1348 © 2021 Annals of Medical and Health Sciences Research Original Article Research Article How to Cite this Article: Alfakeh SA. Impact of Covid-19 on the Mental Health of University Students. Ann Med Health Sci Res. 2021;11:1348-1353. This is an open access article distributed under the terms of the Creative Com- mons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. Impact of Covid-19 on the Mental Health of University Students Sulhi A Alfakeh * Assistant Professor, Child and Adolescent Psychiatrist, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Introduction According to the World Health Organization’s (WHO) World Mental Health Surveys International College Student Project, depression disorders are very common among respondents from 21 countries, with 21.2% lifetime prevalence and 18.5% 12 month prevalence. Generalized anxiety disorder was the second most prevalent mental health illness among college students, with a lifetime prevalence of 18.6% and a 12-month prevalence of 16.7%. [1] The Saudi National Mental Health Survey showed that the rate of major depressive disorder was 6.0% and that the rate of generalized anxiety disorder was 1.9%. [2] AMR et al. stated that 21.9% of undergraduate students at King Faisal University reported symptoms of depression or anxiety, with 9.9% reporting symptoms of major depression and 14.0% reporting symptoms consistent with generalized anxiety. [3] Coronavirus Disease (COVID-19) cases have been reported in 213 countries, areas, and territories globally. The increased spread of COVID-19 led the WHO to declare a pandemic. The main symptoms of COVID-19 are fever, shortness of breath, cough, and fatigue. As of April 27, 2020 there were 2810325 confrmed cases and 193825 confrmed deaths according to the ofcial WHO website. According to the Ministry of Health in Saudi Arabia, there were 17522 confrmed cases as of April 26, 2020. Ofcials in Saudi Arabia have taken various actions to limit the spread of COVID-19, including closing all colleges, universities, and schools on March 9, 2020 and students were instructed to use distance learning tools to complete their courses. The continuous reporting of the latest confrmed COVID-19 cases in Saudi Arabia and globally, with the concomitant social distancing measures and university closures, is likely to afect the mental wellbeing of many university students. There have been many reports on the psychological efects of the COVID-19 pandemic on the public, hospital staf, patients, children, and older adults. [4,5] However, to date, only a few studies on the mental health efects of COVID-19 and the wellbeing of college students have been conducted during the pandemic. [6] This study aimed to estimate the mental health impact of COVID-19 on university students in Saudi Arabia. It was conducted to investigate the psychological status of university students during the pandemic for the following reasons: to evaluate the prevalence of stress, anxiety, and depression of university students during the pandemic; and to provide a basis for universities and governmental policies to support university students afected by COVID-19. Materials and Methods Study population and sample The study population comprised undergraduate students of King Abdulaziz University. Using cluster sampling of the Abstract Objective: To estimate the psychological impact of COVID-19 on university students in Saudi Arabia. Method: The Depression Anxiety Stress Scales 21 (DASS-21) questionnaire was distributed via the university students’ emails. Of the 71,945 full-time undergraduate university students, 3,515 respondents completed the questionnaire. The questionnaire also included demographic information, such as age, gender, source of income, living arrangements, smoking status, and weekly physical exercise. Results: Nearly half of the participants experienced normal levels of stress (40.5%, n=1425) and anxiety (42.4%, n=1492). In terms of depression, nearly one-third were classifed as normal (29.3%, n=1031); however, one-fourth were classifed as extremely severe (23.8%, n=838). There were signifcantly higher levels of stress among female students. Additionally, a signifcantly higher rate of male students (50.4%, n=667) had normal anxiety levels compared to female students (37.7%, n=825). Finally, a signifcantly higher proportion of female students had symptoms of depression (72.66%, n=1,592) compared with the degrees of depression among male students (67.37%, n=892). Conclusion: We detected that stress, anxiety, and depression increased during the COVID-19 pandemic, and university students were at higher risk of developing mental health issues. An ongoing follow-up and monitoring of psychological consequences and their potential negative impact on academic performance and mental wellbeing are required. Keywords: COVID-19; Anxiety; Stress; Depression; University students Corresponding author: Sulhi A Alfakeh, MD, Assistant Professor, Child and Adolescent Psychiatrist, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia Tel: +966554714410; Fax: 0126498315; E-mail: salfakeh@kau.edu.sa