**1. Introduction**

In December 2019, a COVID-19 outbreak emerged in the city of Wuhan, China. SARS-CoV-2 was soon identified as the novel coronavirus (CoV) causative agent of this outbreak. COVID-19 then spread to all countries in the world, and the disease was declared a pandemic in March 2020 [1]. More than 159 million confirmed cases have been reported worldwide, with 3.4 million deaths as of 10 May 2021. In Egypt, from 3 January 2020 to 10 May 2021, there have been 239,740 confirmed COVID-19 cases and 14,033 deaths [2]. There are several serious impacts of pandemics on different populations, probably due to lack of information about the causative agent, disease progression, and infectious disease control measures [1].

Stress has been reported as a major challenge during the COVID-19 pandemic. Multiple factors that could contribute to stress include the ambiguity and novelty of the COVID-19 pandemic in addition to rapid transmission, high mortality, the unknown actual number of cases, and the unexpected outcome of infection. As a result of stress, levels of anxiety, depression, trauma, suicidal ideation, and panic have elevated during the COVID-19 pandemic. In addition, economic disturbances, community restriction, and uncertainty about the true numbers of COVID-19 cases have contributed to even more stress among the general population.

Reports in the year 2020 have shown that 80% of COVID-19 patients had mild symptoms, high recovery rates, and low mortality rates. However, in comparison to SARS-COV-1 and MERS-CoV combined, SARS-CoV-2 has shown higher transmissibility and mortality. The severe economic sanctions imposed by the governments of several countries, the doubts about the efficacy of personal protective equipment, and fears of shortages in medical supplies can all be reasons contributing to stress among individuals [3–7]. To our knowledge, few studies have investigated the coping strategies of general populations during pandemics. However, personality traits, such as optimism, resilience, and altruism, have previously been shown to have positive effects on reducing psychological stress. In addition, measures such as effective infection control, personal protective measures, clear institutional policies, and protocols have led to stress reduction among various populations [8].

This study aims to evaluate the impact of stress during the COVID-19 outbreak on the prevalence of anxiety and/or depression, predictive factors for the development of anxiety and/or depression, attitude towards COVID-19, and different coping strategies among the Egyptian population in response to the COVID 19 pandemic. Furthermore, we sought to correlate anxiety and depression with different coping strategies.
