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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.

Udupi, May 16: Close on the heels of six Covid-19 cases being detected in a little over 24 hours, Udupi recorded its first death of a Covid-19 patient. The victim is a 54-year-old man from Mumbai, who died due to a heart attack on Thursday. His reports came back on Saturday, and confirmed that he had Covid-19. The Udupi district administration has arranged to carry out his last rites as per government designated guidelines for Covid-19 victims.

A medical bulletin issued by the superintendent of Kasturba Hospital, Manipal, stated that the patient was admitted due to a heart-related issue on May 13.

Some members on the team that treated the patient have been quarantined. The hospital’s emergency department will operate as usual, and the outpatient department will operate as usual from 8.30am to 1pm, following government guidelines, the bulletin said. Deputy commissioner G Jagadeesha said that since the patient was from Mumbai, the authorities collected his swab sample for testing, as a precautionary measure.

The man suffered from chest pain, and was initially taken to the taluk hospital at Kundapur from where he was shifted to Kasturba Hospital, due to the seriousness of his condition. The doctors operated on him on May 13, and he suffered a severe heart attack on May 14 and died, the DC said. “Three hospital staff without PPE kits, who attended to the patient, have been quarantined,” the DC said, adding that the operating doctors and nurses had worn PPE kits.

In addition, 5 others who travelled with the person from Mumbai and 57 people with him at the Kundapur isolation centre, have been designated as primary contacts, and 38 others as secondary contacts, and quarantined. The staff at Kundapur taluk hospital too had taken precautions in handling the patient, the DC said. Udupi presently has six active cases, including a 1-year-old child and 5 others, all of whom returned from Dubai on May 12.

Mangaluru, May 4: The district administration has set up seven check-posts to monitor those entering Dakshina Kannada from other districts and states amidst coronavirus crisis.

The check-posts are located at up seven check-posts at Talapady, Hejamady, Gundya, Jalsoor, Charmadi, Naravi and Kallugundi. 

According to Deputy Commissioner Sindhu B Rupesh, all those who enter the district will be screened. Those who come from outside the district and state will be asked to remain in quarantine. 

As the relaxation is announced for 12 hours, the public should be cautious while venturing out of the house. Wearing a mask in public is mandatory in addition to maintaining social distance. 

Further, she said of the 24 cases reported in the district, only four had symptoms of breathlessness and others were asymptomatic. Of the nine active cases in the district, the condition of one patient is serious while two are likely to be discharged from hospital shortly, said the DC.