Impact of the COVID-19 Epidemic on hospitalization for diabetic foot ulcers during lockdown: A French nationwide population-based study

Diabet Med. 2021 Jul;38(7):e14577. doi: 10.1111/dme.14577. Epub 2021 Apr 13.


Aims/hypothesis: The aim of this study was to examine the impact of the COVID-19 epidemic on the hospitalization rates for diabetic foot ulcer (DFU), osteomyelitis and lower limb revascularization procedure in people with DFU.

Methods: This nationwide retrospective cohort study included hospital data on all people hospitalized in France for diabetes in weeks 2-43 in 2020, including the COVID-19 lockdown period, compared to same period in 2019.

Results: The number of hospitalizations for DFU decreased significantly in weeks 12-19 (during the lockdown) (p < 10-4 ). Hospitalization for foot osteomyelitis also decreased significantly in weeks 12-19 (p < 10-4 ). The trend was the same for lower limb amputations and revascularizations associated with DFU or amputation.

Conclusions/interpretation: The marked drop in hospitalization rates for DFU, osteomyelitis and lower limb revascularization procedures in people with DFU observed in France during the lockdown period suggests that COVID-19 was a barrier to DFU care, and may illustrate the combined deleterious effects of hospital overload and changes in health-related behaviour.

Keywords: COVID-19; diabetes complications; diabetes foot ulcers; hospital data; lockdown; lower limb amputations; osteomyelitis.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation / statistics & numerical data
  • Amputation / trends
  • COVID-19 / epidemiology*
  • COVID-19 / prevention & control
  • Cohort Studies
  • Communicable Disease Control / methods
  • Diabetic Foot / epidemiology*
  • Diabetic Foot / therapy*
  • Epidemics
  • Female
  • France / epidemiology
  • History, 21st Century
  • Hospitalization / statistics & numerical data*
  • Hospitalization / trends
  • Humans
  • Lower Extremity / surgery
  • Male
  • Middle Aged
  • Quarantine*
  • Retrospective Studies
  • SARS-CoV-2 / physiology