Explaining the Long-Term Effects of COVID-19 on Spiritual Health in Individuals with a History of Hospitalization Due to Coronavirus Infection

Abstract

Background: Hospitalization for COVID-19 has been associated with profound psychological, social, and spiritual consequences that may persist long after physical recovery. Although previous studies have examined the immediate spiritual impact of COVID-19, few have explored how spiritual experiences evolve over time among individuals hospitalized for the disease. Understanding these long-term experiences is essential to developing holistic recovery programs that address spiritual well-being alongside physical and psychological health. Objectives: This study aimed to explore the long-term effects of COVID-19 on the spiritual health of individuals with a history of hospitalization for coronavirus infection. Methods: This longitudinal qualitative study used conventional qualitative content analysis to explore the spiritual experiences of individuals hospitalized with COVID-19 over a four-year period. Participants were selected through purposive sampling to ensure variation in age, gender, educational level, and illness severity. Initially, 120 participants were recruited, and annual follow-up interviews were conducted; 86 participants completed the fourth-year interview. Data were collected through semistructured, in-depth interviews at four time points. Longitudinal analysis involved comparing participants’ narratives across interview waves to identify continuity, change, and transformation in spiritual experiences over time. Data were analyzed through systematic coding, categorization, and theme development. Trustworthiness was established using Lincoln and Guba’s criteria of credibility, transferability, dependability, and confirmability. Results: The analysis revealed five interconnected themes reflecting the evolving nature of spiritual experiences following COVID-19 hospitalization. Participants described changes in spiritual beliefs, experiences of uncertainty and spiritual struggle, processes of meaning reconstruction, and the development of coping strategies throughout the four-year follow-up period. Longitudinal comparisons indicated that participants’ spiritual experiences were dynamic and nonlinear. Early narratives often involved fear, vulnerability, and questioning, whereas later accounts frequently reflected adaptation, reinterpretation of illness experiences, and renewed perspectives on life purpose. Participants described spiritual practices and reflection as meaningful resources during recovery and emphasized the importance of family, community, and spiritual connections in restoring a sense of belonging. For some participants, long-term integration of the illness experience was associated with perceived spiritual growth, strengthened values, and a deeper sense of meaning, although these experiences varied among individuals. Conclusions: The findings suggest that hospitalization for COVID-19 may have lasting effects on spiritual health that extend well beyond physical recovery. Participants’ experiences indicate that spiritual health is not static but evolves through a longitudinal process of crisis, reflection, adaptation, and growth. These changes influenced participants’ relationships with themselves, others, and God and contributed to their psychological and social recovery. The findings highlight the importance of integrating spiritual care into long-term post-COVID support services and recovery programs.