E-Cigarette Users at Higher Risk for Symptomatic COVID-19

People who use electronic vaping devices and contract COVID-19 are more likely to experience symptoms, according to a study recently published in the Journal of Primary Care & Community Health.

The study cohort included patients identified by Mayo Clinic between March 1, 2020-February 28, 2021 with a confirmed COVID-19 RT-PCR positive test result. Of the 1734 patients in the study, 289 reported current vaping. The vapers were age and gender matched to 1445 COVID-19 patients who did not vape. Other collected data included age, gender, race, ethnicity, marital status, and lifestyle history (i.e., vaping and smoking).

Investigators performed logistic regression analysis of each reported symptom using generalized estimating equations (GEE). The variance estimates accounted for the 1:5 age, sex, and race cohort matched study design.

Among the COVID-19 patients who vaped, 16% reported chest pain or tightness, as opposed to 10% among the non-vapers. Patients who vaped were also more likely to develop chills (25% vs 19%, P = .0016), myalgia (39% vs 32%, P = .004), headaches (49% vs 41%, P = .026), anosmia/dysgeusia (37% vs 30%, P = .009), nausea/vomiting/abdominal pain (16% vs 10%, P = .003), diarrhea (16% vs 10%, P = .004), and non-severe light-headedness (16% vs 9%, P < .001).

Prior studies have shown e-cigarette use is correlated with lung inflammation and injury, but there are many uncertainties surrounding the health effects of e-cigarettes, largely due to the vast differences in vaping devices, ingredients, and usage.

The increased lung tissue inflammation induced by COVID-19 infection and vaping may increase the chances of systemic inflammation.

Robert Vassallo, MD, a Mayo Clinic pulmonologist, critical care specialist, and study coauthor, said, “"During a pandemic with a highly transmissible respiratory pathogen like SARS-CoV-2, it is highly advisable to reduce or stop vaping and e-cigarette use, and minimize the potential for increased symptoms and lung injury.”

The study authors concluded that vapers experience higher frequency of COVID-19 symptoms in comparison to the matched cohort of non-vapers. They recommended further research to determine whether vaping influences the post-COVID-19 symptom experience.