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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.

Thiruvananthapuram, Apr 24: Kerala Chief Minister Pinarayi Vijayan on Thursday said that there is no community spread or the expected phase three spread of coronavirus in the state so far but the threat continues.

Speaking to media persons here on Thursday, Vijayan said that Kasargod, Kannur, Kozhikode, and Malappuram districts will be in the red zone with full restrictions.

"All the other ten districts in the State will be in the orange zone. With the detection of new cases today, the status of Kottayam and Idukki districts have been changed from green to orange. The district administration will decide on the hotspot areas to be closed," he said.

He said there would be an increase in the number of random tests in the red zones.

"In an effort to confirm that there is no community spread in the State, random antibody tests would be conducted among health workers, police personnel, home delivery persons, volunteers and migrant labourers," he added.

The Chief Minister said that COVID-19 labs set up at the Pariyaram Government Medical College at Kannur and the Kottayam Medical College have got the approval from the ICMR for coronavirus testing. The lab at Kannur Medical College will start functioning from Friday.

The UV sterilised lab, spread over 2,200 sq ft is equipped with four real-time PCR machines. In the first phase, this lab will be able to do 15 tests per day, which will be gradually increased to conduct 60 tests in the next phase.

"With the opening of these two new labs, tests to detect COVID-19 will be conducted in 14 government labs in Kerala. Apart from this, there are two private labs also in Kerala which are doing these tests. Since the number of coronavirus cases is again increasing in the State, the government has decided to procure ten real-time PCR machines to ramp up testing," he added.

Udupi, July 1: In a concerning development, another SSLC student in Udupi district has tested positive for covid-19.

With this the number of covid-19 patients among SSLC students in the coastal district rose to three. All of them are girls.

The fresh case has been reported from Byndoor. She has already written three papers.

She had reportedly developed some of the symptoms and hence her throat swabs were sent for testing on June 30. Today she received positive report, sources said.