The incidence and severity of diabetic hand infection presentations during the COVID-19 pandemic

Diabetic hand infections are difficult to treat and can present with high morbidity. We set out to identify any changes in presentation and disease severity during the COVID-19 pandemic. A total of 61 pre-COVID and 32 during COVID patients with diabetes with a hand infection requiring intravenous antibiotics were included in the study. The pandemic caused a decrease in the number and proportion of presentations. Hospital admissions reduced as service provision was amended to enable increased outpatient treatment. However, there was a significant increase in surgical management (25 vs. 21, p = 0.02), total complications (5 vs. 8, p < 0.05) and incidence of amputations (2 vs. 4, p = 0.09). Mean haemoglobin A1C was also higher (48 mmol/L vs. 40 mmol/L, p < 0.05). While fewer patients attended the service during the pandemic, we witnessed an increased severity of hand infections in those we treated. There is a role for daily outpatient administration of intravenous antibiotics in selected patients to reduce the number of hospital admissions.