Remote ophthalmology with a smartphone adapter handled by nurses for the diagnosis of eye posterior pole pathologies during the COVID-19 pandemic.

Introduction: The use of smartphones to provide specialist ophthalmology services is becoming a more commonly used method to support patients with eye pathologies. During the COVID-19 pandemic, demand for telehealth services such as tele-ophthalmology, is increasing rapidly.Methods: In 2019, the agreement between diagnostic tests was investigated by comparing the diagnostic performance for eye posterior pole pathologies of the images obtained by a smartphone coupled to a medical device known as open retinoscope (OR), handled by a nurse and subsequently assessed by an ophthalmologist versus the images obtained by an ophthalmologist using a slit lamp associated to a 76 diopter indirect ophthalmic lens (Volk Super FieldVR ) (SL-IOL) at the outpatient department of a hospital. The OR used in this study worked with a 28 diopter indirect lens.Results: An examination of 151 dilated eyes (79 adult patients, mean age of 66.7 years, 59.5% women) was conducted. Sensitivity was 98.9%, specificity was 89.8%, the positive predictive value was 93.8% and the negative predictive value was 98.2%. The kappa index between both tests was 0.90 (95% CI: 0.83-0.97) in basic diagnosis, 0.81 (95% CI: 0.74-0.89) in syndromic diagnosis (13 categories) and 0.70 (95% CI: 0.62-0.77) in advanced diagnosis (23 categories).Discussion: Images obtained by a nurse using a smartphone coupled to the OR and subsequently assessed by an ophthalmologist showed a high diagnostic performance for eye posterior pole pathologies, which could pave the way for remote ophthalmology systems for this patient group.

Whole Sequencing and Detailed Analysis of SARS-CoV-2 Genomes in Southeast Spain: Identification of Recurrent Mutations in the 20E (EU1) Variant with Some Clinical Implications.

During the COVID-19 pandemic caused by SARS-CoV-2, new waves have been associated with new variants and have the potential to escape vaccinations. Therefore, it is useful to conduct retrospective genomic surveillance research. Herein, we present a detailed analysis of 88 SARS-CoV-2 genomes belonging to samples taken from COVID-19 patients from October 2020 to April 2021 at the "Reina Sofía" Hospital (Murcia, Spain) focused to variant appeared later. The results at the mentioned stage show the turning point since the 20E (EU1) variant was still prevalent (71.6%), but Alpha was bursting to 14.8%. Concern mutations have been found in 5 genomes classified as 20E (EU1), which were not characteristic of this still little evolved variant. Most of those mutations are found in the spike protein, namely Δ69-70, E484K, Q675H and P681H. However, a relevant deletion in ORF1a at positions 3675-3677 was also identified. These mutations have been reported in many later SARS-CoV-2 lineages, including Omicron. Taken together, our data suggest that preferential emergence mutations could already be present in the early converging evolution. Aside from this, the molecular information has been contrasted with clinical data. Statistical analyses suggest that the correlation between age and severity criteria is significantly higher in the viral samples with more accumulated changes.

Validación del modelo de riesgo de mortalidad en una cohorte prospectiva de pacientes de la sexta ola epidémica de la COVID-19 en un servicio de urgencias hospitalario

Objective. To validate risk factors for mortality in patients treated for COVID-19 in a hospital emergency department during the sixth wave of the pandemic. Method. Prospective observational noninterventional study. We included patients over the age of 18 years with a confirmed diagnosis of COVID-19 between December 1, 2021, and February 28, 2022. For each patient we calculated a risk score based on age 50 years or older (2 points) plus 1 point each for the presence of the following predictors: Barthel index less than 90 points, altered level of consciousness, ratio of arterial oxygen saturation to fraction of inspired oxygen less than 400, abnormal breath sounds, platelet concentration less than 100 x 109/L, C-reactive protein level of 5 mg/dL or more, and glomerular filtration rate less than 45 mL/min. The model was assessed with the area under the receiver operating characteristic curve (AUC). Results. Of the 1156 patients included, 790 (68%) had received at least 2 vaccine doses. The probability of 30-day survival was 96%. A risk score was calculated for 609 patients. Four hundred seventeen patients were at low risk of death, 180 were at intermediate risk, and 10 were at high risk. The probability of death within 30 days was 1%, 13%, and 50% for patients in the 3 risk groups, respectively. The sensitivity, specificity, and positive and negative predictive values of a risk score of 3 points or less were 88%, 72%, 19%, 99%, respectively. The AUC for the model was 0.87. Conclusion. The risk model identified low risk of mortality and allowed us to safely discharge patients treated for COVID-19 in our tertiary-care hospital emergency department.

