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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. 

Bengaluru, Mar 13: In the wake of fresh cases of Covid-19 reported in Karnataka, Infosys Foundation chairperson Sudha Murty has urged the Karnataka government to take steps to shut malls and theatres, saying the coronavirus multiplies in air-conditioned areas.

In a letter to the government, she said preventive measures should be taken to control the spread of coronovirus before it gets worse.

Murty, who also leads the State government-constituted Karnataka Tourism Task Force, said she has discussed the current situation with Chairman and Executive Director of Narayana Health, Devi Prasad Shetty.

She suggested closure of all schools and colleges with immediate effect, malls, theatres and “all air-conditioned areas where the virus multiplies”, and allow only essential services like pharmacy, grocery and petrol bunks.

“It is not scientifically proven that the virus dies in high temperature,” she said pointing to spread of the virus -- despite heat -- in peak summer in Australia and Singapore, which have “summer all 12 months”.

“I request you to vacate one government hospital with at least 500 - 700 beds for this purpose (to deal with coronavirus cases), which requires oxygen lines and pipes,” she said.

“Infosys Foundation, the philanthropic and CSR arm of software major Infosys, would do the civil work and Devi Shetty has agreed to share resources like medical equipment,” she added.

“We would like to work with the government proactively so that we can prevent this as early as possible,” Sudha Murty said.

The total number of confirmed coronavirus positive cases in Karnataka is five, including the 76-year old man from Kalaburagi who died on Tuesday night.