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Linking local COVID-19 and population statistics to a U.S.-based survey we recently conducted, we examine the spatial variation in the impact of COVID-19 on Americans' attitudes toward China. The research strategy capitalizes on differential local COVID-19 incidence rates as varying dosages of COVID-19 impact across local contexts in the United States. Our results reveal negative yet heterogeneous effects of the ongoing COVID-19 pandemic on Americans' attitudes toward China. We find that greater local exposure to COVID-19 is associated with a lower level of trust in Chinese and a less favorable attitude toward China. These findings lend consistent support to behavioral immune system theory by bridging the literature on contextual variations in public attitudes, with broader implications for U.S.-China relations. [ABSTRACT FROM AUTHOR]

• This case-control study assessed the psychological status of COVID-19 patients. • It showed that COVID-19 patients had higher prevalence of mental problems, such as anxiety, depression, suicidal ideation, and insomnia compared to controls. • Our findings highlighted the urgent need for psychological assistance for COVID-19 patients. The coronavirus disease 2019 (COVID-19) has caused widespread panic due to its highly infectious and pandemic transmission. We aimed to evaluate the psychological impact of the COVID-19 outbreak on infected subjects in China. This case-control, survey-based study assessed the psychological status of COVID-19 patients and non-infected controls from February 10 to March 18, 2020, in China. Sex, age, education years, marital status, jobs, annual household income, living status, and geographic origin were matched between the two groups. The main outcome measures included anxiety, depression, insomnia, help-seeking behaviors, and treatment for mental problems. A total of 326 patients and 1304 (1:4 ratio) matched non-infected controls were enrolled. Compared with controls, patients had higher scores on the Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) (all p <0.01). Patients had higher rate of any mental problems (62.6% vs 42.5%, p <0.01), anxiety (27.3% vs 12.2%, p <0.01), depression (26.7% vs 14.6%, p <0.01), suicidal ideation (16.0% vs 10.7%, p <0.01), and insomnia (57.7% vs 36.7%, p <0.01). Among the subjects with mental problems, the proportion of seeking help (15.2% vs 6.9%, p <0.01) and receiving treatment (11.3% vs 4.3%, p <0.01) was higher in patients than controls. Our study showed a higher prevalence of mental problems in COVID-19 patients compared to controls, suggesting a great psychological impact of COVID-19 infection. Our findings highlighted the urgent need for psychological assistance for COVID-19 patients. [ABSTRACT FROM AUTHOR]