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

Background: The coronavirus disease 2019 (COVID-19) pandemic was associated with an increase in mortality rates globally. Given the high numbers of deaths and the potentially traumatic characteristics of COVID-19 deaths, it was expected that grief-related distress would be higher in COVID-19 bereaved (compared to non-COVID-19 bereaved) people. This systematic review investigates the empirical evidence regarding this claim. More specifically, this review summarizes studies up to December 2024, evaluating the prevalence and correlates of positive and negative psychological effects of COVID-19 bereavement. Methods: Systematic searches were conducted in PsychInfo, Web of Science, and Medline by two independent reviewers. Eligible studies included quantitative research in 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: We identified 9918 articles, whereof 28 studies met the inclusion criteria. Rates of psychological outcomes were primarily reported in terms of (early) PG, depression, posttraumatic stress, anxiety, and pandemic grief, and varied widely between studies (e.g., PG rates ranged between 30 % and 87 %). No studies reported on positive psychological outcomes. Closer kinship to the deceased, death unexpectedness, and COVID-19 stressors were identified as correlates of increased psychopathology. Conclusions: Due to the small number and heterogeneity of studies, knowledge about psychological effects of COVID-19 bereavement is limited. This review offers a synthesis of research evidence to inform clinicians, policy makers, public health professionals, and future research concerned with psychological effects of COVID-19 bereavement.