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

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.