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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.

Benglauru, May 17: A garment company manager jumped to death from his third-floor house on Saturday, four days after having killed his wife and wrapping her body in a blanket. 

Manish Kumar, 42, gave a relative and neighbours frightening moments before committing suicide at AECS Layout, Kudlu Gate, Southeast Bengaluru. The relative had come over after Kumar’s brother called him from Delhi, saying he had stopped responding to phone calls. 

The relative, who lives in Hongasandra, arrived at Kumar’s house around noon. He knocked on the door which was bolted from the inside but didn’t get a response. When he asked the neighbours, they said they didn’t have a clue. The relative and the neighbours decided to break the door open. 

But as they entered the house, they got the shock of their lives. Kumar was slitting his wrist with a blade. He then ran into the bathroom and locked himself in. They followed him and asked him to open the door. But he ignored them. They had to break open the bathroom door, too. By this time, Kumar had slashed his hands, chest and other parts of the body. Waving the blade at them, he asked them to stay away. 

Even the relative and the neighbours pleaded with him to drop the blade, he ran out and jumped off the building. He was taken to a hospital but it was too late. 

A bigger shock awaited them. They felt a foul smell emanating from the house. When they went in, they found the decomposed body of Kumar’s wife, Sandhya, 35, wrapped in a blanket. They called the cops. 

Police found a death note purportedly written by Kumar on May 12. “We suspect he killed her on that day,” said a police officer investigating the case. 

Police said the death note specifies what made Kumar kill his wife and commit suicide. Sandhya suspected him of having an affair since he regularly chatted up some bar dancers he had met in Gurgaon and Delhi. She accessed his phone and saw the calls and the WhatsApp messages he had sent them. The issue rocked their marital life and they often fought over it. He then decided to kill his wife and commit suicide, as per the death note. 

Police said Kumar appeared to have spent the last four days at home, with his wife’s body wrapped in the blanket. “We don’t know whether he tried to dispose of the body or didn’t want to see it,” the officer said. Police couldn’t determine how he killed her and are waiting for the post-mortem report. 

Joshi Srinath Mahadev, DCP (Southeast), said the couple hailed from Bihar. “We are waiting for Sandhya’s relatives to arrive in Bengaluru. A case of murder and suicide has been registered at the Parappana Agrahara police station.” Another officer said the couple had a love marriage.

More than 500 flights are expected to be operated in the fourth phase of Vande Bharat Mission, the “paid evacuation” mission of the government of India during covid-19 crisis.

This includes both Air India and private carriers who are ramping up their operations in a big way. 

Air India will be operating 170 flights till 15th of July to and from 17 countries, including Australia, Bahrain, Bangladesh, Canada, Germany, Japan, Kuwait, Malaysia, Oman, Saudi Arabia, Qatar and Philippines.

Private airlines such as IndiGo and GoAir will have significant participation in the fourth phase of Vande Bharat Mission. 

The Civil Aviation Ministry said that among others, Indigo will operate 238 flights from Qatar and 219 flights from Kuwait. GoAir will operate 41 flights from Kuwait. Phase Four will particularly focus on countries where there still are a large number of Indians who have registered to return.

Meanwhile, a record five lakh stranded Indians have returned safely to India under the Mission till now. The operations commenced on 7th May and in less than two months, nearly five lakh four thousand stranded Indians from 137 countries have returned to their homes.