Effects of the COVID-19 Pandemic on Grief: A Prospective Survey Among Community Hospital Next-of-Kin.

Abstract

Background: Over one million Americans have died from coronavirus disease 2019 (COVID-19). Increased isolation resulting from social distancing, public health restrictions, and hospital visit limitations may affect the ability to perform normal mourning practices. Grief experts expect higher rates of prolonged grief disorder (PGD) because of the pandemic, but empirical evidence is limited. Objectives: To compare grief severity using PG-13-R scores among those bereaved during the COVID-19 pandemic to prepandemic controls. Design: Prospective cohort trial. Setting/Subjects: One hundred twenty-three next-of-kin of deceased individuals at a secondary medical center in the United States. Measurements: We compared the PG-13-R score and demographic characteristics across three periods based on the time of their relative's death: prepandemic (n = 42, November 2019-March 19, 2020), early-pandemic (n = 42, March 20, 2020-June 2020), and mid-pandemic (n = 39, July 2020-October 2020). Linear regression investigated the association between the PG-13-R score and COVID-19-related death, hospice use, and grief support services while controlling for demographic characteristics. Results: There were no statistical differences in unadjusted PG-13-R score, individual PG-13-R questions, and demographic characteristics across three periods. In adjusted analyses, COVID-19-related death was associated with an increased PG-13-R score (coefficient: 6.17; p = 0.031), while hospice use was associated with a decline in the PG-13-R score (coefficient: -3.68; p = 0.049). Conclusion: Individuals have adapted to COVID-19 societal changes, including how they grieve. However, COVID-19-related deaths may lead to a higher risk for PGD, consistent with COVID-19 grief studies globally.