Coronavirus infection in children might not begin with a cough. Children suffering from diarrhea and sickness alongside a fever or history of exposure to the novel coronavirus should be suspected of being infected with COVID-19, according to a new study.

The researchers suggested that the gastrointestinal symptoms exhibited by some children might hint at potential infection via the digestive tract since the receptors in the lung cells target by the coronavirus could also be present in the intestines.

"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," the study’s lead author Dr. Wenbin Li, who works at the Department of Pediatrics, Tongji Hospital, Wuhan, China told MedicalXpress.

“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,” he added.

Key findings of the study:

  • All the children who were a part of this study had pneumonia confirmed by chest CT scan soon after admission.
  • Their COVID-19 symptoms were initially mild or relatively hidden before their admission to hospitals.
  • Importantly, 4 out of 5 cases had digestive tract symptoms as the first COVID-19 manifestation.
  • This information can be used to quickly diagnose and isolate pediatric patients with similar symptoms and choose early treatment options and reduce transmission.
  • Gastrointestinal symptoms have also been recorded in adult patients.
  • This is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the first manifestation in children.

Why does COVID-19 cause gastrointestinal symptoms?

These symptoms might be associated with the distribution of receptors and the transmission pathway associated with the coronavirus infection in human beings. Also, the coronavirus infects individuals via the ACE2 receptor- which can be found in the lung cells as well as that of the intestines. This might also explain that COVID-19 might infect people not only via the respiratory tract in the form of air droplets but also through the digestive tract by contact or possibly a fecal-oral transmission.

coronavirus symptoms suffered by children may sometimes be different from that of adults
coronavirus symptoms suffered by children may sometimes be different from that of adults Sharon McCutcheon - Unsplash