A cross-sectional study of knowledge, attitude, behaviour and preventive measures for COVID-19 infection in Lebanon

Background: The World Health Organization has often reiterated its recommendations for the prevention of COVID-19, however, the success of these measures largely depends on public knowledge and attitudes. Aims: This study assessed the relationship between knowledge, attitude, behaviour and preventive measures for COVID-19 infection in a Lebanese population. Methods: This cross-sectional study was conducted between September and October 2020 using the snowball sampling technique and an online self-administered questionnaire. The questionnaire had 4 parts targeting sociodemographic characteristics; medical history; knowledge, attitude and practices (preventive measures and behaviours related to COVID-19); and mental health variables such as psychological distress. Two models were derived using multivariable binomial logistic regression to optimize the picture of COVID-19 correlates. Results: Our sample comprised 1119 adults. Being older, female, a regular alcohol consumer, waterpipe smoker, having low level of education, low family income, and having contact with a COVID-19 patient correlated with increased odds of ever having been diagnosed with COVID-19. Participants who had ever been diagnosed with COVID-19 had a significantly better knowledge and a higher risky practice scale [adjusted odds ratio (ORa) = 1.49; 95% CI 1.27–1.74; P < 0.001; and ORa = 1.04; 95% CI 1.01–1.08; P = 0.024, respectively]. Conclusion: The most important predictors of COVID-19 infection appear to be generally well-known among the general population, however, their knowledge and adherence to preventive measures should be continuously re-evaluated. This study highlights the need for greater awareness to improve precautionary behaviours among the public.

A cross-sectional study of knowledge, attitude, behaviour and preventive measures for COVID-19 infection in Lebanon

Background: The World Health Organization has often reiterated its recommendations for the prevention of COVID-19, however, the success of these measures largely depends on public knowledge and attitudes. Aims: This study assessed the relationship between knowledge, attitude, behaviour and preventive measures for COVID-19 infection in a Lebanese population. Methods: This cross-sectional study was conducted between September and October 2020 using the snowball sampling technique and an online self-administered questionnaire. The questionnaire had 4 parts targeting sociodemographic characteristics; medical history; knowledge, attitude and practices (preventive measures and behaviours related to COVID-19); and mental health variables such as psychological distress. Two models were derived using multivariable binomial logistic regression to optimize the picture of COVID-19 correlates. Results: Our sample comprised 1119 adults. Being older, female, a regular alcohol consumer, waterpipe smoker, having low level of education, low family income, and having contact with a COVID-19 patient correlated with increased odds of ever having been diagnosed with COVID-19. Participants who had ever been diagnosed with COVID-19 had a significantly better knowledge and a higher risky practice scale [adjusted odds ratio (ORa) = 1.49; 95% CI 1.27–1.74; P < 0.001; and ORa = 1.04; 95% CI 1.01–1.08; P = 0.024, respectively]. Conclusion: The most important predictors of COVID-19 infection appear to be generally well-known among the general population, however, their knowledge and adherence to preventive measures should be continuously re-evaluated. This study highlights the need for greater awareness to improve precautionary behaviours among the public.

Mental health during COVID-19: an evaluation of an academic university’s contribution to existing research (preprint)

Background:Increases in mental health problems have been observed during COVID-19 pandemic. Therefore, this topic of research became a priority, especially at the academic level. The objectives of this review were to summarize an institutional contribution to mental health research during the era of COVID-19. Methods: A scoping review of studies conducted at a local university and examining alterations in mental health during the pandemic during the last three years was conducted. Results: Fifty-five studies were included. These focused on different mental health changes that occurred in the era of COVID-19 such as changes in work habits or existing psychological conditions, COVID-19-related fear depression, anxiety and stress. Most of the included studies  were observational (76.7%). The majority of the publications were published in Scimago Journal Rank Q1 journals (57.1%). The average number of citations per publication was 15.3±30.13 [0-125]. The number of citations was higher in papers with international collaboration of authors (p=0.031). Publications with COVID-19 as a main objective were more cited than papers not directly related to this subject (25.9±39.45 vs. 4.14±3.2; p=0.044). Conclusion: Mental health problems are a common response to the COVID-19 pandemic. The contribution of a local university to different mental health research studies that took place during COVID-19 outbreak have underlined this reality. However, more representative research from other institutional settings will be needed, particularly in vulnerable populations.

