Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 May;38(4):e3520.
doi: 10.1002/dmrr.3520. Epub 2022 Feb 2.

Covid-19 lockdown showed a likely beneficial effect on diabetic foot ulcers

Jean-Baptiste Bonnet  1   2 , Valérie Macioce  3 , Abdulkader Jalek  1   2 , Karim Bouchdoug  3 , Cécile Elleau  1 , Marie-Françoise Gras-Vidal  1 , Julie Pochic  1 , Antoine Avignon  1   2 , Ariane Sultan  1   4
Affiliations
Observational Study

Covid-19 lockdown showed a likely beneficial effect on diabetic foot ulcers

Jean-Baptiste Bonnet et al. Diabetes Metab Res Rev. 2022 May.

Abstract

Aims: During the Covid-19 epidemic, many countries imposed population lockdown. This study aimed to analyse diabetic foot ulcer (DFU) evolution of outpatients between the lockdown period and 1 month after its end.

Materials and methods: We conducted a prospective, observational, single-centre study without modification of care. All patients who followed up for a DFU in the study centre between 15 April 2020 and 11 May 2020 were included. The baseline assessment occurred 4 weeks after the beginning of lockdown and the follow-up visit 4-6 weeks after easing of lockdown. The primary analysis was based on the Site, Ischaemia, Neuropathy, Bacterial infection, Area, Depth (SINBAD) classification.

Results: Twenty-seven patients were included, median 69.4 years, and 25 were followed-up at easing of lockdown. The median SINBAD score was 2 (interquartile range 1; 3) at inclusion and 1 (1; 2) at easing of lockdown, with a mean change of -0.32 (95% confidence interval -0.93; 0.29). Seventy-two percent of the population had a stable or improved score between the two visits. The proportion of patients using off-loading footwear was higher among those whose SINBAD score improved compared to those whose score worsened or remained stable (72%, 44% and 28%, respectively). Diabetes type was linked to DFU prognosis. Five patients (20%) were hospitalized during the follow-up period.

Conclusion: Lockdown appears to have had a positive effect on DFU if patients remain under the care of their expert wound centre. We believe this effect is related to better compliance with offloading. The wide use of tele-medicine seems relevant for the follow-up of DFU.

Keywords: Covid-19; SINBAD; diabetes; diabetic foot ulcer; healing; lockdown.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the population
See this image and copyright information in PMC

References

    1. Urbančič‐Rovan V. Diabetic foot care before and during the COVID‐19 epidemic: what really matters? Diabetes Care. 2021;44(2):e27‐e28. - PMC - PubMed
    1. Meloni M, Izzo V, Giurato L, Gandini R, Uccioli L. Management of diabetic persons with foot ulceration during COVID‐19 health care emergency: effectiveness of a new triage pathway. Diabetes Res Clin Pract. 2020;165:108245. - PMC - PubMed
    1. Jaly I, Iyengar K, Bahl S, Hughes T, Vaishya R. Redefining diabetic foot disease management service during COVID‐19 pandemic. Diabetes Metab Syndr Clin Res Rev. 2020;14(5):833‐838. - PMC - PubMed
    1. Kelahmetoglu O, Camlı MF, Kirazoglu A, et al. Recommendations for management of diabetic foot ulcers during COVID‐19 outbreak. Int Wound J. 2020;17(5):1424‐1427. - PMC - PubMed
    1. Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376(24):2367‐2375. - PubMed

Publication types