Evaluation of the discrimination and calibration of predictive scores of mortality in ECMO for patients with COVID-19.

BACKGROUND: The criteria for the selection of COVID-19 patients that could benefit most from ECMO organ support are yet to be defined. In this study, we evaluated the predictive performance of ECMO mortality predictive models in patients with COVID-19. We also performed a cost-benefit analysis depending on the mortality predicted probability. We conducted a retrospective cohort study in COVID-19 patients who received ECMO at two tertiary care hospitals between March 2020 to July 2021. MATERIALS AND METHODS: We evaluated the discrimination (C-statistic), calibration (Cox calibration), and accuracy of the prediction of death due to severe ARDS in V-V ECMO score (PRESERVE), the Respiratory Extracorporeal Membrane Oxygenation Survival Score (RESP) score, and the PREdiction of Survival on ECMO Therapy-Score (PRESET) score. In addition, we compared the RESP score with Plateau pressure instead of Peak pressure. RESULTS: We included a total of 36 patients, 29 (80%) of them male and with a median (IQR) APACHE of 10 (8-15). The PRESET score had the highest discrimination (AUROCs 0.81 [95%CI 0.67-0.94]) and calibration (calibration-in-the-large 0.5 [95%CI -1.4 to 0.3]; calibration slope 2.2 [95%CI 0.7/3.7]). The RESP score with Plateau pressure had higher discrimination than the conventional RESP score. The cost per QALY in the USA, adjusted to life expectancy, was higher than USD 100 000 in patients older than 45 years with a PRESET > 10. CONCLUSION: The PRESET score had the highest predictive performance and could help in the selection of patients that benefit most from this resource-demanding and highly invasive organ support.

Age differences in knowledge, attitudes and preventive practices during the COVID-19 pandemic in Spain.

This study aims at describing the evolution of Spanish population preventive practices during the COVID-19 pandemic of the between January and June 2021, and differences by age group. Data was drawn from the COSMO-Spain online survey, rounds (R) 4, 5 and 6. Multiple linear regression models with preventive practices as dependent variable were performed. Preventive practices (p = 0.001) and concern about coronavirus (p = 0.003) decreased throughout the three rounds, knowledge decreased from R4 to R6 (p = 0.002) and health literacy had a higher value in R6 (p < 0.001). Older the age was associated with higher the frequency of preventive practices, and levels of health literacy and concern about coronavirus (p < 0.001). The regression model showed that, in the 18-29 year group, a greater frequency of preventive practices was associated with being female (ß = 0.20; p < 0.001), greater concern about coronavirus (ß = 0.16; p < 0.018) and frequency of information seeking (ß = 0.24; p < 0.001). For 61 years old and older, a higher frequency of preventive practices was associated with greater concern about coronavirus (ß = 0.21; p < 0.002) and lower pandemic fatigue (ß = - 0.13; p < 0.037). These findings point to the need for effective public health interventions tailored to the characteristics of age population groups.

Demystifying Bretton Woods Institutions' Rhetoric on Public Services.

This article reviews Bretton Woods Institutions' approach to public services, including during the recent COVID-19 crisis. Drawing on the specific case of IMF and World Bank's response to the multiple crisis triggered by the pandemic, it shows that there is a discourse-practice disjuncture in the institutions approach to public services as they continue to favour austerity and market-oriented solutions for the delivery of public services. The article therefore seeks to demystify the Bretton Woods institutions rhetoric and demand the adoption of a different way of understanding public services, and social policy more broadly.

Trends in COVID-19 Vaccine Acceptance in Spain, September 2020‒May 2021.

Objectives. To analyze factors associated with COVID-19 vaccine acceptance in Spain, over time. Methods. We used data from a national study that included 5 online surveys carried out every 2 months from September 2020 to May 2021. Each round recruited a sample of 1000 participants aged 18 years or older. We performed a multivariable logistic regression with vaccination acceptance as the dependent variable. We evaluated time trends through the interaction terms of each of the explanatory variables and the time. Results. Vaccination acceptance increased from 43.1% in September 2020 to 84.5% in May 2021. Sex, age, concerns about disease severity, health services overload, and people not wearing a face mask, together with adherence to preventive behavior, health literacy, and confidence in scientists, health care professionals' information, and adequacy of governmental decisions, were variables associated with vaccination acceptance. Conclusions. In a changing situation, vaccine acceptance factors and time trends could help in the design of contextualized public health messages. It is important to strengthen the population's trust in institutions, health care professionals, and scientists to increase vaccination rates, as well as to ensure easy access to accurate information for those who are more reluctant. (Am J Public Health. 2022;112(11):1611-1619. https://doi.org/10.2105/AJPH.2022.307039).

