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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.

Bengaluru, May 30: Bengaluru City civic body Bruhat Bengaluru Mahanagara Palike (BBMP) has slapped a fine of Rs 50,000 on the food delivery startup Swiggy for irresponsible disposal of waste, an official said on Friday.

"Thinking of food is great - Swiggy. Hope you also think of segregating waste and disposing of it responsibly," tweeted BBMP Solid Waste Management Special Commissioner D. Randeep.

Randeep said a penalty of Rs 50,000 was imposed on Swiggy Kitchen at Katriguppe in the city for the violation.

"The incident with respect to waste segregation has been brought to our notice and happened at one of our kitchens in Bengaluru," confirmed a Swiggy spokesperson to IANS without revealing the exact details.

He said the startup is aware of its civic responsibility and has stringent processes to ensure high standards of compliance.

"While we investigate and rectify the root cause of the matter, we are reinforcing necessary awareness on the best practices to be followed amongst our teams and partner network to ensure complete compliance with waste management," the spokesperson added.

Swiggy has been penalised earlier as well for its irresponsible disposal of waste.

Recently, the BBMP’s solid waste management department has also fined an apartment complex Rs 15,000 for not segregating waste into dry, wet and reject categories.

Waste disposal norms for apartments

"Segregation of waste is mandatory in apartments. Onus of enforcing segregation rules lies on the (apartment) association and waste should be segregated as dry, wet and reject," said Randeep.

InClover Grand Apartments at Baiyappanhalli was penalised for the offence of improper waste disposal. Similarly, BBMP marshals also caught and fined some people openly discarding waste in public spaces.

"Dear citizens, please change your old habits. Our marshals are watching and will fine those who throw garbage in public spaces," BBMP Special Commissioner Randeep said.

He shared the photographs of two scooter-borne individuals being caught in the act and penalised at Kuvempunagar in Bengaluru.