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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.

Kochi, Mar 2: The Vatican has rejected the second appeal by Sister Lucy Kalappura -- one of the nuns who protested against rape accused Bishop Franco Mulakkal -- against her expulsion from Franciscan Clarist Congregation (FCC).

In her plea, she had demanded that her version be heard and her expulsion from FCC revoked.

She was expelled from FCC for participating in public protests demanding the arrest of Franco Mulakkal in the nun rape case.

''I got a letter from Vatican which says my appeal has been rejected. But the rest of the letter is written in the Latin language. So after I understand it, I will respond," Sister Lucy told news agency.

''The authorities are contemptuous of those who make such complaints. That is why the letter is written in Latin. Sister Lucy would continue her legal fight in the courts,'' said George Moolechalil, who has been authorised by Sister Lucy to communicate with the media on her behalf.

A petition of Sister Lucy is still pending at Mananthavady Munsif Court at Wayanad that demands that she should not be expelled from the convent where she is staying.

Thrissur, Feb 2: The Kerala government on Saturday said the condition of the medical student, kept in an isolation ward in Thrissur after testing positive for the novel coronavirus is satisfactory and that three people have been arrested for spreading false information on social media about the disease.

The woman, who tested positive, is a student of Wuhan university and is undergoing treatment at the Thrissur Medical College Hospital.

"The health status of the student who tested positive for coronavirus remains satisfactory.

The hospital authorities have confirmed that the health condition of all symptomatic persons under isolation in hospitals are "stable", a bulletin said.

Health Minister K K Shailaja said Kerala has strengthened surveillance and control measures against the epidemic, which has been declared by WHO as a global emergency,

She told reporters here that three people have been arrested for spreading false information about those who had arrived in the state from coronavirusa affected countries and are under home surveillance.

Six others had forwarded the posts and the cyber cell was probing the matter, Shailaja said.

The minister had earlier warned that strong action would be taken against those putting out false news on the disease.

Police said Sabari was arrested on Friday and released on bail, while two others-- Shafi and Siraj were arrested on Saturday.

Two cases have been registered in two police stations in Thrissur in this connection, they said.

A medical bulletin said that till date, 1793 people who travelled from coronavirus affected countries have been identified and placed under surveillance.