PRESSÃO SELETIVA E IMPACTO NA RESISTÊNCIA A CEFTAZIDIMA/AVIBACTAM NO MUNDO REAL

Patógenos Gram-negativos são responsáveis pela maioria das infecções nosocomiais ou associadas aos cuidados de saúde, principalmente casos de pneumonia associada à ventilação (PAV). Pacientes com fatores predisponentes, como vítimas de queimaduras graves, aqueles com função imunológica reduzida e aqueles internados em unidade de terapia intensiva (UTI), apresentam risco aumentado de infecções. Embora a extensão relatada de coinfecção com patógenos bacterianos em pacientes hospitalizados com COVID-19 varie, P. aeruginosa está entre as espécies mais frequentemente identificadas em tais pacientes, com uma proporção maior em pacientes criticamente enfermos de UTI. Além disso, os pacientes ventilados com COVID-19 podem ter maior risco de desenvolver PAV. Nosso objetivo foi avaliar no período de 3 anos da utilização da Ceftazidima/avibactam o impacto no perfil de sensibilidade aos Gram negativos mais frequentes nas infecções nosocomiais.

Perception of musculoskeletal pain in the state of confinement: associated factors.

OBJECTIVE: to describe the perception of musculoskeletal pain in the population and how the state of confinement (adopted as a measure to control contagion by COVID-19) has interfered with it, as well as identifying the sociodemographic, occupational, physical, and psychosocial factors involved. METHOD: an observational, cross-sectional and analytical study, with simple random probabilistic sampling, aimed at residents in Spain over 18 years old during the confinement period. An ad hoc survey was conducted, consisting in 59 items. RESULTS: a total of 3,247 surveys were answered. Persistent musculoskeletal pain or significant episodes thereof increased 22.2% during confinement. The main location was the spine (49.5%). The related factors were decreased physical activity, increased seated position, and use of electronic devices. The psychological impact of confinement was also related to the perception of musculoskeletal pain. CONCLUSION: the state of confinement causes an increase in the perception of musculoskeletal pain. The identification of a particularly sensitive population profile, as well as that of the related factors, allows establishing multidisciplinary approaches in health promotion.

Acute Renal Failure in COVID-19: Aetiology and Renal Evolution. AKI-COVID Registry of the Spanish Society of Nephrology

BACKGROUND AND AIMS Acute kidney injury (AKI) has been described as a frequent complication in patients with COVID-19. The incidence of AKI is estimated to be around 5%–80% depending on the series;however, data characterizing the type of AKI and the evolution of renal function parameters in the medium-long term are still limited. METHOD Based on the initial AKI-COVID Registry, we developed an extended registry where we registered retrospectively new variables that included clinical and demographic characteristics, infection severity parameters and data related to AKI (ethology, KDIGO classification, need of renal replacement therapy, analytic values: baseline creatinine, maximum creatinine during admission, creatinine at discharge or death, creatinine at 1 month after hospitalization and urinary parameters). Recovery of kidney function was defined as difference in at discharge or posthospitalization creatinine < 0.3 mg/dL with respect basal creatinine. RESULTS Our analysis included 196 patients: 74% male, mean age 66 + 13 years;65% hypertensive, 33% diabetic and 22% chronic kidney disease. According to the KDIGO classification: 66% AKI KDIGO3, 17% KDIGO2 and 15% KDIGO1. Creatinine values ​​are summarized in Table 1. We found significant differences in the baseline/high creatinine differential;these differences were lost after hospitalization.Table 1. Analytical evolution of the patients included in the study. ANOVA test for independent samples The main types of AKI were prerenal (35%) and acute tubular necrosis secondary to sepsis (ATN) (53%). 89% of patients with ATN presented AKI KDIGO 3, compared with 57% in the prerenal group (P < .001). Patients with prerenal AKI had greater comorbidity. On the other hand, patients with ATN AKI developed more serious COVID-19 infection: higher percentage of severe pneumonia, admission to the intensive care unit and need for orotracheal intubation. The analytical parameters were more extreme in patients with ATN AKI, except for creatinine and urea upon admission, which were higher in the prerenal AKI group. A total of 89 patients died during the study;65% of ATN AKI patients versus 31% of prerenal-AKI patients (P < .001). The ATN was a mortality risk factor, whit a hazard ratio 2.74 [95% confidence interval (95% CI )1.29–5.7] (P = .008) compared with the prerenal AKI. CONCLUSION AKI in hospitalized patients with COVID19 presented with two different clinical patterns. Prerenal AKI more frequently affected older, more comorbid patients, and with a mild COVID19 infection. The NTA AKI affected younger patients, with criteria of severity of infection and multiplying mortality almost three times. In analytical control 1-month post-hospitalization, most of the patients recovered their kidney function. Although the implications of AKI associated with COVID-19 in the development of chronic kidney disease are still unclear, our data suggest that most patients will recover kidney function in a medium term.

