Now that COVID-19 is in the picture, people with compromised lungs or an underlying health condition should be extra careful when vaping.

A new study found links between vaping and symptoms of bronchitis in young adults, including coughing, wheezing and chest whistles. While avid smokers experienced more pronounced symptoms, these symptoms specific existed no matter the regularity of vaping.

The study, published in JAMA Network Open, provides some supporting data for the mysterious vaping condition that appeared in 2019, which made a lot of people very ill for no known reason. The disease, known as EVALI, affected more than 2,800 people from all over the US, resulting in deaths and hospitalizations that preceded COVID-19.

Researchers examined more than 2,000 young adults who answered questions in regard to their history of vaping and smoking, and their respiratory health. Study results showed that participants who had vaped cannabis had stronger links to symptoms of bronchitis, like coughs, congestion and phlegm, when compared to participants who had never vaped.

The more times that participants had smoked over the previous 30 days, the higher the odds were of developing these kinds of symptoms. When vaping cannabis three or more times within the past month, researchers noted twice the risk for wheezing and in some cases there were instances of chest whistling. These results weren’t associated with people who vaped nicotine.

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“More research is needed to determine if these relatively short term observations are harbingers of chronic changes and the development of chronic lung diseases,” Dr. Albert Rizzo told CNN.

Cases of EVALI have decreased throughout this year, with people steering clear of unknown brands of e-vapes and black markets cannabis cartridges. Still, a lot remains unknown, including the differences between vaping nicotine and cannabis and the effects of some of the chemicals that are present in these cartridges.

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Now that COVID-19 is in the picture, people with compromised lungs or an underlying health condition should be extra careful when vaping, steering clear of black market products and perhaps looking for other sources of cannabis. It’s 2020, and methods of getting high abound.