Kannada now compulsory in all schools

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.

New Delhi, Jan 14: The Kerala government has challenged the new Citizenship (Amendment) Act (CAA) before the Supreme Court, becoming the first state to do so amid nationwide protests against the religion-based citizenship law. The Supreme Court is already hearing over 60 petitions against the law.

Kerala's Left-led government in its petition calls the CAA a violation of several articles of the constitution including the right to equality and says the law goes against the basic principle of secularism in the constitution.

The Kerala government has also challenged the validity of changes made in 2015 to the Passport law and the Foreigners (Amendment) Order, regularising the stay of non-Muslim migrants from Pakistan, Bangladesh and Afghanistan who had entered India before 2015.

The Citizenship Amendment Act (CAA), eases the path for non-Muslims in the neighbouring Muslim-majority nations of Pakistan, Afghanistan and Bangladesh to become Indian citizens. Critics fear that the CAA, along with a proposed National Register of Citizens (NRC), will discriminate against Muslims.

The Kerala petition says the CAA violates Articles 14, 21 and 25 of the constitution.

While Article 14 is about the right to equality, Article 21 says "no person will be deprived of life or personal liberty except according to a procedure established by law". Under Article 25, "all persons are equally entitled to freedom of conscience."

Several non-BJP governments have refused to carry out the NRC in an attempt to stave off the enforcement of the citizenship law.

Over 60 writ petitions have been filed in Supreme Court so far against the Citizenship (Amendment) Act. Various political parties, NGOs and also MPs have challenged the law.

The Supreme Court will hear the petitions on January 22.

During the last hearing, petitioners didn't ask that the law be put on hold as the CAA was not in force. The Act has, however, come into force from January 10 through a home ministry notification.