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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 1: Karnataka government has assigned State Nodal Officers after the Ministry of Home Affairs (MHA) order regarding the inter-state movement of stranded migrant workers, tourists, pilgrims and students during the lockdown period.

The Nodal officers have also been appointed for coordination with 11 different states.

In an order issued on Thursday, Karnataka Government wrote, "To facilitate smooth and orderly movement of persons across State borders as per SOPs, the undersigned, in the exercise of powers conferred under the Disaster Management Act, 2005, and in the capacity as Chairman, State Executive Committee, hereby appoint the following officers as Nodal officers to coordinate with Nodal Officers of States/Union Territories (UTs) mentioned against their names."

Dr Rajkumar Khatri, IAS and Arun Jeji Chakravarthy, IPS will be overall in charge of the movement of stranded people from outside States/UTs to Karnataka.

N Manjunatha Prasad, IAS and P S Sandhu, IPS will be overall in charge of the movement of stranded people from Karnataka to other States/UTs.

New Delhi, Apr 15:  Union Health Minister Dr Harsh Vardhan on Wednesday said that both Maharashtra and Karnataka are in a bit of trouble due to spike in COVID-19 cases.

"Bihar is not in so much trouble right now, but definitely, Maharashtra is in a bit of trouble, particularly Mumbai and as well as Karnataka," said Vardhan in a video conference meeting while speaking about surge in COVID-19 tally in the country.

"But I was happy to see the confidence of 3 secretaries more particularly when Maharashtra Secretary said with confidence 'we will take care of it'," he said.

According to the ministry, Maharashtra is the worst-affected state with 2,687 cases of which 259 patients have recovered/discharged while 178 patients have lost their lives due to the virus.

Karnataka has confirmed 277 positive COVID-19 cases, including 75 cured and discharged and 11 deaths.

India's tally of coronavirus cases has risen to 11,933, said the Union Ministry of Health and Family Welfare on Wednesday.

Out of the total tally, 10197 cases are active while 1344 patients have been cured/discharged and migrated and 392 people have succumbed to the virus.