A study yesterday in Frontiers shows that university students experienced increased psychological distress during COVID-19 but used fewer mental health support services. This is the first known study to use a national dataset to compare use of mental health services pre- and post-pandemic. 

More U.S. college students suffered from mental health concerns during the pandemic, but fewer received necessary mental health treatment.

"More U.S. college students suffered from mental health concerns during the pandemic, but fewer received necessary mental health treatment," said first study author Elaine Russell, from George Mason University's College of Public Health, in a press release from that school.

The findings were based on data from fall 2019, early spring 2020, and spring 2021 surveys. Participants were limited to full-time undergraduate students aged 18 to 24 attending four-year universities in the United States. A total of 88,986 completed the National College Health Assessment before the COVID-19 pandemic, and 96,489 completed it during the pandemic.

High levels of stress during pandemic 

The participants were given a survey to assess mental health, stress, and loneliness, and asked how and if they accessed on-campus mental health services. Across all measures, mental health was worse in 2021 compared to 2019 and 2020. Of note, rates of students suffering from severe psychological distress increased from 19.0% pre-pandemic to 26.8% in spring 2021.

"During the peak of COVID-19, 82.4% of students reported experiencing moderate to high stress over the past 30 days, compared to 75.8% pre-COVID-19, which was also found to be statistically significant," the authors wrote. 

Due, in part, to campus shutdowns, students' rates of on-campus use of mental health services decreased from 58.6% to 44.4%, and rates of using services in the local community near campus decreased from 24.8% to 21.9%. 

Non-White and male students were less likely to use mental health services after the pandemic began compared to female students.

"This research study is important in helping to identify students who were at the greatest risk of psychological distress and least likely to access necessary mental health services," the authors concluded.

A study of two different strategies for optimizing antibiotic therapy in intensive care unit (ICU) patients with pneumonia found that both provided high rates of appropriateness in empiric antibiotic selection, but one was better at reducing antibiotic overuse, researchers reported today in Open Forum Infectious Diseases.

In the study, researchers from the University of Michigan and the University of Kansas compared two strategies for selecting empirical antibiotic treatment in patients with hospital-acquired and ventilator-associated pneumonia (HAP/VAP) caused by gram-negative bacteria, which is a common infection in intensive care units and associated with high morbidity and mortality. Guidelines recommend administering two antipseudomonal agents, but they lack clear guidance on which antibiotics to use. 

One strategy is to develop local antibiograms based on common pathogens and use the results to inform treatment strategies. The other is to base treatment on patient-specific risk factors, such as previous antibiotic use. 

To compare the two, the researchers spent one period (2021) collecting respiratory cultures and reviewing patient charts from ICU patients at a tertiary care hospital in Michigan to develop optimal empiric antibiotic regimens based on local antibiograms and a risk factor-based algorithm. In the second period (2022), they hypothetically applied the strategies to patients to compare rates of appropriate therapy and antibiotic overuse.

Risk factor–based approach offers advantages

The analysis found that risk factor–based regimens had a higher appropriateness rate compared to regimens derived from antibiograms (89.9% vs 83.7%). Additionally, applying antibiogram-based regimens resulted in a higher prevalence of antibiotic overuse than a patient-specific risk factor–based approach (69.8% vs. 40.3%), with excess overuse driven by a higher frequency of unnecessary use of combination therapy. 

"Both patient-specific risk factors and unit-specific combination antibiogram approaches were useful and can be applied in empiric antibiotic selection," the study authors wrote. "However, the patient-specific risk factor-based approach offers higher rate of appropriateness therapy and advantages in reducing the overuse of combination agents."

Amid unprecedented flooding across several parts of the country, South Sudan has declared a cholera outbreak, with 50 suspected cases reported so far, the World Health Organization (WHO) said today.

The outbreak’s location is Renk County in northern South Sudan, a border area where refugees are fleeing armed conflict in neighboring Sudan, the WHO said.

Flooding has affected more than 81,000 people and has displaced more than 46,000 in Upper Nile state, which includes Renk County.

South Sudan has activated a cholera task force, and the WHO said it is working closely with health officials to provide support, including the establishment of two cholera treatment units. The WHO also said it has deployed two rapid response teams and has delivered 12 metric tons of emergency kits, enough to treat 74,000 people.

Cholera activity and outbreaks have been on the rise since 2021, driven by complex factors that include population displacements and natural disasters. In a recent report, the WHO said cases this year are down from 2023 numbers, but deaths have more than doubled.