Abstract
OBJECTIVE: Evidence demonstrates that Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection influences mental health through biological, psychological, and social mechanisms. In the post-pandemic period, defined as the time following the easing of major public health restrictions and the return to normalcy in daily life, university students represent a vulnerable population, experiencing a high prevalence of psychological problems due to the lingering influence of the pandemic on daily life and the emergence of long-term health consequences. There is an urgent need to understand these mental health symptoms and quantify their associated factors. METHODS: A questionnaire was designed to investigate the mental health symptoms of anxiety, depression, and insomnia among university students in Wuhan, focusing on four key domains: individual, family, school, and pandemic. Logistic regression was employed to analyze the related factors and conduct attribution analysis. RESULTS: Of the 2,668 eligible participants, 2,112 (79.2%) self-reported Omicron infection, and 352 (16.7%) experienced Long-COVID. The prevalence of moderate-to-severe depression was 18.2% (95% CI: 16.8%-19.7%), anxiety was 8.9% (95% CI: 7.8% - 10.0%) and insomnia was 31.4% (95% CI: 29.6%-33.1%). Moderate-to-severe psychological symptoms among university students were associated with ten factors across the four key domains, with total weighted Population Attributable Fractions (PAFs) accounting for 60.1% of depression, 40.8% of anxiety, and 61.6% of insomnia. Individual factors had the highest PAFs, contributing 31.2% to depression, 23.8% to anxiety, and 25.1% to insomnia, followed by pandemic-related PAFs of 17.7% ,10.3%, and 21.9% for depression, anxiety, and insomnia, respectively. CONCLUSION: The psychological challenges confronting university students in Wuhan are alarmingly severe, with individual factors superimposed on the pandemic caused by SARS-CoV2 being the primary contributors. We propose targeted intervention measures: strengthening psychological counseling services, increasing communication and exchange to enhance students' psychological resilience, raising awareness about mental health and lifestyle, alleviating students' fear of sequelae, assisting university students with academic planning and career guidance, cultivating adaptability, and promoting overall physical and mental health.