1. Introduction
Coronavirus Disease 2019 (COVID-19) has recently been epidemic spread worldwide. The “affected areas” based on reports of the World Health Organization (WHO) are considered those countries, provinces, territories, or cities experiencing ongoing transmission of COVID-19, in contrast to areas reporting only imported cases. As of 27 February 2020, although China, especially the province of Hubei, has experienced sustained local transmission, they reported many confirmed cases since the outbreak. Lately, the situation in China has shown a significant decrease in cases. Concurrently, an increasing number of countries, rather than China, have reported cases, including through local transmission of COVID-19 [1]. Stressful life events are with subsequent psychosocial problems [2]; in a meta-analysis, researchers report a total of 27,475 subjects included in 12 studies. The results indicated that the incidence of anxiety equaled 25% (95%CI: 0.19-0.32), and the incidence of depression was measured as 28% (95%CI: 0.17-0.38). In a cross-sectional study among Iranian students, mild to severe anxiety and depression prevalence was 38.1% and 27.6%, respectively. Anxiety and changes in sleep patterns were the most common symptoms. High anxiety levels were related to the female gender, lower Grade Point Average (GPA), and experience of COVID-19 symptoms; students with lower GPA and prior experiences of COVID-19 symptoms were more likely to feel depressed [3]. 
Sometimes, germophobia is mysophobia, microphobia, bacteriophobia, bacillophobia, verminophobia, and germaphobia. It is distress about microorganisms, such as bacteria, viruses, germs, and pollution. Phobias are exaggerated, irrational, persistent, and excessive fear about situations and objects. The specific phobia belongs to anxiety disorders in the 5th edition of the Diagnostic And Statistical Manual of mental disorders (DSM-5). The fear or anxiety associated with the presence of a particular situation or object that can be recognized as the phobic stimulus is a crucial key feature of this disorder [4]. Germophobia is an irrational fear of germs [5]. Rituals characterize it as repeated behavior for control and the obsession with contamination [6, 7]. Moreover, it could be a psychological issue among individuals [8].
These facts led the researchers to investigate the phobias of the virus and bacteria in the Iranian adult population. The researchers developed a questionnaire for assessing germophobia, according to the fact that there is no available standard instrument.
2. Materials & Methods 
The study sample was 113 individuals of the Iranian population. They believed they were concerned about germs. They were selected with snowball sampling and completed study questionnaires based on the Internet. The 83 participants completed the Germophobia Questionnaire (GPQ) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) after a week as a retest assessment. 
3. Results  
The results illustrate that the GPQ has minimum acceptable internal consistency with Cronbach’s alpha coefficient (a=0.67). The reliability coefficients with split-half were (0.72), and one-week test-retest (0.73). Furthermore, the GPQ demonstrates moderate convergent validity with the contamination obsessions checklist of Y-BOCS (r=0.44). Finally, the exploratory factor analysis indicates 3-factors of the GPQ (see Table 1 English).


The results also illustrate no differences between the levels of germophobia among men and women, different demographic statuses. 
4. Discussion & Conclusion 
Based on the obtained findings, the GPQ has acceptable and good psychometric properties; thus, researchers can use the GPQ as a reliable and validated instrument for assessing the germophobia levels in epidemic and pandemic crises, like COVID-19. 
The results indicate no gender-wise differences between germophobia levels different demographic statuses. These findings were also reported by [34, 35, 36] but are opposed to [37]. Distel et al. (2008) examined the genetic and environmental influences in a large sample of Dutch twins on specific phobias. Accordingly, they assessed their interaction with gender and age. There were no significant differences among genders in the influence of genetic effects. Besides, there was no evidence for genotype x sex interactions [34]. As mentioned earlier, COVID-19 has become a pandemic. People are exposed to a common virus and fail to find a vaccine. It has caused a general fear of the disease [36]; in such circumstances that everyone is bombarded by real or fake news from different sources, the anxiety level will be definitively increased; as a result of most individuals, regardless of their gender, educational degree, marital status, and also those with and without a history of the infectious disease may have some quasi-germophobic experiences. 
This study has some limitations. The first limitation of this study was that the samples were selected from the general population with relatively high education then they were not assessed by interviews or self-report. Another limitation of the present study was that the research was conducted due to the COVID-19 pandemic, which can be considered history-graded influences [38]; this may increase participants’ scores in GPQ. In future research, this questionnaire should also be studied in other populations such as persons with generalized anxiety disorder, obsessive-compulsive disorder, patients with infectious diseases, other significant developmental periods, and lower educational status. Eventually, it is recommended that the study of these proposed populations be repeated in the subsequent periods when the COVID-19 pandemic is over. 
Informed consent 
Informed consent was obtained from all individual participants included in the study. 

Ethical Considerations
Compliance with ethical guidelines
All procedures performed in the present study involving human participants were per the ethical standards of the institutional and national research committee (the study was approved by the Department of Psychology and Research Program Committee (RPC) of COVID-19 in Tehran Provincial branches of IAU), PCO of IRI, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article also does not contain any studies with animals performed by any authors.

Funding
Any organization or institution did not fund this study; it was performed by personal budget.

Authors' contributions
This study did not have any financial support from governmental, non-governmental, academic or non-academic institutions and organizations. 

Conflicts of interest
All authors declared no conflicts of interest.


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