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The engagement with online health misinformation, particularly duringCOVID-19, poses unprecedented threats to societal well-being. Thesusceptibility to misinformation is heightened within a multi-topic contextduring health crises. This paper addresses a critical gap in understandingonline engagement with multi-topic misinformation related to COVID-19. Weconduct a comprehensive analysis of 7273 fact-checked source news claimsrelated to COVID-19 and their corresponding social engagement on X/Twitterthrough the lens of topic diversity and conspiracy theories. Our analysisyields several key findings: (i) False news, especially when accompanied byconspiracy theories, exhibits higher topic diversity compared to true news.(ii) In terms of engagement from source claims to online posts, false news hasa longer lifetime and receives more posts on X/Twitter compared to true news.Additionally, the integration of conspiracy theories is associated with alonger lifetime of COVID-19 misinformation. (iii) News posts characterized byheightened topic diversity receive increased social engagement on X/Twitter interms of reposts, likes, and replies. However, the effect of topic diversity ismoderated by the news veracity. High topic diversity is linked to moreengagement with true news posts compared to false news posts. (iiii) Theintegration of conspiracy theories is linked to more social engagement withmisinformation on X/Twitter. False news posts that contain conspiracy theories,on average, receive 40.8% more reposts, 45.2% more likes, and 44.1% morereplies compared to false news posts without conspiracy theories. Thesefindings offer insights into understanding the engagement with multi-topicmisinformation during health crises and highlight the importance of consideringtopic diversity and conspiracy theories in developing targeted interventions.

Topic Diversity and Conspiracy Theories Shape Engagement with COVID-19 Misinformation on X/Twitter