Background: The Coronavirus Disease (COVID-19) outbreak is one of the public health problems that pose a serious mental health concern due to its high morbidity and mortality rate. It has increased the burden of psychological distress in the communities. This study aimed to systematically review the distress of the COVID-19 pandemic on psychological distress and its associated factors among the predominantly Ethiopian general population. Method: A systematic review and meta-analysis study were conducted. Different primary studies that assessed the psychological distress of COVID-19 in Ethiopia were extracted by Microsoft Excel and exported to STATA version 14 for further analysis. Random-effect model meta-analysis was used to estimate each study's pooled effect size and effect with their 95% confidence interval. Funnel plots analysis and Egger regression tests were conducted to detect the presence of publication bias. Sub-group analysis and sensitivity analysis were conducted. This is registered in PROSPER registration protocol CRD42022308347. Results: Thirteen studies with 6,838 participants were included in this systematic review and meta-analysis study. The pooled prevalence of COVID-19 psychological distress in Ethiopia was 32.84%, with a 95% CI of 31.78 to 33.90. Being female [AOR= 1.99 (95% CI:1.60, 2.48)], poor social support [AOR= 3.50 (95% CI: 2.26,5.42)], previous depression [AOR=4.43(95% CI: 2.22,8.86)], and substance use [AOR= 3.93 (95% CI: 2.32,6.67)] were the factors associated with psychological distress among the Ethiopian community during COVID-19 pandemic. Conclusion: The prevalence of psychological distress during the COVID-19 pandemic was high in the Ethiopian community. Immediate and timely assessment and treatment of psychological distress is essential to improve the health status and quality of life of the distressed population.

Keywords: Coronavirus Disease-19, meta-analysis, psychological impact, systematic review, Ethiopia.