Managing Endothelial Dysfunction in COVID-19: A Pilot, Double-Blind, Placebo-Controlled, Randomized Clinical Trial at the Lebanese American University Medical Center - Rizk Hospital (MEDIC-LAUMCRH) (preprint)

Background Coronavirus disease 2019 (Covid-19) is associated with endothelial dysfunction. Pharmacologically targeting the different mechanisms of endothelial dysfunction may improve clinical outcomes and lead to reduced morbidity and mortality Methods In this pilot, double-blind, placebo-controlled, randomized clinical trial we assigned patients who were admitted to the hospital with mild, moderate, or severe COVID-19 infection to receive, on top of optimal medical therapy, either an endothelial protocol consisting of (Nicorandil, L-arginine, Folate, Nebivolol, and Atorvastatin) or placebo for up to 14 days. The primary outcome was time to recovery, measured by an 8 category ordinal scale and defined by the time to being discharged from the hospital or hospitalized for infection-control or other nonmedical reasons. Secondary outcomes included the composite outcome of ICU admission or the need for mechanical ventilation, all-cause mortality, and the occurrence of side effects Results Of 42 randomized patients, 37 were included in the primary analysis. The mean age of the patients was 57 years; the mean BMI of study participants was 29.14. History of hypertension was present in 27% of the patients, obesity in 45 % , and Diabetes Mellitus in 21.6%. The median(Interquartile range) time to recovery was not significantly different between the endothelial protocol group (6 [4-12] days) and the placebo group (6 [5-8]days)(p-value = 0.854). Furthermore, there were no statistically significant differences in the need for mechanical ventilation or ICU admission, all-cause mortality, and the occurrence of side effects between the endothelial protocol group and the placebo group. Conclusion Among patients hospitalized with mild, moderate, or severe COVID-19 infection, targeting endothelial dysfunction by administering Nicorandil, L-arginine, Folate, Nebivolol, and Atorvastatin on top of optimal medical therapy did not decrease time to recovery. However, this treatment protocol was associated with an excellent safety profile. Adequately sized prospective randomized controlled trials are needed for the evaluation of the role of treating endothelial dysfunction in COVID-19 infection.

The Effects of COVID-19 On The Quality of Life Among a Sample of The General Lebanese Population (preprint)

Background: Infectious illness outbreaks, such as COVID-19, have a devastating impact on physical health and social and psychological well-being. Therefore, the objective of this study was to assess the quality of life (QOL) after the COVID-19 outbreak in a sample of the Lebanese population and compare sociodemographic factors associated with QOL among COVID-19 patients and healthy controls. Methods: : A cross-sectional study conducted between January and March 2021 during the lockdown imposed by the Lebanese Government enrolled 2349 Lebanese adults. The major dependent variable was the 12-item Short Form Survey (SF-12), often used as a QOL measure for assessing the impact of health on an individual's everyday life. Results: : In participants with non-positive PCR, linear regression showed that higher income (Beta=2.224) is associated with a higher QOL score. Whereas higher household crowding index (Beta=-0.537), older age (Beta=-0.109), being married (Beta=-1.308), having hypertension (Beta=-2.479), and other chronic diseases (Beta=-3.704) were associated with a lower QOL score.In participants with positive PCR, linear regression showed that the female gender (Beta=2.416) and a higher income (Beta=4.856) were associated with a higher QOL score. Whereas shortness of breath (beta=-2.607), sore throat (Beta=-5.654), sneezing (Beta=-3.761), and having a chronic disease other than hypertension (Beta=-3.181) were associated with a lower QOL score. Conclusion: Overall, factors such as age, male gender, married status, crowded household, low monthly income, high BMI, the presence of chronic disease, and severe COVID-19 symptoms were related to lower QOL after the covid-19 pandemic.

