The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index; none of the 12 sources its claims cite is checked for support yet.
COVID-19: a heavy toll on health-care workers
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Claims the paper makes
8 Not checked yet · 2 Own interpretation
In the paper
“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”
What the sources say
- Not checked yetcites [10] Pinho-Gomes, 2020, Where are the women? Gender inequalities in COVID-19 research authorship, BMJ Glob Health source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Following the outbreak of severe acute respiratory syndrome in 2003, health-care workers reported chronic stress effects for months to years.4”
What the sources say
- Not checked yetcites [4] Maunder, 2006, Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak, Emerg Infect Dis source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These findings were supported by a systematic review of 13 studies including more than 33 000 participants.6”
What the sources say
- Not checked yetcites [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
plaincorrelationaln = 33,000- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“COVID-19 has also had a disproportionate effect on women health-care workers.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- 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.
None of the sources cited for this claim have been checked yet.
In the paper
“Health-care workers are known to be at risk for anxiety, depression, burnout, insomnia, moral distress, and post-traumatic stress disorder.2, 3”
What the sources say
- Not checked yetcites [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 yetcites [3] Poncet, 2007, Burnout syndrome in critical care nursing staff, Am J Respir Crit Care Med source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 5
In the paper
“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”
What the sources say
- Not checked yetcites [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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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”
What the sources say
- Not checked yetcites [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 yetcites [8] Giusti, 2020, The psychological impact of the COVID-19 outbreak on health professionals: a cross-sectional study, Front Psychol source
- Not checked yetcites [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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“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”
What the sources say
- Not checked yetcites [5] Lai, 2020, Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019, JAMA Netw Open source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“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”
What the sources say
- Not checked yetcites [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 yetcites [3] Poncet, 2007, Burnout syndrome in critical care nursing staff, Am J Respir Crit Care Med source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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.”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measured
Citations
Cites
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., Li, R., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.3976 · Cited by 8,015
Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2020.05.026 · Cited by 3,617
Maunder, R., Lancee, W., Balderson, K., Bennett, J., Borgundvaag, B., Evans, S., Fernandes, C., Goldbloom, D., Gupta, M., Hunter, J., et al. (2006) · Emerging Infectious Diseases · doi:10.3201/eid1212.060584 · Cited by 1,109
Burnout syndrome in critical care nursing staff
Poncet, M. C., Toullic, P., Papazian, L., Kentish-Barnes, N., Timsit, J.-F., Pochard, F., Chevret, S., Schlemmer, B., & Azoulay, É. (2007) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200606-806oc · Cited by 750
Self-citationCarmassi, C., Foghi, C., Dell'Oste, V., Cordone, A., Bertelloni, C. A., Bui, E., & Dell'Osso, L. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113312 · Cited by 607
The psychological impact of the COVID-19 outbreak on health professionals: A cross-sectional study
Giusti, E. M., Pedroli, E., D'Aniello, G. E., Stramba Badiale, C., Pietrabissa, G., Manna, C., Stramba Badiale, M., Riva, G., Castelnuovo, G., & Molinari, E. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01684 · Cited by 533
Moss, M., Good, V. S., Gozal, D., Kleinpell, R., & Sessler, C. N. (2016) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201604-0708st · Cited by 327
Self-citationAzoulay, E., Cariou, A., Bruneel, F., Demoule, A., Kouatchet, A., Reuter, D., Souppart, V., Combes, A., Klouche, K., Argaud, L., et al. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202006-2568oc · Cited by 272
Self-citationWhere are the women? Gender inequalities in COVID-19 research authorship
Pinho-Gomes, A.-C., Peters, S., Thompson, K., Hockham, C., Ripullone, K., Woodward, M., & Carcel, C. (2020) · BMJ Global Health · doi:10.1136/bmjgh-2020-002922 · Cited by 270
Sterling, M. R., Tseng, E., Poon, A., Cho, J., Avgar, A. C., Kern, L. M., Ankuda, C. K., & Dell, N. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.3930 · Cited by 210
Cited by
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Items 101–101 of 101
Pflaum-Carlson, J., Redding, A., Murphy, D., MacLean, L., Hamilton, J., & Santarossa, S. (2025) · BMC Research Notes · doi:10.1186/s13104-025-07435-5
“Healthcare workers face rising levels of distress, anxiety, and emotional exhaustion, with burnout and work-place attrition escalating [1, 2].”
Metadata
- 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
- ORCID
- Venue
- The Lancet Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 9
- Issue
- 3
- Pages
- 226-228
- ISSN
- 2213-2600 (ISSN-L)
- PMC
- PMC7906726
- OpenAlex
- W3127745374
- Semantic Scholar
- a006366a7bf5eafeab41c05cf60bb5ac09628677
- 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
- bronze
- doi.org
- Licence
- 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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