Prevalence and correlates of positive and negative psychological effects of bereavement due to COVID-19: A living systematic review

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic is associated with an increase in mortality rates globally. Given the high numbers of deaths and the potentially traumatic characteristics of COVID-19 deaths, it is expected that grief-related distress levels are higher in COVID-19 bereaved (compared to non-COVID-19 bereaved) people. This living systematic review (LSR) investigates the empirical evidence regarding this claim. More specifically, this LSR summarizes studies evaluating prevalence and correlates of positive and negative psychological effects of COVID-19 bereavement. This iteration synthesizes evidence up to July 2022. Methods: Systematic searches were conducted in PsychInfo, Web of Science, and Medline by two independent reviewers. Eligible studies included quantitative peer-reviewed articles reporting on positive and/or negative psychological outcomes, using validated measures, in COVID-19 bereaved adults. The primary outcome was prolonged grief symptoms (PG). Results: Searches identified 9871 articles, whereof 12 studies met the inclusion criteria. All studies included prevalence rates and/or symptom-levels of psychological outcomes after COVID-19 losses. Prevalence rates of psychological outcomes were primarily reported in terms of (acute) PG, pandemic grief, depression, anxiety, and functional impairment, and varied widely between studies (e.g., ranged between 29% and 49% for acute PG). No studies reported on prevalence rates of positive psychological outcomes. Closer kinship to the deceased, death unexpectedness, and COVID-19 stressors were identified as correlates of increased psychological symptoms. Conclusions: Due to the small number and heterogeneity of studies, knowledge about psychological effects of COVID-19 bereavement is limited. This LSR offers a regular synthesis of up-to-date research evidence to guide clinicians, policy makers, public health professionals, and future research on the psychological effects of COVID-19 bereavement.