Combined Anticoagulant and antiplatelet therapy is associated with an improved outcome in hospitalized COVID-19 patients: a propensity matched cohort study (preprint)

Background: COVID-19 is a respiratory disease that results in a prothrombotic state manifesting as thrombotic, microthrombotic and thromboembolic events. As a result, several antithrombotic modalities have been implicated in the treatment of this disease. This study aimed to identify if therapeutic anticoagulation or concurrent use of antiplatelet and anticoagulants was associated with an improved outcome in this patient population. Methods: A retrospective observational cohort study of adult patients admitted to a single university hospital for COVID-19 infection was performed. The primary outcome was a composite of in-hospital mortality, ICU admission, or the need for mechanical ventilation. The secondary outcomes were each of the components of the primary outcome, in-hospital mortality, ICU admission, or the need for mechanical ventilation. Results: 242 patients were included in the study and divided into 4 subgroups: therapeutic anticoagulation (TAC), prophylactic anticoagulation + antiplatelet (PACAP), therapeutic anticoagulation + antiplatelet (TACAP), and prophylactic anticoagulation (PAC) which was the reference for comparison. Multivariable cox regression analysis and propensity matching were done and showed when compared to PAC, TACAP and TAC were associated with less in-hospital all cause mortality with an adjusted hazard ratio (aHR) of 0.113 (95% confidence interval (CI) 0.028-0.449) and 0.126 (95% CI, 0.028-0.528) respectively. The number needed to treat (NNT) in both subgroups was 11. Furthermore, PACAP was associated with a reduced risk of invasive mechanical ventilation with an aHR of 0.07 (95% CI, 0.014-0.351). However, the was no statistically significant difference in the occurrence of major or minor bleeds, ICU admission, or the composite outcome of in-hospital mortality, ICU admission or the need for mechanical ventilation. Conclusion: The use of combined anticoagulant and antiplatelet agents or therapeutic anticoagulation alone in hospitalized COVID-19 patients was associated with a better outcome in comparison to prophylactic anticoagulation alone without an increase in the risk of major and minor bleeds. Sufficiently powered randomized controlled trials are needed to further evaluate the safety and efficacy of combining antiplatelet and anticoagulants agents or using therapeutic anticoagulation in the management of patients with COVID-19 infection.

The Impact of Covid19 Pandemic, Financial Wellness, and Online Teaching on The Mental Health of Lebanese Schoolteachers (preprint)

Teaching is mentally and physically draining occupation, and due to Covid-19, education shifted to online methods, which made it even harder. Lebanon is facing a huge economic crisis, making it harder on teachers to maintain mental health. An observational cross-sectional study was carried out, enrolling 300 schoolteachers assessing sociodemographic factors, teaching status, financial wellness, fear of covid-19, and mental health. Results showed high prevalence of depression, anxiety, and stress. Teachers showed severe levels of anxiety and stress with correlation to online teaching, with added depression when correlated with fear of Covid19 and financial wellness. Urgent measures should be taken to minimize the stressful environment and worsening situation in Lebanon.

Assessing Changes in Lifestyle and Health-Related Behaviors During the COVID-19 Pandemic: A Cross-Sectional Web-Based Survey Among Lebanese Adults (preprint)

Background: The novel coronavirus disease 2019 (COVID-19) has quickly become a worldwide threat to human health and has significantly impacted peoples’ lives and changed their lifestyle and health behaviors (LHB). This study aims to assess changes in lifestyle and health-related behaviors such as daily habits, dietary habits, physical activity, sleep patterns, psychological problems, and sexual behaviors among the general population in Lebanon during the COVID-19 pandemic. Methods A cross-sectional web-based survey conducted between January 9 and January 28, 2021, enrolled 403 Lebanese adults. The study questionnaire was developed on Google forms in English and Arabic. It included questions about sociodemographic characteristics, COVID-19, and behavior changes (smoking, alcohol consumption, sexual and hygiene behaviors, and intake of nutritional supplements and immunity-boosting foods), in addition to three scales, i.e., the Lifestyle and Health Behaviors Changes (LHBC-17), WHO-5 Well-being Index, and Fear of COVID-19 scale (FCV-19S). Data analysis was done on SPSS software version 21. Results The mean age of participants was 29.74 ± 10.81 years, with 51.2% of females. Most participants reported that COVID-19 has profoundly affected their LHBs, whether positively or negatively. Female gender (Beta=-2.336), living in Lebanon (Beta=-7.502), smoking nargileh (Beta=-3.433), having a high BMI (Beta=-0.263), and spending more hours per day using electronic devices during the COVID-19 lockdown (Beta=-0.853) were significantly associated with lower LHBC-17 scores (negative LHB changes). Whereas, living in an urban region (Beta = 2.464), having a job (Beta = 1.920), good overall health (Beta = 3.543), a higher quality of life (Beta = 0.204), and having physical (Beta = 2.101) and mental (Beta = 1.586) health unaffected by the COVID-19 lockdown were all significantly associated with higher LHBC-17 scores (positive LHB changes). Conclusions Lebanese adults reported several unfavorable lifestyle changes and psychological problems during the lockdown due to COVID-19. Health-promotion strategies are needed to assess negative changes both on physical or mental health and maintain as much as possible positive health-related behaviors among the Lebanese population.

