Introduction
In dealing with coronavirus disease 2019 (COVID-19) pandemic, quarantine and some social gathering restrictions have been recommended. Although these measures could help reduce the rate of infection, restricting the participation of people in normal daily living activities, sports activities, and traveling can lead to some negative influences [3]. In the past pandemics, it was shown that severe restrictions such as self-quarantine caused depression and anxiety in people [4]. Depression and anxiety can weaken the immune system and make people vulnerable against diseases such as COVID-19 [5]. Several previous studies have shown that self-quarantine is a predictor of depressive symptoms [6, 7, 8]. One of the important variables associated with depression is personality [9]. The personality is defined as specific and explicit patterns of thinking, emotion and behavior which determine the personal traits of individuals in interacting with social environment [10]. Personality traits affect how we understand the external stressors such as health problems, and can play a role in responding to pandemics [11].
Pandemics have a negative impact on the health and cause sudden changes in lifestyle with social and economic consequences due to social distancing and self-quarantine [13]. One of the best ways to maintain the health and prevent diseases is to have health promoting behaviors [14]. Health promoting behaviors are voluntary behaviors for promoting physical and mental health [15]. 
According to the important role of personality traits and lifestyle on mental health, this study aims to evaluate the role of personality traits and health-promoting lifestyles in predicting anxiety and depression during the COVID-19 pandemic. The question is whether personality traits or health-promoting lifestyles have a greater role in predicting anxiety and depression.
Methods
This cross-sectional study was performed during the fourth wave of COVID-19 outbreak and social restrictions in April 2021 in Najafabad, Iran on 225 people aged >18 years who were selected using a convenience sampling method. Questionnaires were distributed online by adding the links in virtual social channels and groups. Inclusion criteria were consent to participate, age >18 years, living in Najafabad city, while exclusion criteria were a history of depression and anxiety disorders before the outbreak, and return of incomplete questionnaires. In this regard, 8 people were excluded due to having a history of depression and anxiety before the COVID-19 outbreak, and finally the data of 217 questionnaires were analyzed. The used instruments in this study were Corona Disease Anxiety Scale, Beck Depression inventory, McCray and Costa’s Big-Five-Factor Inventory, and Walker’s Health Promoting Lifestyle Profile. Raw data were analyzed in SPSS v. 24 statistical software using descriptive statistics, Pearson correlation test, and multiple linear regression analysis.
Results
There was a significant positive relationship between neuroticism and depression (P<0.001), while the relationship of extraversion, openness, agreeableness, and conscientiousness with depression was significantly negative (P<0.05). There was a significant negative relationship between health-promoting lifestyles and depression (P<0.05) (Table 1).


Among the variables included in the regression model, neuroticism, extraversion, self-actualization and physical activity were significant predictors of depression and had the greatest effect on depression (P<0.05) (Table 2).


There was a significant positive relationship between neuroticism and COVID-19 anxiety (P<0.01), while the relationship of extraversion, openness, and agreeableness with anxiety was significantly negative (P<0.05). There was no significant relationship between conscientiousness and COVID-19 anxiety (P>0.05). There was a significant negative relationship between health-promoting lifestyles and COVID-19 anxiety (P<0.05) (Table 1).
In the regression equation, neuroticism, extraversion, agreeableness and health responsibility were significant predictors of COVID-19 anxiety (P<0.05) (Table 3).


Discussion
This results of the present study showed that the personality traits of neuroticism and extroversion were significant predictors of depression and COVID-19 anxiety. During the outbreak of COVID-19, a neurotic person may experience the greatest negative impact and the greatest amount of depression and anxiety. The extraversion trait composed of traits related to overall energy, assertiveness, sociability, and positive insight about future [38, 39]. The presence of these traits help extroverts deal with psychological consequences of the COVID-19 outbreak. This personality trait may play a role in activating copying mechanisms (e.g. communication with others, showing high spirits, etc.) [28]. The extroverts can obtain more social support in this period by using their verbal abilities and generating intimate relationships, resulting in their greater satisfaction and happiness. 
The agreeableness personality trait was also the significant predictor of COVID-19 anxiety. With higher agreeableness trait, one can experience lower Covid-19 anxiety. It is expected that people with agreeableness, a positive attitude towards life, and greater adaptability to the conditions experience a greater sense of security and peace of mind than others during the COVID-19 outbreak.
Among the domains of health-promoting lifestyles, self-actualization and physical activity were the significant predictors of depression; i.e., by having more self-actualization and physical activity, people are less likely to be depressed. To explain this finding, we can refer to the increase in the secretion of endorphins and serotonin during physical activity which cause pleasant feelings and reduced depressive symptoms [44, 45]. Self-actualization plays an essential role in achieving positive well-being during the COVID-19 pandemic [50]. 
Health responsibility, as one of lifestyle domains, was a negative predictor of COVID-19 anxiety. It seems that people with higher health responsibility are more sensitive and cautious about their health during the outbreak, which causes a sense of relief about their health and not transmitting the disease to their relatives; this can lead to the experience of less anxiety. 
Finally, regarding the study question, it can be said that the relationship of personality traits with COVID-19 anxiety and depression was greater compared to health-promoting lifestyle domains; and personality traits play a greater role in predicting anxiety and depression.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Yazd University (Code: IR.YAZD.REC.1399.045)

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
All authors contributed equally in preparing all parts of the research.

Conflicts of interest
The authors declare that there is no conflict of interest

Acknowledgements
The authors would like to thank all people participated in the study for their cooperation.


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