<![CDATA[Digital learning has transformed medical education by improving access and flexibility; however, excessive screen exposure, information overload, and continuous online academic demands may adversely affect students’ psychological and physiological well-being. This study examined the associations among digital academic stress, psychological distress, and systemic inflammation, as measured by the neutrophil-to-lymphocyte ratio (NLR), among medical students. An analytical observational study with a cross-sectional design was conducted among 124 students at the Faculty of Medicine, Universitas Lampung, Indonesia. Participants completed questionnaires assessing digital academic stress and psychological distress using the Depression Anxiety Stress Scales–21 (DASS-21) and underwent complete blood count examinations. Associations were analyzed using correlation tests and multiple linear regression analysis. Digital academic stress was positively associated with psychological distress (p < 0.01). Students with moderate-to-high psychological distress had significantly higher NLR values than those with lower distress levels (p = 0.02). Digital academic stress was also positively correlated with NLR (r = 0.29, p = 0.003) and remained an independent predictor of elevated NLR after multivariable adjustment (? = 0.24, p = 0.01). These findings indicated that digital academic stress was associated with both psychological distress and low-grade systemic inflammation. Medical schools should optimize digital learning environments, promote balanced academic workloads, and strengthen psychological support systems to protect students’ mental and physiological health.]]>
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