What is EVALI Disease?
EVALI is a severe inflammatory lung disease, often requiring hospitalization, believed to be caused by certain chemicals in vaping products. One of the primary symptoms of this disease is shortness of breath. EVALI is a newly recognized disease, and while it is treatable, research on it is still ongoing.
This disease, associated with e-cigarette use, leads to lung damage. It typically occurs in individuals who have used e-cigarettes within 90 days prior to symptom onset.
EVALI can develop suddenly, presenting acutely, or it may progress gradually and steadily. In severe cases, it can be life-threatening.
Causes of EVALI Disease
The primary cause of EVALI disease is e-cigarette and vaping usage. Experts are not entirely certain which components of the e-liquids directly lead to inflammation, but there is a suspected link between EVALI and vitamin E acetate. Additionally, some manufacturers add THC-containing e-liquids. While vitamin E is safe when used in creams, lotions, or as a supplement, heating and inhaling it as vapor can cause lung damage.
Symptoms of EVALI Disease
Symptoms of EVALI disease include:
- Chest pain
- Chills
- Cough
- Fever
- Shortness of breath
- Diarrhea
- Tachycardia
- Nausea
- Vomiting
- Abdominal pain
- Unexplained weight loss
In some cases, EVALI can be fatal.
Diagnosis Criteria for EVALI Disease
Diagnosing EVALI can be challenging because its symptoms are similar to other lung diseases. The diagnostic process typically begins with a review of the patient's medical history and a physical examination, where the lungs are listened to. Patients may also be asked the following questions:
- What symptoms are being experienced?
- Is there a history of smoking?
- Has the patient used e-cigarettes within the past three months?
- Were nicotine, THC, or both used?
- Where was the e-liquid for vaping purchased?
Additionally, several tests may be conducted to confirm the diagnosis, including:
- Blood oxygen levels may be measured using a blood sample or pulse oximetry to determine how much oxygen is in the blood.
- Imaging tests can be used to assess the extent of lung damage.
- Lung function tests can measure how well the lungs are working.
Treatment Methods for EVALI Disease
Since EVALI shares symptoms with lung infections, antibiotics or antiviral medications are often prescribed first. Other treatment methods include:
- Corticosteroids may be prescribed to help reduce inflammation. These can be administered via inhalers or nebulizers.
- Oxygen therapy
- In severe cases, mechanical ventilation may be required.
Who is at Risk for EVALI Disease?
EVALI can occur in anyone who uses e-cigarettes. However, the risk of requiring hospitalization due to the disease is higher in the following situations:
- Being under 35 years old
- Using THC vapor
- Obtaining THC-containing e-cigarettes from unofficial sources
Risk Factors for EVALI Disease
More than 50% of EVALI patients require admission to the intensive care unit. Serious complications of EVALI include:
- Acute respiratory distress syndrome
- Respiratory failure
- Need for intubation and mechanical ventilation
- Death
