**1. Introduction**

When pneumonia was detected in December 2019 in Wuhan, Hubei Province, China, its origin was unknown. However, by the beginning of January 2020, it was identified as the novel SARS-CoV-2 virus which causes the disease known as COVID-19 [1–3]. Its course goes through a series of systemic physical symptoms, such as fever, cough, fatigue, headache and diarrhea, and also respiratory affections that could include rhinorrhea, pneumonia or acute respiratory distress syndrome [3–5].

COVID-19 characteristics facilitated its rapid expansion, leading the World Health Organization to define it as a global pandemic on 31 January 2020 [6]. Its incubation period is about 5.2 days [7], with symptoms appearing in an average of 14 days [8]. In addition, a high percentage of virus carriers are asymptomatic, but they are nevertheless infective and can infect others if not detected in time [9], which, along with the enormous stream of transportation, could amplify its spread [10,11] and the danger it represents to public health [12].

Due to the spread of the virus and the disease it causes, as well as the inexistence at the present time of effective treatments or vaccination against SARS-CoV-2 [13,14], a number of measures have been taken to reduce its spread and protect the population. These may be grouped in two main measures: limiting movement of the population and home confinement [15,16]. These measures, in addition to the pandemic itself, can have

**Citation:** Pérez-Fuentes, M.d.C.; Herrera-Peco, I.; Jurado, M.d.M.M.; Oropesa, N.F.; Gázquez Linares, J.J. Predictors of Threat from COVID-19: A Cross-Sectional Study in the Spanish Population. *J. Clin. Med.* **2021**, *10*, 692. https://doi.org/ 10.3390/jcm10040692

Academic Editor: Michele Roccella Received: 12 January 2021 Accepted: 4 February 2021 Published: 10 February 2021

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effects, not only on particular individuals but also on the physical and mental health of the entire population [17–22], and especially frontline professionals, such as healthcare workers [23,24]. With respect to the COVID-19 disease itself, as described in other infectious disease epidemics [25–28], some people have negative emotions causing behavior and attitudes that cause them to avoid contact with disease [29]. This defensive reaction to perceived threat from the disease can cause severe psychological maladjustments such as stress, depression and anxiety [17,20,26,30].

The confinement due to the COVID-19 pandemic has been described by some authors as a possible cause of collective hysteria [31–33], a situation which, if it worsens and measures are hardened to mass quarantine, could generate anxiety [18]. It has been observed that people subjected to isolation may experience feelings of loneliness and anger in addition to problems in relating to others person-to-person and even in group social relations when isolation ends [33,34].

The unpredictability of information received from authorities on control of the disease or severity of risk of contagion, and disinformation from both traditional communication media [18,35] and on social networks such as Twitter, YouTube, Instagram or Facebook, among others [36–38] combine with the situation above, generating stress, fear, guilt, displeasure [18,34,35,38] and so forth. Although they may not be considered mental illnesses in themselves, they can lead to situations compromising mental health [35]. Therefore, one's perception of the disease depends on the interpretation of experiences, how that interpretation is transferred to active behavior, the response to social reactions and the personal meaning attributed to the experience [39]. In the situation of imminent alarm in which society around the world now finds itself with COVID-19 and its effect on health [16,17,24], the perception adults have of the disease as government measures change their habits, becomes very important. Perhaps one of the most significant changes is in the care of children or other dependents [40], as women, who traditionally care for the most vulnerable members of the family [41–43], could find their situation worsened under conditions such as those generated by the current pandemic.

The significant role of healthcare professionals as guarantors of both physical and mental health of the population [44], even in situations of public health conflict [45] should also be mentioned. At the present time, there is not much information on the psychological impact and mental health of the general population [6]. A large number of scientific publications have focused on analysis and identification of epidemiological and clinical characteristics of infected patients, genome identification and morphology of the virus and situations related to the logistics and political and healthcare policy decisionmaking [5,32,46]. The the psychological state of the Spanish population has not yet been defined, although there are such studies on specific groups in the Spanish population, like nurses [47] or university students [48].

The objective of this study was to explore the threat perceived by Spanish society from the lockdown imposed because of the COVID-19 epidemic. We think that uncertainty and lack of information about COVID-19 could affect cognitive and emotional health [7]. An evaluation of perceived threat by COVID-19 [39] that would provide information on which groups are the most sensitive to the pernicious effects on mental health of both COVID-19 and the measures taken to slow down its contagion would be useful for healthcare authorities as well as primary care professionals in attending patients.

#### **2. Method**

#### *2.1. Participants*

The study sample was made up of a total of 1043 Spanish adults residing in 19 autonomous regions of which Andalusia was most represented with 37.9% of the participants, followed by Madrid with 27.5%. Of these 29 were eliminated because of random or incongruent answers on control questions included in the questionnaire, leaving 1014 participants in the study.

Ethical research standards were complied with, providing information on the project and requesting consent to participate. The study was approved by the University of Almería Bioethics Committee.

#### *2.2. Design and Data Collection*

A cross-sectional observational study planned was carried out as an online survey due to the state of emergency decreed in Spain last 14 March and the restriction of movement, making a person-to-person format impossible.

The sample was acquired by snowball sampling by spreading the link to the questionnaire on social networking sites. Data was acquired from 18 March through 23 March 2020.
