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May 12: Children suffering from non-respiratory disease symptoms like diarrhea and fever, or those with a history of exposure to the novel coronavirus, should be suspected of having COVID-19, a new study says.

According to the research, published in the journal Frontiers in Pediatrics, gastrointestinal symptoms first suffered by some children hints at potential infection with SARS-CoV-2 through the digestive tract.

"This case series is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the first manifestation in children," the scientists from Tongji Hospital in China wrote in the study.

They explained that the gastrointestinal symptoms could be arising since the type of receptors in lung cells targeted by the virus can also be found in the intestines.

Most children are only mildly affected by COVID-19, and the few severe cases often have underlying health issues, the researchers said.

"It is easy to miss its diagnosis in the early stage, when a child has non-respiratory symptoms, or suffers from another illness," said study co-author Wenbin Li, who works at the Department of Pediatrics, Tongji Hospital.

"Based on our experience of dealing with COVID-19, in regions where this virus is epidemic, children suffering from digestive tract symptoms, especially with fever and/or a history of exposure to this disease, should be suspected of being infected with this virus," Li said.

In the study, the scientists described the clinical features of children admitted to hospital with non-respiratory symptoms, who were subsequently diagnosed with pneumonia and COVID-19.

"These children were seeking medical advice in the emergency department for unrelated problems, for example, one had a kidney stone, another a head trauma," Li said.

The study noted that all the children had pneumonia, which was confirmed by chest X-ray scan before or soon after admission.

These children were then confirmed to have COVID-19.

While their COVID-19 symptoms were initially mild or relatively hidden before their hospital admission, four out of the five cases had digestive tract symptoms as the first manifestation of this disease, the researchers said.

Li hopes that doctors will use the findings to quickly diagnose and isolate patients with similar symptoms, which may aid early treatment and reduce transmission.

According to the researchers, the children's gastrointestinal symptoms, which have also been recorded in adult patients, could be an additional route of infection.

"The gastrointestinal symptoms experienced by these children may be related to the distribution of receptors and the transmission pathway associated with COVID-19 infection in humans," Li explained.

Since the virus infects people via the ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines, COVID-19 might infect patients not only through the respiratory tract in the form of air droplets, but also through the digestive tract by contact or fecal-oral transmission, the study noted.

While COVID-19 tests can occasionally produce false positive readings, Li said all the five children assessed in the study were infected with the disease.

However, he cautioned that more research is needed to confirm their findings.

"We report five cases of COVID-19 in children showing non-respiratory symptoms as the first manifestation after admission to hospital. The incidence and clinical features of similar cases needs further study in more patients," he said.

Mangaluru, Mar 24: Seven people were arrested on Tuesday for violating prohibitory orders imposed under Section 144 of CrPC in Mangaluru during the lockdown in Karnataka, Commissioner of Police PS Harsha said.

Chief Minister BS Yediyurappa on Monday had announced a complete lockdown in the state till April 1.
"In the wake of the coronavirus outbreak, the entire state will be locked down from 12 am of March 23 to April 1. People are requested to strictly follow it to contain the coronavirus spread," he said.
Earlier, the state government had ordered the suspending of all public and private transport services.
According to the data compiled by the Indian Council of Medical Research (ICMR), the total number of the infection-related death toll in the country rose to nine on Tuesday, while the total number of active cases reached 482.

Mangaluru, Jun 13: A bus agent died after the compound wall of his house collapsed on him at Matadagudde, near Gurupura-Kaikamba, on Friday afternoon. This is the first rain-related death reported in Dakshina Kannada.

The victim is Narayana Naika, 52. According to police, heavy rain on Friday afternoon blocked a small water stream adjacent to his compound wall, and the deceased was clearing it. The stone compound wall then suddenly collapsed on him, and he got buried underneath. He sustained grievous head injuries and died on the way to hospital.

Narayana is survived by his wife and two children.

Dakshina Kannada received an average rainfall of 26.1mm in the last 24 hours till 8.30 am on Friday. The highest rainfall was recorded at Puttur and Mangaluru taluks at 31.3mm and 30.3mm, respectively. Bantwal and Sullia taluks received 26.3mm and 24.6mm of rain, respectively.