E-cigarette or vaping product use-associated lung injury (EVALI) masquerading as COVID-19. 2021

Nandita Ganne, and Raj Palraj, and Elizabeth Husted, and Ishan Shah
Family Medicine, Mayo Clinic Health System, La Crosse, Wisconsin, USA ganne.nandita@mayo.edu.

SARS-CoV-2, the novel coronavirus causing COVID-19, has caused a global pandemic resulting in over 4 million deaths globally (data current as of 14 July 2021). E-cigarette or vaping product use-associated lung injury (EVALI) is a type of acute lung injury of unclear pathogenesis. The two pathologies present with overlapping clinical symptoms, laboratory values and imaging, making them difficult to distinguish, especially in the setting of a global COVID-19 pandemic. We present the case of a 32-year-old woman treated for COVID-19 despite multiple negative SARS CoV-2 PCR tests and nucleocapsid antibody test. On further investigation, she endorsed use of E-cigarettes and was subsequently diagnosed with EVALI. The patient was treated with oral and intravenous steroids, resulting in significant improvement in her symptoms. This case highlights the challenge of diagnosing rarer aetiologies of respiratory distress during the COVID-19 pandemic.

UI MeSH Term Description Entries
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072137 Vaping Inhaling of vapors produced by ELECTRONIC NICOTINE DELIVERY SYSTEMS such as E-CIGARETTES. ECig Use,Ecigarette Use,Nicotine Vaping,THC Vaping,E-Cig Use,E-Cigarette Use,Electronic Cigarette Use,Vape,Cigarette Use, Electronic,E Cig Use,E Cigarette Use,E-Cig Uses,E-Cigarette Uses,ECig Uses,Ecigarette Uses,Electronic Cigarette Uses,Nicotine Vapings,THC Vapings,Use, E-Cig,Use, E-Cigarette,Use, ECig,Use, Ecigarette,Use, Electronic Cigarette,Uses, Ecigarette,Vapes,Vaping, Nicotine,Vaping, THC,Vapings, Nicotine,Vapings, THC
D000086382 COVID-19 A viral disorder generally characterized by high FEVER; COUGH; DYSPNEA; CHILLS; PERSISTENT TREMOR; MUSCLE PAIN; HEADACHE; SORE THROAT; a new loss of taste and/or smell (see AGEUSIA and ANOSMIA) and other symptoms of a VIRAL PNEUMONIA. In severe cases, a myriad of coagulopathy associated symptoms often correlating with COVID-19 severity is seen (e.g., BLOOD COAGULATION; THROMBOSIS; ACUTE RESPIRATORY DISTRESS SYNDROME; SEIZURES; HEART ATTACK; STROKE; multiple CEREBRAL INFARCTIONS; KIDNEY FAILURE; catastrophic ANTIPHOSPHOLIPID ANTIBODY SYNDROME and/or DISSEMINATED INTRAVASCULAR COAGULATION). In younger patients, rare inflammatory syndromes are sometimes associated with COVID-19 (e.g., atypical KAWASAKI SYNDROME; TOXIC SHOCK SYNDROME; pediatric multisystem inflammatory disease; and CYTOKINE STORM SYNDROME). A coronavirus, SARS-CoV-2, in the genus BETACORONAVIRUS is the causative agent. 2019 Novel Coronavirus Disease,2019 Novel Coronavirus Infection,2019-nCoV Disease,2019-nCoV Infection,COVID-19 Pandemic,COVID-19 Pandemics,COVID-19 Virus Disease,COVID-19 Virus Infection,Coronavirus Disease 2019,Coronavirus Disease-19,SARS Coronavirus 2 Infection,SARS-CoV-2 Infection,Severe Acute Respiratory Syndrome Coronavirus 2 Infection,COVID19,2019 nCoV Disease,2019 nCoV Infection,2019-nCoV Diseases,2019-nCoV Infections,COVID 19,COVID 19 Pandemic,COVID 19 Virus Disease,COVID 19 Virus Infection,COVID-19 Virus Diseases,COVID-19 Virus Infections,Coronavirus Disease 19,Disease 2019, Coronavirus,Disease, 2019-nCoV,Disease, COVID-19 Virus,Infection, 2019-nCoV,Infection, COVID-19 Virus,Infection, SARS-CoV-2,Pandemic, COVID-19,SARS CoV 2 Infection,SARS-CoV-2 Infections,Virus Disease, COVID-19,Virus Infection, COVID-19
D000086402 SARS-CoV-2 A species of BETACORONAVIRUS causing atypical respiratory disease (COVID-19) in humans. The organism was first identified in 2019 in Wuhan, China. The natural host is the Chinese intermediate horseshoe bat, RHINOLOPHUS affinis. 2019 Novel Coronavirus,COVID-19 Virus,COVID19 Virus,Coronavirus Disease 2019 Virus,SARS Coronavirus 2,SARS-CoV-2 Virus,Severe Acute Respiratory Syndrome Coronavirus 2,Wuhan Coronavirus,Wuhan Seafood Market Pneumonia Virus,2019-nCoV,2019 Novel Coronaviruses,COVID 19 Virus,COVID-19 Viruses,COVID19 Viruses,Coronavirus 2, SARS,Coronavirus, 2019 Novel,Coronavirus, Wuhan,Novel Coronavirus, 2019,SARS CoV 2 Virus,SARS-CoV-2 Viruses,Virus, COVID-19,Virus, COVID19,Virus, SARS-CoV-2,Viruses, COVID19
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D055370 Lung Injury Damage to any compartment of the lung caused by physical, chemical, or biological agents which characteristically elicit inflammatory reaction. These inflammatory reactions can either be acute and dominated by NEUTROPHILS, or chronic and dominated by LYMPHOCYTES and MACROPHAGES. E-Cigarette Use-Associated Lung Injury,E-Cigarette or Vaping Product Use-Associated Lung Injury,EVALI,Vaping Product Use-Associated Lung Injury,Chronic Lung Injury,Lung Injuries,Pulmonary Injury,Chronic Lung Injuries,E Cigarette Use Associated Lung Injury,E Cigarette or Vaping Product Use Associated Lung Injury,EVALIs,Injuries, Lung,Injuries, Pulmonary,Injury, Lung,Injury, Pulmonary,Lung Injuries, Chronic,Lung Injury, Chronic,Pulmonary Injuries,Vaping Product Use Associated Lung Injury
D058873 Pandemics Epidemics of infectious disease that have spread to many countries, often more than one continent, and usually affecting a large number of people. Pandemic
D066300 Electronic Nicotine Delivery Systems Devices or objects designed to provide NICOTINE in the form of an inhaled aerosol. E-Cig,E-Cigarette,Electronic Cigarette,Electronic Cigarettes,Electronic Nicotine Delivery System,E-Cigarettes,E-Cigs,Cigarette, Electronic,Cigarettes, Electronic,E Cig,E Cigarette,E Cigarettes,E Cigs

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