Table 1: Comparison between EVALI and COVID-19.
|
EVALI |
COVID-19 |
Demographics |
Usually young patients |
Any age |
Exposure |
Use of E-CIGs or ENDS |
Mainly human to human transmission of the virus; through respiratory droplets or aerosols. |
Clinical presentation |
More common: Respiratory symptoms; Less common: Gastrointestinal symptoms. |
Usually respiratory symptoms. |
Labs finding |
Nonspecific elevation of white counts, liver enzymes, inflammatory markers. |
Lymphopenia is observed in COVID-19 elevated procalcitonin. |
Imaging |
X-ray: Bilateral pulmonary infiltrates CT scan Bilateral ground-glass opacities with areas of lobular or subpleural sparing. |
CT scan: Bilateral ground-glass opacities and peribronchovascular and subpleural reticular markings. |
Bronchoscopy |
Vitamin E and nicotine metabolite detection in lavage |
positive for SARS-CoV-2 by RT-PCR |
Histopathology |
Variable: Acute fibrinous pneumonitis. Diffuse alveolar injury. Foamy macrophages. Organizing pneumonia. |
Inflammatory changes with some organization. |
Management |
Stop further exposure; Symptomatic treatment with steroids or inhaled medications. |
Supportive care; Suggested treatments: Lopinavir/ ritonavir, chloroquine, hydroxychloroquine; Steroids are not recommended. |
Prevention |
Public awareness about health concerns of EVALI. |
Social distancing, isolation. |