In Nadia’s Reversed Ending, Lucio’s dogs, Mercedes and Melchior, go mad with grief after their owner’s murder. They angrily stalk after Nadia and the player character with their mouths dripping blood, but do not attack. What becomes of them is unknown, and it is possible that they are simply an illusion.
And in Muriel’s Reversed End, Muriel’s wolf companion Inanna is captured by the antagonist and trapped in a cage during the climax. What becomes of her is unknown, as she is not shown or mentioned in the subsequent one-year timeskip; she may have perished in the intervening time, or she may have simply parted ways with her human companions.
Lucio was arguably abused (at least emotionally neglected) by his mother as a child. Though he is not abusive to the MC in his route, he is a villain in other routes and may still count for people.
While unintentional, Asra's parents did leave for their jobs one day and not come back. In his route (at least in the upright ending, I haven't gotten the downtirned ending) they can be found again, having been trapped in a different realm, and they are able to reconnect. However, he spends a vast majority of his childhood without his parents, and homeless.
Muriel's parents also sent him off to Vesuvia, where he was later abandoned by the person who was supposed to watch him. This was not done out of malice, but to keep him safe during a large attack on his people. He does not remember this and believes he was unwanted ans abandoned. It is later cleared up, but the abandonment theme is still strong prior to this in his route.
The five Courtiers are all demonic to varying degrees, and in multiple routes their demonic forms are either seen or described, and they all contain similarly varying degrees of body horror.
a main character lost a limb in battle and has a metal prosthetic arm, his original arm is shown in flashbacks but the amputation itself is never shown
Julian has an eyepatch and (SPOILER) in his route you see his diseased eye, but it doesn't look particularly gory (the sclera is red rather than white). In one of his paid scenes the story of how this happened is briefly explained.
Lucio kills his father in a flashback story, and his mother in Muriel’s route. Portia’s route contains a flashback to the storm where her and Julian’s parents were killed, but the parents themselves are not shown on screen.
While it may not count as he is considered dead by most characters, Nadia begins a romance with the MC on her route while her husband, Lucio, is still around as a ghost (trapped in the realm between life and death).
Additionally, Lucio cheated on Nadia with Valerius while married to her, though this is mostly discussed by the devs outside of the game and as far as I recall only hinted at in the game itself.
There is an optional scene in the Autumn-themed side story “PSL” where, if the player follows Julian and Lucio into a corn maze, they reach a crossroads where they can choose to head towards either a crow or a red balloon. Choosing to head towards the balloon results in the characters being chased by haunted house-style actors in clown costumes.
As explained in the cheating section above, some may consider Nadia beginning a romance with the MC while Lucio is still present (a ghost but not fully dead) cheating. The MC can be female. Additionally, Lucio cheated on Nadia with Valerius while married to her, though this is mostly discussed by the devs outside of the game and as far as I recall only hinted at in the game itself.
[SPOILERS] not a modern hospital, but an ominous doctor is violent with the protagonists of one route in a medical setting, threatening medical-themed violence
Trauma features most prominently in Julian and Muriel’s respective routes. The former was a doctor during a widespread high-mortality epidemic, while the latter was blackmailed into becoming a gladiator and forced to fight and execute prisoners for entertainment.
Aside from a few cheeky references to the word “fuck,” there’s no verbal profanity stronger than the word “bitch.” However, in Julian’s Reversed Ending, the player is given the option to make an obscene gesture at Lucio.
Julian and Portia are coded as Jewish but this has never been confirmed and is never commented on in-game. Judaism is presumably nonexistent in Vesuvia and no characters are coded as stereotypes.
The MC has no canon age but is implied to be pretty young, as is Portia. The MC can romance Lucio and Nadia, who are confirmed by the devs to be around 40, and Portia and Nadia can end up together in some endings.
Not necessarily for crying, but Julian's fits of self-loathing are framed and treated as overdramatic pity parties; choosing to comfort him during one of these episodes is a point towards his bad ending. (Though it takes many other choices to fully tip the scales)
The game can end 'upright' or 'reversed', 'upright' endings are typically happy, whereas 'reversed' endings are typically bittersweet or sad. Even in 'reversed' endings, the main character will still be together with their love interest.
And in Muriel’s Reversed End, Muriel’s wolf companion Inanna is captured by the antagonist and trapped in a cage during the climax. What becomes of her is unknown, as she is not shown or mentioned in the subsequent one-year timeskip; she may have perished in the intervening time, or she may have simply parted ways with her human companions.