Coronavirus infection in children may not start with a cough: researchers

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Coronavirus infection in children may not start with a cough, researchers warn in a new study.

The small study, which is published in the journal Frontiers in Pediatrics, says that gastrointestinal symptoms, as well as a fever and exposure to coronavirus, could indicate COVID-19 infection in children.

“Children suffering from sickness and diarrhea, coupled with a fever or history of exposure to coronavirus, should be suspected of being infected with COVID-19,” the researchers said in a statement.

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The research is based on five children with non-respiratory symptoms who were hospitalized at the Wuhan Children’s Hospital in China between Jan. 23 and Feb. 20, 2020. All of the children, whose ages ranged from 2 months to 5.6 years, were later confirmed to have pneumonia and 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,” said the study’s author Dr. Wenbin Li, who works at the Tongji Hospital in Wuhan, in the statement. “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."

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“The virus infects people via the ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines,” Li explained. “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."

Li says that more research is needed to confirm the findings.

"We report five cases of COVID-19 in children showing non-respiratory symptoms as the first manifestation after admission to hospital,” he said, in the statement. “The incidence and clinical features of similar cases needs further study in more patients."

The coronavirus is widely believed to have first emerged in December in the Chinese city of Wuhan. While scientists have not yet worked out how exactly how the novel coronavirus first infected people, there is evidence that it originated in bats, which spread to another animal, possibly a pangolin, at a “wet market” in Wuhan.

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In addition to selling fresh meat, fish and produce, wet markets typically sell an array of exotic animals and pangolins have already been eyed as a possible host.

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As of Wednesday morning, more than 4.27 million coronavirus cases have been diagnosed worldwide, at least 1,370,016 of which are in the U.S., according to data compiled by Johns Hopkins University. The disease has accounted for at least 292,316 deaths around the world, including at least 82,389 people in the U.S.

Fox News’ Greg Norman and the Associated Press contributed to this article. Follow James Rogers on Twitter @jamesjrogers