A Cross-Sectional Study of COVID-19-Related Bullying in a Sample of Lebanese Adults: Scale Validation, Correlates, and Mediating Effect of Fear and Anxiety (preprint)

Background: The COVID-19 pandemic has led to prolonged exposure to stress and anxiety, raising concerns about a large spectrum of psychological side effects. The primary objective of the study was to validate the COVID-19 Bullying Scale (CBS-11). The second objective was to explore factors associated with COVID-19-related bullying and evaluate the mediating effect of fear and anxiety between knowledge and COVID-19-related bullying. Methods: : A cross-sectional online survey conducted between December 20, 2020, and January 5, 2021, involved 405 Lebanese adults recruited using the snowball sampling technique. The CBS-11, an 11-item tool specially created for this study, was used to measure bullying behaviors towards COVID-19 patients. Results: : All items of CBS-11 converged over a 1-factor solution with an eigenvalue over 1, accounting for a variance of 75.16%. The scale has a high Cronbach’s alpha (0.974), indicating excellent reliability. A positive correlation was found between the COVID-19 bullying scale and fear, anxiety, and stigma discrimination. The logistic regression showed that higher fear of COVID-19 (ORa=1.04), a positive attitude toward COVID-19 preventive measures and hygiene recommendations (ORa=1.18), higher stigma discrimination scores (ORa=1.09), and having a health professional family member (ORa=2.42) were significantly associated with bullying. Conclusion: Our main findings show that CBS-11 could be an efficient tool to measure bullying behaviors toward COVID-19 patients. Stigma discrimination and fear from COVID-19 were associated with higher bullying attitudes. Future prospective studies are needed to understand better the factors related to bullying among adults during a pandemic, such as COVID-19.

Factors related to Pregnancy Status Among Lebanese Women During COVID-19 Confinement (preprint)

Background: During the coronavirus disease confinement, couples are likely to spend more free time together at home, which could have a positive impact on the amount and level of intimacy. However, home confinement and lockdowns have created challenges and vulnerabilities, causing relevant changes in sexual health and couple stability, particularly in women. The objective of this study was to evaluate the socio-economic and psychological factors related to current pregnancy status and unwanted pregnancy among a sample of Lebanese women during the COVID-19 lockdown.Methods: A cross-sectional online-based study was conducted between June 8 and August 1, 2020, among 369 Lebanese women. The questionnaire developed on Google Forms was distributed through social media and WhatsApp groups, using the snowball technique. The current pregnancy status and unwanted pregnancy were assessed using binary questions (Yes/No).Results: Our results showed that 11.1% of women were pregnant, of whom 22.0% reported unwanted pregnancies. Having children (ORa=0.183) and using contraceptives (ORa=0.231) were at lower odds of getting pregnant. Higher psychological violence would negatively affect pregnancy, but the association tended to significance (p=0.065). Also, regular visits to the physician for routine checkups (ORa=0.053) were significantly associated with lower odds of unwanted pregnancy. Higher psychological violence would affect unwanted pregnancy; however, the association tended to significance (p=0.056). Conclusion: Our main findings indicate that women of younger age, smoking less, and never working were at a higher probability of being pregnant. Furthermore, psychological violence tended to be an associated factor for current pregnancy status and unwanted pregnancy. More information and awareness are needed to encourage women to conceive and maintain their well-being during a pandemic.

Psychological Distress Among Lebanese Women During the COVID-19 Confinement: Any Mediating Effect of Violence? (preprint)

