e-cig users have more COVID-19 symptoms

It is well-established that smokers and former smokers who are infected with COVID-19 do worse. (How smoking affects risk of infection is still an open question.) Now, there is evidence that vaping makes COVID worse among people who are infected.

David McFadden and colleagues at the Mayo Clinic have published “Symptoms COVID 19 Positive Vapers Compared to COVID 19 Positive Non-vapers” that, as the title indicates, compare symptoms in infected people who do and do not use e-cigs. They find that people diagnosed with COVID-19 who vaped were more likely to have chest pain or tightness (16% vs 10%, vapers vs non vapers), chills (25% vs 19%), muscle weakness (39% vs 32%), headaches (49% vs 41%), loss of smell/taste (37% vs 30%), nausea/vomiting/abdominal pain (16% vs 10%), diarrhea (16% vs 10%), and non-severe light-headedness (16% vs 9%).

While the authors do not discuss the underlying biological reasons, these findings are consistent with other research showing that vaping depresses immune function similar to smoking.

Here is the abstract:

Objectives: The purpose of the present study was to assess and describe the severity of symptoms reported by Covid-19 positive patients who vaped (smoked e-cigarettes) when compared to those who did not vape or smoke at the time of the diagnosis of Covid-19.

Methods: Patients from this study are from a well-characterized patient cohort collected at Mayo Clinic between March 1, 2020 and February 28, 2021; with confirmed COVID-19 diagnosis defined as a positive result on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays from nasopharyngeal swab specimens. Among the 1734 eligible patients, 289 patients reported current vaping. The cohort of vapers (N = 289) was age and gender matched to 1445 covid-19 positive patients who did not vape. The data analyzed included: date of birth, gender, ethnicity, race, marital status, as well as lifestyle history such as vaping and smoking and reported covid-19 symptoms experienced.

Results: A logistic regression analysis was performed separately for each symptom using generalized estimating equations (GEE) with robust variance estimates in order to account for the 1:5 age, sex, and race matched set study design. Patients who vaped and developed Covid-19 infection were more likely to have chest pain or tightness (16% vs 10%, vapers vs non vapers, P = .005), chills (25% vs 19%, vapers vs non vapers, P = .0016), myalgia (39% vs 32%, vapers vs non vapers, P = .004), headaches (49% vs 41% vapers vs non vapers, P = .026), anosmia/dysgeusia (37% vs 30%, vapers vs non vapers, P = .009), nausea/vomiting/abdominal pain (16% vs 10%, vapers vs non vapers, P = .003), diarrhea (16% vs 10%, vapers vs non vapers, P = .004), and non-severe light-headedness (16% vs 9%, vapers vs non vapers, P < .001).

Conclusion: Vapers experience higher frequency of covid-19 related symptoms when compared with age and gender matched non-vapers. Further work should examine the impact vaping has on post-covid symptom experience.

The full citation is: McFadden DD, Bornstein SL, Vassallo R, Salonen BR, Bhuiyan MN, Schroeder DR, Croghan IT. Symptoms COVID 19 Positive Vapers Compared to COVID 19 Positive Non-vapers. J Prim Care Community Health. 2022 Jan-Dec;13:21501319211062672. doi: 10.1177/21501319211062672. PMID: 34986700; PMCID: PMC8744181. It is available for free here.

Published by Stanton Glantz

Stanton Glantz is a retired Professor of Medicine who served on the University of California San Francisco faculty for 45 years. He conducts research on tobacco and cannabis control and cardiovascular disease/

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