The relation between thrombus burden and early mortality risk in inpatients diagnosed with COVID-19-related acute pulmonary embolism: a retrospective cohort study

Abstract Background COVID-19-related acute pulmonary thromboembolism (APE) is associated with poor outcomes in patients with COVID-19. There are studies investigating the association between thrombus burden and high risk of early mortality in the pre-COVID-19 period. This study aimed to evaluate the relationship between clot burden and early mortality risk in COVID-19-related APE patients. Methods In this single-center retrospective cohort study, the data of hospitalized adult patients followed up for COVID-19-related APE between April 1, 2020, and April 1, 2021, were electronically collected. A radiologist evaluated the computed tomography (CT) findings and calculated the Mastora scores to determine clot burden. The early mortality risk group of each patient was determined using 2019 the European Society of Cardiology guidelines. Results Of the 87 patients included in the study, 58 (66.7%) were male, and the mean age was 62.5±16.2 years. There were 53 (60.9%) patients with a low risk of mortality, 18 (20.7%) with an intermediate-low risk, and 16(18.4%) with an intermediate-high/high risk. The median total simplified Mastora scores were 11.0, 18.5, and 31.5 in the low, the intermediate-low, and the intermediate-high/high-risk groups, respectively (p = 0.002). With the 80.61% of post-hoc power of the study, intermediate-high/high early mortality risk was associated statistically significantly with the total simplified Mastora score (adj OR = 1.06, 95%CI = 1.02–1.11,p = 0.009). Total simplified Mastora score was found to predict intermediate-high/high early mortality risk with a probability of 0.740 (95% CI = 0.603–0.877): At the optimal cut-off value of 18.5, it had 75.0% sensitivity, 66.2% specificity, 33.3% positive predictive value, and 92.2% negative predictive value. Conclusions The total simplified Mastora score was found to be positively associated with early mortality risk and could be useful as decision support for the risk assessment in hospitalized COVID-19 patients. Evaluation of thrombus burden on CT angiography performed for diagnostic purposes can accelerate the decision of close monitoring and thrombolytic treatment of patients with moderate/high risk of early mortality

Effects of psychiatric symptoms, age, and gender on fear of missing out (FoMO) and problematic smartphone use:Apath analysis with clinical-based adolescent sample

Background: Fear of missing out (FoMO) is a kind of anxiety that arises from FoMO on rewarding online social experiences that others might be having. Recent studies demonstrated that there is a strong relationship between FoMO and problematic smartphone use (PSU). In this study, we aimed to address the relationship between age, gender, psychiatric symptoms, PSU, and FoMO among a clinical-based adolescent sample. Methods: In total, 197 adolescents (136 boys, 1218 years) who applied to psychiatry clinics were recruited in the study. Path analysis with observed variables was used to investigate the relationships of PSU and FoMO with each other and with psychiatric symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism), age, and gender. Results: Path analysis showed that age (B-1 = 2.35, P < 0.001), somatization (B1 = 1.19, P < 0.001), hostility (B-1 = 0.92, P = 0.001), and paranoid ideation (B-1 = 0.93, P = 0.005) have significant positive effect on PSU, when interpersonal sensitivity has a significant negative effect (B-1 = -1.47, P < 0.001). For FoMO, male gender (B-0 = 0.35, P < 0.001), anxiety (B-1 = 1.37, P < 0.001), and PSU have positive effects, whereas age (B-1 = -1.60, P < 0.001), depression (B-1 = -0.58, P = 0.004), and hostility (B-1 = -0.49, P = 0.001) have a negative effect. Conclusions: Our study demonstrated that although PSU and FoMO are closely related to each other in previous studies, they have different associations with age, gender, and psychiatric symptoms among a clinical-based adolescent sample. The positive effects of PSU, anxiety on FoMO are predictable; however, the negative effect of age, hostility, and depression on FoMO was interesting. These relationships could be related to social exclusion-hostility and impulsivity-male gender/younger age associations in adolescence. In addition, we did not find a significant effect of FoMO on PSU, this could be related to the social and non-social use of smartphones, and should be reevaluated in clinical samples in the future