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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.

The Brazilian government said that the Amazon rainforest witnessed deforestation of a record 829 sq km in May, the highest monthly level since 2015.

On Friday, the National Institute for Space Research (INPE) said that deforestation in the Amazon increased by 91 sq km compared to the same period last year, reports Xinhua news agency.

Between January and April, destruction of the forest by illegal loggers and ranchers rose 55 per cent, or a total of 1,202 sq km was wiped out, it said.

The Real-time Deforestation Detection system, a federal project created to monitor human activity in the Amazon, alerted authorities to the increase in the rate of destruction of the rainforest.

A recent study by the Amazon Environmental Research Institute (IPAM) warned that deforestation in 2020 could reach 11,900 sq km if the pace of May, June, and July follows the historical average.

Deforestation in the region has soared since President Jair Bolsonaro took office last year, according to conservation groups.

He has argued that more farming and mining in protected areas of the forest were the only way to lift the region out of poverty.

Bolsonaro's environmental policies have been widely condemned but he has rejected the criticism, saying Brazil remains an example for conservation.

Google on Monday announced it is gradually winding down its free public Wi-Fi Station programme currently available at over 400 railway stations in India, and will work with the Indian Railways and Railtel Corporation to help them with existing sites so they can remain useful resources for people.

Google launched its Station initiative in India in 2015 to bring fast, free public Wi-Fi to over 400 of the busiest railway stations in the country by mid-2020.

"We crossed that number by June 2018 and implemented Station in thousands of other locations around the country in partnership with telecommunications companies, ISPs and local authorities," Caesar Sengupta, Vice President, Payments and Next Billion Users, Google, said in a statement.

"Over time, partners in other countries asked for Station too and we responded accordingly. We're grateful for these partnerships, especially with the Indian Railways and the Government of India, that helped us serve millions of users over the last few years," he added.

According to Google, the decision to shut Station has been taken keeping the affordable mobile data plans and mobile connectivity in mind that is improving globally including in India.

"India, specifically now has among the cheapest mobile data per GB in the world, with mobile data prices having reduced by 95 per cent in the last 5 years, as per TRAI in 2019," said Sengupta.

The Indian users consume close to 10GB of data, each month, on average, according to reports.

"Our commitment to supporting the next billion users remains stronger than ever, from continuing our efforts to make the internet work for more people and building more relevant and helpful apps and services," Sengupta noted.

Global networking giant Cisco last year teamed up with Google to roll out free, high-speed public Wi-Fi access globally, starting with India.

The first pilot under the partnership was rolled out at 35 locations in Bengaluru.

Sengupta said that in addition to the changed context, the challenge of varying technical requirements and infrastructure among our partners across countries has also made it difficult for Station to scale and be sustainable, especially for our partners.

"And when we evaluate where we can truly make an impact in the future, we see greater need and bigger opportunities in building products and features tailored to work better for the next billion user markets," he said.