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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.

Udupi, Jul 8: A 15-year-old boy belonging to Saligrama in Udupi district, who was under home quarantine with his mother, allegedly committed suicide by hanging himself yesterday.

His throat swabs were sent for testing. The report received today and it showed that he did not have coronavirus.
 
The boy, a class ten student studying in Kota, was quarantined along with his mother at home after a person in a family, where she was working as a maid tested positive for Covid-19.

The boy is suspected to have taken the extreme step out of depression as he was not allowed to go out. The last rites were held today.

Bengaluru, Jul 3: The Karnataka government is allowing select asymptomatic and mildly symptomatic Covid-19 patients to recuperate at home as part of home isolation guidelines, an official said on Friday.

"Only those who are asymptomatic or mildly symptomatic shall be allowed to be in isolation at home," said a health official, highlighting that such patients should be properly oriented on home isolation.

However, before home isolation, a health team will visit the patient's house and assess its suitability for executing home isolation.

Similarly, the patient should be provided with a tele-consultation link for initial triage, daily follow up and during the entire home isolation time.

For a daily update, the patient isolated at home should give a report on his health status to the physician or health authorities.

"The home isolation shall be with the knowledge of the family members, neighbours, treating physician and local health authorities," said the official.

Though home isolation is allowed, it is not a blanket permission for all asymptomatic and mildly symptomatic cases in Karnataka to avail.

"Such cases should have the requisite facility at their residence for self-isolation and also for quarantining the family contacts. A care giver should be available to provide care on 24x7 basis," said the official.

Likewise, the caregiver should also have a regular communication link between him and the hospital during the home isolation.

No patient above 50 years will be allowed to avail home isolation.

"If the patient has the following comorbidities: hypertension, diabetes, obesity, thyroid disease, they shall be well managed and under good clinical control as assessed by medical officer," he said.

However, patients with comorbidities such as kidney diseases, dialysis, heart diseases, stroke, tuberculosis, cancer and HIV cannot avail home isolation.

Likewise, immunity compromised patients and those on steroids also cannot be on home isolation.

Though pregnant women are not allowed to avail this facility, lactating women are allowed after due instruction and assessment.

The Health Department has also issued several other guidelines and protocols for a patient choosing home isolation.