Impact of Stress Induced by the COVID-19 Pandemic on Medical Student Learning

Introduction: The COVID-19 pandemic has become a serious challenge to educational systems worldwide. The relevance of this study is determined by the need to understand long-term effects of pandemic stress on the professional development of medical workers.

Objective: To conduct a comprehensive analysis of the impact of COVID-19-related stress on the cognitive functions and academic performance of medical students.

Materials and Methods: From September 2022 to May 2023, we conducted a survey of 150 second and third-year medical university students aged 19–21 years. The main (experimental) group consisted of 100 students who studied during the peak of the pandemic (2020–2021), while the control group comprised 50 students who entered the university after the epidemiological situation had normalized. The Perceived Stress Scale (PSS-10), the Hospital Anxiety and Depression Scale (HADS), our self-developed questionnaire on stress factors, neuropsychological tests, and the analysis of academic performance were used.

Results: High stress levels (PSS-10 ≥ 20) were detected in 78 % of the students in the main group against 35 % in the control group (p < 0.001) while clinical anxiety was observed in 42 % versus 18 %, respectively (p < 0.001). The dominant stressors were professional (4.2 ± 0.7 points) and academic (3.9 ± 0.8 points). In the main group, short-term memory decreased by 25.6 % (p < 0.001), attentional concentration worsened by 66.7 % (p < 0.001), and logical thinking productivity dropped by 22.0 % (p < 0.001). The mean grade point average (GPA) in the main group was 3.8 ± 0.4 versus 4.5 ± 0.3 in the controls (p < 0.001). A strong negative correlation was found between stress and academic performance (r = –0.74).

Conclusion: The COVID-19 pandemic led to a significant increase in stress and anxiety among medical students, as well as to persistent impairments in cognitive functions and a decline in academic performance, which necessitates the development of psychological and pedagogical support programs. 

1. Badillo-Sánchez N, Gómez-Salgado J, Allande-Cussó R, et al. Impact of the COVID-19 pandemic on the mental health of nursing students: A systematic review and meta-analysis. Medicine (Baltimore). 2025;104(2):e40797. doi: 10.1097/MD.0000000000040797

2. Sahu P. Closure of universities due to coronavirus disease 2019 (COVID-19): Impact on education and mental health of students and academic staff. Cureus. 2020;12(4):e7541. doi: 10.7759/cureus.7541

3. Roberts BL, Karatsoreos IN. Brain-body responses to chronic stress: A brief review. Fac Rev. 2021;10:83. doi: 10.12703/r/10-83

4. Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. Investigating mental health of US college students during the COVID-19 pandemic: Cross-sectional survey study. J Med Internet Res. 2020;22(9):e22817. doi: 10.2196/22817

5. Garg AS, Tiwari DS, Shah VR, Patel NP. Depression anxiety stress and fear of COVID-19 among adolescent students and its relationship with possible predictors. Ind Psychiatry J. 2024;33(Suppl 1):S171-S176. doi: 10.4103/ipj.ipj_80_24

6. Zolotareva AA. Somatic symptoms and health risk behavior in Russian youth: Lessons learned from the COVID-19 pandemic. Zdorov’e Naseleniya i Sreda Obitaniya. 2024;32(2):26-31. (In Russ.) doi: 10.35627/2219-5238/2024-32-2-26-31

7. Schmidt MV, Robinson OJ, Sandi C. EJN stress, brain and behaviour special issue. Eur J Neurosci. 2022;55(9- 10):2053-2057. doi: 10.1111/ejn.15718

8. Dost S, Hossain A, Shehab M, Abdelwahed A, Al-Nusair L. Perceptions of medical students towards online teaching during the COVID-19 pandemic: A national cross-sectional survey of 2721 UK medical students. BMJ Open. 2020;10(11):e042378. doi: 10.1136/bmjopen-2020-042378

9. Li Y, Wang A, Wu Y, Han N, Huang H. Impact of the COVID-19 pandemic on the mental health of college students: A systematic review and meta-analysis. Front Psychol. 2021;12:669119. doi: 10.3389/fpsyg.2021.669119

10. Dąbrowska-Galas M, Dąbrowska J. Stress and physical activity level during COVID-19 pandemic in medical students from Medical University in Katowice. Przegl Epidemiol. 2022;76(2):200-209. doi: 10.32394/pe.76.20

11. Marvaldi M, Mallet J, Dubertret C, Moro MR, Guessoum SB. Anxiety, depression, trauma-related, and sleep disorders among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2021;126:252-264. doi: 10.1016/j.neubiorev.2021.03.024

12. Krishnamoorthy Y, Nagarajan R, Saya GK, Menon V. Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res. 2020;293:113382. doi: 10.1016/j.psychres.2020.113382

13. Pfefferbaum B, North CS. Mental health and the Covid-19 pandemic. N Engl J Med. 2020;383(6):510-512. doi: 10.1056/NEJMp2008017

14. Yılmaz Koğar E, Koğar H. A systematic review and meta-analytic confirmatory factor analysis of the perceived stress scale (PSS-10 and PSS-14). Stress Health. 2024;40(1):e3285. doi: 10.1002/smi.3285

