Radiologic, Pathologic, Clinical, and Physiologic Findings of Electronic Cigarette or Vaping Product Use–associated Lung Injury (EVALI): Evolving Knowledge and Remaining Questions

Kligerman, Seth; Raptis, Costa; Larsen, Brandon T.; Henry, Travis S.; Caporale, Alessandra; Tazelaar, Henry D.; Schiebler, Mark L.; Wehrli, Félix W.; Klein, Jeffrey S.; Kanne, Jeffrey P.

doi:10.1148/radiol.2020192585

Cited by 123 publications

(198 citation statements)

References 77 publications

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“…However, additional imaging findings have been reported including linear, curvilinear or perilobular opacities, consolidation and diffuse GGO, which can mimic various pathological processes such as other infections, inhalational exposures, and drug toxicities 31,32 . Moreover, Valente et al 33 evidenced the importance to report also the incidental findings, not linked to the pneumonia, including peripheral pulmonary artery aneurysms or incidental pulmonary nodules.…”

Section: Ct and Rt-pcr Performance Results Mean Value Of Temporal DImentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system

Grassi

Fusco

Paola

et al. 2020

Sci Rep

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To assess the use of a structured report in the Chest Computed Tomography (CT) reporting of patients with suspicious viral pneumonia by COVID-19 and the evaluation of the main CT patterns. This study included 134 patients (43 women and 91 men; 68.8 years of mean age, range 29–93 years) with suspicious COVID-19 viral infection evaluated by reverse transcription real-time fluorescence polymerase chain reaction (RT-PCR) test. All patients underwent CT examinations at the time of admission. CT images were reviewed by two radiologists who identified COVID-19 CT patterns using a structured reports. Temporal difference mean value between RT-PCRs and CT scan was 0.18 days ± 2.0 days. CT findings were positive for viral pneumonia in 94.0% patients while COVID-19 was diagnosed at RT-PCR in 77.6% patients. Time mean value to complete the structured report by radiologist was 8.5 min ± 2.4 min. The disease on chest CT predominantly affected multiple lobes and the main CT feature was ground glass opacity (GGO) with or without consolidation (96.8%). GGO was predominantly bilateral (89.3%), peripheral (80.3%), multifocal/patching (70.5%). Consolidation disease was predominantly bilateral (83.9%) with prevalent peripheral (87.1%) and segmental (47.3%) distribution. Additional CT signs were the crazy-paving pattern in 75.4% of patients, the septal thickening in 37.3% of patients, the air bronchogram sign in 39.7% and the “reversed halo” sign in 23.8%. Less frequent characteristics at CT regard discrete pulmonary nodules, increased trunk diameter of the pulmonary artery, pleural effusion and pericardium effusion (7.9%, 6.3%, 14.3% and 16.7%, respectively). Barotrauma sign was absent in all the patients. High percentage (54.8%) of the patients had mediastinal lymphadenopathy. Using a Chest CT structured report, with a standardized language, we identified that the cardinal hallmarks of COVID-19 infection were bilateral, peripheral and multifocal/patching GGO and bilateral consolidation with peripheral and segmental distribution.

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Section: Ct and Rt-pcr Performance Results Mean Value Of Temporal DImentioning

confidence: 99%

Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system

Grassi

Fusco

Paola

et al. 2020

Sci Rep

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show abstract

“…These studies have shown that COVID-19 often produces a CT pattern resembling organizing pneumonia, notably peripheral ground-glass opacities (GGO) and nodular or mass-like GGO that are often bilateral and multilobar (11). However, additional imaging findings have also been reported including linear, curvilinear or perilobular opacities, consolidation, and diffuse GGO, which can mimic several disease processes including other infections, inhalational exposures, and drug toxicities (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Radiological Society of North America Expert Consensus Document on Reporting Chest CT Findings Related to COVID-19: Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA

Simpson¹,

Kay²,

Abbara³

et al. 2020

Radiology: Cardiothoracic Imaging

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“…In patients presenting with EVALI, the main symptoms include shortness of breath, cough, chest pain, diarrhea, abdominal pain, fever, and fatigue [ 13 , 14 ]. Symptoms occur anywhere from hours to weeks prior to presentation.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Finally, the recent coronavirus disease of 2019 (COVID-19) pandemic has resulted in further diagnostic challenges related to EVALI. There is a tremendous amount of overlap between the imaging findings of COVID-19 and EVALI [ 14 ]. However, the movement towards widespread pre-procedural testing for COVID has made it less likely for pulmonary specimens to be obtained from unrecognized COVID-19-positive patients.…”

Section: Practical Impact Of Evali On Pathology Practicementioning

confidence: 99%

Vaping-related lung injury

et al. 2020

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The use of electronic nicotine delivery systems has increased in popularity dramatically over the past decade. Although lung diseases caused by vaping have been reported since the modern invention of the electronic cigarette, in the summer of 2019, patients began to present to health care centers at epidemic levels with an acute respiratory illness relating to vaping, which the Center for Disease Control termed E-cigarette or vaping product use-associated lung injury (EVALI). This review discusses electronic nicotine delivery systems as well as the etiology, clinical presentation, imaging findings, pathologic features, treatment, and long-term consequences of EVALI. We conclude with the practical impact EVALI has had on the practice of pathology.

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Radiologic, Pathologic, Clinical, and Physiologic Findings of Electronic Cigarette or Vaping Product Use–associated Lung Injury (EVALI): Evolving Knowledge and Remaining Questions

Cited by 123 publications

References 77 publications

Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system

Coronavirus disease 2019 (COVID-19) in Italy: features on chest computed tomography using a structured report system

Radiological Society of North America Expert Consensus Document on Reporting Chest CT Findings Related to COVID-19: Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA

Vaping-related lung injury

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