Gujarat: Pregnant Dalit woman, family beaten up for not disposing cow carcass

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.

Thiruvananthapuram, Mar 28: Kerala Chief Minister Pinarayi Vijayan has sought Prime Minister Narendra Modi's intervention to remove the blocking of roads including state highway along the border of Karnataka in view of lock down to contain the spread of COVID-19.

In a letter sent to the Prime Minister on Friday evening, the Chief Minister said certain actions by the Karnataka Police have resulted in the blocking the Thalassery-Coorg State Highway-30. This road connects Kerala with Coorg in Karnataka via Veerajapettah. This route is a lifeline for flow of essential commodities to Kerala."

"If this is blocked, vehicles carrying essential commodities will have to travel a much longer route to reach our state. Given the situation of national lock down, this will add much more hardship to people," it said.

"You will naturally agree with me that no action impeding the movement of essential commodities should be initiated at this moment of crisis," he hoped.

The Indian government has advised expats in the UAE and the Gulf against travel till flight curbs to their home country are lifted. This follows the clamour from some quarters for special repatriation flights to India.

A senior Indian External Affairs Ministry (foreign ministry) official said Indian citizens are safe in the countries they reside in. Prime Minister Narendra Modi had spoken to leaders of Gulf countries who assured him of their welfare, the Indian foreign ministry said. Meanwhile, the Minister of State for External Affairs, V Muraleedharan,, according to a Malayalam news report, also ruled out special flights.

Responding to a question from Khaleej Times on blue-collar workers' angst following job losses, Vikas Swarup, Secretary West in the foreign ministry said, "Insofar as repatriation is concerned, as you are aware, government has advised against all travel, and Indians have been told to stay where they are, As and when the (21-day) lockdown is lifted, and normal civil aviation resumes, Indians wishing to come back will be able to do so."

According to the latest data from the Indian foreign affairs ministry, there are 1,400 cases of Covid-19 infections among Indian expats in the Gulf region.

Swarup said infected Indians are being treated and kept in isolation in the UAE and Gulf. "Our missions have established contact with all the community leaders and the situation is under control," he said.

Cargo flights operating as usual  

Cargo flights carrying fruits and vegetables from India to the Gulf have not been disrupted and would continue as usual, the diplomat said. "We are also helping with medicines based on the requests of Gulf countries," he said.

Eight million India expats live in the Gulf, including close to three million in the UAE. They account for more than 60 per cent of remittances to their home country.

India's long lockdown of 21 says ends next Tuesday. Indications are that it could be extended. Some states like Orissa have already stretched it till the end of the month and others are expected to follow suit.

The government believes that the disease is now concentrated in 75 districts, and the focus should be on these areas to manage and contain the virus.