Cited by 381COVID-19 and Mental HealthHealthcare professionals’ stress and burnoutHealthcare Systems and Challenges

COVID-19: a heavy toll on health-care workers

Open access

Integrity signals

Registry

Crossref · 10.1016/s2213-2600(21)00068-0

Cites

10 of 10 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 12 cited sources checked · 0 supported · 0 flagged

  • Premisecitation
    § COVID-19: a heavy toll on health-care workers

    During the pandemic, women in health care produced less academic work than men, evidenced by their lower representation among authors generating new pandemic knowledge.

    “Burdened by these obligations, women had reduced academic productivity relative to men, as evidenced by fewer women being part of the cohort producing new knowledge about the pandemic.10”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10] Pinho-Gomes, 2020, Where are the women? Gender inequalities in COVID-19 research authorship, BMJ Glob Health source

      Not checked in the free run.

  • Premisecitation
    § COVID-19: a heavy toll on health-care workers

    After the 2003 SARS outbreak, health-care workers reported chronic stress effects lasting months to years.

    “Following the outbreak of severe acute respiratory syndrome in 2003, health-care workers reported chronic stress effects for months to years.4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Maunder, 2006, Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak, Emerg Infect Dis source

      Not checked in the free run.

  • Premisecitation
    § COVID-19: a heavy toll on health-care workers

    A meta-analytic review covering 13 studies and over 33,000 participants corroborated the high rates of mental health symptoms among health-care workers during COVID-19.

    “These findings were supported by a systematic review of 13 studies including more than 33 000 participants.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Pappa, 2020, Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis, Brain Behav Immun source

      Not checked in the free run.

  • Interpretationreasoning
    § COVID-19: a heavy toll on health-care workers

    Women working in health care were disproportionately affected by the COVID-19 pandemic.

    “COVID-19 has also had a disproportionate effect on women health-care workers.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Women make up 70% of the global health and social care workforce, which places them at risk of infection and associated physical and mental health problems during a pandemic.
    • Rests on an assumption: The pandemic worsened gender disparities in paid and unpaid work and in household duties, and raised the likelihood of job loss and domestic violence.
  • Premisecitation
    § COVID-19: a heavy toll on health-care workers

    Anxiety, depression, burnout, insomnia, moral distress, and post-traumatic stress disorder are recognized risks for health-care workers.

    “Health-care workers are known to be at risk for anxiety, depression, burnout, insomnia, moral distress, and post-traumatic stress disorder.2, 3”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [2] Moss, 2016, A critical care societies collaborative statement: burnout syndrome in critical care health-care professionals. A call for action, Am J Respir Crit Care Med source

      Not checked in the free run.

    • cites [3] Poncet, 2007, Burnout syndrome in critical care nursing staff, Am J Respir Crit Care Med source

      Not checked in the free run.

  • May combine two claims. 5
  • May combine two claims.

    Premisecitation
    § COVID-19: a heavy toll on health-care workers

    Home health-care workers faced additional challenges that worsened existing inequities, including limited or no PPE, varying employer support, and a difficult choice between working with risk or losing wages and benefits.

    “Home health-care workers experienced additional challenges that exacerbated the inequities they face as a marginalised workforce, including limited or no PPE, varying levels of employer support, and the difficult choice of working with its attendant risk or losing wages and benefits.1”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Sterling, 2020, Experiences of home health care workers in New York City during the coronavirus disease 2019 pandemic: a qualitative analysis, JAMA Intern Med source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § COVID-19: a heavy toll on health-care workers

    Research in Italy and France found high rates of depressive symptoms, post-traumatic stress disorder, and burnout among health-care workers; younger age, female sex, nursing role, and direct care of COVID-19 patients were risk factors for adverse psychological outcomes.

    “Studies from Italy and France reported a high prevalence of depressive symptoms, post-traumatic stress disorder, and burnout; risk factors for adverse psychological outcomes included younger age, female sex, being a nurse, and working directly with patients with COVID-19.7, 8, 9”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [7] Carmassi, 2020, PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: what can we expect after the COVID-19 pandemic, Psychiatry Res source

      Not checked in the free run.

    • cites [8] Giusti, 2020, The psychological impact of the COVID-19 outbreak on health professionals: a cross-sectional study, Front Psychol source

      Not checked in the free run.

    • cites [9] Azoulay, 2020, Symptoms of anxiety, depression, and peritraumatic dissociation in critical care clinicians managing patients with COVID-19. A cross-sectional study, Am J Respir Crit Care Med source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning
    § COVID-19: a heavy toll on health-care workers

    The pandemic intensified external work-related stressors and the trauma of treating critically ill patients, which are key contributors to poor mental health in health-care workers.

    “Extrinsic organisational risk factors—including increased work demands and little control over the work environment—and the trauma of caring for patients who are critically ill have been heightened by the COVID-19 pandemic and represent important exacerbating factors for poor mental health among health-care workers.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation
    § COVID-19: a heavy toll on health-care workers

    In a Chinese study of health-care workers treating COVID-19 patients, reported rates were 50% depression, 45% anxiety, 34% insomnia, and 72% distress.

