Background: Currently, there are few studies analyzing how COVID-19 has impacted the chiropractic profession. A recent paper, however, analyzed changes made to chiropractic practice by comparing the 7 different international regions represented by the World Federation of Chiropractic (WFC). In overall healthcare, there is limited research on specialty-based stress levels both before and during COVID-19. Our survey was conducted to collect self-reported data on how COVID-19 has affected U.S. doctors of chiropractic. Methods: An electronic survey was sent to U.S. chiropractors nationwide via social media and email. The survey collected personal and practice demographic information, o ce protocols, changes made during COVID-19, chiropractic profession opinions/stances, information related to stress, and personal beliefs/opinions. Data was analyzed using descriptive statistics. Results: 750 U.S. chiropractors responded. Just over half of respondents reported moderate levels of stress, and just over 30% reported severe levels due to a variety of reasons related to both personal and professional circumstances. The primary stressors were nancial and business concerns. The highest stress levels were among employers responsible for others. A majority reported beliefs that the chiropractic profession should not advertise that spinal manipulation provides any immune system bene t. 13% of the respondents believed chiropractors should be marketing immune bene ts during this time. A shift toward telehealth was reported, with 18% adding it to their services. Conclusion: Stress levels were high across the population. A range of opinions existed regarding spinal manipulation and immunity bene ts. The majority reported there was not su cient evidence to support such a belief; however, a group of respondents believed that chiropractors should be marketing immune-enhancing bene ts to the population. A logical next step would be to study why such beliefs persist. This information may be useful in better understanding how chiropractors have experienced the global effects of COVID-19 across the United States. Background A novel coronavirus emerged from Wuhan, China in December of 2019. International travel and community spread allowed Coronavirus Disease 2019 (COVID-19) to quickly become a global pandemic in early 2020. The rst case of COVID-19 in the United States was con rmed in January 2020 (1). By May 12, 2020, there were over 1.3 million con rmed cases in the U.S. along with more than 80,000 deaths. This has increased subsequently (2). The federal government offered guidance to limit spread (3), but governors of individual states were directed to make their own decisions regarding their response (4). This led to heterogeneous responses across the U.S. with many but not all states implementing stay-at-home orders (5). These orders have had profound economic effects, where even the healthcare sector has suffered. This sector of the U.S. economy has seen an 18% drop in healthcare spending with multiple health systems reporting drops ...

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