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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.

Mysuru, Mar 15: The renowned Mysore Palace will remain closed for tourists for a week from March 15 to 22, in the wake of the coronavirus outbreak, Mysore Palace committee said on Saturday.

The Karnataka government has ordered shutting down for a week all places and activities where people gather in large number including swimming pools, shopping malls, schools, colleges and cinema halls, state Health Minister B Sriramulu said amid the coronavirus threat.

This comes after Chief Minister BS Yediyurappa chaired an emergency meeting with ministers and senior officials on Friday to discuss the situation.

Earlier, schools in the state had announced early summer vacation for their students this academic year as a precautionary measure. Other public places have been shut down in the state amid the coronavirus scare.

The central government had on Thursday said that the death of the 76-year-old man from Kalaburagi in Karnataka was confirmed to be caused due to co-morbidity while he was also tested positive for COVID-19. The man visited Saudi Arabia on January 29 and returned to India a month later on February 29.

Till date, India has reported two deaths and 84 confirmed cases of the deadly coronavirus.

The World Health Organisation (WHO) has declared the coronavirus outbreak a pandemic. The virus, which originated in the Chinese city of Wuhan last year has spread to more than 100 countries worldwide, infecting over 1,30,000 people.

Udupi, Jun 4: Karnataka Medical Education Minister Dr K Sudhakhar on Wednesday said that he will take up an issue before a high-powered committee on COVID-19 to find out the possibility of imposing lockdown on a particular house of the person infected with the virus instead of sealing down of entire areas.

Talking to reporters here on Tuesday after reviewing the district's prevailing COVID situation, the minister said the concept and modalities of declaring any area as containment zone has undergone changes in the last two months.

"Hitherto, we were declaring the entire area as the containment zone after detection of coronavirus positive cases. Subsequently, the area of the containment zone was decreased from the whole area to a particular street," the Minister said.

"Now, BJP MLA Raghupati Bhat has given a suggestion to seal down a particular house of the positive patient which would be taken up before the high-powered panel. The district administration concerned could supply all essential items to the particular family," he said.

He further said that the Union government has been providing all facilities to all the states to deal with the situation."