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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.

Mumbai, Jun 12: Following an overwhelming response for the mega rights issue of Mukesh Ambani-owned Reliance Industries, the partly paid-up rights shares are set to debut on stock exchanges on June 15.

The biggest ever Rs 53,124 crore rights issue was subscribed 1.59 times and received bids worth Rs 84,000 crore on June 3.

Reliance said the rights issue saw a huge investor interest, including from lakhs of small investors and thousands of institutional investors, both Indian and foreign.

In 2019, Ambani said in the Reliance's annual general meeting that the company will be net zero debt by March 2021. The company is on course to achieve its target ahead of the deadline.

"In spite of the COVID-19 crisis and the lockdowns, the due-diligence by Saudi Aramco for the planned investment in the O2C business is on track as both the parties are committed and actively engaged," he said recently.

"With a strong visibility to these equity infusions, Reliance is set to achieve net zero debt status ahead of its own aggressive timeline. We believe rights issue was a part of the company's strategy of deleveraging its balance sheet," said Ambani. 

New Delhi, Apr 17: The Indian Railways turned 167 years old on Thursday and for the first time ever, its trains did not carry any passengers on its birthday and instead stood idle in the yards waiting for the nationwide lockdown to end.

On this day 167 years ago, the wheels of the first passenger train in the country from Mumbai to Thane started rolling.

In 1974, Indians experienced life without trains for the first time. In May 1974 during the strike of the railways that lasted for around three weeks, drivers, station masters, guards, track staff and many others went on 'chakka jam' demanding fixed working hours for train drivers and an across-the-board pay hike.

"I can recall those times vividly. I remember that our leader George Fernandes had almost secured a deal with the then railway minister, but it fell through when it was taken to the then Prime Minister Indira Gandhi," All India Railwaymens Federation General Secretary Shiv Gopal Mishra, who was an apprentice in the railways at that time, told PTI.

"Fernandes was arrested in Lucknow. The workers went through a lot at that time. But those were days that angry workers had refused to give in and took great risks to get their demands met," he said.

However, just like this time, four decades ago too freight trains carrying essential supplies were run and the unions agreed to let some passenger trains run on the trunk routes like the Kalka Mail from Howrah to Delhi.

"Never ever in its history, there has been such a long interruption of services. Not during the World Wars, not during the 1974 railway strike, or any other national calamity or natural disaster," a railway spokesperson said.

The first Indian Railways passenger train was flagged off on April 16, 1853, from Mumbai to nearby Thane.

On Thursday, the Railway Ministry wished the railways a happy birthday on Twitter - "Today, 167 years ago with the zeal of 'never to stop' the wheels of the first passenger train from Mumbai to Thane started rolling. For the first time, passenger services are stopped for your safety. Stay indoors & make the nation victorious," it said.

Railway has suspended all passenger services since March 25 till May 3 due to the coronavirus outbreak. Around 15,523 trains run by the railways have been affected including 9,000 passenger trains and 3,000 mail express services which are run daily. It caters to over 20 million passengers every day.

According to the Union health ministry, the death toll due to coronavirus rose to 414 and the number of cases to 12,380 in the country on Thursday.