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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.

Leiden, Jul 2: Astronomers have discovered a luminous galaxy caught in the act of reionizing its surrounding gas only 800 million years after the Big Bang.

The research, led by Romain Meyer, PhD student at UCL in London, UK, has been presented at the virtual annual meeting of the European Astronomical Society (EAS).

Studying the first galaxies that formed 13 billion years ago is essential to understanding our cosmic origins. One of the current hot topics in extragalactic astronomy is 'cosmic reionization,' the process in which the intergalactic gas was ionized (atoms stripped of their electrons).

Cosmic reionization is similar to an unsolved murder: We have clear evidence for it, but who did it, how and when? We now have strong evidence that hydrogen reionization was completed about 13 billion years ago, in the first billion years of the universe, with bubbles of ionized gas slowly growing and overlapping.

The objects capable of creating such ionized hydrogen bubbles have however remained mysterious until now: the discovery of a luminous galaxy in which 60-100 percent of ionizing photons escape, is likely responsible for ionizing its local bubble. This suggests the case is closer to being solved.

The two main suspects for cosmic reionization are usually 1) a population of numerous faint galaxies leaking ~10 percent of their energetic photons, and 2) an 'oligarchy' of luminous galaxies with a much larger percentage (>50 percent) of photons escaping each galaxy.

In either case, these first galaxies were very different from those today: galaxies in the local universe are very inefficient leakers, with only <2-3 percent of ionizing photons escaping their host. To understand which galaxies governed cosmic reionization, astronomers must measure the so-called escape fractions of galaxies in the reionization era.

The detection of light from excited hydrogen atoms (the so-called Lyman-alpha line) can be used to infer the fraction of escaping photons. On the one hand, such detections are rare because reionization-era galaxies are surrounded by neutral gas which absorbs that signature hydrogen emission.

On the other hand, if this hydrogen signal is detected it represents a 'smoking gun' for a large ionized bubble, meaning we have caught a galaxy reionizing its surroundings. The size of the bubble and the galaxy's luminosity determines whether it is solely responsible for creating this ionized bubble or if unseen accomplices are necessary.

The discovery of a luminous galaxy 800 million years after the Big Bang supports the scenario where an 'oligarchy' of bright leakers emits most of the ionizing photons.

"It is the first time we can point to an object responsible for creating an ionized bubble, without the need for a contribution from unseen galaxies.

Additional observations with the upcoming James Webb Space Telescope will enable us to study further what is likely one of the best suspects for the unsolved case of cosmic reionization," said Meyer.