Although people were well informed, increased worries resulted in emotional instability during the first week of the coronavirus disease 2019 (COVID-19) outbreak in Italy, according to survey results published in JAMA Network Open.

Knowledge about COVID-19 and the recommended health behaviors, as well as worries, social appraisal, and preventive behaviors were analyzed from a survey conducted online in Italy from February 26, 2020, to March 4, 2020. Answers were compared between groups in living in the quarantine zone (ie, red zone), areas with restricted movements (ie, yellow zone), and COVID-19-free regions (ie, green zone).

Of the 3109 people living in Italy who accessed the questionnaire, 2886 responded at least partially. Of these 2886 participants, the average age was 30.7 years and 76.3% were women. The mean score of correct answers was 77.4%, suggesting most participants were well informed about the virus characteristics and recommended behaviors.

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Although the quality of life scores were similar across the zones, mental health was negatively associated with contagion-related worries, social appraisal, and preventive behaviors in the yellow zone. Emotional stability negatively correlated with higher worries and perceived susceptibility in the yellow and green zones.

“These findings suggest that during the first week of the COVID-19 outbreak in Italy, people were well informed and had a relatively stable level of worries,” the study authors wrote. “Increased scores for worries and concerns were associated with more cognitive rigidity and emotional instability.”

Disclosure: Study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Pagnini F, Bonanomi A, Tagliabue S, et al. Knowledge, concerns, and behaviors of individuals during the first week of the coronavirus disease 2019 pandemic in Italy.. JAMA Netw Open. Published online July 24, 2020. doi:10.1001/jamanetworkopen.2020.15821