{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:51:31Z","timestamp":1787226691590,"version":"build-2736575974"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>E\u2010cigarette, or vaping products produce an aerosol by heating nicotine, or cannabis including tetrahydrocannabinol (THC) and cannabidiol (CBD), mixed with other chemicals that help make the aerosol. They are increasingly popular among teenagers and young adults, with a 2023 survey reporting that 2.13 million middle and high school students in the United States used e\u2010cigarettes within the last 30 days. The use of e\u2010cigarette, or vaping products could lead to an acute pulmonary inflammatory syndrome called e\u2010cigarette, or vaping, product use\u2010associated lung injury (EVALI). We review the challenges in diagnosing and treating EVALI, especially during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a literature search on June 10, 2024 using the PubMed database. We searched for articles, case reports and CDC reports investigating the pathogenesis, treatment, and challenges of diagnosing EVALI during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The exact causes of EVALI are not completely understood, although it has been linked to the use of THC and vitamin E acetate. There are no specific biomarkers to diagnose EVALI and it is typically diagnosed through a process of eliminating other possible conditions. Eight studies detailed cases where pediatric patients were initially diagnosed with COVID\u201019 or community\u2010acquired pneumonia, despite multiple negative COVID\u201019 tests, and were later found to have EVALI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After alerting the public about the removal of vitamin E acetate from vape liquids in 2020, there has been a decline in cases of EVALI, although they are still detected. Therefore, it is necessary to continue looking for diagnostic markers of EVALI and further investigate the toxicity of vapes and e\u2010cigarettes to prevent the recurrence of another EVALI epidemic, especially among teenagers and young adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.27448","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T08:13:47Z","timestamp":1734941627000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["E\u2010cigarette, or Vaping, Product Use Associated Lung Injury: Epidemiology, Challenges, and Implications With COVID\u201019"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7355-8529","authenticated-orcid":false,"given":"Winny","family":"Soerianto","sequence":"first","affiliation":[{"name":"Curriculum in Toxicology and Environmental Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilona","family":"Jaspers","sequence":"additional","affiliation":[{"name":"Curriculum in Toxicology and Environmental Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"},{"name":"Center for Environmental Medicine, Asthma, and Lung Biology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"},{"name":"Department of Pediatrics, School of Medicine University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,23]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Smoking and Tobacco Use; Electronic Cigarettes","author":"CDC","year":"2021"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7244a1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2161-0105"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30360-X"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1916433"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202209-796ST"},{"key":"e_1_2_8_8_1","volume-title":"The Lung Injuries Associated With Use of Vaping Products","author":"Commissioner O.","year":"2024"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.0756"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6841e3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11604-021-01120-w"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.19.22251"},{"key":"e_1_2_8_13_1","volume-title":"COVID\u201019 Treatment and Preventive Medication","author":"CDC"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12112"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.11.042"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2324709620972243"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30321-0"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/21501319211062672"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocpiqo.2021.03.002"},{"key":"e_1_2_8_20_1","article-title":"E\u2010Vape and E\u2010Cigarettes\u2010Associated Lung Injury (EVALI) in the COVID\u201019 Pandemic: A Diagnostic Dilemma and Therapeutic Challenge","volume":"14","author":"Mandal G.","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","unstructured":"R.Abdelmaseih R.Abdelmasih S. M.Hasan J. J.Chacko andR.Ramos De Oleo \u201cIn a World of Horses Don't Miss Zebras: A Case of E\u2010cigarette or Vaping Use\u2010Associated Lung Injury (EVALI) in the COVID\u201019 Era \u201d inTP60. TP060 Clinical Cases From Environmental and Occupational Health: Vaping COVID\u201019 and Other Unique Exposures A3012\u2013A3012(American Thoracic Society 2021) https:\/\/doi.org\/10.1164\/ajrccm-conference.2021.203.1_MeetingAbstracts.A3012.","DOI":"10.1164\/ajrccm-conference.2021.203.1_MeetingAbstracts.A3012"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","unstructured":"K.Hamid S.Perinkulam Sathyanarayanan M.Hamza andS. bHelbergVaping Is It a Safer Alternative Then Smoking? in TP60. TP060 Clinical Cases From Environmental and Occupational Health: Vaping COVID\u201019 and Other Unique Exposures A3015\u2013A3015(American Thoracic Society 2021) https:\/\/doi.org\/10.1164\/ajrccm-conference.2021.203.1_MeetingAbstracts.A3015.","DOI":"10.1164\/ajrccm-conference.2021.203.1_MeetingAbstracts.A3015"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-243885"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.08.1432"},{"key":"e_1_2_8_25_1","article-title":"A Case Series of E\u2010Cigarette or Vaping\u2010Associated Lung Injury With a Review of Pathological and Radiological Findings","volume":"14","author":"Pourshahid S.","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050313X20969590"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25804"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.27448","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.27448","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.27448","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T15:31:09Z","timestamp":1771428669000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.27448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,23]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/ppul.27448"],"URL":"https:\/\/doi.org\/10.1002\/ppul.27448","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,23]]},"assertion":[{"value":"2024-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e27448"}}