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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.

We, the undersigned express our solidarity with Dr Zafarul Islam Khan, renowned scholar, journalist and presently Chairman of the Delhi Minorities Commission.

We strongly condemn the continued media trial and targeting of Dr Zafarul Islam Khan for his Facebook post thanking Kuwait for expressing solidarity with Indian Muslims. In his Facebook post, he mentioned the appalling deterioration of human rights of Indian Muslims who have been targeted by Hindutva bigots. A few politicians with ulterior motives and news channel anchors known for spreading bigotry and Islamophobia have mischievously sought to misinterpret his statement and ridiculously label him as anti-Hindu and anti-India.

He has only reiterated what many citizens of India, public figures, international institutions, various European governments, the United States of America and United Nations human rights mechanisms have repeatedly underlined their concern at the increasing human rights abuse and violations of religious minorities in India.

Dr Zafarul Islam Khan is a man of integrity. He is a scholar who is known to stand up for constitutional freedoms and values.

His work as the Chairman of Delhi Minorities Commission has been warmly applauded by human rights activists and NGOs across different faiths. His timely interventions on problems of minorities in Delhi have made him a respectable figure among not only Muslims but Sikh, Christians, Jains and Parsis. He is a humanist in the truest sense of the word.

The hateful propaganda against Dr Khan is one more illustration as how certain Indians fail to differentiate between Hinduism, a religion and Hindutva which is a supremacist political ideology.

Dr Zafarul Islam Khan is a leading Indian intellectual whose niche area is Islamic studies and Arab world. He enjoys great respect in the Arab and Muslim world for his understanding and knowledge. He is an alumni of the esteemed Jamia Al-Azhar and Manchester University.

Dr Khan is known for taking bold public positions. He was the first Muslim scholar in the world who denounced ISIL, which later became IS or ISIS. He issued a statement opposing the barbaric crimes of ISIL (IS or ISIS) and Boko Haram against minorities. He takes strong stands against extremism of all sorts. That makes him a prominent critic of RSS.

Dr Khan is a scholar ambassador and earned international prestige for the India. Any attack and targeting of him, is actually an insult to Indian constitution and ethos.

We demand the appropriate authorities of the Government of India take strong legal action against those who are distorting Dr Khan’s Facebook post, and spreading vicious false propaganda against him.

Signed by:

Swami Agnivesh

Mohammad Adeeb
Arun Kumar (Prof)

Zafar Jung

Kamal Faruqui

Annie Namala

Kavita Krishnan

Subhash Gatade

Jawed Naqvi

Indu Pratap Singh

Avinash Kumar

Iftikhar Gilani

Anil Chamadia

Xavier Dias

Denzil Fernandes (Dr)

Irfan Engineer

Faisal Khan

John Dayal (Dr)

Mujtaba Farooque

Ravi Nair

Abubakr Sabbaq (Adv)

Gopal Menon

Bilal Khan

Ashok Choudhury

Jaffer Latief Najar

Mujahid Nafis

Aseem Sundan

Poojan Sahil

Ankur Otto

Mariya Salim

Tanweer Alam

Juned Khan

E M Abdul Rahiman

Aditi Dutta

Devika Prasad

Ameeque Jamei

Suhaib Ansari

Gurminder Singh

A C Michael

Neelima Sharma

Aftab Alam (Dr)

Dhruva Narayan

Syed Saif Ur Rahman

Tanweer Fazal (Dr)

Thouseef Madikeri (Dr)

N.D. Jayaprakash

Salahuddin Ansari

Satyajeet Nambiar

Suhail KK

Abu Sufiyan

Sujata Madhok

Tariq Khan

Violin Mathew Benjamin

Shamsul Islam (Prof)

Sreedhar Ramamurthi

Mohd. Shahid (Prof)

Anand Vivek Taneja (Dr)

Kush Kumar Singh (Dr)

Mangla Verma

Vipul Kumar

Waquar Hasan

Braham Prakash

Abdul Rashid Agwan

Fawaz Shaheen

Guman Singh

Mohammed Hafeez Ulla

Kp Sasi

Mushfique Raza Khan

Partha S Banerjee

Gautam Majumdar

S.Q. Masood

Aiman J Khan

M. K. Faizy

Tasleem Rehmani (Dr)

Mohammed Shafi

Lenin Raghuvanshi (Dr)

Malik Motasim Khan

Kripal Singh Mandloi

Labeed Shafi

Qamar Intakhab

Raees Ahmed Siddiqui

Laeeq Ahmed Khan

Anthony Arulraj

Sadiq Zafar

Biju Gopidasan

George Pulikuthiyil

Mohd Abdullah

Mohd Sorab Hussain

Mukunda Kattel

Sandeep Pendse

Paul Newman

Ovais Sultan Khan