung injury.
User behavior: Certain vaping behaviors, such as modifying devices or using them at high temperatures, can increase the risk of exposure to harmful substances.
Pre-existing lung conditions: Individuals with pre-existing lung conditions, such as asthma or chronic obstructive pulmonary disease (COPD), may be at higher risk of developing EVALI.

It’s important to note that while these factors are believed to play a role in the development of EVALI, research into the exact cause and mechanisms of the condition is ongoing.

How is the diagnosis of EVALI made?

The diagnosis of e-cigarette or vaping product use-associated lung injury (EVALI) is based on a combination of clinical findings, imaging studies, and a thorough evaluation of the patient’s history, including vaping or e-cigarette use. The following steps are typically involved in diagnosing EVALI:

Medical history and physical examination: Your healthcare provider will ask about your symptoms, including any respiratory or gastrointestinal symptoms, as well as your vaping or e-cigarette use history. They will also perform a physical examination to assess your overall health and look for signs of lung injury.
Imaging studies: Chest X-rays or computed tomography (CT) scans may be performed to evaluate the lungs for signs of inflammation, fluid buildup, or other abnormalities.
Laboratory tests: Blood tests may be done to check for signs of infection or inflammation. In some cases, a bronchoscopy with bronchoalveolar lavage (BAL) may be performed to collect fluid from the lungs for analysis.
Exclusion of other conditions: Your healthcare provider will also consider and rule out other possible causes of your symptoms, such as infections, autoimmune diseases, or other lung conditions.
Evaluation for vaping-related lung injury: If EVALI is suspected, your healthcare provider may ask about specific vaping products you have used, including the brand, type, and source. They may also inquire about the use of THC-containing products and whether any products were obtained from informal sources.

It’s important to seek medical attention if you develop respiratory symptoms, especially if you have a history of vaping or e-cigarette use. Prompt diagnosis and treatment are essential for managing EVALI and preventing complications.

What is the treatment for EVALI?

The treatment for e-cigarette or vaping product use-associated lung injury (EVALI) depends on the severity of the condition and may include the following approaches:

Supportive care: Many cases of EVALI can be managed with supportive care, which may include rest, hydration, and monitoring of oxygen levels.
Supplemental oxygen: In cases where oxygen levels are low, supplemental oxygen therapy may be necessary to help improve breathing and oxygenation.
Corticosteroids: In some cases, corticosteroids may be prescribed to help reduce inflammation in the lungs and improve symptoms. The use of corticosteroids is based on individual patient factors and the severity of the condition.
Antibiotics: If there is evidence of a bacterial infection, antibiotics may be prescribed. However, antibiotics are not effective against viral infections, which are often associated with EVALI.
Avoiding vaping or e-cigarette use: It is important to stop using e-cigarettes or vaping products to prevent further lung injury and allow the lungs to heal.
Hospitalization: Severe cases of EVALI may require hospitalization, where more intensive treatments such as mechanical ventilation or extracorporeal membrane oxygenation (ECMO) may be necessary.
Monitoring and follow-up: Regular monitoring and follow-up with healthcare providers are important to track progress and ensure that the lungs are healing properly.

It’s important to seek medical attention if you develop symptoms of EVALI, especially if you have a history of vaping or e-cigarette use. Early diagnosis and treatment can help improve outcomes and reduce the risk of complications.

How many years does it take for vape to damage your lungs?

Vaping has been linked to several respiratory problems, including lung injury and disease. The exact timeline of damage from vaping is still being researched, but here’s what we know so far:

Acute lung injury (EVALI): In 2019, a mysterious lung injury outbreak, known as EVALI (e-cigarette or vaping product use-associated lung injury), was reported in the United States. Most cases were linked to vaping products containing THC (tetrahydrocannabinol, the psychoactive compound in cannabis). The symptoms included coughing, shortness of breath, chest pain, and fatigue. Many cases required hospitalization, and some resulted in long-term lung damage or even death.
Chronic lung damage: Long-term vaping has been linked to chronic lung damage, which can occur even without severe acute injuries. Studies have shown that regular vaping can cause:
- Inflammation: Vaping can cause chronic inflammation in the lungs, which can lead to permanent damage over time.
- Fibrosis: Repeated exposure to e-liquids can cause scar tissue to form in the lungs, making it harder for them to function properly.
- Emphysema: Vaping has been linked to the development of emphysema, a chronic lung disease characterized by the destruction of air sacs in the lungs.
Timeframe: The exact timeframe for lung damage from vaping is not yet well-defined. However, studies suggest that:
- Acute lung injuries can occur within days or weeks of starting to vape.
- Chronic lung damage may develop over several months or years of regular vaping.

It’s essential to note that individual results may vary, and the extent of lung damage depends on several factors, including:

Frequency and duration of vaping
Type and strength of e-liquids used
Presence of other underlying health conditions
Genetic predisposition

To minimize the risks associated with vaping, it’s crucial to:

Avoid using e-cigarettes or vaping products altogether.
If you’re already a vaper, consider quitting or reducing your use.
Choose e-liquids with nicotine-free options and minimal additives.
Be aware of the ingredients and warnings on e-liquid packaging.

Remember, it’s always better to prioritize your health and avoid using e-cigarettes or vaping products altogether. If you have concerns about your lung health or experience any symptoms related to vaping, consult a healthcare professional for guidance.