Background: Violence among women is associated with poor psychological health and increased internalizing symptoms, such as depression, stress, and anxiety. The primary objective was to evaluate the association of marital conflict, pregnancy status, socioeconomic status, and stressful life events with violence, depression, anxiety, and stress. The secondary objective was to evaluate the mediating effect of violence on psychological distress. Methods: : A cross-sectional study was conducted among 369 women between June 8 and August 1, 2020. The questionnaire was developed on Google Forms and distributed online, using the snowball technique. Results: : Higher marital conflict (Beta=0.159), financial difficulties (Beta=2.572), a history of child abuse (Beta=2.546), and higher violence scores (Beta=0.121) were significantly associated with higher depression scores. Higher marital conflict (Beta=0.358) and having financial difficulties (Beta=3.859) were significantly associated with higher anxiety scores. Higher marital conflict (Beta=0.070) and financial difficulties (Beta=1.483) were significantly associated with higher perceived stress scores. Composite abuse scale partially mediated the association between pregnancy status (25.28%), financial difficulties (7.71%), history of child abuse (21.92%), abuse by a family member (50.50%), and anxiety scale. Also, the composite abuse scale partially mediated the association between marital conflict (21.42%), financial difficulties (14.17%), history of child abuse (20.05%), abuse by a family member (33.57%), and depression scale. Conclusion: Our main findings suggest that violence mediated the association between pregnancy status, marital conflicts, financial difficulties, and depression and anxiety but did not mediate between these factors and stress. Further studies are needed to understand better the factors that mediate the relations between domestic violence and mental well-being among Lebanese women.

Gender Differences in Mental Health Outcomes Amid the COVID-19 Pandemic and a Collapsing Economy: A Cross-Sectional Study (preprint)

Background: Emergency plans to contain the COVID-19 failed to take into consideration the repercussions of the combined economic and sanitary crisis among the most vulnerable populations who might be disproportionately affected, including women and abused people. This study primarily aimed to assess the effects of the COVID-19 and economy-related variables on Lebanese adults’ mental health, focusing on gender differences.Methods: An online-based cross-sectional study was conducted between May 10-20, 2020, using validated scales. All adults living in Lebanon, with access to the internet, were eligible, regardless of their age, socioeconomic status, race, ethnicity, nationality, sex, gender identity, religion, geography, ability, and culture (n=502).Results: The multivariate analysis, adjusted on sociodemographic characteristics, economic, and coronavirus-related variables, showed that women exhibit higher levels of stress, anxiety, and post-traumatic stress symptoms (PTSS) than men. Moreover, violence at home was associated with more stress and insomnia, with borderline results for anxiety and well-being. No significant difference was found for PTSS. Conclusion: In the context of combined health and economic crises, mental health outcomes are not equally felt by women. Additional studies in a few months would help better understand the long-term impact, especially on PTSS and QOL, which might not be perceptible during the crisis. Focused public health strategies are warranted to support and protect the most vulnerable populations.

Factors related to Pregnancy Outcome Among Lebanese Women During COVID-19 Confinement (preprint)

Background: During the coronavirus disease confinement, couples are likely to spend more free time together at home, which could have a positive impact on the amount and level of intimacy. However, home confinement and lockdowns have created challenges and vulnerabilities, causing relevant changes in sexual health and couple stability, particularly in women. The objective of this study was to evaluate the socio-economic and psychological factors related to current pregnancy status and unwanted pregnancy among a sample of Lebanese women during the COVID-19 lockdown.Methods: A cross-sectional online-based study was conducted between June 8 and August 1, 2020, among 369 Lebanese women. The questionnaire developed on Google Forms was distributed through social media and WhatsApp groups, using the snowball technique. The current pregnancy status and unwanted pregnancy were assessed using binary questions (Yes/No).Results: Our results showed that 11.1% of women were pregnant, of whom 22.0% reported unwanted pregnancies. Having children (ORa=0.183) and using contraceptives (ORa=0.231) were at lower odds of getting pregnant. Higher psychological violence would negatively affect pregnancy, but the association tended to significance (p=0.065). Also, regular visits to the physician for routine checkups (ORa=0.053) were significantly associated with lower odds of unwanted pregnancy. Higher psychological violence would affect unwanted pregnancy; however, the association tended to significance (p=0.056). Conclusion: Our main findings indicate that women of younger age, smoking less, and never working were at a higher probability of being pregnant. Furthermore, psychological violence tended to be an associated factor for current pregnancy status and unwanted pregnancy. More information and awareness are needed to encourage women to conceive and maintain their well-being during a pandemic.

