DySP suicide case: Supreme Court issues notice to VHP leader Praveen Khandya

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 11: Amidst the mounting number of covid-19 cases, Karnataka is witnessing another disturbing trend of increasing number of people ending their life. After the lockdown was relaxed, the state saw a worrying jump in the number of suicides.

According to statistics, as many as 2,211 suicide cases have been registered in just two months. The number of suicides rose by 23% in May to 1,127, and by another 18% in June to 1,084, from an average of 912 suicides in the first three months of the year. 

In April, however, the number nearly halved to 477. But April was also the month during which the lockdown (announced on March 24) was complete, and everyone was at home -- which, experts say, could have prevented people with suicidal tendencies from taking their own lives.

Shockingly, number of teenagers including school children committing suicide also increased in the state in past couple of months.

With the pandemic still accelerating and impacting people in multiple ways, the World Health Organisation has urged people to pay greater attention to mental health and suicide prevention. 

Dr Poonam Khetrapal Singh, Regional Director, World Health Organisation (WHO), South-East Asia Region, said stigma related to Covid-19 infection may lead to feelings of isolation and depression. Another precipitating factor impacting mental health amidst Covid-19 could be domestic violence, which is reported to have increased globally as several countries imposed lockdowns, she said.

“Hitting lives and livelihoods, the pandemic is causing fear, anxiety, depression and stress among people. Social distancing, isolation and coping with perpetually evolving and changing information about the virus has both triggered and aggravated existing and pre-existing mental health conditions, which need urgent attention,” she said.

Dr H Chandrashekar, professor and head of the department of psychiatry at Victoria Hospital, said reasons for suicide are always multi-factored, combined, cumulative, unresolving and interrelated.

“There is grief everywhere now due to deaths related to Covid-19, and it may have an adverse effect on some. But people should be watchful of their family members, especially those who are in depression and have a history of suicide attempts. One should never ignore signs, like when someone says they feel like ending their life. They should not be left alone, and unconditional support needs to be given. Also, objects that could be used to commit suicide must be kept away from them,” Dr Chandrashekar said.