Management of Acute Appendicitis in Children during Coronavirus Disease-2019 - Perspective of Pediatric Surgeons from South Asia: a survey finding.

Background Non-operative treatment (NOT) of pediatric appendicitis as opposed to surgery elicits great debate and is potentially influenced by physician preferences. Owing to the effects of the COVID pandemic on healthcare, the practice of NOT has generally increased by necessity and may, in a post-COVID world, change surgeons' perceptions of NOT. Objective The objective was to determine whether the use of NOT has increased in usage in South Asia and whether these levels of practice would be sustained after the pandemic subsides. Methods A survey was conducted by pediatric surgeons regarding their position, institute, country, number of appendicitis cases managed, and their mode of treatment between identical time periods in 2019 and 2020 (April 1 to August 31). It also directly posed the question as to whether they would continue with the COVID imposed level of NOT after the effect of the pandemic diminishes. Results A total of 134 responses were collected. A significant increase in the practice of NOT was observed for the entire cohort, although no effect was observed when grouped by country or institute. When grouped by position, seniors increased the practice of NOT the most, while juniors reported the least change. The data suggests that only professors would be inclined to maintain the COVID level of NOT practice after the pandemic. Conclusions Increased practice of NOT during the COVID pandemic was observed in South Asia, particularly by senior surgeons. Only professors appear inclined to consider maintaining this increased level of practice in the post-COVID world.