BACKGROUND: The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic. METHODS: We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2u2009=u2009substantially reduced to 2u2009=u2009substantially increased) and perceived importance of 13 preparations (1u2009=u2009not important to 5u2009=u2009extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels., RESULTS: 16u2009512 adults participated, with 10u2009351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m)u2009=u20090.84, standard error (SE)u2009=u20090.01), cooking at home (mu2009=u20090.78, SEu2009=u20090.01), social activities (mu2009=u2009-0.68, SEu2009=u20090.01), duration of screen time (mu2009=u20090.67, SEu2009=u20090.01), and duration of sitting (mu2009=u20090.59, SEu2009=u20090.01). Alcohol (mu2009=u2009-0.36, SEu2009=u20090.01) and tobacco (mu2009=u2009-0.38, SEu2009=u20090.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (mu2009=u20093.50, SEu2009=u20090.01), getting prescribed medicine in a hospital visitu2009/u2009follow-up in a community pharmacy (mu2009=u20093.37, SEu2009=u20090.01), and online shopping (mu2009=u20093.33, SEu2009=u20090.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised. CONCLUSIONS: Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics.