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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.

Mangaluru, May 13: Karnataka revised its standard operating procedure (SOP) for international passengers to allow pregnant women, children and senior citizens to entre home quarantine if they test negative for covid-19. 

The development comes after former minister and Mangaluru MLA U T Khader urged the government to follow the Kerala model in handling the repatriates and take extra care of pregnant women and senior citizens at Mangaluru and Bengaluru Airports.

Passengers will be initially dived into two categories. Category A includes passengers symptomatic on arrival while Category B passengers are those asymptomatic on arrival. 

While category A passengers will be directly shifted to covid-19 hospital, category B passengers will be sent to 14-day institutional quarantine.

If there are pregnant women, children below 10 years of age and senior citizens in category B, they will remain in institutional quarantine until they obtain a negative report (after throat swab testing for covid-19). It may take one or two days to get the throat swab testing report. 

Kasaragod, Apr 21: Kerala reported a spike in COVID-19 cases on Tuesday with 19 people testing positive, after a decline in the numbers in the past few days, as the total infections touched 426 in the southern state.

Kannur recorded 10 cases, Palakkad four, Kasaragod three and Malappuram and Kollam one each, Chief Minister Pinarayi Vijayan told reporters here.

The number of those getting infected were in single digits over the past few days.

Of the 10 positive cases from Kannur, nine of them had come from abroad and one had been infected through contact, he said.

Pointing out that the positive cases in Palakkad,Malappuram and Kollam had come from neighbouring Tamil Nadu, Vijayan said there is need to enforce strict vigilance in places bordering neighbouring states.

Sixteen people tested negative on Tuesday, while the total active cases 117, he added.

At least 32,000 people are under observation,

Of the around 20,000 samples sent, 19,440 had returned negative, Vijayan said.