Cough may not be key symptom of coronavirus infection in children

Coronavirus in children has been a bit of a mystery since the start of the outbreak. While initial research suggested that children are not as susceptible to severe Covid-19 as adults and those with co-morbidities, further studies indicated that children may be hit harder by Covid-19 than initially thought.

Because of guidelines telling us to look out for mainly three symptoms (a dry cough, fever and breathlessness), we might be missing Covid-19 in children, according to a new study published in Frontiers in Pediatrics.

Digestive symptoms in children can be a sign of coronavirus

The study suggests that gastrointestinal symptoms such as diarrhoea and an upset stomach might be the first hints of coronavirus infection, as SARS-CoV-2 doesn’t only attack cells in the lungs, but also cells in the digestive system.

Dr Wenbin Li from the Department of Pediatrics at the Tongji Hospital in Wuhan, China, explains this connection between the stomach and coronavirus: "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 faecal-oral transmission."

While Covid-19 is mostly a respiratory disease, the full scope of the disease is not yet fully understood and we may miss other symptoms.

"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," Dr Li said in a statement.

He also stated that children with unexplainable digestive ailments paired with a fever and/or a history of exposure to the virus could possibly have Covid-19.

What the study entailed

For this research, Li investigated the clinical details of children admitted to hospital without any respiratory symptoms but subsequently testing positive for Covid-19.

"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 as having Covid-19. While their initial symptoms may have been unrelated, or their Covid-19 symptoms initially mild or relatively hidden before their admission to hospital, importantly, four of the five cases had digestive tract symptoms as the first manifestation of this disease," he said

Quicker diagnosis, isolation

Li stated that the purpose of this study is for doctors to be aware that children may be infected with Covid-19, even though it’s not suspected and the child might not display respiratory symptoms.

Not only will this ensure quicker treatment for the child, but parents will also know that they need to isolate their child to reduce the risk of the virus spreading.

Image credit: iStock

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