The results of a study by doctors working in the pediatric ward of Tongjiv Wuhan Hospital are published in Frontiers in Pediatrics.
In most children cases of COVID-19 its' course is mild, the authors write, and infrequent difficult cases are usually associated with the presence of chronic diseases. Coronavirus infection, however, is dangerous because it is easy to miss at an early stage, when the child has no respiratory symptoms.
Describing the features of COVID-19 in children who were admitted to the hospital and were subsequently diagnosed with pneumonia caused by COVID-19, Chinese doctors pay attention to a symptom such as gastrointestinal upset. Children suffering from weakness and diarrhea in combination with fever, who have a history of contact with the carrier of the coronavirus, should be suspected of becoming infected with COVID-19, the authors of the study say.
According to their statistics, in 4 out of 5 of their patients, it was the symptoms of the digestive tract that were the first manifestation of the disease that turned into pneumonia, although initially the disease was mild. The authors of the study suggest that gastrointestinal symptoms mean the possibility of infection through the digestive tract.
The virus is known to penetrate human cells through the ACE2 receptor, which can be found in the lungs as well as in the intestines. Probably, COVID-19 can be infected not only through the respiratory tract, when drops with the virus penetrate into them, but also through the digestive tract through contact or fecal-oral transmission.
It is worth noting the quantitative limitations of the study: Chinese researchers describe only five cases of children with COVID-19, whose first symptoms at admission to the hospital were not respiratory, but gastrointestinal manifestations.