Family Medicine, Mayo Clinic Health System, La Crosse, Wisconsin, USA
Infectious Disease, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
BMJ Case Rep. 2021 Jul 23;14(7):e243885. doi: 10.1136/bcr-2021-243885.
SARS-CoV-2, the novel coronavirus causing COVID-19, has caused a global pandemic resulting in over 4 million deaths globally (data current as of 14 July 2021). E-cigarette or vaping product use-associated lung injury (EVALI) is a type of acute lung injury of unclear pathogenesis. The two pathologies present with overlapping clinical symptoms, laboratory values and imaging, making them difficult to distinguish, especially in the setting of a global COVID-19 pandemic. We present the case of a 32-year-old woman treated for COVID-19 despite multiple negative SARS CoV-2 PCR tests and nucleocapsid antibody test. On further investigation, she endorsed use of E-cigarettes and was subsequently diagnosed with EVALI. The patient was treated with oral and intravenous steroids, resulting in significant improvement in her symptoms. This case highlights the challenge of diagnosing rarer aetiologies of respiratory distress during the COVID-19 pandemic.
新型冠状病毒（SARS-CoV-2）导致了 COVID-19 大流行，目前已在全球造成超过 400 万人死亡（截至 2021 年 7 月 14 日的数据）。电子烟或蒸气相关肺损伤（EVALI）是一种不明发病机制的急性肺损伤。这两种病变表现出重叠的临床症状、实验室值和影像学特征，使其难以区分，尤其是在全球 COVID-19 大流行的背景下。我们报告了一例 32 岁女性的病例，尽管进行了多次 SARS-CoV-2 PCR 检测和核衣壳抗体检测均为阴性，但仍被诊断为 COVID-19。进一步调查发现，她承认使用电子烟，随后被诊断为 EVALI。该患者接受了口服和静脉注射类固醇治疗，其症状显著改善。该病例突出了在 COVID-19 大流行期间诊断罕见呼吸窘迫病因的挑战。
