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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.

Newsroom, Jun 2: The government of India has announced operation of another 20 special flights to repatriate stranded NRIs from Kingdom of Saudi Arabia under Vande Bharat Mission.

All the repatriation flights will take off from three major airports – Dammam, Riyadh and Jeddah – between June 10 and June 16. Most of the flights will land in Kerala.

The first flight from Saudi Arabia to Karnataka in the new schedule will be operated on June 11. It will take off from Jeddah with passengers from both Kerala and Karnataka. After landing in Kozhikode it will continue its journey to Bengaluru. 

The next three flights  –  Dammam to Bengaluru on June 12, Jeddah to Bengaluru on June 13 and Riyadh to Bengaluru on June 15 – will directly fly to Karnataka. 

Even though thousands of Mangalureans are stranded in Saudi Arabian cities due to lockdown, the government has not announced any flight to Mangaluru International Airport.

The following are the newly announced flights from Saudi Arabia to India:

Mar 5: The government on Thursday asserted that there is no shortage of raw ingredients or medicines in the country as it has taken various initiatives to tackle the challenge posed by the coronavirus outbreak.

All initiatives are also being taken to ensure that there is no impact of the disease in India, Minister of Chemicals and Fertilizers D V Sadananda Gowda said.

"There is no shortage of any APIs in the country. We have sufficient APIs (active pharmaceutical ingredients) and medicines in the country," he said.

Gowda was addressing the 5th international exhibition and conference on the pharmaceutical and medical industry organised by the Department of Pharmaceuticals, Gujarat government and industry chamber Ficci here.

For another three months there is no shortage for undertaking production in the pharma sector, he added.

"Our government has taken all initiatives to ensure that as far as our country is concerned the coronavirus should be stopped, and there is no hazard as far as this issue is concerned," Gowda reiterated.

Coronavirus is a challenge and "we should make all efforts that need to be taken..., " he added.

On Tuesday, India, the world's largest maker of generic drugs, restricted the export of common medicines such as paracetamol and 25 other pharmaceutical ingredients and drugs made from them, as it looks to prevent shortages amid concerns of the coronavirus outbreak turning into a pandemic.

Besides over-the-counter painkiller and fever reducer paracetamol, drugs restricted for exports included common antibiotics metronidazole, and those used to treat bacterial and other infections as well as Vitamin B1 and B12 ingredients.

A notification by the Directorate General of Foreign Trade (DGFT) had said the export of 26 active pharmaceutical ingredients (APIs) and formulations would require licence.