Public health investigation yields connection between vaping, severe lung disease

Researchers have used imaging findings to establish a connection between the use of e-cigarettes and severe pulmonary disease, sharing their findings in the New England Journal of Medicine. The report is part of an ongoing public health investigation involving patients from Wisconsin and Illinois.

The team explored data from 53 cases reported to the Wisconsin Department of Health Services and Illinois Department of Public Health (IDPH). All cases involved “generally young, healthy persons” who experienced pulmonary disease after e-cigarette use—or “vaping”—90 days before the onset of symptoms.

For each patient, the symptoms first began from April to August 2019, a time “outside the typical influenza season.” Eighty-three percent of the patients were male.

The authors noted that 91% of the patients had abnormal chest x-rays. Forty-eight of the 53 patients underwent CT imaging, and the CT findings were abnormal 100% of the time. Opacities were present in both lungs in 100% of the patients, and ground-glass opacities were observed in both lungs of four patients.

“Although the definitive cause of this cluster remains unknown, the severity of the illness and the recent increase in the incidence of this clinical syndrome indicates that these cases represent a new or newly recognized and worrisome cluster of pulmonary disease related to vaping,” wrote Jennifer E. Layden, MD, of the IDPH, and colleagues.

The authors did add that it is still too early to make any final determinations—but the similarities between these cases makes it worth exploring each case further.

“Given the disparate nature of e-cigarette–associated illnesses that have been reported in the literature, it is notable that case patients in Wisconsin and Illinois presented with similar clinical findings and progression of disease, which suggests a similar pathophysiological mechanism of lung injury,” Layden et al. wrote.

So should individuals who currently use e-cigarettes be concerned? According the study’s authors, users should “consider” not using them until the investigation has come to a close and some more concrete answers are in place.

“Adult smokers who are attempting to quit should consult with their health care provider and use proven treatments,” the authors concluded. “Irrespective of these findings, e-cigarettes should never be used by youths, young adults, pregnant women, and adults who do not currently use tobacco products.”

More Radiology Business coverage of this topic can be read here