Utilization of Mental Health Services Among Black Adolescents During the COVID-19 Pandemic: a Narrative Review of the Literature

Purpose of Review Black youth have disproportionately experienced inequities and barriers to care in accessing mental health services. The purpose of this review is to offer a summary of the currently available literature on mental health service utilization by Black youth during the COVID-19 pandemic, compared to prior. A narrative review was conducted in PubMed, Web of Science, psychINFO, and Embase from March 1, 2020 to September 1, 2022, to find studies that examined differences in the utilization of mental health services among Black youth. Recent Findings Our results found only 3 studies which examined pre and during the COVID-19 mental health utilization rates among Black youth. Among these studies, time period, study design, sample size, race data, and change in mental health utilization were evaluated. Summary From these results, we found that Black youth were overall less likely to utilize services for mental health during the pandemic. However, there were also findings that offer insights into innovative strategies to meet the needs of this unique population. As mental health service utilization has decreased and been slower to rebound from the pandemic compared to other health services, additional research on this topic is needed to ensure that the mental health needs of Black youth are being met.

Microbial signatures in the lower airways of mechanically ventilated COVID19 patients associated with poor clinical outcome (preprint)

Mortality among patients with COVID-19 and respiratory failure is high and there are no known lower airway biomarkers that predict clinical outcome. We investigated whether bacterial respiratory infections and viral load were associated with poor clinical outcome and host immune tone. We obtained bacterial and fungal culture data from 589 critically ill subjects with COVID-19 requiring mechanical ventilation. On a subset of the subjects that underwent bronchoscopy, we also quantified SARS-CoV-2 viral load, analyzed the microbiome of the lower airways by metagenome and metatranscriptome analyses and profiled the host immune response. We found that isolation of a hospital-acquired respiratory pathogen was not associated with fatal outcome. However, poor clinical outcome was associated with enrichment of the lower airway microbiota with an oral commensal (Mycoplasma salivarium), while high SARS-CoV-2 viral burden, poor anti-SARS-CoV-2 antibody response, together with a unique host transcriptome profile of the lower airways were most predictive of mortality. Collectively, these data support the hypothesis that 1) the extent of viral infectivity drives mortality in severe COVID-19, and therefore 2) clinical management strategies targeting viral replication and host responses to SARS-CoV-2 should be prioritized.

Strong Effects of Population Density and Social Characteristics on Distribution of COVID-19 Infections in the United States (preprint)

Background Coronavirus disease 2019 (COVID-19) has devastated global populations and has had a large impact in the United States. The objective of this manuscript is to study the relation of population demographics, social characteristics, and social distancing on the number of infections and deaths in the US. Methods Data came from publicly available sources. Social distancing was measured by the change in the rate of human encounters per km2 relative to the pre-COVID-19 national average. A smooth generalized additive model for counts of total infections and deaths at US county-level included population demographics, social characteristics, and social distancing. Results The model strongly predicted the geo-spatial variations in COVID-19 infections and deaths, 97.2% of variation in infections and 99.3% of variation in deaths from March 15, 2020. US counties with higher population density, poverty index, civilian population, and minorities, especially African Americans, had a higher rate of infections and deaths, and social distancing was associated with a slower rate of infections and deaths. The number of people infected was increasing; however, the rate of increase of new infections was showing signs of plateauing from the second week of April. Our model estimates that 1,865,580 US residents will test positive for infections and 117,246 fatalities by June 1, 2020. Importantly, our model suggests significant social differences in the infections and deaths across US communities. Areas with a larger African American population and a higher poverty index are expected to show higher rates of infections and deaths. Conclusion Preventive steps, including social distancing and community closures, have been a cornerstone in slowing the transmission and potentially reducing the spread of the disease. Crucial knowledge of the role of social characteristics in disease transmission is essential to understand and predict current and future disease distribution and plan additional preventive steps.