Background–The pandemic of COVID-19 in Italy represents a unique threat in terms of psychological distress, especially among healthcare professionals. This study represents a first attempt to investigate both the psychological states and coping strategies of Italian healthcare professionals during the COVID-19 outbreak. Importantly, we assessed psychological distress and coping strategies regarding two phases, pre-COVID (asking participants to retrospectively recall their state in December 2019) and during the time of survey, which was in the midst of the COVID emergency outbreak (March-April 2020).Methods–Self-administered questionnaires were distributed online to healthcare professionals of different Italian regions from March 26 to April 9, 2020. The questionnaire included three main sections measuring changes in psychological states, coping strategies and demographic variables. Two linear regression models were run to analyze variations in both general health and infection-risk perception depending on changes in psychological states, coping strategies, personality trait, and demographic variables.Results– Altogether, the direct exposure to the virus and a negative impact of the COVID-19 emergency outbreak on contextual psychological functioning contribute to the deterioration of physical and mental health, which may lead to severe future consequences for Italian healthcare workers, if not provided immediately with an effective support program. Conclusions– Both immediate and long-term monitoring psychological assistance services for healthcare workers should be implemented by local and national institutions to reestablish psychological well-being and enhance self-confidence and resilience of Italian hospital personnel. These intervention programs should especially target women, and professionals at their first steps into the hospital job.