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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, Mar 21: Appealing for support to the Prime Minister's call for observing 'Janata Curfew' on Sunday to contain the outbreak of COVID-19, Karnataka Chief Minister B S Yediyurappa has asked people not to come on roads immediately after the end of curfew time as it can nullify the measure.

Noting that people have extended both moral and societal support to this unique curfew, he said "Now, my appeal to people on behalf of Prime Minister Narendra Modiji is, don't come on roads and out of your dwellings immediately after nine in the night when curfew time ends. Remain settled in your houses and bungalows avoiding all public appearances on roads and other public places."

"Your coming out in open can nullify the 14-hour measure to contain the spread of virus. As a co-operation to authorities and the society, please remain indoors and stay with your near and dear ones," he said in a release.

Calling for "resolve and restraint" to fight the virus, the Prime Minister during his address to the nation on Thursday had asked the entire country to observe 'Janata curfew' on Sunday.

Calling for a 'Janata curfew' on March 22 from 7 am-9 pm, Modi had said no citizen, barring those in essential services, should get out of their house, and asserted that it will be a litmus test to show how much India is ready to take on the challenge of the coronavirus pandemic.

Stating the Karnataka government has so far been dealing successfully in containing the Covid-19 virus, Yediyurappa said this has happened because of people's co- operation.

He also asked people not to forget to involve in a bout of applause as a mark of appreciation to people involved in containing the spread of the virus and treating those affected by it.

Three new COVID-19 cases have been confirmed in Karnataka on Saturday, taking the total number of infections to 18 in the state.

Bosnia, Jul 12: Bosnians commemorated on Saturday the massacre of about 8,000 Muslim men and boys in Srebrenica, marking the 25th anniversary of killings that shocked the world and have stood out as Europe's only atrocity since World War Two constituting genocide.

Nine newly identified victims were buried at a flower-shaped cemetery near the town, where tall white tombstones mark the graves of 6,643 other victims.

"After 25 years we succeeded in finding his mortal remains, so they can be laid to their final rest," said Fikret Pezic, who buried his father Hasan.

The remains of some 1,000 victims of the massacre in the eastern town during Bosnia's 1992-1995 war are still missing.

Ifeta Hasanovic decided to bury incomplete remains of her husband, saying: "We were aware they cannot be complete after 25 years, at least there are some, I did not want to make any new delays."

World leaders addressed the ceremony by video link, unable to attend because of coronavirus epidemic. Instead of the tens of thousands visitors who typically attend the commemoration each year, only a few thousand came after organisers banned organised visits.

During the Bosnian war, Bosnian Serb forces pushed non-Serbs out of territories they sought for their Serb statelet. Fleeing Muslims took shelter in several eastern towns, including Srebrenica, that were designated as United Nations "safe zones".

On July 11, 1995, the Serb forces commanded by General Ratko Mladic overran Srebrenica, which was protected by lightly armed Dutch peacekeepers.

They sent women and children away and captured and executed the men and boys they found. The bodies were dumped into mass graves and later exhumed by U.N. investigators and used as evidence in war crimes trials of Bosnian Serb leaders.

"We grieve with the families that tirelessly seek justice for the 8,000 innocent lives lost, all these years later," said U.S. Secretary of State Mike Pompeo. Washington brokered Bosnia's peace deal months after the massacre.

Most people at the commemoration were Muslim Bosniaks, reflecting conflicting narratives about the bloodshed - which hinders reconciliation nearly 25 years after the end of war in which about 100,000 people were killed.

The U.N. war crimes tribunal for the former Yugoslavia convicted Mladic and his political chief Radovan Karadzic over Srebrenica genocide but they remained heroes for Serbs, many of whom deny that genocide happened.

On Saturday, the Serbs in the nearby town of Bratunac organised an event marking July 11 as the "Srebrenica Liberation Day".

Sefik Dzaferovic, the Bosniak chairman of Bosnia's tripartite presidency, called for legislation that would ban denial of genocide.

"There can be no trust as long as we witness attacks on the truth, denial of genocide and glorification and celebration of executors," Dzaferovic told the commemoration gathering.