Lung damage associated with e-cigarette smoking (EVALI)

This article describes clinical cases of lung damage associated with e-cigarette smoking, EVALI (from E-cigarette and Vaping use-Associated Lung Injury) with a brief review of the literature. With the proliferation and popularization of electronic cigarettes, lung injury associated with their smoking is becoming more common. The term EVALI emerged in 2019 during the largest outbreak in the United States of America (USA), at which time criteria for verifying the diagnosis were developed. This review provides descriptions of a variety of vaping devices and smoking liquids, presents possible mechanisms of lung tissue damage resulting from smoking e-cigarettes, as well as traumatic effects from exploding lithium vape batteries. The most frequent clinical manifestations are respiratory (dyspnea, cough, chest pain, hemoptysis), constitutional (fever, general weakness) and gastroenterologic (nausea, vomiting, diarrhea, abdominal pain) symptoms. The radiologic and histologic pictures of the disease are nonspecific and varied. The diagnosis of “vape disease” includes a wide range of investigations and is a “diagnosis of exclusion”. There are no standardized approaches in the treatment of EVALI, but most patients require oxygen therapy, respiratory support, and the use of systemic glucocorticosteroids. In the current literature there is no information about chronic lung damage against the background of smoking electronic cigarettes. The presented article describes clinical cases of acute lung tissue damage and long-term consequences as a result of vaping. Thus, EVALI is an emerging disease requiring further surveillance and study.

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