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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.

US dictionary Merriam-Webster will update the meaning of the word "racism" after being contacted by a Missouri black woman, who claimed the current definition fell short of including the systematic oppression of people of colour, according to media reports.

"A revision to the entry for racism is now being drafted to be added to the dictionary soon, and we are also planning to revise the entries of other words that are related to racism or have racial connotations," according to a statement of the 189-year-old dictionary shared by Kennedy Mitchum, a recent graduate of Drake University in Iowa, on her Facebook.

Mitchum, 22, emailed the dictionary last month, following the death of African American George Floyd in the custody of four Minneapolis police officers, Xinhua news agency reported.

"I kept having to tell them that definition is not representative of what is actually happening in the world," Mitchum told CNN. "The way that racism occurs in real life is not just prejudice, it's the systemic racism that is happening for a lot of black Americans."

Merriam-Webster's first definition of racism is "a belief that race is the primary determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race."

"It's not just disliking someone because of their race," Mitchum wrote in a Facebook post on Friday. "This current fight we are in is evidence of that, lives are at stake because of the systems of oppression that go hand-in-hand with racism."

The US space agency has thrown open a challenge to win over Rs 26 lakh, calling the global community to send novel design concepts for compact toilets that can operate in both microgravity and lunar gravity.

NASA is preparing for return to the Moon and innumerable activities to equip, shelter, and otherwise support future astronauts are underway.

The astronauts will be eating and drinking, and subsequently urinating and defecating in microgravity and lunar gravity.

NASA said that while astronauts are in the cabin and out of their spacesuits, they will need a toilet that has all the same capabilities as ones here on Earth.

The public designs for space toilet may be adapted for use in the Artemis lunar landers that take humans back to the Moon.

"Although space toilets already exist and are in use (at the International Space Station, for example), they are designed for microgravity only," the US space agency said in a statement.

NASA's Human Landing System Programme is looking for a next-generation device that is smaller, more efficient, and capable of working in both microgravity and lunar gravity.

The new NASA challenge includes a Technical category and Junior category and the last date to send designs is August 17.

NASA's Artemis Moon mission will land the first woman and next man on the lunar surface by 2024.

The Artemis programme is part of America's broader Moon to Mars exploration approach, in which astronauts will explore the Moon and experience gained there to enable humanity's next giant leap, sending humans to Mars.