Bihar toppers, college director arrested; Answersheets may have been changed

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 21: The total number of Covid-19 cases in Karnataka breached the 70,000 mark on Tuesday as the state reported 3,649 fresh infections, while 61 fatalities took the death toll to 1,464, the health department said.

The day also saw 1,664 patients getting discharged after recovery. Out of 3,649 fresh cases reported on Tuesday, a whopping 1,714 were from Bengaluru urban alone. As of July 21 evening, cumulatively 71,069 Covid-19 cases have been confirmed in Karnataka, which includes 1,464 deaths and 25,459 discharges, the health department said in its bulletin.

It said that out of the 44,140 active cases, 43,557 patients are in isolation at designated hospitals and are stable, while 583 are in Intensive Care Units.

Twenty-two out of 61 deaths reported on Tuesday are from Bengaluru urban, followed by five each from Dakshina Kannada, Mysuru and Dharwad, four each from Kolar and Belagavi, three each from Hassan, Tumakuru and Haveri, Bidar 2, and one each from Chikkaballapura, Chikkamagaluru, Chamarajanagara, Gadag and Vijayapura.

Most of the deceased either had a history of Severe Acute Respiratory Infection (SARI) or Influenza-like illness (ILI). Out of 3,649 cases tested positive on Tuesday, contacts of the large number of the cases are still under tracing.

Among the districts where new cases were reported, Bengaluru urban accounted for 1,714, Ballari 193, Dakshina Kannada 149, Mysuru 135, Yadgir 117, Uttara Kannada 109, Hassan 107, Kolar 103, followed by others.

Bengaluru urban district topped the list of positive cases, with 34,943 infections, followed by Dakshina Kannada 3,829 and Kalaburagi 2,966. Among discharges Bengaluru urban was on top with 7,476 discharges, followed by Kalabuagi 1,834 and Udupi 1,731.

A total of 10,64,734 samples were tested so far, out of which 43,904 were tested on Tuesday alone, the bulletin said. It said that 19,328 of the 43,904 samples tested today were rapid antigen tests.

Bengaluru, June 22: Even as the covid-19 positive cases are steadily increasing in Karnataka, an expert has claimed that community transmission has begun in Bengaluru and cases could keep rising over the next two months.

“If you look at the natural course of this virus across countries around the world, it is about six months. Now we’re in the fourth month. This will go on for another two months. It also sounds like this is the beginning of the peak. There is also a possibility of the number of cases going up from now on. Even across India, cases are increasing,” says Dr CN Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences and Research and State Task Force member.

Besides the increase in number of cases, the virus is advancing silently, stealthily. A lot of people who are testing positive are asymptomatic. In areas like Padarayanapura, Nanjangud and many places in north Karnataka, there have been positive cases who have not had any contact with infected individuals. Some cases recorded in Bengaluru over the last two to three days have not had any contact with Covid-positive people.

Dr Manjunath adds: “We are in community transmission. This will happen because nature is ahead of everything. We have to take all possible precautionary measures at our command. This has to happen. Only then some kind of herd immunity will be developed.”

“We are expanding the guidelines of testing to include a large number of people to be tested. Now, according to the Indian Council for Medical Research (ICMR) guidelines, only symptomatic Influenza like Illness (ILI) or Severe Acute Respiratory Infection (SARI), or a person coming in contact with an infected person are being tested.

But since we have crossed 100 days in Karnataka from the first reported case and we’re getting cases with no travel history or contact with a Covid-positive person, we have to start random testing across the sub-group population. Only then will we understand the burden of the disease and what precautions need to be taken,” he says.