Implications of electronic cigarette use in COVID-19: a systematic review of the literature




COVID-19; Vaping; Health Impact Assessment; Health teaching.


E-cigarette use can weaken the respiratory system and compromise the immune response, thus, there is greater susceptibility to respiratory infections, such as that caused by COVID-19. In this sense, the objective of this study is to analyze the impact on the infection caused by COVID-19 in young people who use electronic cigarettes. As for the methodology, it is a systematic review of the literature that searched for articles in the Virtual Health Library (BVS), U.S. National Library of Medicine (PubMed) and Google Scholar with the following descriptors: “Vaping” AND “COVID-19”. Of the 321 articles found, 285 were excluded due to escape from the topic, duplicity and unavailability of the full text, and the final corpus consisted of 27 articles, which were categorized into two axes: (I) Effects of electronic cigarettes in increasing the risk of transmission, infection and complications by COVID-19 and (II) Pathophysiology of the consequences of electronic cigarettes in the body. Vaporization is related to the occurrence of serious lung injuries that can cause decreased airway resistance to pathogens, increasing susceptibility to infections and complications from COVID-19. Therefore, it is extremely important to understand the relationship between vaping use and COVID-19 to understand its impact.


Archie, S. R. & Cucullo, L. (2020). Cerebrovascular and neurological dysfunction under the threat of COVID-19: is there a comorbid role for smoking and vaping?. International journal of molecular sciences 21(11), 3916.

Alqahtani, J. S., Aldhahir, A. M., Oyela, T., Alghamdi, S. M., Almamary, A. S. (2021). Smoking cessation during COVID-19: the top to-do list. NPJ Primary Care Respiratory Medicine 31(1): 1-3.

Besaratinia, A. (2021). COVID-19: a pandemic converged with global tobacco epidemic and widespread vaping —state of the evidence. Carcinogenesis 42(8), 1009-1022.

Brar, E., Saxena, A., Dukler, C., Xu, F., Saxena, D., Brar, P. C. & Li, X. Vaping. (2021). SARS-CoV-2, and multisystem inflammatory syndrome: a perfect storm. Frontiers in Pediatrics 9, 647925.

Blalock, K., Breve, F., Varrassi, G., Magnusson, P. & Pergolizzi, J. (2021). Vaping and subsequent comorbidities potentially associated with increased mortality and more severe illness in COVID-19: a narrative review. Signa Vitae 17(6): 25-36.

Farsalinos, K., Barbouni, A. & Niaura, R. (2020). Smoking, vaping and hospitalization for COVID-19. Qeios, 10 p.

Gaiha, S. M., Cheng, J. & Halpern-Felsher, B. (2020). Association between youth smoking, electronic cigarette use, and COVID-19. Journal of adolescent health 67(4), 519-523.

Gupta, P. S. & Kalagher, K. M. (2021). Where there is (no) smoke, there is still fire: A review of trends, reasons for use, preferences and harm perceptions of adolescent and young adult electronic cigarette use. Current Pediatrics Reports 9(3), 47-51.

Hopkins, D. B. & Al-Hamdani, M. (2021). Young Canadian e-cigarette users and the COVID-19 pandemic: examining vaping behaviors by pandemic onset and gender. Frontiers in public health 202(8), 1083.

Jessri, M., Sultan, A. S., Magdy, E., Hynes, N. & Sultan, S. (2020). Nicotine e-vaping and cardiovascular consequences: a case series and literature review. European Heart Journal: Case Reports 4(6), 1.

Kashyap, V. K., Dhasmana, A., Massey, A., Kotnala, S., Zafar, N., Jaggi, M., Yallapu, M. M. & Chauhan, S. C. (2020). Smoking and COVID-19: adding fuel to the flame. International journal of molecular sciences 21(18), 6581.

Kaur, G., Lungarella, G. & Rahman, I. (2020). Suscetibilidade de SARS-CoV-2 COVID-19 e tempestade inflamatória pulmonar por fumar e vaporizar. Jornal de inflamação 17(1), 1-8.

Kavuluru, R., Noh, J. & Rose, S. W. (2021). Twitter discourse on nicotine as potential prophylactic or therapeutic for COVID-19. International Journal of Drug Policy 99, 5 p.

