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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, July 23: The High Court of Karnataka has directed the state government to formulate Standard Operating Procedure (SOP) for child protection, particularly for cases of child pornography and child missing.

A division bench comprising Chief Justice Abhay Shreeniwas Oka and Justice M Nagaprasanna passed a detailed order and asked the state government to submit compliance within three months.

The division bench passed the order on two PILs, including a suo motu litigation registered in 2018. The PILs were registered to ensure effective implementation of the directions of the Supreme Court on the Juvenile Justice (Care and Protection of Children) Act, 2015 (JJ Act).

The bench observed that in normal courses, courts do not issue writ of mandamus to the legislature on rule-making aspects. However, when the failure of the state is demonstrated under exceptional circumstances, courts can issue directions. The bench directed the state government to expedite the rule-making process to ensure proper implementation of the JJ Act.

The bench expressed displeasure on the insensitive police investigation in cases of child pornography. “The police machinery did not show the sensitivity expected from it while dealing with cases of alleged child pornography. Therefore, it will be appropriate if the state issues SOP or guidelines for dealing with cases of child pornography so that proper investigation is carried out in such cases. As we are directing the formation of SOP for dealing with child pornography cases, the state is also directed to formulate guidelines on child missing cases,” the bench said.

The bench had been issuing several directions since 2018 and has also been monitoring police investigations. The court observed that while the state government has incorporated several directions, some issues still remain unaddressed.

The bench directed the government to have dedicated staff for the Directorate of Integrated Child Protection Scheme considering the sensitive nature of work.

On working of Juvenile Justice Boards (JJB), the court asked the Registrar General of the Karnataka High Court to issue directions to the principal magistrates of all the JJBs in the state to sit on all working days for a minimum of six hours a day. 

The high court directed the state to exercise the rule-making powers for obtaining an annual report from the State Commission for Protection of Child Rights.

Udupi, Jun 2: As many as 150 persons tested positive for COVID-19 in Udupi district on Tuesday. This is the highest spike in COVID-19 cases in a single day in the district.

According to the district administration, all the 150 persons have travel history from Maharashtra. The number of COVID-19 cases has more than doubled when compared to June 1, when the district recorded 73 cases.

Deputy Commissioner G. Jagadeesha said here that of the 150 persons who tested positive, 120 were male and 30 female. This also included nine children aged less than 10. All these persons had been shifted to the designated hospitals for treatment.

He said that since 2,000 persons were tested in the last two days, 150 persons were found positive. Earlier, about 200 to 300 persons were being tested daily and about 10 to 15 used to be found positive. Nearly 10 % of persons coming from Mumbai/Maharashtra tested positive for COVID-19.

“We have 1,120 beds to treat COVID-19 positive cases in the district. Even after including these 150 persons, we still have 800 beds left. Hence, people need not panic. We will provide treatment for all affected persons,” Mr. Jagadeesha said.

With 150 cases on Tuesday, the total number of persons who have tested positive in the district since March has touched 410. There are 345 active cases.

As many as 63 persons who had recovered had been discharged from hospitals. There was one death due to the disease on May 14. The test reports of nearly 5,400 persons are still awaited.

The district had recorded only three COVID-19 cases from March 29 to May 14. But the number of COVID-19 cases started increasing from May 15.