The first symptoms of coronavirus in children may not manifest as a cough. Fever and gastrointestinal symptoms, on the other hand, could warn of COVID-19 infection in children.
A study of recently published in the journal Frontiers in Pediatrics and focused on the manifestation of the symptoms of the disease caused by SARS-CoV-2 in infants, recommends assuming that children present discomfort along with gastrointestinal symptoms like diarrhea and fever. COVID-19 could infect them.
The study entitled Clinical characteristics of 5 COVID-19 cases with non-respiratory symptoms as the first manifestation in children, similarly suggests that these gastrointestinal symptoms could be an indicator that the transmission route of COVID-19 might not be solely respiratory, with the possibility of contracting the disease through the digestive tract.
This is because the type of receptors in the lung cells that the virus targets can also be found in the intestines.
The COVID-19 transmission route may not be solely respiratory, according to new research.
There should be no reason for fear-mongering, as most children are mildly affected by Coronavirus (COVID-19), and then some severe cases often have underlying health problems.
“However, it is simple to miss the diagnosis of COVID-19 in its early stage, when a child does not have respiratory symptoms or suffer from another disease,” explains the doctor from the Pediatrics Department at Tongji Hospital in China (Wuhan), Wenbin Li, lead author of the study.
1. Symptomatology in children
“According to our experience in the treatment of COVID-19 in regions where this virus is epidemic, it should be suspected that children suffering from symptoms of the digestive tract, especially with fever, and especially if they have a history of exposure to the disease, they are infected with the coronavirus, “continues Li.
In their study, the doctor and his colleagues detailed the clinical characteristics of the children admitted to the hospital with non-respiratory symptoms but who were subsequently diagnosed with pneumonia and COVID-19.
“These children sought emergency medical advice for unrelated problems: for example, one had a kidney stone and the other a trauma to the head.
However, pneumonia was confirmed by chest computed tomography before or shortly after admission. They later confirmed that they had COVID-19.
“Although the initial symptoms may not be related; or the symptoms of COVID-19 were initially mild or remained relatively hidden before admission to the hospital, the critical thing is that 4 of the 5 cases studied presented symptoms of the digestive tract such as the first manifestation of the disease, “explains the doctor.
By highlighting the cases, Li hopes that doctors will use this information to quickly diagnose and isolate patients with similar symptoms, which will help early treatment and reduce transmission.
2. A possible new route of infection
The researchers link children’s gastrointestinal symptoms, which have also been reported in adult patients, with a possible additional route of infection.
Li explains that: “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 individual cells of the lungs and intestines. This suggests that COVID-19 could affect patients through the respiratory tract and the digestive tract by contact or fecal-oral transmission. ”
While COVID-19 screening tests can occasionally produce false-positive readings, Li is sure that these five children were infected with the disease, but he warns that more research is needed to confirm his findings.
“We report 5 cases of COVID-19 in children who show non-respiratory symptoms as the first manifestation after hospital admission. However, the incidence and clinical characteristics of similar cases require further study in more patients,” concludes the doctor.
