Beyond infection: A mixed methods exploration of university students' perceived health impacts of the COVID-19 pandemic

The COVID-19 pandemic affected everyone-far beyond the burden of infection. Because university students are vulnerable to stress-related diseases, we aimed to (a) explore the perceived impact of the COVID-19 pandemic on university students' physical and mental health; (b) examine the perceived impact of pandemic-related changes in university studies and everyday life; and (c) identify key factors for health promotion and pandemic preparedness. Using a qualitatively driven mixed methods approach, in four studies during the COVID-19 pandemic, we cross-sectionally assessed German university students over four terms from the summer of 2020 to the winter of 2021-2022. Qualitative content analyses of responses from N = 1892 students revealed the pandemic's mainly negative impact on mental and physical health. Increased psychological burden and distress were mainly connected to overwhelming feelings of helplessness, hopelessness, paralysis, and uncertainty about the future under pandemic circumstances. In addition, students attributed negative health conditions to the shift to digital classes and social isolation. Some students also reported positive changes because of the pandemic, such as feeling less stressed or experiencing personal growth. Based on the qualitative results, we developed items to quantitatively assess the perceived health impacts of the pandemic. Analyses using data from N = 3197 students show correlational relationships between the perceived negative impacts of the pandemic on their health and life satisfaction. We derive implications for future pandemic preparedness and discuss the potential of the university setting for health promotion.