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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, Jun 29: Witnessing azure skies and breathable air for the last three months, Delhi on Monday recorded deterioration in its air quality, with particulate matter with diameter of 2.5 and 10 microns -- too small to be filtered out of the human body -- standing at 52 and 297 micrograms per cubic respectively.

Gufran Beig, Project Director of System of Air Quality Weather Forecasting and Research (SAFAR), said that the sudden spike in air pollution is due to a mild dust storm blowing from Rajasthan.

"Since the wind direction is changing and moist air is coming in, the air quality in Delhi will become better by tomorrow," Beig told IANS.

Central Pollution Control Board (CPCB) data showed that the overall air quality near Delhi Technical University (DTU) area stood at 326 micrograms per cubic, followed by 308 at Narela and 307 at Mundka.

Out of 36 stations, the AQI in as many as 30 stations was above 200 micrograms per cubic till 1 pm on Monday.

The System of Air Quality Weather Forecasting and Research categorises air quality in the 0-50 range as good, 51-100 as satisfactory, 101-200 as moderate, 201-300 as poor, 301-400 as very poor, and above 400 as severe.

According to SAFAR's website, "PM 10 (coarser dust particle) is the lead pollutant. AQI is likely to improve to moderate category by tomorrow, and further improvement is expected by July 1."

Researchers indicated that PM 10 and PM 2.5 will be 170 and 47 micrograms per cubic on Tuesday.

With no vehicles plying on the roads or industries shut due to the lockdown since March 25, Delhi's air quality had improved drastically.

According to a study conducted by the Indian Institute of Technology (IIT), Delhi, if the low levels of air pollution reached during the lockdown period are maintained, India's annual death toll could reduce by 6.5 lakh.

Toronto, May 7: Scientists have uncovered how bats can carry the MERS coronavirus without getting sick, shedding light on what triggers coronaviruses, including the one behind the COVID-19 pandemic, to jump to humans.

According to the study, published in the journal Scientific Reports, coronaviruses like the Middle East respiratory syndrome (MERS) virus, and the COVID19-causing SARS-CoV-2 virus, are thought to have originated in bats.

While these viruses can cause serious, and often fatal disease in people, bats seem unharmed, the researchers, including those from the University of Saskatchewan (USask) in Canada, said.

"The bats don't get rid of the virus and yet don't get sick. We wanted to understand why the MERS virus doesn't shut down the bat immune responses as it does in humans," said USask microbiologist Vikram Misra.

In the study, the scientists demonstrated that cells from an insect-eating brown bat can be persistently infected with MERS coronavirus for months, due to important adaptations from both the bat and the virus working together.

"Instead of killing bat cells as the virus does with human cells, the MERS coronavirus enters a long-term relationship with the host, maintained by the bat's unique 'super' immune system," said Misra, one of the study's co-authors.

"SARS-CoV-2 is thought to operate in the same way," he added.

Stresses on bats, such as wet markets, other diseases, and habitat loss, may have a role in coronavirus spilling over to other species, the study noted.

"When a bat experiences stress to their immune system, it disrupts this immune system-virus balance and allows the virus to multiply," Misra said.

The scientists, involved in the study, had earlier developed a potential treatment for MERS-CoV, and are currently working towards a vaccine against COVID-19.

While camels are the known intermediate hosts of MERS-CoV, they said bats are suspected to be the ancestral host.

There is no vaccine for either SARS-CoV-2 or MERS, the researchers noted.

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"We see that the MERS coronavirus can very quickly adapt itself to a particular niche, and although we do not completely understand what is going on, this demonstrates how coronaviruses are able to jump from species to species so effortlessly," said USask scientist Darryl Falzarano, who co-led the study.

According to Misra, coronaviruses rapidly adapt to the species they infect, but little is known on the molecular interactions of these viruses with their natural bat hosts.

An earlier study had shown that bat coronaviruses can persist in their natural bat host for at least four months of hibernation.

When exposed to the MERS virus, the researchers said, bat cells adapt, not by producing inflammation-causing proteins that are hallmarks of getting sick, but instead by maintaining a natural antiviral response.

On the contrary, they said this function shuts down in other species, including humans.

The MERS virus, the researchers said, also adapts to the bat host cells by very rapidly mutating one specific gene.

These adaptations, according to the study, result in the virus remaining long-term in the bat, but being rendered harmless until something like a disease, or other stressors, upsets this balance.

In future experiments, the scientists hope to understand how the bat-borne MERS virus adapts to infection and replication in human cells.

"This information may be critical for predicting the next bat virus that will cause a pandemic," Misra said.