Direct (e.g. being in contact with the virus) and indirect traumatic experiences (e.g. Distressing Social Media Exposure: DSME) of the COVID-19 pandemic led to a variety of psychological and psychosocial consequences. They represent COVID-19-related Posttraumatic Stress Symptoms (PTSS) risk factors, whereby their interactions and their relations to gender have not yet been explored.
 1368 participants filled in an online survey between the January and March 2021. Risk Ratios and 95% CIs were calculated to estimate the magnitude of the risk related to a reported COVID-19 infection, reported COVID-19 symptom severity, gender and DSME on COVID-19-related PTSS. A 2x2x2 ANOVA was used to determine the main and interaction effects of a COVID-19 infection, gender and DSME on COVID-19 PTSS.
 174 (13%) participants reported COVID-19-related PTSS, which was more prominent in female (n=127; 15%), than in male participants (n=49; 9%). Individuals, who reported to have or have had a COVID-19 infection showed a significantly higher risk (RR=2.50, LCI=1.87, UCI=3.32) for COVID-19-related PTSS, especially when severe COVID-19 symptoms were reported (RR=4.01, LCI=2.66, UCI=6.03). Whereas non-infected females were at higher risk than males (p≤.001, LCI=16.96,UCI=23.81), a non-significant mean difference of 6.54 (p=.159, LCI=-14.62,UCI=1.54) between males and females was found when COVID-19 infections were reported. DSME increased the Risk Ratios by 2.81 (LCI=2.08, UCI=3.79) and was more prominent in males.
 The results from this study indicate that severe COVID-19 symptoms, DSME and female gender are risk factors for COVID-19 related PTSS. This underlines the need for effective public health measures for prevention.