    “Among health-care workers treating patients with COVID-19, a Chinese study reported high rates of depression (50%), anxiety (45%), insomnia (34%), and distress (72%).5”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] Lai, 2020, Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019, JAMA Netw Open source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § COVID-19: a heavy toll on health-care workers

    In normal working conditions, severe burnout syndrome affects up to 33% of critical care nurses and as many as 45% of critical care physicians.

    “Under usual working conditions, severe burnout syndrome affects as many as 33% of critical care nurses and up to 45% of critical care physicians.2, 3”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [2] Moss, 2016, A critical care societies collaborative statement: burnout syndrome in critical care health-care professionals. A call for action, Am J Respir Crit Care Med source

      Not checked in the free run.

    • cites [3] Poncet, 2007, Burnout syndrome in critical care nursing staff, Am J Respir Crit Care Med source

      Not checked in the free run.

5 of 5
  • The paper relies on this without support.

    Women make up 70% of the global health and social care workforce, which places them at risk of infection and associated physical and mental health problems during a pandemic.

    “Women comprise 70% of the global health and social care workforce, putting them at risk of infection and the range of physical and mental health problems associated with their role as health professionals and carers in the context of a pandemic.”
  • The paper relies on this without support.

    The pandemic worsened gender disparities in paid and unpaid work and in household duties, and raised the likelihood of job loss and domestic violence.

    “The pandemic exacerbated gender inequities in formal and informal work, and in the distribution of home responsibilities, and increased the risk of unemployment and domestic violence.”
  • The paper relies on this without support.

    Migrants, poor people, and racialised groups experienced higher infection and mortality from COVID-19.

    “The COVID-19 pandemic is a stark reminder of racial and socioeconomic disparities, with disproportionate infection and death rates among migrants, the poor, and racialised groups.”
  • The paper relies on this without support.

    Health care-associated COVID-19 was common in low- and middle-income countries, partly because of PPE shortages, heavier workloads, poor training and infection control, and pandemic fatigue.

    “LMICs experienced high rates of health care-associated COVID-19, due in part to a shortage of PPE, increased workload, inadequate training and infection control practices, and pandemic fatigue.”
  • The paper relies on this without support.

    Work-related psychological distress, including burnout, is an unavoidable occupational health problem.

    “Burnout and other forms of work-related psychological distress are unavoidable occupational health issues.”
  • The paper relies on this without support.

    Hospitals and intensive care units worldwide were overwhelmed by the COVID-19 pandemic.

    “The COVID-19 pandemic has challenged and, in many cases, exceeded the capacity of hospitals and intensive care units (ICUs) worldwide.”
  • The paper relies on this without support.

    The pandemic created extra, frequently preventable, stressors and anxiety for health-care workers.

    “Sadly, health-care workers have also faced many additional—often avoidable—sources of stress and anxiety, and long shifts combined with unprecedented population restrictions, including personal isolation, have affected individuals' ability to cope.”
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Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Healthcare workers face rising levels of distress, anxiety, and emotional exhaustion, with burnout and workplace attrition escalating.

    “Healthcare workers face rising levels of distress, anxiety, and emotional exhaustion, with burnout and workplace attrition escalating [1, 2].”

    From Recruitment, retention and recouperation: lessons learned from a study aimed at assessing burnout mitigation in physician learners (2025) · cites this paper as [1]

    The paper’s main text (page unavailable) describes exhaustion and heightened sources of stress and anxiety during COVID-19, and reports high rates of distress and burnout among health-care workers. It also notes cases of workers abandoning their posts, but does not establish that workplace attrition was escalating or document a rise in burnout rates. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Authors
Mehta, S., Machado, F., Kwizera, A., Papazian, L., Moss, M., Azoulay, É., & Herridge, M.
Affiliations
  • University of Toronto (CA)
  • Universidade Federal de São Paulo (BR)
  • Makerere University (UG)
  • Aix-Marseille Université (FR)
  • University of Colorado Anschutz (US)
  • Hôpital Saint-Louis (FR)
  • University Health Network (CA)
Corresponding author
Mehta, Sangeeta
Venue
The Lancet Respiratory Medicine
Publisher
Elsevier BV
Published
2021-03
Volume
9
Issue
3
Pages
226-228
ISSN
2213-2600 (ISSN-L)
OpenAlex
W3127745374
Cited by
381
References
10
Citations by year
2026: 8 · 2025: 27 · 2024: 51 · 2023: 98 · 2022: 112 · 2021: 84
FWCI
58.83
Type
journal article
Language
en
Open access
Locations
  • The Lancet Respiratory Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Merck Sharp and Dohme
  • Gilead Sciences
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
  • Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
Keywords
COVID-19 pandemic, healthcare workers, occupational stress, anxiety, burnout, personal protective equipment, infection risk, long shifts, isolation, intensive care unit, hospital capacity
MeSH terms
Occupational Stress, COVID-19, SARS-CoV-2, Health Personnel, Humans, Workload, Workplace

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