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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 18: The Karnataka government has managed to get the contact details of nine out of 10 foreign nationals who had visited Jubilant Life Sciences, a pharmaceutical company in Mysuru district's Nanjangud which has been declared a coronavirus hotspot, State minister S Suresh Kumar said on Saturday.

As many as 66 people have tested positive for COVID-19 in Nanjangud.

While investigating the source of virus in what is now known as 'Nanjangud cluster', the Mysuru administration could get information that 10 foreign nationals had visited this town, Kumar told reporters.

Soon the External Affairs Ministry's help was sought which managed to track nine of them, Kumar said, adding that the MEA contacted its embassies in China, Germany, Japan and the USA to track these persons.

"Out of 10, they could contact nine and got details. All of them have said that they were all healthy and they did not have any symptoms.

Hence, they did not feel the need to undergo COVID-19 tests," the minister said.

He opined that many people do not show the symptoms but they could be carriers of the virus.

Coronavirus India update: State-wise total number of confirmed cases, deaths on April 18

"It all depends on the person's immunity," Kumar explained.

A foreign national from Germany who had visited Nanjangud could not be reached as her contact details were not available.

Gadag, May 9: It is the month of April, and the season of mangoes is very much here. However, the mango farmers of Gadag are suffering huge losses amid the coronavirus lockdown due to the absence of transportation facilities along with several other issues that have been impacting their business adversely.

Speaking to media persons, Vishwanath Odugowdar, a mango farmer said, "Due to transportation problems we are not being able to export mangoes to different countries. We are trying to sell them in nearby markets."

"We are not in a situation to pack, transport and export the mangoes to different countries as we did earlier especially 
when it comes to Alphonso mangoes which is one of the most loved varieties. So, we are packing mangoes at our place. Somehow this year we have got very good quality of mangoes," he added.

Farmers here are incurring huge losses as mandis and markets across the country are shut while the transport of Alphonso mangoes has also come to a halt owing to the lockdown.

The small and medium scale farmers in places like Gadag, Dharwad, Bagalkote in north Karnataka have started packing the mangoes themselves in their farms in a bid to sell the fruit themselves.