Associations between COVID-19 infection experiences and mental health problems among Chinese adults: A large cross-section study

Objectives: This study aimed to: 1) estimate the prevalence of the coronavirus disease 2019 (COVID-19) infection and mental health problems in Chinese adults, after the relaxation of the dynamic zero-COVID-19 policy; 2) examine the relationship between multi-dimensional variables related to COVID-19 infection and mental health symptoms; 3) explore the differences in the above relationship between healthcare workers (HCWs) and general populations.Method: A large cross-sectional survey of residents in Beijing was conducted from January 13th to February 9th, 2023. A total of 53,762 adults were included in our analyses.Results: The infection rate of COVID-19 was 83.6 % in our study sample. The prevalence of depressive and post-traumatic stress symptoms (PTSS) was 20.0 % and 19.2 % in full sample, respectively. People with COVID-19 infection experience developed more mental health problems, especially for those still having physical symptoms. However, participants recovered from infection had lesser PTSS. Multi-dimensional variables related to COVID-19, i.e., infection status, frequency of infection, time from firstly tested positive, number, duration, severity of physical symptoms and the lowest SpO2, were all significantly associated with mental health symptoms. Occupational types were found to moderate the above relationships, and healthcare workers had less mental health symptoms though they had more infection exposure.Limitation: This was a cross-sectional study, limiting the causal inference.Conclusions: Multi-dimensional indicators related to COVID-19 infection are associated with mental health symptoms. The findings call for that more personalized mental health service should be delivered to the general populations with COVID-19 infection experience.