Vaping Links to Covid Risk Are Becoming Clear

Vaping Links to Covid Risk Are Becoming Clear

Twenty-year-old Janan Moein vaped his first pen a year ago. By late fall, he was blowing through several THC-laced cartridges a week — more, he said, than most people can handle.

Then in early December, he found himself in the emergency room of Sharp Grossmont Hospital in San Diego with a collapsed lung and a diagnosis of vaping-related lung illness. His hospital stay plunged him into a medically induced coma, forced him onto a breathing machine and stripped nearly 50 pounds off his 6-foot-1-inch frame in just two weeks.

At one point, Mr. Moein said, his doctors gave him a 5 percent chance of survival. He resolved that the wax pen he had vaped before his hospitalization would be his last.

When he contracted a mild case of Covid-19 during a family barbecue three months ago, he knew he had quit not a moment too soon. “If I had caught Covid-19 within the week before I got really ill, I probably would have died,” he said.

The active contents of cigarettes and vapes vary immensely, ranging from nicotine to THC, the high-inducing ingredient in marijuana. But many experts are more concerned about the other ingredients that tend to accompany them: additives like heavy metals and vitamin E acetate, which bathe the lung in toxins and ultrafine particles that can poison or pulverize delicate tissues.

Decades of research have unmasked smoking’s ability to put the immune system on the fritz. The punch of harmful chemicals packed into each puff is thought to discombobulate the system of checks and balances needed to direct disease-fighting cells and molecules toward harmful invaders like germs, while waylaying any misguided attacks on healthy tissues.

A body hamstrung by a smoking habit can struggle to rouse a sufficient defense against viruses — but has little trouble turning its arsenal of weapons inward. Eventually, deteriorating lungs can become chronically inflamed and awash with mucus, narrowing the airways and stymieing the flow of oxygen into the blood. Certain patients may end up with lungs pockmarked by scar tissue, further impeding the movement of air.

Dr. Lovinsky-Desir describes the internal architecture of these tissues as bunches of gas-filled grapes, enmeshed in a network of blood vessels. “Chronic smoking destroys those grapes,” she said. “They become saggy and floppy.”

Smoke can also compromise little hairlike structures known as cilia that boot toxins and microbes out of the airways, making it easier for pathogens to set up shop in the lungs.

Less is known about vaping, a relative newcomer. But similar trends have been noted for e-cigarettes and vape pens. Several studies have shown that vaping makes mice more vulnerable to bacteria and viruses, and sends surges of inflammation throughout the body, beyond the boundaries of the lungs.

Mr. Moein was one of thousands who last year fell prey to a disease called e-cigarette or vaping-associated lung injury, or Evali. Many Evali patients had vaped products containing a sticky substance called vitamin E acetate, which has been found in the branded Dr. Zodiak cartridges Mr. Moein preferred.

Mr. Moein still recalls his hospital stay in vivid detail.

“My lips were blue,” he said. “They had to tape my eyes shut. I was hallucinating the entire time that the nurses were trying to kill me, that the walls were made of human skin. It was a really bad situation.”

Nearly a year later, Mr. Moein, a towering athlete who played competitive sports in high school, said he was now once again “very healthy.”

But Dr. Laura Crotty Alexander, a pulmonologist and vaping expert at University of California San Diego and one of Mr. Moein’s doctors, said experts were still teasing apart the potential long-term effects of vaping, even brushes briefer than his.

“Just because he feels 100 percent recovered doesn’t mean his lung function returned to 100 percent,” she said.

After peaking last September, emergency department visits linked to Evali plummeted. But the Centers for Disease Control and Prevention has not updated their counts since February, leaving experts worried that concerns over vaping have fallen to the wayside. “This has not gone away from patients,” said Michelle Eakin, a pulmonary disease expert at Johns Hopkins University.

Still unclear are the long-term consequences of Covid’s effects on those who smoked or vaped. Accumulating evidence suggests that the coronavirus can wreak havoc on blood vessels, seeding clots that suffocate and warp tissues, including the lungs — most likely making any smoking or vaping after Covid even more dangerous than before.

“I used to tell him, ‘You’re out of touch, vaping is safer,’” he said. “At one point, I was getting so many articles that I blocked his number.”

But last year’s events flipped Mr. Moein’s worldview. The pandemic, he said, is another reminder that the risks of vaping simply aren’t worth it: “There’s no way in hell that vaping helps Covid-19.”

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