Objectives: To assess the association between students' financial loss and depressive symptoms during the first wave of the coronavirus disease 2019 (COVID-19) pandemic and whether this association varied by countries having different levels of lockdown measures. Methods: This cross-sectional survey, conducted in spring 2020, included 91,871 students from 23 countries. Depressive symptoms were measured using the shortened Center for Epidemiological Studies Depression Scale and information on lockdowns retrieved from the COVID-19 government response tracker. The association between financial loss and depressive symptoms was investigated estimating prevalence ratios (PR) with multilevel Poisson models. Results: Some 13% of students suffered financial loss during the lockdown and 52% had a relatively high depression score, with large between-countries differences. Minimally and maximally adjusted models showed a 35% (PR = 1.35, 95% Confidence Interval (CI) = 1.29-1.42) and 31% (PR = 1.31, 95% CI = 1.26-1.37) higher prevalence of depressive symptoms in students who lost economic resources compared to students with stable economic resources. No substantial differences in the association were found across countries. Conclusion: Depressive symptoms were more frequent among students who suffered financial loss during the pandemic. Policy makers should consider this issue in the implementation of COVID-19 mitigating measures.

3rd Faculty of Medicine Charles University Prague Czechia

Centre for Population Family and Health Department of Sociology University of Antwerp Antwerp Belgium

Department of Biomedical Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy

Department of Readaptation and Geriatrics Faculty of Medicine Université de Genève Geneva Switzerland

Department of Social Work Bern University of Applied Sciences Bern Switzerland

Department of Sociology Faculty of Arts McGill University Montreal QC Canada

Health and Demographic Research Group Department of Sociology Ghent University Ghent Belgium

Institute of Primary Health Care University of Bern Bern Switzerland

Institute of Sociological Research Geneva School of Social Sciences University of Geneva Geneva Switzerland

National Institute of Mental Health Prague Czechia

Population Health Laboratory University of Fribourg Fribourg Switzerland

School of Population and Global Health McGill University Montreal QC Canada

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