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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.

Thiruvananthapuram, Apr 10: Kerala Chief Minister Pinarayi Vijayan on Friday said that it has been 100 days since the first COVID-19 case was reported and shared the updated figures of positive cases, along with the efforts made by the state government to contain the virus.

"100 Days of #COVID19 | Kerala Story It's been 100 days since the first case was reported. 258 active cases, 97 recovered, Total confirmed: 357 Deaths: 2. 12,710 samples tested Special COVID-19 Hospital, 1,251 Community Kitchens, 28,08,650 Individuals Served, 3,676 Destitutes Rehabilitated," Vijayan tweeted.

India's first case was reported in Kerala in January. The patient was a student, who was studying at Wuhan University in China.

Meanwhile, the Ministry of Health and Family Welfare on Friday informed that India's total number of COVID-19 positive cases now stands at 6,412. Out of these, 5,709 are active patients and 504 of them have been cured/discharged and migrated.

With 30 new deaths reported in the last 12 hours, the death toll has reached 199.

New Delhi, Jun 13: Loss of smell or taste has been added to the list of COVID-19 symptoms, according to the revised clinical management protocols released by the Union Health Ministry on Saturday.

The ministry said that coronavirus-infected patients reporting to various COVID-19 treatment facilities have been reporting symptoms like fever, cough, fatigue, shortness of breath, expectoration, myalgia, rhinorrhea, sore throat and diarrhea.

They have also complained of loss of smell (anosmia) or loss of taste (ageusia) preceding the onset of respiratory symptoms.

Older people and immune-suppressed patients in particular may present with atypical symptoms such as fatigue, reduced alertness, reduced mobility, diarrhoea, loss of appetite, delirium, and absence of fever, the ministry said.

Children might not have reported fever or cough as frequently as adults.

The US's national public health institute, the Centers for Disease Control and Prevention (CDC), had in early May incorporated "a new loss of taste or smell" in the list of COVID-19 symptoms.

According to the data from Integrated Health Information Platform and Integrated Disease Surveillance Programme, portal case investigation forms for COVID 19 (n=15,366), the details on the signs and symptoms reported are (as on June 11), fever (27 per cent), cough (21 pc), sore throat (10 pc), breathlessness (8 pc), Weakness (7 pc), running nose (3pc ) and others 24 pc.

According to the health ministry, people infected by the novel coronavirus are the main source of infection.

Direct person-to-person transmission occurs through close contact, mainly through respiratory droplets that are released when the infected person coughs, sneezes, or talks.

These droplets may also land on surfaces, where the virus remains viable. Infection can also occur if a person touches an infected surface and then touches his or her eyes, nose, or mouth.

The median incubation period is 5.1 days (range 2–14 days). The precise interval during which an individual with COVID-19 is infectious is uncertain.

As per the current evidence, the period of infectivity starts 2 days prior to onset of symptoms and lasts up to 8 days.

The extent and role played by pre-clinical/ asymptomatic infections in transmission still remain under investigation.