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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.

Feb 5: Tesla is making Elon Musk a lot richer without paying him a dime.

A blistering stock rally has bolstered the value of CEO Musk's 19% stake in the electric car maker by $16 billion since the start of 2020, to $30 billion.

Tuesday's steep climb in the share price could sweeten Musk's payday under his record-breaking compensation package, which is built on stock options that rely on market value targets. Two milestones have now been achieved that could see Musk unlock options worth $1.8 billion.

The controversial chief executive, who is also the majority owner and CEO of rocket maker SpaceX, recently testified that he did not have a lot of cash as he successfully defended himself in a defamation lawsuit. He previously has taken loans using his Tesla shares as collateral.

Musk does not take a salary, choosing instead a risky options package that envisions the stock market value of Tesla rising to $650 billion over 10 years, a prospect that was derided by some investors when the deal was announced in 2018.

That target now looks less crazy. Shares of Tesla have rallied over 50% since the company posted its second consecutive quarterly profit last Wednesday, which was viewed as a major accomplishment for a company competing against established automotive heavyweights including General Motors Co  and BMW.

Tesla shares have climbed about 400% since early June, helped by the company's better-than-expected financial results and ramped-up production at its new car factory in Shanghai.

On Tuesday, Tesla surged as much as 24% before falling back in the final minutes of the trading session to end the day up 13.7%. That put its market capitalization at $160 billion, almost twice the combined value of Ford Motor and General Motors.

The shares had also rallied on Monday, partly fueled by Panasonic Corp's 6752.T saying its automotive battery venture with Tesla was profitable for the first time.

The options Musk was awarded in 2018 vest incrementally based on targets for Tesla's stock market value and its financial performance. The market capitalization would have to sustainably rise by $50 billion increments over the agreement's 10-year period, with the full package payout reached if the market cap reaches $650 billion, as well as the company's meeting revenue and profit targets.

Musk is on his way to seeing his first two tranches of options vest. He achieved operational targets on revenue and adjusted earnings last year.

The rise in Tesla's market capitalization last month to a target of $100 billion opened the way for Musk's first tranche of options to vest. With Tuesday's surging share price, the market capitalization blew past the second target of $150 billion, opening the way for the second tranche to vest. Tesla's market capitalization must stay at or above each target level for one- and six-month averages for each set of options to vest.

Tesla was valued at about $52 billion when shareholders approved the pay package in March 2018, a time when the company faced a cash crunch, production delays and increasing competition from rivals.

A full payoff for Musk would surpass anything previously granted to U.S. executives, according to Institutional Shareholder Services, a proxy advisor that recommended investors reject the pay package deal at the time.

Musk currently owns about 34 million Tesla shares, and his compensation package would let him buy another 20.3 million shares if all his options tranches vest.

When Tesla unveiled Musk’s package, it said he could in theory reap as much as $55.8 billion if no new shares were issued. However, Tesla has since awarded stock to employees and last year sold $2.7 billion in shares and convertible bonds, diluting the value of the stock.

Musk has transformed Tesla from a niche car maker with production problems into the global leader in electric vehicles, with U.S. and Chinese factories. So far it has stayed ahead of more established rivals including BMW and Volkswagen.

Many investors remain skeptical that Tesla can consistently deliver profit, cash flow and growth. More Wall Street analysts rate Tesla "sell" than "buy," and the company's stock is the most shorted on Wall Street.

Mumbai, Jun 27: The Bombay High Court observed that COVID-19 patients from poor and indigent sections cannot be expected to produce documentary proof to avail subsidised or free treatment while getting admitted to hospitals.

The court on Friday was hearing a plea filed by seven residents of a slum rehabilitation building in Bandra, who had been charged ₹ 12.5 lakh by K J Somaiya Hospital for COVID-19 treatment between April 11 and April 28.

The bench of Justices Ramesh Dhanuka and Madhav Jamdar directed the hospital to deposit ₹10 lakh in the court.

The petitioners had borrowed money and managed to pay ₹10 lakh out of ₹12.5 lakh that the hospital had demanded, after threatening to halt their discharge if they failed to clear the bill, counsel Vivek Shukla informed the court.

According to the plea, the petitioners were also overcharged for PPE kits and unused services.

On June 13, the court had directed the state charity commissioner to probe if the hospital had reserved 20% beds for poor and indigent patients and provided free or subsidised treatment to them.

Last week, the joint charity commissioner had informed the court that although the hospital had reserved such beds, it had treated only three poor or indigent persons since the lockdown.

It was unfathomable that the hospital that claimed to have reserved 90 beds for poor and indigent patients had treated only three such persons during the pandemic, advocate Shukla said.

He further argued that COVID-19 patients, who are in distress, cannot be expected to produce income certificate and such documents as proof.

However, senior advocate Janak Dwarkadas, who represented the hospital, said the petitioners did not belong to economically weak or indigent categories and had not produced documents to prove the same.

A person who is suffering from a disease like COVID-19 cannot be expected to produce certificates from a tehsildar or social welfare officer before seeking admission in the hospital, the bench noted and asked the hospital to deposit ₹10 lakh in court within two weeks.