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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, Jun 24: Karnataka Minister of Medical Education Dr K Sudhakar said on Tuesday that the directors of institutions will be held responsible if any there are any complaints and lack of facilities in the treatment of COVID-19 patients.

'Since a couple of days, there are reports in media regarding the admission of COVID-19 patients, lack of hygiene and the supply of sub-standard food to patients. The country is appreciating Karnataka and Bengaluru for controlling the spread of coronavirus. This was possible due to tireless efforts from past several months and these kinds of reports emerging now cannot be tolerated," Sudhakar said.

He added, "There can be no compromise in the treatment of COVID-19 patients. It must be ensured that these kinds of complaints will not be repeated. Directors of hospitals will be held responsible if there are complaints."

The medical education minister further said that asymptomatic patients will be kept in COVID-Care Centres and if they develop symptoms in the care centres, they will be shifted to hospitals for further treatment.

"Since the COVID-19 cases are increasing, private hospitals have been roped in to treat coronavirus patients. Officials have to ensure that beds are reserved and all arrangements are made as per the government order. Guidelines will soon be issued for monitoring asymptomatic cases in COVID care centres," he added.

Karnataka on Tuesday reported 322 fresh COVID-19 positive cases and eight deaths.
According to the state health department, the total number of positive cases has mounted to 9,721 and 150 deaths. So far, 6,004 people have been discharged.

Bengaluru, Feb 21: The Supreme Court in its interim order on Thursday allowed the plea of the Karnataka government for implementation of the final award by a tribunal for sharing of water between Goa, Karnataka and Maharashtra from the Mahadayi river.

The interim order was passed by a bench comprising Justice D Y Chandrachud and Justice Hemant Gupta after hearing the counsel from the three states. The bench said the final hearing in the matter will take place in July.

It also said the interim order is subject to the final outcome of the petitions filed by the three states against the tribunal's award.

The Mahadayi Water Dispute tribunal had passed the order on August 14, 2018, allocating 13.42 TMC ( Thousand Million Cubic Feet.) water (including 3.9 TMC for diversion into the depleted Malaprabha river basin) from the Mahadayi river basin to Karnataka.

Maharashtra was allotted 1.33 TMC water while Goa was given 24 TMC in the final decision of the tribunal. The UPA-2 government had constituted Mahadayi Water Disputes Tribunal in 2010.

Karnataka government, which has locked horns with the neighbouring Goa on the larger issue of sharing Mahadayi River water between both the states, had petitioned the tribunal seeking the release of 7.56 tmcft of water for the Kalasa-Banduri Nala project.

The Kalasa-Banduri Nala (diversion) project, which will utilise 7.56 tmcft of water from the inter-state Mahadayi river, is being undertaken by Karnataka to improve drinking water supply to the twin cities of Hubballi-Dharwad and the districts of Belagavi and Gadag.

It involves building barrages across Kalasa and Banduri, the tributaries of the Mahadayi River, to divert 7.56 tmc water to the Malaprabha river which fulfils the drinking water needs of the twin cities.