Lallai, V., Manca, L. & Fowler, C. D. (2021). E-cigarette vape and lung ACE2 expression: Implications for coronavirus vulnerability. Environmental toxicology and pharmacology 86, 103656.

Lee, A. C., Chakladar, J., Li, W. T., Chen, C., Chang, E. Y., Wang-Rodriguez, J. & Ongkeko, W. M. (2020). Tobacco, but not nicotine and flavor-less electronic cigarettes, induces ACE2 and immune dysregulation. International journal of molecular sciences 21(15), 5513.

Li, D., Croft, D. P., Ossip, D. J. & Xie, Z. (2020). The association between statewide vaping prevalence and COVID-19. Preventive Medicine Reports 20, 101254.

Marques, P., Piqueras, L. & Sanz, M. J. (2021). An updated overview of e-cigarette impact on human health. Respiratory Research 22(1), 1-14.

Masso-Silva, J. A., Moshensky, A., Shin, J., Olay, J., Nilaad, S., Advani, I., Crotty & Alexander, L. E. (2021). Chronic E-cigarette aerosol inhalation alters the immune state of the lungs and increases ACE2 expression, raising concern for altered response and susceptibility to SARS-CoV-2. Frontiers in Physiology 12, 563.

McAlinden, K. D., Lu, W., Ferdowsi, P. V., Myers, S., Markos, J., Larby, J., Chia, C., Weber, C. H., Haug, G., Eapen, M. S. & Sohal, S. S. (2021). Electronic cigarette aerosol is cytotoxic and increases ACE2 expression on human airway epithelial cells: implications for SARS-CoV-2 (COVID-19). Journal of Clinical Medicine 10(5), 1028

Mungia, R. & Valdez, D. N. (2020). Smoking, Vaping, and the Benefits Cessation in Times of COVID-19: A Public Health Perspective. Frontiers in Dental Medicine 21, 6 p.

Münzel ,T., Hahad, O., Kuntic, M., Keaney, J. J. F., Deanfield, J. E. & Daiber, A. (2020). Effects of tobacco cigarettes, e-cigarettes, and waterpipe smoking on endothelial function and clinical outcomes. European heart journal 41(41), 4057-4070.

Naidu, V., Zeki, A. A. & Sharma, P. (2021). Sex differences in the induction of angiotensin converting enzyme 2 (ACE-2) in mouse lungs after e-cigarette vapor exposure and its relevance to COVID-19. Journal of Investigative Medicine 69(5), 954-961.

Pino, L. E., Triana, I., Pérez, C., Piotrostanalzki, A., Ruiz-Patiño, A., Lopes, G. & Cardona, A. F. (2021). Electronic nicotine delivery systems (ECs) and COVID-19: the perfect storm for young consumers Clinical and Translational Oncology 23(1), 5-9.

Schiliro, M., Vogel, E. R., Paolini, L. & Pabelick, C. M. (2021). Cigarette smoke exposure, pediatric lung disease, and COVID-19. Frontiers in physiology 12, 1-12.

Sifat, A. E., Nozohouri, S., Villalba, H., Vaidya, B. & Abbruscato, T. J. (2020). The Role of Smoking and Nicotine in the Transmission and Pathogenesis of COVID-19. Journal of Pharmacology and Experimental Therapeutics 375(3), 498-509.

Sivaraman, V., De’Jana, P. R. Z, Jones, M. M. & Onyenwoke, R. U. (2021). Vaping Exacerbates Coronavirus-Related Pulmonary Infection in a Murine Model. Frontiers in physiology 12.

Thulasee, J., Croghan, I. T., Hays, J. T., Schroeder, D. R., Warner, D. O. (2021). "Electronic cigarette use is not associated with COVID-19 diagnosis." Journal of Primary Care & Community Health 12, 1-5.



How to Cite

ROCHA, M. F. de A. .; BEZERRA, R. E. de A. .; VELOSO, W. G. .; GOMES, L. de A. .; TAVARES , L. F. G. .; ARAÚJO, Y. B. de . Implications of electronic cigarette use in COVID-19: a systematic review of the literature. Research, Society and Development, [S. l.], v. 11, n. 7, p. e34611730005, 2022. DOI: 10.33448/rsd-v11i7.30005. Disponível em: Acesso em: 26 may. 2024.



Health Sciences