In the risky-choice framing effect, different wording of the same options leads to predictably different choices. In a large-scale survey conducted from March to May 2020 and including 88,181 participants from 47 countries, we investigated how stress, concerns, and trust moderated the effect in the Disease problem, a prominent framing problem highly evocative of the COVID-19 pandemic. As predicted by the appraisal-tendency framework, risk aversion and the framing effect in our study were larger than under typical circumstances. Furthermore, perceived stress and concerns over coronavirus were positively associated with the framing effect. Contrary to predictions, however, they were not related to risk aversion. Trust in the government’s efforts to handle the coronavirus was associated with neither risk aversion nor the framing effect. The proportion of risky choices and the framing effect varied substantially across nations. Additional exploratory analyses showed that the framing effect was unrelated to reported compliance with safety measures, suggesting, along with similar findings during the pandemic and beyond, that the effectiveness of framing manipulations in public messages might be limited. Theoretical and practical implications of these findings are discussed, along with directions for further investigations.