Despite respiratory problems being the most noticeable symptom of Covid-19, the disease can start with digestive problems in Children, according to the authors of a study.
The research, published in the journal Frontiers in Pediatrics, involved five children aged between two and five from Wuhan, the Chinese city that was the original epicenter of the Covid-19 pandemic. In four of these patients, the disease first manifested with digestive tract symptoms.
The children visited the emergency department of Wuhan Children's Hospital between January 23 and February 20, 2020, for problems unrelated to Covid-19, but later tested positive for the coronavirus at the facility. They had no respiratory symptoms, such as a cough, when they first arrived.
The authors highlighted that as their Covid-19 progressed, four out of the five children had a fever. However, as the children had coexisting problems, it's not clear if the fever was due to those or their coronavirus infection. All of the children had CT chest scans, and showed signs of pneumonia—a complication of Covid-19.
The digestive symptoms the children had suggest the coronavirus not only infects patients through the respiratory tract, as the virus travels on droplets, but also the digestive tract, the authors said. This could happen if a person ingests feces, they said, and could be possible as "children are active and do not pay much attention to hand hygiene."
"Consequently, the likelihood of infection through the digestive tract by contact or fecal–oral transmission is likely to be significantly greater for children than for adults, and gastrointestinal symptoms as the first manifestation might be more common in children," they wrote.
Most of the children who fall seriously ill usually have underlying conditions, the authors said. Usually, kids recover after one to two weeks of their first symptoms showing.
Children may have a less serious form of Covid-19 because their immune systems are immature, the team explained. But as two participants who became severely ill had multiple organ problems, the virus may cause an overreaction of the immune systems, known as a cytokine storm.
Co-author Dr. Wenbin Li, of the Department of Pediatrics at China's Tongji Hospital in Wuhan, said in a statement:
"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."
Li went on: "The gastrointestinal 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."
(Source: Newsweek)
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