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Here, we focus on the COVID-19 pandemic and address a critical gap in understanding engagement with multi-topic misinformation on social media at two user levels: news source sharers (who post news items) and post viewers (who engage with news posts). To this end, we analyze 7273 fact-checked source news items and their associated posts on X through the lens of topic diversity and conspiracy theories. We find that false news, especially those containing conspiracy theories, exhibits higher topic diversity than true news. At news source sharer level, false news has a longer lifetime and receives more posts on X than true news, with conspiracy theories further extending its longevity. However, topic diversity does not significantly influence news source sharers' engagement. At post viewer level, contrary to news source sharer level, posts characterized by heightened topic diversity receive more reposts, likes, and replies. Notably, post viewers tend to engage more with misinformation containing conspiracy narratives: false news posts that contain conspiracy theories, on average, receive 40.8% more reposts, 45.2% more likes, and 44.1% more replies compared to those without conspiracy theories. Our findings suggest that news source sharers and post viewers exhibit distinct engagement patterns on X, offering valuable insights into refining misinformation interventions at these two user levels.<\/jats:p>","DOI":"10.1145\/3757479","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T17:32:00Z","timestamp":1760635920000},"page":"1-53","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From News Source Sharers to Post Viewers: How Topic Diversity and Conspiracy Theories Shape Engagement With Misinformation During a Health Crisis"],"prefix":"10.1145","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6181-7311","authenticated-orcid":false,"given":"Yuwei","family":"Chuai","sequence":"first","affiliation":[{"name":"University of Luxembourg, Luxembourg, Luxembourg"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5319-8060","authenticated-orcid":false,"given":"Jichang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Beihang University, Beijing, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8229-3270","authenticated-orcid":false,"given":"Gabriele","family":"Lenzini","sequence":"additional","affiliation":[{"name":"University of Luxembourg, Luxembourg, Luxembourg"}]}],"member":"320","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_1_1_1","doi-asserted-by":"publisher","DOI":"10.1257\/jep.31.2.211"},{"key":"e_1_2_1_2_1","first-page":"2707","volume-title":"Proceedings of the ACM Web Conference","author":"Ballard Cameron","year":"2022","unstructured":"Cameron Ballard, Ian Goldstein, Pulak Mehta, Genesis Smothers, Kejsi Take, Victoria Zhong, Rachel Greenstadt, Tobias Lauinger, and Damon McCoy. 2022. 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