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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, Mar 27: India should take a cue from the UK and Italy and allow final year medical students to skip exam and bring them into the hospital system immediately to fight the war against COVID-19, noted cardiac surgeon Devi Prasad Shetty on Friday said.

The Chairman and Founder of the city-based Narayana Health said there should be some reforms in medical education like the UK and Italy.
In the UK, he noted, final year medical students have been told that they don't need to appear for the exam, and they will be given pass based on the past performance and they can get into the hospital system to fill the shortage.

Italy got 10,000 more doctors following the move to cut short the duration of MBBS by nine months, according to him.

COVID-19 battle can be only won by young doctors and young nurses. Its like a war, Shetty told PTI.

He said: Senior doctorsnone of them will be able to touch the patients because they are past the age of 50. A person who is past the age of 50 is very vulnerable himself.

This is a very contagious disease. "But we dont have that many battalion (of doctors). We need one and half lakh doctors to manage all these government
hospitals and private hospitals (to fight COVID-19)", he added.

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Mangaluru, May 9: A team of doctors at Mangaluru's Mangala Hospital has developed a 'bubble helmet' that will provide an alternative to patients who need an oxygen mask.

The team was led by Dr Ganapathi, medical director of Mangala Hospital and Mangala Kidney Foundation in the city.

The bubble helmet, which has a special collar attached to it, helps the patients with breathing issues, and to avoid using ventilator facility.

Dr Ganapathi said, "When a patient needs intubation we will be providing them oxygen bubble helmets and we will first give it a trial before we intubate a patient."

"I have converted an ordinary snorkelling mask into a ventilator assist device, this mask can be used as a personal protection device by connecting it to a bacterial viral filter," he added.

Dr Ganapathi said that the connector has been made available in India and a snorkelling mask can be easily converted into a ventilator assist device. And it will make the management of coronavirus patients easy.