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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.

Bantwal, Jan 15: Two people died in a head-on collision between two two-wheelers at Mani-Mysuru Highway in Bantwal last night, police said on Wednesday.

Police said that Parikshit (19) and Padmanabha Gowda (28) were heading towards Mane while Mohammed Ajmal (19) on his activa was on his way towards Kodaje when they collided head-on.

All the victims were immediately rushed to hospital for treatment where two of them breathed its last after not responding to the treatment.

Parikshit and Ajmal lost their lives while Gowda suffered critical injuries, the police said.

In another road accident reported from Kodangayi near Radukatte in Vittla, seven people including women and children sustained injuries when a Maruti Omni and another vehicle collided here on Tuesday evening.

Kasaragod, Mar 23: The district administration on Monday decided to abandon efforts to map out the movement details of the NRI who came from Dubai recently and came into contact with many in North Kerala.

The district has been completely locked down since Monday morning, on the directive of the Central Government. Prohibitory orders have been slapped in the district since Sunday night to restrict socialisation of the people.

As the person now in isolation have allegedly been non-cooperative, the authorities were finding it difficult to sketch out a rote map as his movement and socialisation has been so vast and wide since his arrival here on March 12.

The middle aged and popular NRI who landed at Karipur airpprt on March 11 had been in Calicut till midnight prior to boarding the Maveli Express to make it to his hometown Kasaragod, which is 160 kms away from Calicut. He had come into contact with very many, including two MLAs of the district, prior to getting tested positive and getting isolated in the hospital.