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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/Udupi, Jul 26: Karnataka’s twin coastal districts of Dakshina Kannada and Udupi have recorded 369 new coronavirus positive cases and 10 more deaths related to the covid-19 in past 24 hours. 

Dakshina Kannada

With 199 new covid-19 cases, DK’s covid toll mounted to 4,811. The district also recorded eight new covid-related deaths. The death toll mounted to 123. 

Among the 199 new cases are 31 primary contacts, 73 with influenza-like illness (ILI), and 10 with severe acute respiratory illness (SARI). As many as 83 cases are under investigation. Two of the patients have international travel history.

Eight deaths:

A 71-year-old man from Mangaluru, who was admitted to a private hospital on July 19, passed away on July 23. He was diagnosed with ARDS/multiorgan dysfunction, chronic renal disease, diabetes, and hypertension. His throat swabs tested positive for covid-19. 

A 70-year-old man from Mangaluru, who was admitted to a private hospital on July 20, passed away on July 24. He had developed sepsis, chronic kidney disease, lower respiratory tract infection, and other ailments. 

A 55-year-old man from Puttur was admitted to a private hospital on July 23, and passed away a day later. He was diagnosed with septic shock with acute kidney injury with severe metaboic acidosis. 

A 56-year-old man from Mangaluru who was admitted to a private hospital on July 20 passed away on July 24. He was suffering from acute respiratory distress syndrome, multi-organ dysfunction syndrome and ischemic heart disease.

A 72-year-old man from Mangaluru who was admitted to a private hospital on July 18 passed away on July 24. He was suffering from refractory hypoxemia/refractory ARDS, septic shock, secondary bacterial infection, renal failure, acute coronary event, and other ailments. 

A 45-year-old woman from Mangaluru who was admitted to a private hospital on July 24 passed away the same day. She had been diagnosed with metastatic carcinoma of right lung and pneumonia. 

A 55-year-old man from Mangaluru who was admitted to a private hospital on July 21 and passed away on July 24. As per the district bulletin, he was suffering from refractory hypoxemia/refractory ARDS, septic shock, secondary bacterial infection, renal failure, acute coronary event, and other ailments.

A 70-year-old man from Mangaluru suffering from severe pneumonia with ARDS, multiorgan dysfunction, sepsis, chronic kidney disease and hypothyroidism was admitted to a private hospital on July 24 and passed away the same day.

Though the above patients contracted coronavirus, the exact cause of their deaths is being investigated by a team of experts and their report is awaited.

Udupi

The district recorded 170 new covid-19 cases and the total confirmed cases mounted to 3,388. Among the new cases, 86 are in Udupi, 31 in Kundapur, and 52 in Karkala. They include 106 male and 63 women. As many as 2,133 patients have been discharged so far, and 1,241 cases are currently active. 

The district also recorded two covid-19 related deaths – a woman and a man. One is a 63-year-old resident of Byndoor and the other is from Udupi's Indiranagar area. Both had been admitted to the ICU of a private hospital. 

Byndoor resident passed away on the night of Saturday July 26, the Udupi resident died on Sunday. The last rites of both the deceased were conducted as per protocol.

Udupi, May 24: Three among the 18 coronavirus positive cases reported in Udupi district today were policemen. 

A police constable of Karkala Rural Police Station and ASI of Ajekar Police Station were tested positive for COVID-19 on Sunday and authorities have taken steps to seal the Police Stations they were working. A policeman from Brahmavar police station also tested positive.

The district administration reported seal Karkala Rural Police station, Ajekar Police Station, and Brahmavar Police Station. Apart from them Karkala Town Station and Circle station are being sealed. All the policemen and policewomen working in these five stations will be quarantined.

Superintendent of Police N Vishnuvardha said that ''all the primary contacts of the police officers who were tested positive will undergo screening and their swabs will be collected and sent to Lab for test.''