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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.

Mangaluru, Mar 16: As a precaution against the spread of Covid-19, the Karnataka State Road Transport Corporation (KSRTC) on Monday decided to cut down its premium, non-AC sleeper, Rajahamsa and express bus services from Mangaluru to Bengaluru and Kasaragod following poor patronage.

The cut down in services is as per the direction of KSRTC's Central office that wants bus services to be operated on priority.

KSRTC Mangaluru Divisional Controller S N Arun said that the corporation has decided to cut down 40 trips to Bengaluru. Concerning Kasaragod, it has reduced the number of trips from 40 to 35. "These include a reduction in services to Mysuru and Dharmasthala also," he added.

Mysuru, May 6: A seven-months pregnant woman fled Covid-19 hotspot Mumbai along with her family, and made it to her village 1000 km away in KR Pet taluka in Mandya district of Karnataka, flashing her mother's ID card at each checkpost. After reaching her destination, she got herself tested for Covid-19.

She tested positive for the virus on Monday in Mandya.

The 20-year-old woman (assigned the number P637) had been living with her husband and in-laws at Santa Cruz East, Agripada in Mumbai for the past three years. To get out of the containment zone, they started out from Mumbai at 7.30 pm on April 23 -- she, her husband, brother-in-law, co-sister and their children, and a 19-year-old girl. She made it past checkposts at Belagavi, Hubballi, Davanagere, Kadur, Arasikere, Channarayapatna and Shravanabelagola and reached her village Jaaginakere at 3 pm on April 24.

She stayed at her home in the village from 24 April to April 29. With the Mandya district administration testing people on a campaign mode in the entire district, she and her family got themselves tested on May 1.

Her test returned positive on May 4, according to deputy commissioner M V Venkatesh.

Along with her, the 19-year-old girl (P638) who travelled with the family also tested positive. The girl is in the sixth semester of her BE Electronics course at an engineering college in Mumbai.

This is not the first case of a corona fugitive from Mumbai. Earlier, a 50-year-old man who ran a hotel in Mumbai travelled in a vehicle carrying dates and reached Channarayapatna in Hassan district.

In fact there have been three such incidents, including that of seven people coming to Mandya from Mumbai transporting a dead man's body for cremation in his native village of B Kodagalli in Pandavapura taluk.

Mandya deputy commissioner Dr Venkatesh has appealed to natives of Mandya who are stuck in Mumbai to stay there till the Covid situation comes to control.

So far 28 people in Mandya diatrict have tested positive for Covid 19. Seven people have been discharged. Currently there are 21 active cases being treated at the Mandya Institute of Medical Sciences.