He also suggests vaping or smoking could be a risk factor.

“Anything that might be trashing the lungs in terms of their ability to withstand infection or in terms of the tissue integrity of that lung surface would be a risk category that we should be looking at carefully,” Steinberg says.

“One of the most difficult weeks of my life."

Colin Finnerty wonders if his nicotine habit could be why he nearly lost his life to COVID19.

“I did vape and I did smoke and it did hit me super, super, super violently,” says Finnerty.

The blond, athletic 21-year-old lives in a coronavirus hotspot in south central Idaho. Until he fell ill, he was a lift operator at Sun Valley Ski Resort.

Initially, Finnerty felt like he caught a cold.

“Like an everyday thing,” says Finnerty. “I really didn’t think twice about it.”

A few days passed, and then suddenly he woke up early one night drenched in sweat.

“I feel like I'm in a sauna,” says Finnerty. “I felt like I was melting, like my brain was like trying to force its way out of my skull.”

He was overcome by waves of dizziness, delusion and nausea. Finnerty’s temperature spiked to 103.9 °F. He spent seven hours slouched over a toilet vomiting until he dry heaved painfully.

“So I started to panic,” he says. “I was freaking out.”

It started to register that this could be COVID19, but it was hard to believe, because he had heard over and over that people his age are not generally at risk.

Eventually, Finnerty’s mother begged him to go to the hospital. He was diagnosed with mild pneumonia in one lung. A nurse collected a sample to test for COVID19 and urged him to self-quarantine. He was discharged with a bottle of antibiotics.

Two days later, Finnerty raced back to the emergency room.

“He looked like he wanted to jump out of his skin, clearly afraid of what was going on,” says Dr. Terry O’Connor, an emergency room physician at St. Luke’s Wood River Medical Center. “This does not look like anything else you've really seen before.”

Nurses ordered morphine to relieve Finnerty's pain. Further testing revealed pneumonia in both lungs. They put him on oxygen support, and an ambulance rushed Finnerty to a larger urban hospital three hours east in Boise, Idaho.

He spent the next six days coughing up blood, suffering from extreme dehydration, high fevers and body aches.

“This was one of the most difficult weeks of my life,” says Finnerty. “Not only physically the pain, but also mentally being in isolation.”

His family members were not allowed to visit, and medical staff limited rounds in an effort to preserve masks and gowns. Finnerty says nurses only delivered water, food and pain meds about every four hours.

A positive test result for COVID19 didn't arrive until a few days after he was discharged.

As he lies in bed at home recovering, surrounded by Pokémon and Donkey Kong figurines, Finnerty kicks himself for vaping for so long.

Scientists Worry Vaping and COVID19 Are A Bad Combo

Dr. Nora Volkow, director of the National Institute on Drug Abuse, warned in a recent blog post that people who vape might suffer more from the virus because it attacks the respiratory system. She wrote, "Vaping, like smoking, may also harm lung health. Whether it can lead to COPD is still unknown, but emerging evidence suggests that exposure to aerosols from e-cigarettes harms the cells of the lung and diminishes the ability to respond to infection."

A recent British Medical Journal review of the research on the respiratory effects of e-cigarettes concludes that, "... e-cigarette aerosol can negatively affect multiple aspects of lung cellular and organ physiology and immune function, e-cigarettes will likely prove to have at least some pulmonary toxicity with chronic and possibly even short term use."

“If people are injuring their lungs with either cigarette smoking or vaping or aerosolized marijuana," says Dr. Michael Schivo, pulmonologist at UC Davis Health. "I would definitely think that that could predispose them to worse infections and worse clinical disease when they're exposed to the respiratory virus," he says.

Schivo emphasizes that concrete data on the coronavirus and vaping doesn’t exist yet. But he assumes that vaping could lead to worse disease.

"It would not surprise me in the least to discover that vaping was a serious risk factor for severity as well as the amount of viral shedding (a public health concern)," said Dr. Jeffrey Gotts, a pulmonologist at UCSF in an email. "But as a clinician and scientist, we need to wait to see what the studies show."

Anti-vaping advocates worry kids might turn to nicotine devices more than usual right now due to boredom, anxiety and social isolation.

"We won't know what the unintended consequences of the shutdown is," says Dr. Elisa Tong, an internal medicine doctor at UC Davis. "Kids are already experimenting with nicotine and marijuana at school in pretty shockingly high numbers. So now with no adult supervision, it will be interesting to see what happens in the next school surveys."