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A teacher in a protective mask teaches children in her classroom at Champ l’Eveque public school in Bruz, western France, on May 12, 2020, after France eased the blockade measures taken to curb the spread of the COVID-19 pandemic, caused by the new coronavirus.
Image credit: AFP
Beijing: Gastrointestinal symptoms such as diarrhea, along with fever or a history of exposure to COVID-19, could indicate coronavirus infection in children, according to a new study.
Published in Frontiers in Pediatrics, the research also suggests that the gastrointestinal symptoms first experienced by some children suggest a possible infection through the digestive tract, as the type of receptors in the lung cells attacked by the virus also can be found in the intestines
“Most children are mildly affected by COVID-19, and the few severe cases often have underlying health problems. It’s easy to miss an early diagnosis when a child has non-respiratory symptoms or another illness, “said study author Dr. Wenbin Li of Tongji Hospital in Wuhan, China.
“According to our experience in the treatment of 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. “he continued.
In this study, the research team details the clinical characteristics of the children admitted to the hospital with non-respiratory symptoms, who were subsequently diagnosed with pneumonia and COVID-19.
“These children were seeking medical advice from the emergency department for unrelated problems, for example, one had a kidney stone and the other a trauma to the head,” the researchers said.
Symptoms of the digestive tract
They all had pneumonia confirmed by computed tomography of the chest before or shortly after admission, and then it was confirmed that they had COVID-19. Although their initial symptoms may be unrelated, or their COVID-19 symptoms were initially mild or relatively hidden prior to hospital admission, the important point is that four of the five cases had symptoms of the digestive tract as the first manifestation of this disease.
The researchers also link children’s gastrointestinal symptoms, which have been reported in adult patients, with a possible additional route of infection.
“The gastrointestinal symptoms experienced by these children may be related to the distribution of receptors and the transmission path associated with COVID-19 infection in humans. The virus infects people through the ACE2 receptor, which can be found in certain cells in the lungs and intestines, “said Li.
This suggests that COVID-19 could infect patients not only through the respiratory tract in the form of air drops but also through the digestive tract by contact or fecal-oral transmission.
“We report five cases of COVID-19 in children who show non-respiratory symptoms as the first manifestation after hospital admission. The incidence and clinical characteristics of similar cases need more study in more patients, “the researchers noted.
By highlighting these cases, the researchers hope that doctors will use this information to quickly diagnose and isolate patients with similar symptoms, which will help early treatment and reduce transmission.
In March, another study from China, published in The American Journal of Gastroenterology, found that diarrhea was a prominent symptom among up to half of COVID-19 patients in Wuhan.
