Acute respiratory distress syndrome associated with e-cigarette or vaping product use in Bogotá, Colombia: a lung injury epidemic.

BACKGROUND

E-cigarette or vaping product use-associated lung injury (EVALI) emerged as a serious public health concern following outbreaks in North America, but remains underreported in Latin America. This study aims to describe the clinical, radiologic, and histopathologic features of EVALI in a tertiary care center in Bogotá, Colombia.

METHODS

We conducted a retrospective case series of patients hospitalized with suspected EVALI between January 2020 and July 2024. Inclusion criteria followed CDC guidelines: history of vaping in the last 90 days, radiographic abnormalities (notably ground-glass opacities), and exclusion of alternative diagnoses. We analyzed demographic, clinical, imaging, and histopathologic data, including ICU admissions and outcomes.

RESULTS

Twenty-five patients met CDC criteria for EVALI. The mean age was 30 years; 80% were male. Most (72%) reported exclusive e-cigarette use, primarily nicotine-based. Informal sourcing of vaping liquids was reported in 28%. The most common symptoms were cough (88%), dyspnea (80%), and fever (76%). Imaging revealed bilateral ground-glass opacities in 88%. ICU admission was required in 76%, and 8% needed mechanical ventilation. Bronchoscopy and/or lung biopsy confirmed organizing pneumonia or acute interstitial inflammation in selected cases. All patients received corticosteroids with clinical and radiological recovery; no deaths occurred, however causality cannot be inferred from this retrospective series.

CONCLUSIONS

This is one of the largest EVALI case series reported in Latin America. Our findings underscore the importance of early recognition and management of EVALI in low- and middle-income countries, particularly amid increasing e-cigarette use among youth. Public health policies must address informal vape markets and misinformation surrounding product safety.