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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, Feb 10: Former finance minister P Chidambaram on Monday tore into the Modi government's handling of the economy, saying it was close to collapse and was been attended by "very incompetent doctors."

Initiating the debate on the Union Budget for 2020-21, he said rising unemployment and falling consumption was making India poorer.

The economy, he said, is facing demand constraints and is investment starved. The economy is facing fall in consumption and rising unemployment.

"Fear and uncertainty prevails in the country," he added.

He said the chief economic advisor to the BJP government for four years, Arvind Subramanian has stated that the economy is in the ICU. But "I would say the patient has been kept out of ICU and incompetent doctors are looking at the patient," Chidambaram said.

"It is dangerous to have a patient out of ICU and being looked upon by incompetent doctors. What is the point standing around and chanting slogan 'Sab ka saath, sab ka vishwas'," he said, adding every competent doctor the Modi government could ever identify has left the country.

His said a list of such people included former RBI governor Raghurman Rajan, former CEA Arvind Subramanian, former RBI governor Urjit Patel and former NITI Aayog vice chairman Arvind Panagariya.

"Who are your doctors, I want to know," he said, adding the government considers Congress as untouchable and doesn't think of any good about the rest of the opposition and so doesn't consult them.

Chidambaram charged that instead of putting money in the hands of people, the Modi government "put money in hands of 200 corporates" by way of corporate tax.

He said Finance Minister Nirmala Sitharaman in her 160- minute budget speech did not talk of the economy and its management.

"You are living in echo chambers. You want to hear your own voice," he said.

Listing problems with the Modi government, Chidambaram said it refuses to admits in mistakes, lives in denial and has predispositions.

The demonetisation of old 1000 and 500 rupee notes, as well as the hurried implementation of the Goods and Services Tax (GST), are "monumental blunders" that ruined the economy, he said, adding the Modi regime is predisposed to protectionism, a 'strong' rupee and is against bilateral and multilateral agreements.

"It is living in denial," he said, adding the economic growth has fallen for hereto unseen six consecutive quarters.

He wondered on the narrative Finance Minister Nirmala Sitharaman was trying to give after reading out a 160-minute budget speech with few pages left unread.

Her budget neither made any reference to the Economic Survey nor picked up a single idea from it, he said.

Chidambaram, who is credited with presenting a 'dream budget' more than two decades back, said the GDP growth has declined for six consecutive quarters, agriculture is growing by just 2 per cent, while consumer price inflation has risen from 1.9 per cent in January 2019 to 7.4 per cent in a matter of 11 months.

Also, food inflation is at 12.2 per cent. Bank credit is growing 8 per cent with non-food credit rising by 7-8 per cent and credit to industry by just 2.7 per cent. Credit to agriculture has declined from 18.3 per cent to 5.3 per cent and that for MSMEs from 6.7 per cent to 1.6 per cent.

Overall industrial index showed just 0.6 per cent growth. "Every major industry is either near zero or in negative zone," he said, adding thermal power plants are operating at just 55 per cent of the capacity as factories have either closed or are on the verge of closure.

"That gives you a good picture of the state of economy. You don't require MRI," he said. "You are in management for six years. How long can you blame previous managers."

He charged the government with burying unfavourable reports such as the labour survey that put unemployment at 45 -year high of 6.1 per cent at end of 2017-18. Also, consumer expenditure has falling to 3.7 per cent between 2011-12 and 2017-18.

Drilling holes in Budget numbers, he said the 2019-20 budget projected a nominal GDP growth of 12 per cent but ended with just 8.5 per cent. Fiscal deficit was targeted to be shrunk to 3.3 per cent of the GDP but ended by at 3.8 per cent and in the next fiscal it is being targeted at 3.5 per cent.

Revenue deficit was targeted at 2.3 per cent in fiscal ending March 31, 2020 but ended up at 2.4 per cent and in the next it will rise to 2.8 per cent, he said, adding capital expenditure in the next fiscal will shrink to 0.7 per cent from 1.4 per cent in the current.

Net tax revenue in the current fiscal was targeted at Rs 16.49 lakh crore but only Rs 9 lakh crore was collected in first nine months till December 2019 and "you want us to believe this will rise to Rs 15 lakh crore by March 2020," he said.

Similarly, expenditure in 2019-20 was pegged at Rs 27.86 lakh crore but only Rs 11.78 lakh crore spent during April- December and by March this is projected to rise to Rs 27 lakh crore.

"You have no money to spend... and these are masked by numbers," he said. "Numbers are not easily acceptable or believable."

Chidambaram said the government is facing shortfall in all forms of taxes - Rs 1.56 lakh crore on corporate tax, Rs 10,000 crore on personal income tax, Rs 30,000 crore on customs, Rs 52,000 crore on excise and Rs 51,000 crore on GST.

This despite "the extraordinary powers" and "all kinds of power" given to lower level tax officials, he said.

He read of list of heads under which allocation has fallen - food subsidy, agriculture, PM-Kisan, rural roads, mid-day meal scheme, ICDS, skill development, Ayushman Bharat, rural development and MGNEGA.

New Delhi, Jul 1: 18,653 COVID-19 cases have been reported in India in the last 24 hours, taking the country's tally of coronavirus cases to 5,85,493, informed the Union Health and Family Welfare Ministry on Wednesday.

As per the Ministry, there are presently 2,20,114 active cases in the country. The number of patients cured/discharged and migrated stands at 3,47,979.

507 deaths due to COVID-19 were reported in the last 24 hours taking the total deaths due to the virus to 17,400.

According to the ministry, Maharashtra is the worst-affected state by the virus with 1,74,761 cases including 7,855 fatalities.

Tamil Nadu is the second worst-hit state with 90,167 cases including 1,201 deaths. Meanwhile, Delhi has a total of 87,360 cases.

The Indian Council of Medical Research said that a total number of 86,26,585 tested up to June 30 of which 2,17,931 samples were tested on Tuesday.