Mobile dependency and uncertainty reduction: influence on showrooming behaviours and user-generated content creation

Purpose>The expanded use of mobile devices for shopping has made mobile showrooming a frequent practice among omnichannel shoppers. This paper aims to shed light on the role of mobile dependency and uncertainty reduction strategies together with the motivation of getting the best value for money in showrooming behaviours and user-generated content (UGC) creation.Design/methodology/approach>Data were collected by means of a questionnaire answered by 659 shoppers in two product categories: clothing and consumer electronics. The research model was tested through partial least squares.Findings>The results suggest that mobile showrooming attitude is positively affected by mobile dependency, value consciousness and need for touch, and negatively by perceived risk of mobile shopping. The results also reveal how UGC is created by showroomers and suggest this behaviour is linked to mobile dependency in the clothing category.Research limitations/implications>All the individuals in the sample had some experience in showrooming, which could affect the results regarding showrooming attitude and intentions. Future research should consider the role of experience and also validate the results across a larger number of product categories.Practical implications>Mobile showrooming is a challenge for multichannel retailers. This paper reveals certain ways in which multichannel retailers could deal with showroomers as potential customers.Originality/value>This study is the first to analyse the role of mobile dependency in showrooming and the chain of effects towards mobile showrooming attitude, behaviour and UGC creation in two different product categories.

Saliva changes in composition associated to COVID-19: a preliminary study.

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2), is usually associated with a wide variety of clinical presentations from asymptomatic to severe cases. The use of saliva as a diagnostic and monitoring fluid has gained importance since it can be used to investigate the immune response and to direct quantification of antibodies against COVID-19. Additionally, the use of proteomics in saliva has allowed to increase  our understanding of the underlying pathophysiology of diseases, bringing new perspectives on diagnostics, monitoring, and treatment. In this work, we compared the salivary proteome of 10 patients with COVID-19, (five patients with mild and five patients with severe COVID-19) and ten control healthy patients. Through the application of proteomics, we have identified 30 proteins whose abundance levels differed between the COVID-19 groups and the control group. Two of these proteins (TGM3 and carbonic anhydrase-CA6) were validated by the measurement of gGT and TEA respectively, in 98 additional saliva samples separated into two groups: (1) COVID-19 group, integrated by 66 patients who tested positive for COVID-19 (2) control group, composed of 32 healthy individuals who did not show any sign of disease for at least four weeks and were negative for COVID-19 in RT-PCR. In the proteomic study there were observed upregulations in CAZA1, ACTN4, and ANXA4, which are proteins related to the protective response against the virus disturbance, and the upregulation of TGM3, that is correlated to the oxidative damage in pulmonary tissue. We also showed the downregulation in cystatins and CA6 that can be involved in the sensory response to stimulus and possibly related to the presence of anosmia and dysgeusia during the COVID-19. Additionally, the presence of FGB in patients with severe COVID-19 but not in mild COVID-19 patients could indicate a higher viral aggregation and activation in these cases. In conclusion, the salivary proteome in patients with COVID-19 showed changes in proteins related to the protective response to viral infection, and the altered sensory taste perception that occur during the disease. Moreover, gGT and TEA could be potential biomarkers of respiratory complications that can occurs during COVID 19 although further larger studies should be made to corroborate this.

Covid-19 mortality in children and adolescents in Mexico.

