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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.

Mangaluru, May 11: The first evocation flight from Dubai to Mangaluru amidst corona crisis is expected to bring back 177 stranded Kannadigas, mainly residents of coastal Karnataka, on Tuesday, May 12.

All the international passengers have to undergo three mandatory upon their arrival at Mangaluru International Airport - the thermal test, pulse oximetry reading and swab test.

They will be categorised based on their health condition and sent to institutional quarantine, said Sindhu B Rupesh, deputy commissioner, Dakshina Kannada.

“Those with some health issues on arrival (Category A) will be ferried through ambulances to quarantine facilities and rest in buses,” she said.

Arriving passengers will be given the option to choose their quarantine home (lodge, hostel and service apartment) based on their budget and preference.

It is learnt that Dakshina Kannada district administration has kept ready close to 1,000 rooms. The tariff for quarantine facilities is between Rs 1,200 and Rs 4,500 (including food) per day.

As per the Karnataka government, as on May 6, about 10,823 stranded expatriates are expected to return home.

The CISF, airport authorities, health and police departments will make arrangements for the arriving repatriates at MIA.

Sindhu said that the district administration has no personal information about the arriving passengers and there is high probability that they may belong to other districts or the neighbouring Kerala.

“So far, the district administration has received the missive that 177 passengers will be landing on May 12. If we are given advance details about the expats from other districts/state, the district administration will alert them to make necessary arrangements,” she said.

Bengaluru, April 3: Former prime minister HD Deve Gowda has written to Kerala Chief Minister Pinarayi Vijayan stating that he has communicated in writing to Karnataka Chief Minister BS Yediyurappa to make arrangements for the passing of vehicles related to medical facilities and essential goods between Mangaluru and Kasargod.

"What made me write this letter is the pain and anguish I experienced when BM Farookhji, the national working president of JDS and K Krishnan Kutty, MLA and a member of your Cabinet and member of JDS, a coalition partner of your government brought to my notice the inhuman and inappropriate action on part of the authorities of Karnataka to block the interstate highway between Mangaluru and Kasargod, bringing the traffic movements between the two states and particularly to Kasargod district having a sizeable population of Kannadigas to a grinding halt," Gowda wrote in the letter.

"I immediately wrote a letter to Yeddiyurappaji, the Chief Minister of Karnataka to make arrangements to permit goods movement and the passage of ambulances and other vehicles for any emergency. But authorities of Karnataka government appears to be very adamant despite the assurance given before the High Court," it added.

Gowda said that the situation is very grim since he learnt that four to five patients died for want of medical facilities since the ambulances ferrying the patients were denied permission to cross the border, to avail treatment from the hospitals at Mangaluru.

He also condemned the Karnataka government for denying access to medical facilities to people in Kerala.

"I very strongly condemn the attitude of the BJP government in Karnataka denying access to people from Kerala to avail medical facilities on emergency and also the movement of essential goods for the survival of the people and deprivation of such emergency services amounts to violation of human rights and opposed to all norms of humanity and humanitarian considerations," the letter read.
Gowda said he will take up the issue with Prime Minister Narendra Modi.

"I take this opportunity to assure you that I will take up this issue with the Prime Minister who had assured while imposing 21 days of lockdown that the supply of essential commodities will be maintained and hospital facilities will be kept open round the clock so as to prevent any untoward incident," he stated.