Mental health difficulties in students with suspected COVID-19 symptoms and students without suspected COVID-19 symptoms: A cross-sectional comparative study during the COVID-19 pandemic

INTRODUCTION: Mental health problems are taking a heavy toll on students during the COVID-19 pandemic. The purpose of this study was to compare the level of anxiety symptoms, depressive symptoms, post-traumatic stress symptoms (PTSS), and fear of COVID-19 between students with suspected COVID-19 symptoms and students without any suspected symptoms during the pandemic in Bangladesh. METHODS: This cross-sectional comparative study was conducted online among Bangladeshi students from May to July 2020. Anxiety symptoms, depressive symptoms, PTSS, and fear of COVID-19 were assessed by using the Generalized Anxiety Disorder scale, Patient Health Questionnaire, the Impact of Event Scale, and Fear of COVID-19 Scale, respectively. College and University students were the participants of the study. RESULTS: Among 3777 students, 1259 had suspected COVID-19 symptoms and 2518 had no suspected COVID-19 symptoms. Students who experienced suspected COVID-19 symptoms had higher prevalence (moderate to severe) of depressive symptoms (61.15% vs. 47.62%), anxiety symptoms (44.96% vs. 36.97%), and PTSS (48.3% vs. 39.75%) compared to those who had no such symptoms. The study identified having suspected COVID-19 symptoms as a significant associated factor for anxiety symptoms (β1′ = 1.39; 95% CI: 1.03–1.74), depressive symptoms (β1′ = 1.88; 95% CI: 1.43–2.32), PTSS (β1′ = 3.66; 95% CI: 2.66–4.65), and fear of COVID-19 (β1′ = 0.48; 95% CI: 0.02 to 0.94). Students with suspected COVID-19 symptoms thought more that they would be better off dead, or of hurting themselves (P < 0.01) and felt more afraid as if something awful might happen (P < 0.01) than their counterparts. CONCLUSION: Mental health difficulties are more prevalent among students with suspected COVID-19 symptoms than the students without having such symptoms. This finding suggests that public health practitioners should deploy a rapid diagnostic system and consider psychological intervention in addition to clinical management for those who have COVID-19 like symptoms during the pandemic.