{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:31:16Z","timestamp":1780097476413,"version":"3.54.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T00:00:00Z","timestamp":1620259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Aims<\/jats:title>\n<jats:p>Limb and patient outcomes in people with diabetic foot complications including diabetic foot ulcer (DFU) provided virtual triage and personalized video consultations during COVID-19 pandemic are not known.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients with foot complications attending the diabetic foot clinic prior to lockdown who sought teleconsultations during COVID-19 lockdown underwent virtual triage to include clinical history, visual inspection of feet, domiciliary wound care (community nurse assisted dressings) and offloading instructions. The subsequent ulcer, limb and mortality outcomes during the following 24 weeks of COVID-19 lockdown (April-September 2020, group 1) were assessed and compared with those who attended foot clinic during the same period in 2019 (April-September, group 2).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Group 1 included 561 participants with foot complications provided with teleconsultations, median age 57 (51 to 63) years and diabetes duration of 10 (5 to 16) years. Twelve patients with severe DFU were excluded and 549 patients [357 (65%) neuropathic foot, 104 (18.9%) ischemic foot and 88 (16%) chronic Charcot foot with deformities] were evaluated. There were 227 (41.3%) participants with active DFU at start of lockdown, 32 (5.8%) with new onset ulcer during lockdown (47.1%) and 290 patients without ulcers. Group 2 included 650 participants; active foot ulcer was present in 366 patients. Wound closed or reduced in area in 78.4% of participants of group 1 compared to 76.0% (p = 0.318) in group 2. Fourteen (5.4%) patients required amputations [3 major and 11 minor] in group 1 during the study period compared to 6.8% in group 2 (p = 0.191). Twenty-one (3.8%) and 28 (4.3%) patients died (p = 0.532) during 24 weeks of follow up in group 1 and 2, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Targeted foot-care service through virtual triage and teleconsultations during COVID-19 pandemic for people with foot complications have similar ulcer and limb outcomes compared to face-to-face foot care delivery.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0251143","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T17:34:30Z","timestamp":1620322470000},"page":"e0251143","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":27,"title":["Virtual triage and outcomes of diabetic foot complications during Covid-19 pandemic: A retro-prospective, observational cohort study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-3102","authenticated-orcid":true,"given":"Ashu","family":"Rastogi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Hiteshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Bhansali A.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward B.","family":"Jude","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"pone.0251143.ref001","doi-asserted-by":"crossref","first-page":"107843","DOI":"10.1016\/j.diabres.2019.107843","article-title":"Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition","volume":"157","author":"P Saeedi","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"issue":"6","key":"pone.0251143.ref002","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/S2213-8587(20)30152-2","article-title":"Practical recommendations for the management of diabetes in patients with COVID-19","volume":"8","author":"SR Bornstein","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"pone.0251143.ref003","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.pcd.2020.06.010","article-title":"COVID-19 and diabetes: What does the clinician need to know?","volume":"14","author":"E Papadokostaki","year":"2020","journal-title":"Prim Care diabetes"},{"key":"pone.0251143.ref004","article-title":"All Feet On Deck-The Role of Podiatry During the COVID-19 Pandemic: Preventing hospitalizations in an overburdened healthcare system, reducing amputation and death in people with diabetes","author":"LC Rogers","year":"2020","journal-title":"J Am Podiatr Med Assoc"},{"issue":"12","key":"pone.0251143.ref005","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1007\/s00592-019-01376-9","article-title":"Mortality in Asian Indians with charcot\u2019s neuroarthropathy: a nested cohort prospective study","volume":"56","author":"S Chaudhary","year":"2019","journal-title":"Acta Diabetol"},{"key":"pone.0251143.ref006","doi-asserted-by":"crossref","first-page":"108113","DOI":"10.1016\/j.diabres.2020.108113","article-title":"Long term outcomes after incident diabetic foot ulcer: Multicenter large cohort prospective study (EDI-FOCUS investigators) epidemiology of diabetic foot complications study: Epidemiology of diabetic foot complications study","volume":"162","author":"A Rastogi","year":"2020","journal-title":"Diabetes Res Clin Pract"},{"issue":"Suppl 1","key":"pone.0251143.ref007","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.2337\/dc20-S011","article-title":"11. 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