OBJECTIVE: To estimate Covid-19 and pre-pandemic low respiratory infection (LRI) mortality in children and adolescents in Mexico. MATERIALS AND METHODS: We estimated the percentage of total mortality attributable to Covid-19 (95% confidence intervals; 95%CI) and made the corresponding estimates for pre-pandemic LRI mortality. RESULTS: In 2019, LRIs represented 8.6% (95%CI 8.3, 8.9) of deaths in children aged 0-9 years, and 2.0% (95%CI 1.8, 2.3) in those aged 10-19 years. In 2020, the corresponding estimates for Covid-19 were 4.4% (95%CI 4.1, 4.6) and 3.7% (95%CI 3.4, 4.1). CONCLUSIONS: Relative to LRI, Covid-19 may be exerting a considerable mortality burden, particularly in older children and adolescents.

Hourly Analysis of Mechanical Ventilation Parameters in Critically Ill Adult Covid-19 Patients: Association with Mortality.

Objective: There exists controversy about the pathophysiology and lung mechanics of COVID-19 associated acute respiratory distress syndrome (ARDS), because some report severe hypoxemia with preserved respiratory system mechanics, contrasting with "classic" ARDS. We performed a detailed hourly analysis of the characteristics and time course of lung mechanics and biochemical analysis of patients requiring invasive mechanical ventilation (IMV) for COVID-19-associated ARDS, comparing survivors and non-survivors. Methods: Retrospective analysis of the data stored in the ICU information system of patients admitted in our hospital ICU that required IMV due to confirmed SARS-CoV-2 pneumonia between March 5th and April 30th, 2020. We compare respiratory system mechanics and gas exchange during the first ten days of IMV, discriminating volume and pressure controlled modes, between ICU survivors and non-survivors. Results: 140 patients were included, analyzing 11 138 respiratory mechanics recordings. Global mortality was 38.6%. Multivariate analysis showed that age (OR 1.092, 95% (CI 1.014-1.176)) and need of renal replacement therapies (OR 10.15, (95% CI 1.58-65.11)) were associated with higher mortality. Previous use of Angiotensin Converting Enzyme inhibitor (ACEI)/angiotensin-receptor blockers (ARBs) also seemed to show an increased mortality (OR 4.612, (95% CI 1.19-17.84)) although this significance was lost when stratifying by age. Respiratory variables start to diverge significantly between survivors and non-survivors after the 96 to 120 hours (hs) from mechanical ventilation initiation, particularly respiratory system compliance. In non survivors, mechanical power at 24 and 96 hs was higher regardless ventilatory mode. Conclusions: In patients admitted for SARS-CoV-2 pneumonia and requiring mechanical ventilation, non survivors have different respiratory system mechanics than survivors in the first 10 days of ICU admission. We propose a checkpoint at 96-120 hs to assess patients improvement or worsening in order to consider escalating to extracorporeal therapies.

Validación temporal de un modelo de riesgo de mortalidad por COVID-19 en una cohorte prospectiva en un servicio de urgencias de un hospital de tercer nivel

