Diagnosis of EVALI in the COVID-19 era
As of Feb 18, 2020, a total of 2807 cases of e-cigarette, or vaping, product use-associated lung injury (EVALI) and 68 attributed deaths have been reported to the US Centers for Disease Control and Prevention.
Diagnostic criteria for EVALI consists of a mixture of non-specific systemic symptoms (eg, fever, chills, and vomiting) and respiratory symptoms (eg, shortness of breath, cough, chest pain, pnoea, and hypoxia), along with detection of lung opacities on imaging. Diagnosis also depends on identifying a history of vaping and careful exclusion of alternative conditions.
A urine drug screen positive for tetrahydrocannabinol, although non-specific for the disease, might be helpful in this aspect by identifying marijuana-containing electronic cigarettes and vape use.