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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, Jan 29: Ramesh Jarkiholi on Tuesday demanded that he and all the newly elected MLAs, who won the bypolls after defecting from the Congress and JD(S), be inducted into the cabinet — likely on January 31 — as promised by chief minister BS Yediyurappa.

"We are hoping all 11 MLAs will be made ministers," Jarkiholi said. "That is what the BJP and the CM promised us and we hope they will keep their promise." This is the first time Jarkiholi has spoken in public on cabinet berths, ever since reports surfaced of the party high command not being in favour of inducting all the turncoats into the council of ministers.

Jarkiholi also said fellow rebel AH Vishwanath should be given a ministerial berth.

Vishwanath, formerly of the JD(S), had lost the bypolls. Jarkiholi said the rebellion would not have succeeded had it not been for Vishwanath.

"Those of us who rebelled against the JD(S)-Congress coalition government got a shot in the arm when Vishwanath supported us," Jarkiholi said. "It is imperative that we support him," he said, even as he sought to distance himself from comments made by newly-elected MLAs ST Somashekar and D Sudhakar, who said Vishwanath cannot demand a ministerial post.

Meanwhile, the BJP issued another deadline — January 31 — to expand the cabinet. "In all likelihood, cabinet expansion will take place on Friday," said an aspirant for a berth. But several BJP functionaries are skeptical of meeting the new deadline.

"Till now, the CM has not been given the green signal by the high command. This is all I can say," said a senior minister in Yediyurappa’s cabinet, while insisting he wouldn’t be surprised if the exercise was postponed till the Delhi elections are over.

Former minister and independent R Shankar, who along with Mahesh Kumatalli and Shrimant Patil accompanied Jarkiholi to a trip to Nanjangud, Mysuru district, has upped the pressure on Yediyurappa to field him in the bypoll to the lone vacant council seat. "I am confident the CM and the BJP will honour promises made to me," Shankar said.

The former minister had joined the BJP during the rebellion, but was not given a ticket to contest the bypolls.

In Chikkamagaluru, deputy chief minister Govind M Karjol insisted he is prepared to step down if needed to enable new entrants into the cabinet. "I’m a disciplined solider of the party. If the BJP directs me to submit my resignation, I will do so and return my official car and take a bus to Bengaluru," Karjol said. He said anyone who doesn’t respect the party line will not grow. "It is imperative to toe the party line," he said.

Bengaluru, Mar 23: Deputy Chief Minister Laxman Savadi cautioned private bus transport services operators, taxis and autorickshaws from exploiting commuters in wake of bus and train services being suspended by the government as precautionary measures to prevent the spread of COVID-19.

In a statement released here on Monday, Transport Minister Savadi said it has come to the notice that private buses, taxis and autorickshaws were misusing the opportunity and exploiting commuters. Inter-district bus services have been suspended in the districts wherein lockdown has been announced to protect the health of people and none should violate the decision of the government, he stated.

Transport and Police Department officials have been asked to taken action against those violating norms and exploiting commuters. Service providers for their profit cannot risk with the health of the people and repeated cases if come to the fore, they will not be spared, Savadi cautioned.

Government has taken measures to prevent spread of COVID-19. Private transport service providers and people should join hands and cooperate to contain it, he appealed.