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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.

Dubai, Apr 26: Families were shattered as the three dead bodies of UAE-based Indian expats were returned to the country from New Delhi, India.

Family members waited outside the Indira Gandhi International Airport for hours, but they were later told to go back home as the remains of expats Jagsir Singh, Sanjeev Kumar and Kamlesh Bhatt were flown back to Abu Dhabi, following a new order implemented by India's Ministry of Home Affairs.

Inderjeet, brother-in-law of Sanjeev based in Al Ain, said their family in Punjab was devastated.

"This is a non-coronavirus death. We had a death certificate as proof and all necessary documents from Indian Embassy. But the body was returned while our family members waited outside the airport. This is very shocking," Inderjeet said.

"The body shouldn't have been returned. It's difficult to travel across states due to Covid-19 restrictions and also to arrange the ambulance," he added.

"Now the embassy has told me to come on Sunday. They said hopefully things will be sorted out in a day or two."

Meanwhile, the family of Kamlesh resides in the Indian state of Uttarakhand. This means, with existing travel restrictions, they had to secure permits from different states to reach New Delhi.

Dubai-based social worker Girish Pant, who is in touch with the family, said they are all depressed with the unfortunate turn of events.

"His brother Vimlesh had to return home without the remains. They are all clueless and in pain. With the new order from the Ministry of Home Affairs, I have informed the family that the body will reach them within 48 hours. I am also coordinating with the Indian Embassy," Pant said.