From a high fever to a dry cough, a number of unpleasant symptoms are known to be associated with coronavirus.
Now, a new study has revealed that many children infected with the virus don’t have these symptoms, and instead present with sickness and diarrhoea.
Researchers from Tongji Hospital in Wuhan say the findings suggest that children may be infected through the digestive tract, rather than the respiratory tract.
Dr Wenbin Li, who led the study, said: “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.
“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.”
In the study, the researchers detailed the clinical features of children admitted to hospital with non-respiratory symptoms, who were then found to test positive for coronavirus.
Dr Li explained: “These children were seeking medical advice in the emergency department for unrelated problems, for example, one had a kidney stone, another a head trauma.
“All had pneumonia confirmed by chest CT scan before or soon after admission and then confirmed to have Covid-19.
“While their initial symptoms may have been unrelated, or their Covid-19 symptoms were initially mild or relatively hidden before their admission to hospital, importantly, 4 of the 5 cases had digestive tract symptoms as the first manifestation of this disease."
Based on the results, the researchers suggest that the gastrointestinal tract may be an additional route of infection.
Dr Li added: “The gastro-intestinal symptoms experienced by these children may be related to the distribution of receptors and the transmission pathway associated with COVID-19 infection in humans.
“The virus infects people via the ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines.
“This suggests 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 fecal-oral transmission."
