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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 5: An FIR has been filed against former journalist and human rights activist Aakar Anil Patel in Bengaluru here over his comments on social media under charges pertaining to provocation with intent to cause riots.

The FIR was registered under Section 117 (abetting commission of an offence by the public or by more than ten persons), 153 (wantonly giving provocation with intent to cause riot), and 505-1-B (intent to cause, or which is likely to cause, fear or alarm to the public, or to any section of the public) of the Indian Penal Code (IPC) at the JC Nagar police station.

According to the FIR filed on June 2, Patel had tweeted that protests like the ones in the US over George Floyd's death are needed in India by the marginalised communities.

Patel, former chief of Amnesty International India, had on May 31 posted from his Twitter account, which is not verified.

On May 25, Floyd died in police custody in Minneapolis, Minnesota, following which protests against police brutality and racism erupted in various cities in the United States. The protests were later replaced by incidents of violence across the country.

India also has witnessed several cases of mob lynchings and custodial deaths in recent years. In most cases victims belong to down trodden communities such as Muslims and Dalits.

Responding to the development, Amnesty International India has said that FIR against Patel is another example of how the right to dissent is being "increasingly" criminalised.

"The Bengaluru police must stop abusing its authority and put an end to the intimidation and harassment of Aakar Patel for exercising his constitutionally guaranteed right to freedom of expression. People of this country have the right to agree or disagree with those in power, and to express these opinions in peaceful protests - without fear or unlawful interference," Amnesty International India Executive Director Avinash Kumar said.

He said that peacefully protesting against the government is not a crime and added that not agreeing with the policies of those in power does not make you a traitor.