15. Colomo N, Olveira C, Hernández-Pedrosa J, et al. Validity of self-rating screening scales for the diagnosis of depression and anxiety in adult patients with bronchiectasis. Arch Bronconeumol (Engl Ed). 2021;57(3):179-185. doi: 10.1016/j.arbres.2020.01.009

16. Lyons Z, Wilcox H, Leung L, Dearsley O. COVID-19 and the mental well-being of Australian medical students: Impact, concerns and coping strategies used. Australas Psychiatry. 2020;28(6):649-652. doi: 10.1177/1039856220947945

17. Zhu H, Yang X, Xie S, Zhou J. Prevalence of burnout and mental health problems among medical staff during the COVID-19 pandemic: A systematic review and meta-analysis. BMJ Open. 2023;13(7):e061945. doi: 10.1136/bmjopen-2022-061945

18. Chinarev VA, Malinina EV, Obukhova MD. Validation of the Russian version of the Recovery Assessment Scale – Domains and Stages (RAS-DS) to assess recovery after the first psychotic episode. Nauchnye Rezultaty Biomeditsinskikh Issledovaniy. 2026;12(1):154-171. (In Russ.) doi: 10.18413/2658-6533-2026-12-1-1-0

19. Lasheras I, Gracia-García P, Lipnicki DM, et al. Prevalence of anxiety in medical students during the COVID-19 pandemic: A rapid systematic review with meta-analysis. Int J Environ Res Public Health. 2020;17(18):6603. doi: 10.3390/ijerph17186603

20. Prado ADS, Kohls E, Baldofski S, et al. How are Brazilian university students coping with the COVID-19 pandemic? Results of an online survey on psychosocial well-being, perceived burdens, and attitudes toward social distancing and vaccination. PLoS One. 2023;18(4):e0284190. doi: 10.1371/journal.pone.0284190

21. Bani I, Mohamed Y, Andrade G. Evaluation of the impact of COVID-19 on stress and burnout among Ajman university (AU) medical students. Acta Psychol (Amst). 2024;246:104245. doi: 10.1016/j.actpsy.2024.104245

22. Baiguzhina OV, Nikolskaya OB, Komissarova OA, Kovaleva OI. The psychological structure of temperament in students with different levels of volitional self-regulation. Psikhologiya. Psikhofiziologiya. 2024;17(4):116–123. (in Russ.) doi: 10.14529/jpps240410

23. Otroshko NA, Romantsova SV, Gladysheva IV, Vervekina NV, Sinyutina SE, Gosteva MS. Lifestyle and health of foreign medical students. Zdorov’e Naseleniya i Sreda Obitaniya. 2025;33(8):36-45. (In Russ.) doi: 10.35627/2219-5238/2025-33-8-36-45

24. Pavlova SI, Drandrova EG, Nayak SC. Self-rated quality of life of foreign medical students getting education in the Chuvash Republic. Zdorov’e Naseleniya i Sreda Obitaniya. 2024;32(4):17-26. (In Russ.) doi: 10.35627/2219-5238/2024-32-4-17-26

25. Klimova EG, Chashchin MV, Golik VE, Chashchin AM, Makeeva LV. Assessing the risks of COVID-19 transmission from healthcare workers to their social and professional contacts. Zdorov’e Naseleniya i Sreda Obitaniya. 2024;32(12):66-73. (In Russ.) doi: 10.35627/2219-5238/2024-32-12-66-73

26. Novokovich YuS, Glotov OS, Danilov LG, et al. Features of the gut microbiome in people with increased anxiety. Nauchnye Rezultaty Biomeditsinskikh Issledovaniy. 2025;11(3):574-591. (In Russ.) doi: 10.18413/2658-6533-2025-11-3-1-0

27. Neronova EG, Li VA. Effect of the COVID-19 pandemic on the frequency and spectrum of chromosomal abnormalities in abortions in early pregnancy failure. Nauchnye Rezultaty Biomeditsinskikh Issledovaniy. 2025;11(3):416-431. (In Russ.) doi: 10.18413/2658-6533-2025-11-3-0-2

28. Khusainov AE, Zulkarnaev TR, Agafonov AI, Povargo EA, Mochalkin PA, Shamsutdinova AF. The level of anxiety among medical university students with physical activity of different intensity. Zdorov’e Naseleniya i Sreda Obitaniya. 2022;30(4):39-43. (In Russ.) doi: 10.35627/2219-5238/2022-30-4-39-43

29. Polyakova OB, Bonkalo T.I. Well-being as a component of subjective health assessment in students. Zdorov’e Megapolisa. 2024;5(2):24-32. doi: 10.47619/2713-2617.zm.2024.v.5i2;24-32

30. Hillebrand JF, Ziólkiewicz OA, Zsuffa JA, Horváth AA, Katz S. A COVID–19-világjárvány hatása a Magyarországon tanuló magyar és külföldi orvostanhallgatók mentális és fizikális egészségére [Impact of the COVID-19 pandemic on the mental and physical health of Hungarian and foreign medical students studying in Hungary]. Orv Hetil. 2023;164(52):2055-2064. (In Hungarian.) doi: 10.1556/650.2023.32940