A persistent cough is a typical symptom of coronavirus in adults. But in children, the cough might not be the first symptom of coronavirus. The new study published in Frontiers in Pediatrics suggests that children with diarrhea and fever should be suspected and tested for coronavirus. It doesn’t matter if they have a traveling or contact history or not.
This new study focuses more on gastrointestinal symptoms more than cough or flu in children. It is quite unlikely because, in adult patients of coronavirus, cough is the foremost and most important symptom of coronavirus. But in children, the intestines are probably the first to be hit by the virus. It suggests that these kids might have gone this infection through the digestive tract and hence the virus doesn’t make to the lungs but to intestines.
Dr. Wenbin Li, from the Department of Pediatrics, Tongji Hospital, Wuhan, China is the first author of this study. He says; “Most children are only mildly affected by COVID-19 and the few severe cases often have underlying health issues. It is easy to miss its diagnosis in the early stage when a child has non-respiratory symptoms or suffers from another illness.”
He further adds that “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.”
The data included in this study was obtained through the children reported to the hospitals and hospitalized for non-respiratory illnesses but later on, they were diagnosed with pneumonia and coronavirus infection both.
Dr. Li confirms that all these children came to the emergency department of the hospital with irrelevant and unrelated coronavirus symptoms. It looked like they are suffering from some other problem and not the coronavirus.
One of the kids reported pain in the kidney caused by a stone, another one had a head injury. But all tests for pneumonia along with chest CT scan either before or after hospitalization confirmed that they are having coronavirus infection.
It shows that their initial symptoms for which they sought medical assistance had no relation with the typical symptoms of coronavirus. There are chances that this infection was mild, hidden, or not dominant at that time, and during the hospitalization period, it showed up more clearly. Also, 4 of the 5 cases among these kids reported weird digestive tract symptoms which somehow became the first manifestation of coronavirus.
Li has highlighted these cases and reported that coronavirus symptoms in children might not be the same as that in adult patients. This information is helpful for the doctors and on the basis of it, they can quickly identify and confirm coronavirus in young kids and start treatment immediately.
A timely diagnosis is necessary to control the transmission of this disease. However, the research evidence on children transmitting coronavirus to adult people is inconclusive. But in any case, the standard preventive measures should be followed whether it is a child patient or an adult patient of coronavirus.
The researchers are also considering the new gastrointestinal signs as a new way by which this virus might show up in other patients as well. These gastro symptoms indicate a new potential route of viral entry and pathogenesis, hence it can’t be ignored.
Li says that these new symptoms of coronavirus in children might be somewhere related to the ACE2 receptors that aid in coronavirus pathogenesis. These receptors are found inside the lungs but they could also be present in intestines, suggesting how the virus made to the intestines.
Overall this study suggests that coronavirus infection might not only be transmitted through the respiratory pipe but also through the GI tract through contact. It also adds the possibility of fecal-oral transmission of the virus.