Anxiety and Mood Disturbance Are Prospectively Associated With Respiratory Infection Risk and the Mucosal Immune Response to Exercise

Harrison, SE ORCID: 0000-0001-7980-0139, Edwards, JP ORCID: 0000-0003-1563-1924, Roberts, R ORCID: 0000-0003-0268-1228 and Walsh, NP ORCID: 0000-0002-3681-6015 (2025) Anxiety and Mood Disturbance Are Prospectively Associated With Respiratory Infection Risk and the Mucosal Immune Response to Exercise. European Journal of Sport Science, 25 (10). ISSN 1746-1391

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Abstract

We prospectively examined whether psychological factors influence (a) respiratory tract infection (RTI) risk and (b) the mucosal immune response to exercise. In Study 1, n = 406 adults (67% male) recorded RTI symptoms for two weeks before and after a marathon. In Study 2, under controlled laboratory conditions, n = 45 adults (51% male) completed 60 min of running at 65% V̇O<inf>2peak</inf> (EX) and seated rest (CON) in randomised order. Anxiety, total mood disturbance (TMD) and perceived psychological stress were measured before exercise. Saliva collected pre- and post-exercise was analysed for secretory immunoglobulin A (SIgA). Fifty runners suffered an RTI post-marathon. Runners prospectively reporting high trait anxiety or TMD were more likely to suffer an RTI post-marathon (OR [95% CI] = 1.06 [1.02–1.11] and 1.04 [1.01–1.07], respectively). Higher trait anxiety and TMD were associated with a greater reduction in saliva SIgA (p < 0.05). There was no association between mucosal immunity and RTI risk (OR [95% CI] = 1.00 [0.97–1.01]). In Study 2, despite no significant difference between EX and CON (p > 0.05), psychological factors were associated with the SIgA secretion rate response to exercise in men (trait anxiety, state anxiety, TMD, psychological stress: r = −0.55, −0.65, −0.61 and −0.66, respectively; p < 0.01). In conclusion, anxiety and mood disturbance were prospectively associated with infection risk after a marathon and the mucosal immune response to exercise. Athletes should optimise psychological well-being to support immune health. Researchers should take account of psychological factors when examining the mucosal immune response to exercise.

Item Type:	Article
Uncontrolled Keywords:	Saliva; Humans; Respiratory Tract Infections; Immunoglobulin A, Secretory; Exercise; Risk Factors; Prospective Studies; Stress, Psychological; Anxiety; Mood Disorders; Immunity, Mucosal; Running; Adult; Middle Aged; Female; Male; Young Adult; Marathon Running; SIgA; anxiety; marathon running; mucosal immunity; stress; Humans; Male; Adult; Respiratory Tract Infections; Immunity, Mucosal; Female; Saliva; Anxiety; Immunoglobulin A, Secretory; Prospective Studies; Stress, Psychological; Middle Aged; Mood Disorders; Marathon Running; Exercise; Young Adult; Running; Risk Factors; 42 Health Sciences; 4207 Sports Science and Exercise; Prevention; Clinical Research; Behavioral and Social Science; Basic Behavioral and Social Science; Physical Activity; Infectious Diseases; Mental Health; Inflammatory and immune system; 3 Good Health and Well Being; Humans; Male; Adult; Respiratory Tract Infections; Immunity, Mucosal; Female; Saliva; Anxiety; Immunoglobulin A, Secretory; Prospective Studies; Stress, Psychological; Middle Aged; Mood Disorders; Marathon Running; Exercise; Young Adult; Running; Risk Factors; 0913 Mechanical Engineering; 1106 Human Movement and Sports Sciences; Sport Sciences; 4207 Sports science and exercise; 5201 Applied and developmental psychology
Subjects:	Q Science > QP Physiology G Geography. Anthropology. Recreation > GV Recreation Leisure > GV561 Sports
Divisions:	Sport and Exercise Sciences
Publisher:	Wiley
Date of acceptance:	15 September 2025
Date of first compliant Open Access:	11 February 2026
Date Deposited:	11 Feb 2026 11:17
Last Modified:	11 Feb 2026 11:17
DOI or ID number:	10.1002/ejsc.70058
URI:	https://researchonline.ljmu.ac.uk/id/eprint/28079

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