Characteristics of Diabetic Foot Ulcer Patients Pre- and During COVID-19 Pandemic: Lessons Learnt From a National Referral Hospital in Indonesia

Em Yunir, Tri Juli Edi Tarigan, Eni Iswati, Angela Sarumpaet, Eunike Vania Christabel, Delina Widiyanti, Wismandari Wisnu, Dyah Purnamasari, Farid Kurniawan, Martha Rosana, Fitri Anestherita, Akhmadu Muradi, Dicky L. Tahapary

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Diabetic foot ulcer (DFU) is one of the most terrifying diabetic complications for patients, due to the high mortality rate and risk for amputation. During the COVID-19 pandemic, many diabetic patients limited their visits to the hospital, resulting in delays for treatment especially in emergency cases. Objective: This study aimed to compare the characteristics of patients with DFU pre- and during COVID-19 pandemic period. Methods: This study was a retrospective cohort study using foot registry data. We compared our patients’ characteristics pre-COVID-19 pandemic period (1 March 2019-28 February 2020) and during COVID-19 pandemic period (1 March 2020-28 February 2021). Results: Cohorts of 84 and 71 patients with DFU pre- and during COVID-19 pandemic period, respectively, were included in this study. High infection grade (66.7% vs 83.1%, P =.032), osteomyelitis event (72.6% vs 87.3%, P =.04), leukocyte count (15 565.0/μL vs 20 280.0/μL, P =.002), neutrophil-to-lymphocyte ratio (7.7 vs 12.1, P =.008), waiting time-to-surgery (39.0 h vs 78.5 h, P =.034), and number of major amputation (20.2% vs 39.4%, P =.014) were significantly higher during the COVID-19 pandemic period. Conclusion: During the COVID-19 pandemic, patients with DFU had more severe infection, higher proportion of osteomyelitis, longer waiting time for getting surgical intervention, and higher incidence of major amputation.

Original languageEnglish
JournalJournal of Primary Care and Community Health
Volume13
DOIs
Publication statusPublished - Mar 2022

Keywords

  • amputation
  • COVID-19
  • diabetic foot ulcer
  • infection
  • mortality
  • waiting time to surgery

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