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Abstract:Objective We aimed ( ⅰ) to explore the correlation between the public′s acute stress reaction( ASR) and the constitution of traditional Chinese medicine ( TCM) during the COVID-19 epidemic and (ⅱ) to provide a basis for adjusting the constitution bias and improving the public′s ability to cope with COVID-19 under the normalized management of the epidemic. Methods From February 3 to February 15, 2022, an electronic questionnaire survey was conducted using a combination of convenient sampling and snowball sampling. Statistics of basic information (gender, age, marital status, educational background, the likelihood of believing that they are infected, the likelihood of believing that people around them are infected, whether the location is a risk area, and whether they have been vaccinated against COVID-19 ), the scores of the Stanford Acute Stress Reaction Questionnaire (SASRQ), and TCM constitution transformation scores of each subscale of a 30-Item Short Version of Constitution in Chinese Medicine Questionnaire ( CCMQ - 30) were calculated. Those with a SASRQ score of ≥40 were included in the ASR group, and those with a SASRQ score of <40 were included in the non-ASR group. The basic information and TCM constitution of the two groups were compared. Spearman correlation analysis and multiple linear regression analysis were performed to examine the correlation between the total SASRQ score and the transformation score of each CCMQ- 30 subscale. Results A total of 1 218 questionnaires were collected, of which 116 invalid questionnaires were excluded, so 1 102 samples were included in the final analysis. The effective rate of the questionnaire was 90. 48%. (ⅰ) There were 892 people in the non-ASR group and 210 people in the ASR group. There were no significant differences in gender, age, marital status, educational background, whether the location was a risk area, the possibility of infection, and vaccination between the two groups (P>0. 05), while there were significant differences in the possibility of believing that people around them are infected (P<0. 05); the proportion of people who perceived the possibility of infection was higher in the ASR group than in the non-ASR group. (ⅱ) There were significant differences in the scores of nine TCM constitutions between the ASR group and the non-ASR group (P< 0. 05). Correlation analysis showed that the total SASRQ score was negatively correlated with balanced constitution (r = -0. 353, P<0. 01), while it was positively correlated with eight biased constitutions; ordered based on the correlation from strong to weak, these constitutions were the following: qi-stagnation, qi-deficiency, blood-stasis, phlegm-dampness, inherited special, yin-deficiency, dampness-heat, and yang-deficiency (r = 0. 235 to 0. 367, P < 0. 01). ( ⅲ) Multiple linear regression analysis controlling for the interaction of biased constitutions showed that qi-stagnation( β′ = 0. 214, P<0. 01), qi-deficiency ( β′ = 0. 139, P<0. 05), and inherited special constitution ( β′ = 0. 088, P < 0. 01) were the independent influencing factors of ASR. Further control for confounding variables yielded similar result. Conclusion Qi-stagnation, qideficiency, and inherited special constitution have a great influence on public ASR. It is suggested to focus on adjusting qi-stagnation, qi-deficiency, and inherited special constitution to improve public physical and mental health under the normal management of the COVID-19 epidemic. [ABSTRACT FROM AUTHOR]