Although children aren't at high risk for COVID-19, there are still a few cases where the virus presents itself to kids, but usually causes a milder infection, the Centers for Disease Control and Protection says.

A new study finds that children suffering from symptoms of the digestive tract, such as diarrhea, vomiting, and fever, should be suspected of having COVID-19. Researchers from China believe that gastrointestinal symptoms initially endured by pediatric patients indicated a potential for the SARS-CoV-2 infection. 

In their research published in the journal Frontiers in Pediatrics, the scientists from Tongji Hospital said that the gastrointestinal symptoms could be appearing because the type of receptors in lung cells directed by the virus could similarly be found in the intestines.

The researchers say that their study is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the initial exhibiting indication in children. The authors added that most children are only mildly affected by COVID-19 and that the few severe cases usually have underlying health issues.

According to Wenbin Li, one of the authors of the study, many health professionals can easily miss diagnosing COVID-19 in children at an early stage, especially in the absence of respiratory symptoms.

Li adds that based on their experience in dealing with pediatric patients of COVID-19, children suffering from gastrointestinal symptoms accompanied by fever and a history of exposure to the disease should be suspected of having the virus. 

In the research, the authors described the clinical features of children admitted with non-respiratory manifestations, were later on diagnosed with pneumonia confirmed by x-ray scans and COVID-19.

Li said how the patients initially came to the emergency department with complaints unrelated to coronavirus such as head trauma or a kidney stone. These children were later on confirmed to have COVID-19, he added.

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Not Always the Lungs Could be the Gut

The scientists said that although the patients' COVID-19 symptoms were mild or relatively hidden to begin with, four out of the five cases had digestive tract manifestations as the first symptom of the disease.

Children's gastrointestinal symptoms, which have also been seen in adult patients, could be an additional route of infection, they added.

Li explained that the digestive symptoms seen in children might be pertinent to the allocation of receptors and the transmission pathway linked with COVID-19 infection in humans.

The study mentioned that since the virus infects people through the ACE2 receptor found in cells both present in the lungs and intestines, COVID-19 might infect patients not only through the respiratory tract through air droplets, but could also reach the digestive tract through fecal-oral or contact transmission. 

While COVID-19 tests can sometimes yield false-positive readings, all the five children assessed in the study were indeed infected with the disease, Li said. Nevertheless, he admitted that more research is needed to be conducted to confirm their findings.

Li is optimistic that doctors will use the findings of his team's study to diagnose and isolate patients with similar symptoms quickly. He says that this may aid in the early treatment of the patients and the reduction of transmission.

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