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Los Angeles, Apr 28: People who experience loss of smell as one of the COVID-19 symptoms are likely to have a mild to moderate clinical course of the disease, according to a study which may help health care providers determine which patients require hospitalisation.

The findings, published in the journal International Forum of Allergy & Rhinology, follows an earlier study that validated the loss of smell and taste as indicators of infection with the novel coronavirus, SARS-CoV-2.

According to the scientists from the University of California (UC) San Diego Health in the US, patients who reported loss of smell were 10 times less likely to be hospitalised for COVID-19 compared to those without the symptom.

"One of the immediate challenges for health care providers is to determine how to best treat persons infected by the novel coronavirus," said Carol Yan, first author of the current study and rhinologist from the UC San Diego Health.

"If they display no or mild symptoms, can they return home to self-quarantine or will they likely require hospitalisation? These are crucial questions for hospitals trying to efficiently and effectively allocate finite medical resources," Yan said.

The findings, according to the researchers, suggest that loss of smell may be predictive of a milder clinical course of COVID-19.

"What's notable in the new findings is that it appears that loss of smell may be a predictor that a SARS-CoV-2 infection will not be as severe, and less likely to require hospitalisation," Yan said.

"If an infected person loses that sense, it seems more likely they will experience milder symptoms, barring other underlying risk factors," she added.

Risk factors for COVID-19 previously reported by other studies include age, and underlying medical conditions, such as chronic lung disease, serious heart conditions, diabetes, and obesity.

In the current study, the scientists made a retrospective analysis between March 3 and April 8 including 169 patients who tested positive for COVID-19 at UC San Diego Health.

They assessed olfactory and gustatory data for 128 of the 169 patients, 26 of whom required hospitalisation.

According to the researchers, patients who were hospitalised for COVID-19 treatment were significantly less likely to report anosmia or loss of smell -- 26.9 per cent compared to 66.7 per cent for COVID-19-infected persons treated as outpatients.

Similar percentages were found for loss of taste, known as dysgeusia, they said.

"Patients who reported loss of smell were 10 times less likely to be admitted for COVID-19 compared to those without loss of smell," said study co-author Adam S. DeConde.

"Moreover, anosmia was not associated with any other measures typically related to the decision to admit, suggesting that it's truly an independent factor and may serve as a marker for milder manifestations of Covid-19," DeConde said.

The researchers suspect that the findings hint at some of the physiological characteristics of the infection.

"The site and dosage of the initial viral burden, along with the effectiveness of the host immune response, are all potentially important variables in determining the spread of the virus within a person and, ultimately, the clinical course of the infection," DeConde said.

If the SARS-CoV-2 virus initially concentrates in the nose and upper airway, where it impacts olfactory function, that may result in an infection that is less severe and sudden in onset, decreasing the risk of overwhelming the host immune response, respiratory failure, and hospitalisation, the scientists added.

"This is a hypothesis, but it's also similar to the concept underlying live vaccinations," DeConde explained.

"At low dosage and at a distant site of inoculation, the host can generate an immune response without severe infection," he added.

Loss of smell, according to the study, might also indicate a robust immune response which has been localised to the nasal passages, limiting effects elsewhere in the body.

Citing the limitations of the study, the scientists said they relied upon self-reporting of anosmia from participants, which posed a greater chance of recall bias among patients once they had been diagnosed with COVID-19.

They added that patients with more severe respiratory disease requiring hospitalisation may not be as likely to recognise or recall the loss of smell.

So the researchers said more expansive studies are needed for validating the results.

New Delhi, Jun 18: Vodafone Idea on Thursday told the Supreme Court that it has incurred Rs 1 lakh crore losses as it insisted it is not in a position to furnish bank guarantees.

A bench comprising Justices Arun Mishra, S. Abdul Nazeer, and M.R. Shah, taking up the adjusted gross revenue (AGR) matter through video conferencing, directed the telecom companies to submit their financial documents and books for the last 10 years.

Asking Vodafone if it was a foreign company, the bench said that how can the company say it would not furnish any bank guarantee.

"What if you fly away overnight in future without paying anything?" it asked.

Senior advocate Mukul Rohatgi, representing Vodafone Idea, denied his client is a completely foreign firm and cited before the bench its tie-ups and investments.

Vodafone owes over Rs 58,000 crore as AGR dues and so far, has paid close to Rs 7,000 crore.

Rohatgi contended before the court that the telecom company is in a tough situation, and cannot furnish any fresh bank guarantee, as profits have eluded the company in past many quarters. He submitted before the bench that Rs 15,000 crore bank guarantees are lying with the government, and his client's losses are over Rs 1 lakh crore.

"I cannot offer any more surety," he informed the bench.

Justice Mishra noted that this is public money and these dues should be recovered. "Do not tell us that you will pay if you were to make profits... the money must come," he noted.

Justice Shah observed that the telecom industry is the only industry which earned during the Covid-19 pandemic. "After all, this money will be used for public welfare", he said.

Rohatgi argued that his client would have to fold up if orders were issued to clear dues tomorrow. "11,000 employees will have to go without notice, as we cannot pay them," he added.

Senior advocate Abhishek Manu Singhvi, appearing for Bharti Airtel, contended before the court that out of Rs 21,000 crore AGR dues, the company has already deposited a sum of Rs 18,000 crore.

He argued that his client has given a bank guarantee, in excess of demand, to DoT, and supported the proposal for phased repayment of remaining AGR dues. He insisted that the company needs to sit down with the government and calculate the dues. Airtel owes Rs 25,976 crore after paying Rs 18,000 crore, as per the government.

Senior advocate Arvind Datar, representing Tata Telecom, informed the bench that his client has paid Rs 6,504 crore in AGR dues so far, and furnishing a bank guarantee may adversely impact investments in the sector.

The total AGR dues are close to Rs 1.5 lakh crore.

The top court will now take up the matter in the third week of July.

In the wake of the gas leak at a factory in Visakhapatnam, the National Disaster Management Authority (NDMA) has issued detailed guidelines for restarting industries after the lockdown and the precautions to be taken for the safety of the plants as well as the workers.

In a communication to all states and union territories, the NDMA said due to several weeks of lockdown and the closure of industrial units, it is possible that some of the operators might not have followed the established standard operating procedures.

As a result, some of the manufacturing facilities, pipelines, valves may have residual chemicals, which may pose risk. The same is true for the storage facilities with hazardous chemicals and flammable materials, it said.

The NDMA guidelines said while restarting a unit, the first week should be considered as the trial or test run period after ensuring all safety protocols.

Companies should not try to achieve high production targets. There should be 24-hour sanitisation of the factory premises, it said.

The factories need to maintain a sanitisation routine every two-three hours especially in the common areas that include lunch rooms and common tables which will have to be wiped clean with disinfectants after every single use, it added.

For accommodation, the NDMA said, sanitisation needs to be performed regularly to ensure worker safety and reduce the spread of contamination.

To minimise the risk, it is important that employees who work on specific equipment are sensitised and made aware of the need to identify abnormalities like strange sounds or smell, exposed wires, vibrations, leaks, smoke, abnormal wobbling, irregular grinding or other potentially hazardous signs which indicate the need for immediate maintenance or if required shutdown, it said.

At least 11 people lost their lives and about 1,000 others were exposed to a gas leak at a factory in Andhra Pradesh''s Visakhapatnam on May 7.

The incident took place after it restarted operations when the government allowed industrial activities in certain sectors following several weeks of lockdown.

The lockdown was first announced by Prime Minister Narendra Modi on March 24 for 21 days in a bid to combat the coronavirus threat. The lockdown was then extended till May 3 and again till May 17.