Coronavirus disease 2019 outbreak: does confinement have any impact on weight variation and weight change perception? (preprint)

Background: In the time of confinement, a reduction of physical activities, unhealthy diet, sedentary behavior, and an increase in sitting time will contribute to weight change. During these stressful times, individuals might have a greater concern about their body image and weight. Therefore, the first objective of the current study is to evaluate the impact of confinement during the COVID-19 outbreak on weight variation. The second objective is to evaluate factors associated with weight perception among a sample of the Lebanese population.Method: A cross-sectional web-based online survey, carried out between 3 and 18 April, 2020, enrolled 407 participants. Due to the confinement situation, the height and weight of the participants were estimated by them themselves. The variation of declared BMI was calculated by taking away the weight estimated during the confinement from the weight estimated before the confinement. The perception of weight change was assessed using one dichotomized question (positive/negative). Results: No significant variation was found for the BMI before and during the confinement (p=0.40). A perceived weight change was found in 212 (52.1%) participants. Multivariable analysis showed that longer duration of confinement (Beta=-0.01), higher restraint (Beta=-0.21), higher physical activity (Beta=-0.006) and low income (Beta=-0.59) were significantly associated with a lower BMI variation. When taking perceived weight change as the dependent variable, the results showed that a higher fear of COVID-19 score (ORa=0.96) was significantly associated with lower positive weight change perception. However, higher confinement duration (ORa=1.07), higher anxiety (ORa=1.05) and higher eating concern (ORa=1.81) were significantly associated with greater weight change perception.Conclusion: Our main results indicate that no significant change in weight was detected before and during confinement. The fear of COVID -19 was not related to weight change; however, a negative association was found with weight perception. Also, longer duration of confinement were associated with a lower declared BMI variation and greater weight change perception. These results are a step forward to understand the long-term effects of confinement on physical and psychological health.

­­The Combined Outcomes of the COVID-19 Pandemic and a Collapsing Economy on Mental Well-Being: A Cross-Sectional Study (preprint)

Objective: To examine the outcomes of COVID-19 and a collapsing economy on mental well-being (MWB) of the general Lebanese population.Design/methods: This cross-sectional study enrolled 502 adults in May 2020.Results: MWB had a mean of 14.80. Female gender, university education, fear of COVID-19, fear of poverty, verbal violence at home, and chronic disease were associated with lower MWB. Better family satisfaction and financial situation were correlated with better MWB. Among workers/looking for a job: physical exercise was associated with better MWB, while previous waterpipe smoking, being self-employed before the crisis, working from home, closure of the institution, and worrying about long-term effects of the crisis on employment status were associated lower MWB. The fear of COVID-19 was not associated with MWB.Practical Implications: The Lebanese government should implement a reliable crisis management strategy that outlines stabilization and recovery measures to help people navigate through this period with minimal impact on mental, physical, and overall quality of life.

Association between eating behavior and quarantine/confinement stressors during the Coronavirus disease 2019 outbreak (preprint)

Background: Quarantine/confinement is an effective measure to face the Coronavirus disease 2019 (COVID-19). Consequently, in response to this stressful situation, people confined to their homes may change their everyday eating behavior. Therefore, the primary objective of this study is to evaluate the association between quarantine/confinement stressors and eating behavior during the COVID-19 outbreak. The secondary objective is to evaluate the association of quarantine/ confinement stressors and eating behavior amongst two groups of participants selected from the population: individuals attending diet clinics and individuals who are not attending diet clinics.Method: A cross-sectional web-based online survey carried out between April 3 and 18, 2020, enrolled 407 participants from the Lebanese population. Eating Disorder Examination – Questionnaire (EDE-Q) were used to measure the behavioral features of eating disorders. Results: More than half of the sample (53.0%) abide to the home quarantine/confinement, 95.4% were living with someone in the quarantine/confinement and 39.6% continued to work from home. Using the lower scores as reference group, higher fear of COVID-19 was found in 182 (44.8%) participants, higher boredom in 200 (49.2%) participants, higher anger in 187 (46.3%) and higher anxiety in 197 (48.5%) participants. A greater fear of COVID-19 (Beta=0.02), higher BMI (Beta=0.05), and physical activity (Beta=1.04) were significantly associated with a higher restraint score. Higher anxiety, higher fear of COVID-19, higher BMI, practicing physical exercise and higher number of adults living in the quarantine/confinement were significantly associated with a higher shape and weight concern. Conclusion: Our results showed that the fear of COVID-19 was correlated with more restraint eating, weight, and shape concern in the whole sample and more specifically in the dietitian clients group. Public health control measures are needed to define factors of eating disorders during the quarantine/confinement period related to the COVID-19 outbreak.