A hierarchical management strategy for diabetic foot patients during the COVID-19 pandemic allowed essential care to be maintained with no observed COVID-19 cases in a small retrospective cohort, though hospital attendance was markedly reduced compared to the prior year.
Hospital attendance for diabetic foot patients during the COVID-19 pandemic period was markedly reduced compared to the corresponding period in 2019.
The majority of patients treated during the pandemic period had severe diabetic foot lesions.
Surgical treatment was required for the majority of patients treated during the study period.
No patients developed laboratory-confirmed COVID-19 during hospitalization or follow-up.
One patient died during the study period from infectious shock secondary to diabetic foot infection, unrelated to COVID-19.
Patients with diabetic foot were identified as potentially more vulnerable during infectious disease outbreaks due to their clinical profile.
This research describes how a single hospital in China managed patients with diabetic foot wounds during the early months of the COVID-19 pandemic (January to March 2020). Diabetic foot is a serious complication of diabetes where wounds on the feet become chronic, infected, and difficult to heal, often requiring repeated hospital visits and sometimes surgery. The study found that far fewer patients came in for care during the pandemic compared to the same period in the previous year, which raises concerns about untreated cases in the broader community. Among the 12 patients who did receive care, most had severe wounds and multiple other health problems, and about two-thirds needed surgery, with an average hospital stay of nearly four weeks. The hospital implemented what the authors call a 'hierarchical management strategy' to continue providing essential diabetic foot care while minimizing COVID-19 risk, and none of the 12 patients contracted COVID-19 during their hospitalization or follow-up period. One patient died from severe infection related to their diabetic foot condition, not from COVID-19. This research suggests that structured management approaches may help maintain care for vulnerable patients with complex chronic conditions during infectious disease outbreaks, though the very small number of patients (only 12) means firm conclusions cannot be drawn. The practical implication of this research is that people with diabetic foot wounds are particularly at risk during public health emergencies because their conditions require ongoing, frequent medical attention that can be disrupted by pandemic conditions. The sharp drop in patient attendance observed in this study suggests that many patients with diabetic foot may have avoided seeking care during the pandemic, potentially leading to worsening of their conditions. The authors call for larger studies to properly evaluate whether hierarchical management strategies can reliably protect this vulnerable population while keeping them safe from additional infections.
Li J, Zhou H, Jin Q, Lu H. (2026). Hierarchical Management of Chronic Infectious Diabetic Foot Wounds During the COVID-19 Pandemic: A Single-Center Retrospective Observational Study.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/71893