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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, Apr 28: Karnataka has found that the rapid antibody test kits for COVID-19 that the Centre supplied to the state have only 47% sensitivity. The state will be returning the kits to the Indian Council of Medical Research (ICMR).

Karnataka had received 11,400 rapid antibody test kits from the ICMR a few days back, out of which it had sent around 200 of them to NIMHANS for validation.

After the ICMR, on Monday, sent a circular to all states to return the test kits to the suppliers, Dr CN Manjunath, Director, Jayadeva Institute of Cardiovascular Sciences and Research, and nodal officer for lab testing in the state's COVID-19 task force, said, "We have cancelled the orders we placed to Guangzhou Wondfo Biotech and Zhuhai Livzon Diagnostics for one lakh rapid antibody test kits. Since the ICMR supplied us with 11,400 kits out of the 6.5 lakh kits it procured, we will be returning the kits to them."

Manjunath told said that the validation at NIMHANS revealed the kits to have only 47% sensitivity. Sensitivity is the ability of a test to identify the true-positives in a population, i.e., the actual number of people who've been infected with the disease. With the rapid antibody testing kits being shelved, the state's plan to randomly test high risk groups has taken a backseat. 

So far, the state has tested 43,791 samples. 

Karnataka now has 22 testing facilities -- 14 government and seven private labs. Many private labs have not tested any samples so far because of the lack of test kits (the state has made it clear that it will not provide test kits to private labs). So, getting an ICMR approval for testing has become a moot point.p

Agreeing to the setback the state's plans of ramping up testing has taken, Manjunath said, "It is true that RT-PCR test kits are in shortage. Even Pune's Mylabs had a shortage in supplying test kits. But we are relying on institutes like Kidwai, Narayana Health and Biocon's Syngene that have received approval for testing. They're big institutes and we hope that they will test a large number of samples."

On reports that the Centre has RT-PCR test kits that will last for only a week, he said, "We have test kits that will last for eight to 10 days. We have ordered for more. We are hoping to receive them before the current kits run out."

Bengaluru, May 22: Amid the fourth phase of nationwide COVID-19 lockdown, inter-state travel from Karnataka is now permitted with the consent of the receiving state, informed Praveen Sood, Karnataka Director General of Police (DGP) and Inspector General (IG).

"Inter-state pass is not required to go out of Karnataka as long as you have the consent of the receiving state," he said.

The order follows MHA's recent announcement of relaxed guidelines amid the nationwide lockdown.

"Due to lockdown, migrant workers, pilgrims, tourists, students and other persons are stranded at different places. They would be allowed to move as under," read the new guidelines while asking states to designate nodal authorities to facilitate the interstate movement.

The Centre has extended the lockdown till May 31 across the country.