Sleep quality among solid organ transplant recipients during the COVID-19 reopening period in China: the interplay of SARS-CoV-2 infection, mental distress, and physical activity

ObjectivesGiven immunosuppression and comorbidities, solid organ transplant (SOT) recipients are more prone to infections during the COVID-19 pandemic. However, little is known about the relationship between SARS-CoV-2 infection and sleep quality in this population. This study aimed to investigate the association between SARS-CoV-2 infection and sleep quality among SOT recipients, examine the moderating roles of anxiety and depression, and explore whether the moderating effects vary with physical activity levels.Methods1121 participants were recruited online in Changsha, China, from February to March 2023. Measurements included sociodemographic and infection-related questionnaire, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, and International Physical Activity Questionnaire Short Form.Results83.0% of participants were infected during China's reopening period, and the average sleep quality score was 7.88 (SD = 3.59), indicating mild sleep disturbance. Anxiety and depression significantly moderated and strengthened the negative relationship between SARS-CoV-2 infection and sleep quality. Additionally, the moderating effects were significant at moderate-high levels of physical activity but not at low-moderate levels.ConclusionsPromoting interventions to alleviate anxiety and depressive symptoms, as well as facilitating a gradual return to general physical activity, is encouraged to mitigate the negative association between SARS-CoV-2 infection and sleep quality among SOT recipients.