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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, Jul 4: In a heart-wrenching incident, a 65-year-old coronavirus patient at Hanumath Nagar in South Bengaluru died outside his house waiting for an ambulance on Friday evening. The body was kept on the road for more three hours.

The deceased tested positive for coronavirus on Friday and immediately called an ambulance to reach a hospital. However, according to his family members, as he waited for the ambulance for nearly three hours, he collapsed on the road in front of his house complaining of breathlessness and died.

As the body lay unattended on the road, it began to rain heavily. Soon, videos of the body lying on the road in the heavy rain went viral on social media. 

A senior doctor in charge of the division, however, claimed that the ambulance had arrived in less than half an hour but the patient had died before they reached the spot. 

"The patient had given samples on Thursday at KIMS and tested positive on Friday. BBMP officials informed them that they would reach his house. But the man, fearing that he may be stigmatised in the locality, began walking to the corner of the road and collapsed on the street and died," the officer said. 

Another health official from Basavanagudi limits said: "As the ambulance staff do not transport the dead, they informed the hearse van, which was set to arrive in 30 minutes. But due to the sudden rain and heavy traffic ahead of the curfew hours, they were stranded for almost three hours later." The officials also said the deceased had been suffering from cardiac ailments for almost 10 years. 

Regretting the incident, BBMP officials said they were helpless as was an acute shortage of hearse vans. "We were told that there were 20 deaths today and there are only eight hearse vans available. They had to shift this patient after attending to another mortality and were stuck in traffic. By then, due to the fear of infection, nobody attended to the deceased," the officer explained. 

BBMP commissioner B H Anil Kumar said that such incidents should not recur and ordered an investigation and sought a report. "We will ensure that such incidents do not recur," Kumar said.  

Following outrage on social media, a hearse van was summoned and the body was shifted to the Victoria Hospital mortuary as per the protocol. Police have opened a case of unnatural death.