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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.

Bengaluru, Jan 5: A day after senior Congress leaders in Karnataka met to build consensus for the way ahead, the race for the post of KPCC President hotted up on Sunday with aspirants and their supporters stepping up efforts to secure the coveted posts.

Senior leader D K Shivakumar, seen as a frontrunner for the post, met former Chief Minister Siddaramaiah at his residence amid reports that he was lobbying in favour of one of his confidants.

Meanwhile, another senior party legislator Satish Jarkiholi made it clear he was capable of discharging the responsibility if the high command asked him to do so.

Also, loyalists of senior leader and former Minister Ramalinga Reddy came up with social media posts, pushing forward his name for KPCC President.

Congress Legislature Party leader Siddaramaiah and state Congress chief Dinesh Gundu Rao quit their posts after the party fared poorly, winning only two of the 15 seats in the bypolls while it had held 12 of them.

According to party sources, though Siddaramaiah is likely to retain the position of Leader of Opposition, the CLP leader post may be given to some one else.

The sources also said replacement of KPCC President was most likely as Dinesh Gundu Rao's resignation could be accepted.

Shivakumar is seen as the frontrunner for the KPCC President post and has already held discussions with high command in this regard.

His meeting with Siddaramaiah, who is expected to travel to Delhi soon to hold discussions with the high command, assumes significance amid reports that the former chief minister was favouring one of his confidants for the post.

Shivakumar during the meeting sought Siddaramaiah's cooperation for his appointment to the coveted post, with a promise to work under his leadership, sources said.

However, speaking to reporters after the meeting, Shivakumar said he had worked under Siddaramaiah as legislator and Minister, and there was nothing special about the nearly two-hour-long meeting.

"...Im not a competitor for any post, I won't ask for any post, that time is over. I'm a karyakarta of the party and will work as karyakarta," he said in response to a question, adding he will abide by the party's decision.

On the other hand, Congressleader andYamakanamaradi MLASatish Jarkiholi said he was ready to take up the responsibility if the party high command decides so.

"It has been decided to cooperate and work under the leadership of anyone, whom the party high command decides (as President). Let's see, it is for the high command to decide (who will be KPCC President)," he said.

In response to a question from reporters in Belagavi if he was aspiring for the post, Jarikholi said, "I havent asked, but if given I will manage it efficiently..."

Meanwhile, loyalist of seven-time Congress MLA Ramalinga Reddy, came up with a social media post, demanding KPCC President post for the leader.

"Seven-time @INCKarnataka MLA and former Home Minister Sri @RLR_BTM for #KPCC President. #Congress #Karnataka #RamalingaReddy #BTMLayout #BBMP #Bengaluru," former Mayor of Bengaluru City and a close confidant of Reddy, B N Manjunatha Reddy tweeted.

Last year during the political turmoil faced by the coalition government, Ramalinga Reddy had threatened to resign, unhappy at being sidelined in the party.

He had later decided to stay with the Congress after the high command intervened.

With a virtual vacuum in the state Congress following the resignation of its top leadership after the rout in the recent Assembly bypolls, senior party leaders had met here on Saturday with an aim to build a consensus for the way ahead.

According to sources, the meeting was convened after instructions from the high command to iron out differences and build consensus on taking the party forward and regarding appointments to key posts, before coming to Delhi for discussions.

Senior leader K H Muniyappa and KPCC Working President Eshwar Khandreare seen as the other aspirants for the President post.

Ssenior leaders G Parameshwara along with H K Patil are among those seen as the frontrunners for the CLP leader post vacated by Siddaramaiah.