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COVID-19 & Children: Coronavirus Infection In Kids Does Not Start With A Cough

According to recent reports by WHO, there are 5,306,235 COVID-19 cases around the world, with 340,047 deaths. On a hopeful note, 2,160,159 have recovered. The need to find a vaccine or a possible medicine that could treat the coronavirus is significant.

Researchers and health experts are ardently focused on studying the novel coronavirus, where new findings and understanding help in the better management of the diseases, and also pave way for a possible effective vaccine.

By focusing on the reported symptoms and risk factors, researchers are carrying out symptoms related studies, where factors such as obesity, smoking, diabetes, air pollution etc. have been explored [1]. And one of the most focused topics was how covid-19 affected children.


How Does The Coronavirus Affect Children?

Health experts and scientists have been studying the degree to which the virus affects children compared to adults [2]. There are far fewer cases of the virus reported in children, where most of the kids contracted the infection from someone they lived with. The Sars-Cov-2 virus usually causes a milder infection in children than in adults or older people [3].

In a recent study, it has been found that coronavirus infection in children may not start with a cough, as previously understood, but with diarrhoea [4].

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Children With Non-respiratory Disease Symptoms Suspected Of COVID-19

Up until now, researchers and health experts linked only respiratory symptoms such as coughing to the coronavirus disease in children [5]. A new study published in the Frontiers in Pediatrics pointed out that children suffering from sickness and diarrhoea, with a fever or history of exposure to coronavirus, should be suspected of being infected with COVID-19 [6].

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The study added that the gastrointestinal symptoms reported by some children hint at a potential infection with SARS-CoV-2 through the digestive tract. These symptoms could be a result of the similarities between the cells that are attacked by the coronavirus. That is, the type of receptors in lung cells targeted by the virus can also be found in the intestines [7].

"It is easy to miss its diagnosis in the early stage when a child has non-respiratory symptoms or suffers from another illness....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," added one of the researchers of the study [8].


Four Out Of The Five Cases Had Digestive Tract Symptoms

While the children had mild or relatively hidden COVID-19 symptoms, most of them had digestive problems - which health experts assert that seems like a definitive symptom of the coronavirus disease in children.

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The researchers added that similar gastrointestinal symptoms, which have also been recorded in adult patients look like an additional route of the coronavirus infection. That is, the gastrointestinal problems may reveal a new transmission pathway associated with COVID-19 infection in humans [9].


ACE2 Receptor Is Found In The Lungs And Digestive Tract

The coronavirus affects the human body via the ACE2 receptor (enzyme) [10]. And as certain cells in both the lungs and intestine have it, it can be pointed out that 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 faecal-oral transmission [11].

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More Studies Required

As the study showed the gastrointestinal symptoms with a link to COVID-19 in children alone, more studies are required to understand whether the same happens in adults. The researchers added that though COVID-19 tests can occasionally produce false-positive readings, four out of five children having the same nature of symptoms could indicate that diarrhoea could be the first manifestation.

"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 need further study in more patients," they added [12].