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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, Jul 10: Accredited Social Health Activist (ASHA) workers under the All India Trade Union Congress (AITUC) on Friday held protests in different parts of Karnataka, demanding personal protective equipment (PPE) kits and a salary of at least Rs 12,000 per month.

According to Madhu Kumari, an ASHA worker from Kalaburgi, ASHA workers currently receive a salary of Rs 3,000 per month.

"Our demand is to increase our wages to at least Rs 12,000 per month. We have been making this demand for the last six months but we have not received any response from the authorities. We will not go back to work until we are given an appropriate response. We did not want to create a difficult situation but the government has given us no choice," Kumari told ANI.

Clad in their signature pink saris, the women were holding posters in their hands and raising slogans to demand appropriate salary for their work and the necessary equipment to protect themselves from the ongoing COVID-19 pandemic.

Farhana, an ASHA worker protesting in Shivamogga, said that the women have been making demands for PPE kits since June 30. "We have been taking care of COVID patients for the last few weeks but have not received adequate PPE kits. A few of us received some in the beginning but they were not enough. We are not even given hand sanitiser or masks to protect ourselves," she added.

"We have sent letters to the District Commissioner's Office and to the Ministry of Health and Family Welfare but our pleas have gone unheard. We are protesting to get the attention of the concerned authorities," she added.

They also demanded that authorities to conduct their COVID-19 tests as they have to deal with patients infected with the virus.

Sajida, an ASHA worker in Kalaburagi said, "We are very stressed about the COVID situation. We take care of sick people day in and day out, but no one is there to take care of us. We want the government to conduct COVID tests for all ASHA workers in the state."