Digital mental health interventions for university students during the COVID-19 pandemic and post-pandemic periods: a systematic review and meta-analysis of randomized controlled trials

Background University students experience elevated levels of anxiety, depression, and stress, prompting growing interest in accessible digital psychological interventions. This systematic review and meta-analysis assessed the effectiveness of digital psychological interventions for university students during the later stages of the coronavirus disease 2019 (COVID-19) pandemic and the post-pandemic periods. Methods PubMed/MEDLINE, Scopus, Web of Science (WoS), and Cochrane were searched for randomized controlled trials involving university students published between 2020 and June 2026. Random-effects models (Hedges’ g, modified Knapp-Hartung [mKH]) were applied, and Risk of Bias was assessed with Risk of Bias 2 (RoB 2). Results A total of 34 trials (6,544 students, 15 countries) were included. Benefits were significant for depression at 8 weeks (g = 0.48), anxiety at 2 and 8 weeks (g = 0.24 and g = 0.57), stress at 4 weeks (g = 0.23), and post-intervention anxiety (g = 0.75; I 2 = 88.6%), but not for pooled anxiety. Overall, 52.9% of studies were at high Risk of Bias, and only one of six active-comparator trials compared digital with face-to-face delivery. Conclusion Digital interventions yield modest short-term benefits, but heterogeneity, high Risk of Bias, and a scarcity of face-to-face comparisons limit confidence. Systematic review registration http://doi.org/10.17605/OSF.IO/E2C78 , identifier (E2C78).