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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.

The Himachal Pradesh police have confirmed the arrested a man for injuring a pregnant cow by feeding her wheat flour ball laced with firecrackers. 

The cow’s jaw was blown off-- reprising the tragic story of a pregnant elephant that lost its life after eating a pineapple stuffed with a firecracker in Kerala.

While the incident took place on May 26 in Jhandutta area of Himachal Pradesh’s Bilaspur district, it came to light only on Saturday, May 6, when the cow’s owner, Gurdayal Singh, uploaded a video of the injured animal on social media.

In the video, Gurdiyal Singh describes how the cow’s mouth had been injured after one Nandlal fed her explosives.

He confirmed that Nandlal works as a mechanic in Singh’s neighbourhood. Singh said that Nandlal has no remorse for his action. Nandlal has said that he is not scared of the repercussions and that he will continue to do whatever he deems fit. “Even the village sarpanch cannot harm me”, challenged Nandlal when confronted by Singh. 

The cow has given birth to a healthy calf since but Singh said the animal is still not able to eat because of an injured jaw and is being administered Glucose.

The video went viral with people demanding strict action against the person who fed firecrackers to the animal.

The practice of studding dough balls with firecrackers isn’t uncommon in Himachal, and farmers resort to this to keep wild animals, especially boards, off their fields. In the Kerala incident too, the explosive-filled-fruit was meant for wild boars. In many parts of the country, including Himachal, the method is also used to hunt for bush meat -- an illegal practice.

Bilaspur superintendent of oolice (SP) Devakar Sharma confirmed the incident and said the cow was fed a highly explosive firecracker popularly called “aalu bomb”. 

Aalu is Hindi for potato. He said a case under Section 286 of the Prevention of Cruelty to Animals Act has been registered and the role of the neighbours named by Singh is being investigated.