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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.

Bengaluru, May 10 The asymptomatic and healthy people among international passengers will now have to undergo institutional quarantine for 14 days, according to the new standard operating procedure (SoP) issued by the Karnataka government for a third time.

The SoP, which has been revised twice, was issued by the Health and Family Welfare Department on Saturday, May 9.

The international passengers will be divided into two categories upon their arrival at the airports. Symptomatic will be directly sent to the covid-19 hospitals. Asymptomatic will not be allowed to go home directly. They will be sent for mandatory quarantine for 14 days in hotels and guest houses. 

Earlier, international passengers had to undergo seven days of institutional and seven days of home quarantine.

Passengers will also be tested only twice — once on arrival and for the second time on the 14th day — instead of the earlier decision to test thrice. They will be discharged from the facility if they test negative.

The first group of 350 people are expected to arrive from London at 3 am on Monday at the Kempegowda International Airport, said Lakshman Reddy, Joint Director, Social Welfare Department. 

Flights are expected from Singapore on May 13, Jeddah on May 14 and San Francisco on May 15. 

Among the stranded include 4,408 tourists and visitors, 3,084 students, 2,784 migrants and 557 ship crew.

New Delhi, April 3: Chairman of Lulu Group, Yusuffali MA on Thursday contributed Rs 25 crores to the Prime Minister's Citizen Assistance and Relief in Emergency Situations (PM-CARES) to combat coronavirus.

"I have humbly contributed INR 25 Crores to the PM Cares Fund to support all relief works in India's fight against the COVID-19," Yusuffali said in a tweet.

Last month, Prime Minister Narendra Modi had created PM CARES Fund and appealed to all the countrymen to show their support for the cause.
The prime minister is the chairman of the trust and its members include the defence minister, the home minister and the finance minister.