Exploring the association of respiratory infection aetiology with mental well-being scores: a longitudinal study

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Background: Acute respiratory infections can disrupt both physical and psychological well-being. This study aimed to examine whether mental well-being differed according to respiratory infection aetiology during the first year of the SARS-CoV-2 pandemic and to identify factors associated with mental well-being over time. Methods: This prospective observational cohort study included 819 adults from nine European countries recruited during 2020 and 2021 as part of the SOS-COVID study. Mental well-being was assessed using the WHO-5 Well-Being Index at day 7 and day 28 following enrolment. Respiratory infection aetiology was classified as SARS-CoV-2, other viral infection, or no virus detected, and additionally grouped as SARS-CoV-2 versus no SARS-CoV-2 detected. Linear mixed-effects models with patients nested within countries examined associations between infection type and well-being scores, adjusting for age, recovery duration and time period. Results: Median WHO-5 well-being scores increased from 13 at day 7 to 18 at day 28. Participants with SARS-CoV-2 infection reported lower median well-being scores (12 and 17 at day 7 and day 28, respectively) compared with other viral infections (15 and 19), non-SARS-CoV-2 infections (13 and 18), and no virus detected (13 and 17). In adjusted analyses, lower day 28 well-being was associated with longer recovery duration (coef = -0.1, 95% CI: -0.2 to -0.1), SARS-CoV-2 infection (coef = -1.1, 95% CI: -1.8 to -0.3), recruitment during July to September and October to December 2020, and increasing age. Approximately 32% of variance in well-being occurred at the country level. Conclusion: SARS-CoV-2 infection was associated with lower mental well-being scores, particularly 1 month following enrolment, compared with other respiratory infection groups. Recovery duration and recruitment period also influenced well-being outcomes, suggesting that both infection-specific and contextual pandemic-related factors contributed to reduced mental well-being.

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