Doctors couldn’t figure out why a young man, recently hospitalized in an intensive care unit, was experiencing a severe course of COVID-19, given his age.
It led Dr. Clara Schroedl, a pulmonologist at Northwestern Memorial Hospital to ask his family, does he vape?
He didn’t, Schroedl said, but it’s a question on the minds of those who treat respiratory conditions, who recall the rash of teens and young adults across the country who vaped and were struggling to breathe requiring hospitalization last summer and fall.
“We just got through the EVALI (e-cigarette or vaping product use associated lung injury) epidemic in this country, so it’s high on people’s minds,” Schroedl said.
But like so many things associated with COVID-19, physicians don’t know if vaping, meaning use of nicotine or marijuana e-cigarettes, could make a person more susceptible to the coronavirus, or exacerbate the symptoms.
“Large-scale epidemiological studies on outcomes of people who vape … are not available,” Schroedl said, and “should be done.”
When word of the coronavirus pandemic in China made its way to the U.S., it was described as a disease that mostly affected the elderly. That message continued earlier this year as COVID-19 spread into Europe and as the U.S. saw its first cases.
But Centers for Disease Control and Prevention data shows U.S. COVID-19-related hospitalizations aren’t sparing the young. The most recent reports show a little more than half of hospitalizations are Americans younger than 65. About 22% are younger than 50. As with many aspects of COVID-19, doctors aren’t sure why.
It could be a number of reasons, including Americans’ obesity rates or other underlying conditions, or that younger people aren’t staying home because they work more essential jobs than the elderly, Schroedl said. But could vaping, a trend more prevalent among younger Americans compared with other countries, be another?
It’s hard to say because of the lack of data, Schroedl said, but there are studies that show vaping can harm lungs, and specifically immune system function in the lungs.
“If anything is causing damage or tissue damage in the lungs … you do worry,” she said. “Potentially the outcome (of COVID-19) could be more severe.”
Schroedl also pointed to data out of China that showed smoking tobacco cigarettes could lead to more severe cases of the coronavirus. That could be from existing lung damage from smoking, she said, or it could be that smokers are more likely to have other underlying conditions, like heart or lung disease.
But due to the respiratory nature of the virus, doctors are worried about patients with already damaged lungs.
“As a pulmonologist, what we’re telling patients … with preexisting lung disease is that they could be more susceptible and could get more severe infection when they get COVID,” said Dr. Renea Jablonski, a pulmonologist at the University of Chicago Medical Center. “But it’s not fully proven yet.”
Schroedl said it’s also hard to know the effects vaping could have on COVID-19 because doctors don’t always ask about it when taking medical histories. However, the recent EVALI outbreak, which ended up being tied to ingredients found in black market, marijuana-filled vaping devices, has prompted many doctors to ask their patients about vaping habits just as they would smoking, she said.
Without more information, it’s important to take any action that could prevent this virus, Schroedl said.
“It’s a great opportunity to quit smoking or vaping,” she said. “That’s one thing you have control over. What better time than now?”
Matthew Myers, president of the Campaign for Tobacco-Free Kids, said vaping is too new of a trend to have all the data needed, but “I haven’t talked to an epidemiologist, a pulmonologist or a pediatrician who isn’t concerned.”
He also pointed to a statement earlier this month from the National Institute on Drug Abuse, which in part warned that because the coronavirus attacks the lungs, its effects could be worse on those who smoke tobacco or marijuana or vape.
“If you’re a young person using these products, you need to recognize this potential increase in vulnerability means you’re facing risk now, not five years or 10 years from now,” Myers said.
And due to the state’s stay-at-home orders, many young people find themselves at home with their parents, away from any pressures from their peers, Myers added.
That could mean many parents “might be learning their kids vape for the first time,” he said. “My hope is that we’re going to see parents support their kids in quitting using e-cigarettes, and kids supporting parents in quitting cigarettes and e-cigarettes.”
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