Objective. To validate a previously described hospital emergency department risk model to predict mortality in patients with COVID-19. Methods. Prospective observational noninterventional study. Patients aged over 18 years diagnosed with COVID-19 were included between December 1, 2020, and February 28, 2021. We calculated a risk score for each patient based on age ≥ 50 years (2 points) plus 1 point each for the presence of the following predictors: Barthel index < 90 points, altered level of consciousness, ratio of arterial oxygen saturation to fraction of inspired oxygen < 400, abnormal breath sounds, platelet concentration < 100 x 109/L, C reactive protein level ≥ 5 mg/dL, and glomerular filtration rate < 45 mL/min. The dependent variable was 30-day mortality. We assessed the score's performance with the area under the receiver operating characteristic curve (AUC). Results. The validation cohort included 1223 patients. After a median follow-up of 80 days, 143 patients had died;901 patients were classified as having low risk (score, ≤ 4 points), 270 as intermediate risk (5-6 points), and 52 as high risk (≥ 7 points). Thirty-day mortality rates at each risk level were 2.8%, 22.5%, and 65.4%, respectively. The AUC for the score was 0.883;for risk categorization, the AUC was 0.818. Conclusion. The risk score described is useful for stratifying risk for mortality in patients with COVID-19 who come to a tertiary-care hospital emergency department. Objetivo. Validación de un indicador de mortalidad previamente descrito en pacientes con COVID-19 en un servicio de urgencias hospitalario (SUH). Método. Estudio observacional prospectivo no intervencionista. Se incluyeron pacientes $ 18 años diagnosticados de COVID-19 (1 de diciembre de 2020 hasta 28 de febrero de 2021). Se calculó el indicador para cada paciente: edad ≥ 50 años (2 puntos), índice de Barthel < 90 puntos (1 punto), alteración de consciencia (1 punto), índice de SaO2/FIO2 < 400 (1 punto), auscultación respiratoria patológica (1 punto), plaquetas < 100 x 109/L (1 punto), proteína C reactiva ≥ 5 mg/dL (1 punto) y filtrado glomerular < 45 mL/min (1 punto). La variable dependiente fue la mortalidad observada a 30 días. El rendimiento del indicador se valoró con el análisis del área bajo la curva de la característica operativa del receptor (ABC-COR). Resultados. La validación del indicador se realizó sobre una cohorte de 1.223 pacientes. Tras una mediana de seguimiento de 80 días, 143 pacientes habían fallecido. Un total de 901 pacientes fueron catalogados como riesgo bajo (indicador ≤ 4 puntos), 270 lo fueron como riesgo intermedio (5-6 puntos) y 52 como riesgo alto (≥ 7 puntos). La mortalidad a 30 días observada en cada categoría fue de 2,8%, 22,5% y 65,4%, respectivamente. El ABC-COR fue de 0,883 para el indicador utilizado cuantitativamente y de 0,818 cuando se usó cualitativamente en forma de categorías de riesgo. Conclusión. El indicador descrito es una herramienta útil para estratificar el riesgo de mortalidad de los pacientes con COVID-19 que consultan a un SUH de un centro de tercer nivel.

Phyx.io: Expert-Based Decision Making for the Selection of At-Home Rehabilitation Solutions for Active and Healthy Aging

While the importance of physical activity in older adults is beyond doubt, there are significant barriers limiting the access of older adults to physical exercise. Existing technologies to support physical activity in older adults show that, despite their positive impacts on health and well-being, there is in general a lack of engagement due to the existing reluctance to the use of technology. Usefulness and usability are two major factors for user acceptance along with others, such as cost, privacy, equipment and maintenance requirements, support, etc. Nevertheless, the extent to which each factor impacts user acceptance remains unclear. Furthermore, other stakeholders, besides the end users, should be considered in the decision-making process to develop such technologies, including caregivers, therapists and technology providers. In this paper, and in the context of physical rehabilitation and exercise at home, four different alternatives with incremental characteristics have been defined and considered: a software-based platform for physical rehabilitation and exercise (Alternative 1), the same software platform with a conventional RGB camera and no exercise supervision (Alternative 2), the same software platform with a convention RGB camera and exercise supervision (Alternative 3) and finally, the same software platform with a depth camera and exercise supervision (Alternative 4). A multiple attribute decision-making methodology, based on the ordinal priority approach (OPA) method, is then applied using a group of experts, including end users, therapists and developers to rank the best alternative. The attributes considered in this method have been usefulness, cost, ease of use, ease of technical development, ease of maintenance and privacy, concluding that Alternative 3 has been ranked as the most appropriate.

A Cross-sectional Study of the Mental Health Symptoms of Latin American, US Hispanic, and Spanish College Students Amid the COVID-19 Pandemic.

Young adults and racial/ethnic minorities report the worst mental health outcomes during the COVID19 pandemic, according to the Center for Disease Control (2020). The objectives of this study were (1) to identify common mental health symptoms among Latin American, US Hispanic, and Spanish college students, and (2) to identify clinical features predictive of higher post-traumatic stress symptoms (PTSS) among this population. The study sample included 1,113 college students from the USA, Mexico, Chile, Ecuador, and Spain who completed an online survey containing demographic questions and mental health screeners. Findings revealed higher scores of depression, suicidality, and PTSS compared to pre-pandemic levels and current scores by non-Spanish speaking college students; however, less than 5% of participants endorsed clinical levels of anxiety. After controlling for demographic profiles and sociocultural values, clinical symptoms of depression, loneliness, perceived stress, anxiety, and coping strategies explained 62% of the PTSS variance. Age, history of mental illness, perceived social support, and familism were not significant predictors. This sample of college students revealed higher mental health symptoms during the COVID-19 pandemic. The high prevalence of PTSS highlights the need to develop pragmatic, cost-effective, and culturally sensitive prevention and intervention strategies to mitigate these symptoms. Implications for college administrators and clinicians are discussed.