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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.

Riyadh, Jun 17: Saudi Arabia is expected to scale back or call off this year's hajj pilgrimage for the first time in its modern history, observers say, a perilous decision as coronavirus cases spike.

Muslim nations are pressing Riyadh to give its much-delayed decision on whether the annual ritual will go ahead as scheduled in late July.

But as the kingdom negotiates a call fraught with political and economic risks in a tinderbox region, time is running out to organise logistics for one of the world's largest mass gatherings.

A full-scale hajj, which last year drew about 2.5 million pilgrims, appears increasingly unlikely after authorities advised Muslims in late March to defer preparations due to the fast-spreading disease.

"It's a toss-up between holding a nominal hajj and scrapping it entirely," a South Asian official in contact with Saudi hajj authorities said.

A Saudi official said: "The decision will soon be made and announced."

Indonesia, the world's most populous Muslim nation, withdrew from the pilgrimage this month after pressing Riyadh for clarity, with a minister calling it a "very bitter and difficult decision".

Malaysia, Senegal and Singapore followed suit with similar announcements.

Many other countries with Muslim populations -- from Egypt and Morocco to Turkey, Lebanon and Bulgaria -- have said they are still awaiting Riyadh's decision.

In countries like France, faith leaders have urged Muslims to "postpone" their pilgrimage plans until next year due to the prevailing risks.

The hajj, a must for able-bodied Muslims at least once in their lifetime, represents a major potential source of contagion as it packs millions of pilgrims into congested religious sites.

But any decision to limit or cancel the event risks annoying Muslim hardliners for whom religion trumps health concerns.

It could also trigger renewed scrutiny of the Saudi custodianship of Islam's holiest sites -- the kingdom's most powerful source of political legitimacy.

A series of deadly disasters over the years, including a 2015 stampede that killed up to 2,300 worshippers, has prompted criticism of the kingdom's management of the hajj.

"Saudi Arabia is caught between the devil and the deep blue sea," Umar Karim, a visiting fellow at the Royal United Services Institute in London, told AFP.

"The delay in announcing its decision shows it understands the political consequences of cancelling the hajj or reducing its scale."

"Buying time"

The kingdom is "buying time" as it treads cautiously, the South Asian official said.

"At the last minute if Saudi says 'we are ready to do a full hajj', (logistically) many countries will not be in a position" to participate, he said.

Amid an ongoing suspension of international flights, a reduced hajj with only local residents is a likely scenario, the official added.

A decision to cancel the hajj would be a first since the kingdom was founded in 1932.

Saudi Arabia managed to hold the pilgrimage during previous outbreaks of Ebola and MERS.

But it is struggling to contain the virus amid a serious spike in daily cases and deaths since authorities began easing a nationwide lockdown in late May.

In Saudi hospitals, sources say intensive care beds are fast filling up and a growing number of health workers are contracting the virus as the total number of cases has topped 130,000. Deaths surpassed 1,000 on Monday.

To counter the spike, authorities this month tightened lockdown restrictions in the city of Jeddah, gateway to the pilgrimage city of Mecca.

"Heartbroken"

"The hajj is the most important spiritual journey in the life of any Muslim, but if Saudi Arabia proceeds in this scenario it will not only exert pressure on its own health system," said Yasmine Farouk from the Carnegie Endowment for International Peace.

"It could also be widely held responsible for fanning the pandemic."

A cancelled or watered-down hajj would represent a major loss of revenue for the kingdom, which is already reeling from the twin shocks of the virus-induced slowdown and a plunge in oil prices.

The smaller year-round umrah pilgrimage was already suspended in March.

Together, they add $12 billion to the Saudi economy every year, according to government figures.

A negative decision would likely disappoint millions of Muslim pilgrims around the world who often invest their life savings and endure long waiting lists to make the trip.

"I can't help but be heartbroken -- I've been waiting for years," Indonesian civil servant Ria Taurisnawati, 37, told AFP as she sobbed.

"All my preparations were done, the clothes were ready and I got the necessary vaccination. But God has another plan."

Bidar, Apr 2: Karnataka Health Minister B Sriramulu on Thursday confirmed that 11 people out of 27 in Bidar, who had participated in Tablighi Jamaat at Delhi's Nizamuddin Markat have been tested positive for COVID-19.

Speaking to news agency, Karnataka Health Minister said, "We are monitoring 362 people who had attended Nizamuddin Markaz in Delhi. Out of 27 people from Bidar who had attended, 11 have tested positive for COVID-19, while results of 16 others are awaited. Total positive cases in the state are 121."
Meanwhile, Tablighi Jamaat's Maulana Saad has stated that he will fully support the government in its fight against the coronavirus.

This comes soon after an FIR was registered against him in connection with the religious gathering organised in Markaz Nizamuddin area of the national capital.

A huge religious gathering was held at the Markaz building in Nizamuddin between March 13-15, the event came into the spotlight after multiple coronavirus cases were confirmed amongst those who attended the event held in mid-March.

An FIR has been registered against Tablighi Jamaat head Maulana Saad and others under the Epidemic Disease Act 1897 in Delhi.
A total of 2,361 people were brought out from the Markaz in a joint operation by authorities which lasted for over 36 hours, following which the South Delhi Municipal Corporation had carried out a sanitisation of the premises and nearby area.