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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, Jul 16: Rattled by the spurt in Covid-19 positive cases, a Karnataka minister on Wednesday said only god would save the people from coronavirus pandemic.

"Only god has to save us from the virus or the people should be made aware of the infection so that they wear mask and maintain social distancing," state Health Minister B Sriramulu told reporters in Chitradurga, 205-km northwest of Bengaluru.

Noting that the infection does not differentiate between rich and poor, police, doctors, politicians or legislators, Sriramulu said the communicable disease could rise to alarming level in the ensuing two months, as the cases were rising daily the world over.

"Who can control coronavirus? In the present situation, only god has to save us. Otherwise, the people should become aware of its (virus) consequences. If we have made mistakes, we are ready to face punishment for them," said Sriramulu, who is the ruling BJP's legislator from the Molakalmuru reserved assembly segment in the district.

Refuting the opposition Congress charge that the cases were rising in the state due to negligence by ministers, officials and legislators, Sriramulu said Karnataka was performing better than other states till the cases began to steadily rise since unlock started and the people were moving in violation of the guidelines.

A record 3,176 cases were reported from across the southern state during the day, taking the Covid tally to a whopping 47,253, including 27,853 active cases after 18,466 were discharged, with 1,076 during the day, while 928 succumbed to the virus, with 87 in the last 24 hours.

In Bengaluru, which is under 9-day lockdown since Tuesday night till July 22 morning, 1,975 positive cases were registered, taking its tally to 22,944, including 17,051 active after 5,455 were discharged so far, with 463 during the day, while 437 died of the infection, with 60 in the last 24 hours.