The COVID-19 pandemic has led to unprecedented changes in the accompaniment of the sick, the dead, and their loved ones. This article analyses the intertwined accompaniment practices performed by health professionals working in hospitals and nursing homes and by the relatives of those who died or striving during the first few months of the pandemic in Barcelona, Spain. We argue that isolation, fear of contagion, and lack of biomedical professionals and infrastructures, produced a resignification of palliative care, social support and grief practices. Moving beyond the Western biomedical professionalization and the institutionalization of dying processes to give more agency to the dying and their loved ones, we apply the term palliative accompaniment to disentangle healthcare and psychosocial support practices adapted to the extreme circumstances of COVID-19, which includes old and new practices to alleviate patients' suffering, relieve their loved ones' anguish and support health professionals. Following the stories of our respondents, the interruption of the face-to-face visits and dying and mourning rituals was eased by the appearance of innovative healthcare practices, communication, and ritualization. However, this necessary evil was not enough to cope with the feelings of abandonment that emerged in response to dying alone and postponing mourning. [ABSTRACT FROM AUTHOR]