Coagulopathy and thromboembolism in children with COVID-19 – pathophysiology, thrombotic risk, clinical manifestations and management

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the beginning of the pandemic, it has been generally accepted that children infected with SARS-CoV-2 either stay asymptomatic or present benign symptoms. Yet SARS-CoV-2 is widely known to cause serious consequences in children and adolescents. Complications may develop during infection, several weeks afterwards, or in the course of multisystem inflammatory syndrome in children (MIS-C). MIS-C manifests with fever, gastrointestinal, cardiovascular and/or neurological symptoms. Moreover, thromboembolism is a relatively common complication of COVID-19 and MIS-C. The purpose of this work was to review current reports on thromboembolic complications among children who underwent SARS-CoV-2 infection. Among the published cases of MIS-C, thromboembolic incidents ranged from 1.4% to 6.5%, taking the form of a brain infarct, deep vein thrombosis, pulmonary embolism, or splenic infarct. Several mechanisms leading to thrombosis in COVID-19 in children are considered. The development of acute infection in the lungs results in local clot formation in the pulmonary microcirculation, leading to perfusion disturbances. ADAMTS13 activity is also mildly reduced in patients infected with SARS-CoV-2, increasing the risk of microthrombosis. COVID-19-associated coagulopathy is characterized by elevated D-dimers and fibrinogen levels. Significantly increased D-dimers probably represent activation of coagulation caused by viremia and cytokine storm, as well as possible organ dysfunction. The treatment of thromboembolism in children includes low and high molecular weight heparins and acetylsalicylic acid. Pediatricians should be aware of the possible multiple complications associated with COVID-19 in children, including thromboembolic incidents

The mediating effect of the need for cognition between aesthetic experiences and aesthetic competence in art

Abstract Although the role of aesthetics and aesthetic education in everyday life was discussed as early as the ancient philosophers, the psychological mechanisms shaping the aesthetic quotient have hardly been investigated by empirical studies. The aim of this study was to examine the direct relationship between experience and aesthetic competence, and the mediating role of need for cognition. The study involved 201 Polish adults, aged 18 to 76 (M = 26.40; SD = 11.89), 65% of whom were women. The respondents completed anonymous questionnaires on an online platform. The surveys included a metric, the Aesthetic Competence Scale (ACS), the Aesthetic Experience Questionnaire (AEQ) and the Need for Cognition Scale (NCS). A positive correlation coefficient was obtained between all three variables studied, with need for cognition acting as a mediator in the relationship between experience and aesthetic competence. The findings indicate that individuals reporting intense aesthetic experiences have a higher aesthetic competence if this relationship is mediated by a high need for cognitive effort