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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 28: Former Chief Minister and senior Congress leader Siddaramaiah asked the Karnataka government to release White Paper over the state of healthcare system and the government's preparedness to address COVID-19 pandemic.

He said that the State Government to come clean on the charges of misappropriation of large sums of funds in the name of fighting the COVID-19 pandemic in the state.

"People are extremely worried about the state of our healthcare system and the government's preparedness to address pandemic. It is the responsibility of Karnataka Chief Minister to clear the doubts and reduce the panic among people. I urge the government to #ReleaseWhitePaper about the same," the Congress leader tweeted.

Siddaramaiah said that the Chief Minister should let people know about the amount of money already spent to improve healthcare facilities, the number of beds and ventilators increased and about the supply of PPE kits to COVID-19 warriors.

"Karnataka Chief Minister should also reveal the contribution of PMO India to our state. Has Karnataka Chief Minister BS Yediyurappa demanded anything from Narendra Modi? How much of PM CARES Fund is spent for Karnataka's healthcare?" he asked in another tweet.

He went on to say that PMO India and Chief Minister of Karnataka "wasted crucial time during lockdown."

"The purpose of lockdown was to fill the gaps in health care system. But they just widened it by frequently changing the protocols and by not doing adequate tests," he said.

"Karnataka Chief Minister and other departments have failed to answer my multiple queries regarding the actions taken. As a leader of opposition, it is my right to question the government on behalf of people. Deliberate act of denying information is a breach of privilege. Government hospitals have reached its capacity and private hospitals are not ready to treat patients at capped prices," he wrote.

Siddaramaiah said that the Karnataka Chief Minister should either convince private players or take action against them, and added, "Not doing both is like pushing people off the cliff."

He tweeted, "The testing rates per day have come down in last 15 days even when the cases are rising. What is stopping the government from increasing the testing? The government is putting people at risk by not testing adequately."

Further attacking the state government, he wrote, "Our state needs 9000 ventilators, but we have only 1500, PMO India has sent 90 to us. Is this a joke to Karnataka Chief Minister and PMO India? #ReleaseWhitePaper about the ways that they plan to increase ventilators."

Bengaluru, May 6: Karnataka has reported 20 new cases of coronavirus taking total number of cases in the state to 693.

The state health department said in a bulletin on Wednesday that 20 new cases have been confirmed for COVID-19 in the state. "The total number of cases in the state is 693," it said.

The count includes 354 patients who have been discharged and 29 patients who succumbed to the disease.

Out of the remaining cases, 303 patients are in isolation at designated hospitals while six patients are in ICU. The bulletin has also reported one death due to non-COVID cause.

The number of COVID-19 cases in the country reached 49,391, according to the Ministry of Health and Family Welfare on Wednesday morning.

This includes 33,514 active cases and 1,694 deaths due to infection so far.

A total of 14,182 persons have been cured and discharged so far, according to the Health Ministry. One patient has migrated.