Major Lower-Limb Amputation During the COVID Pandemic in South India

Abstract

People with diabetes have a higher risk of lower-limb amputations than people without diabetes. The risk of avoidable lower-limb amputations has increased in the coronavirus disease 2019 (COVID-19) lockdown period. Hence, we conducted a retrospective, single-centered study on major amputations during the prepandemic period (March 25, 2019-December 31, 2019) and pandemic period (March 25, 2020-December 31, 2020). During the prepandemic period, 24 major amputations (below-knee and above-knee amputations) were performed and during the pandemic period, 37 major amputations were performed. There was a 54.1% increase in major amputations noted in the pandemic period more than the prepandemic period. This increase may also be due to irregular/missed hospital visits, improper diet, nonadherence to the medications, and physical inactivity. This study shows the indirect effect of the COVID-19 pandemic on people with diabetes, resulting in the increased incidence of lower-extremity amputations (below-knee and above-knee amputations) which might cause a drastic impact on their quality of life. This study also emphasizes the importance of easy and routine access to foot-care specialists to prevent avoidable amputations.

Keywords: COVID-19 lockdown; diabetic amputations; foot care; lower-limb amputations; pandemic.