###### Abstract  
The rapid changes in human contacts due to the COVID-19 crisis have not only posed a huge burden on the population's health but may have also increased the demand for evidence-based psychological programs delivered through digital technology. A systematic review, following the \"Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)\" guidelines, was therefore conducted to explore the advances in stress management interventions utilizing VR and suggest up-to-date directions for future practice. The relevant literature was screened and the search resulted in 22,312 records, of which 16 studies were considered for analysis. The Methodological Index for Non-Randomized Studies (MINORS) was also employed to assess the quality of the included studies. The results suggest that VR-based interventions can facilitate positive changes in subjective stress levels and stress-related biomarkers. However, special attention should be paid to the development of rigorous VR protocols that embrace natural elements and concepts deriving from traditional treatment approaches, such as cognitive behavioral therapy techniques. Overall, this review aims to empower future researchers to grasp the opportunity that the COVID-19 pandemic generated and utilize digital technologies for strengthening individuals' mental health. Future projects need to conduct large-scale VR studies to evaluate their effectiveness compared to other mental health interventions. immersive virtual reality; health; stress management; relaxation; interventions; cognitive behavioral therapy; healthy adults; advances; systematic review +
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immersion and presence are of fundamental relevance to the definition of VR characteristics. Whereas immersion is a property of the virtual environment, presence can be seen as a property of the user [4]. Immersion is achieved when individuals can interact with a digital world that is as real and similar to the real world as possible. Thus, it can be defined as the extent to which virtual environments are able to provide human participants with a comprehensive, encompassing, ambient, and vivid illusion of the reality (e.g., [4]). The more immersive a virtual environment, the stronger an individual's attention is diverted from the real world [5]. Presence is commonly described as the feeling of being present in a virtual environment rather than in the physical place, where the person is [6; 7; 8; 9]. The component of presence is considered to be a profound achievement of VR. In the clinical context, immersive VR technologies are used for effective pain management in patients. Distraction techniques have been used for more than two decades, for example, to distract from pain in the context of medical treatment for children [10]. The assumption is that focusing attention on harmful stimuli increases pain perception and diverting attention away from these stimuli attenuates pain perception [5]. In this regard, immersive VR technologies can be superior to traditional distraction techniques (e.g., watching movies or listening to music). It is hypothesized that the stronger the feeling of presence in the virtual world is, or the more immersive the stimulation is, the more effectively pain perception can be modulated. This phenomenon is also known as sensory shielding [11]. For instance, a study of patients undergoing dental procedures showed that VR reduced anxiety, discomfort, and the time required for each procedure [12]. In addition, VR distraction has been shown to decrease pain effectively during bandage changes in burn victims [13]. Recent studies with regard to the analgesic effects of VR during surgical procedures showed that pain reduction was associated with a decrease in heart rate, respiratory rate, oral secretions, and blood pressure [14; 15]. VR technologies may be seen, however, as a tool that is not only utilized in clinical settings, but also as a means with a broader spectrum of applications.