Gilbert T Chua1, Joshua Sung Chih Wong2, Ivan Lam2, Polly Po Ki Ho3, Wai Hung Chan3, Felix Yat Sun Yau3, Jaime S Rosa Duque1, Alvin Chi Chung Ho4, Ka Ka Siu4, Tammy W Y Cheung5, David Shu Yan Lam5, Victor Chi Man Chan6, Kwok Piu Lee6, Kwing Wan Tsui7, Tak Wai Wong7, Man Mut Yau8, Tsz Yan Yau8, Kate Ching Ching Chan9, Michelle Wai Ling Yu9, Chit Kwong Chow10, Wah Keung Chiu10, Kwok Chiu Chan7, Wilfred H S Wong1, Marco Hok Kung Ho1, Winnie W Y Tso1, Keith T S Tung1, Christina S Wong11, Janette Kwok12, Wing Hang Leung1, Jason C Yam13, Ian C K Wong14,15, Paul Kwong Hang Tam16,17, Godfrey Chi Fung Chan1, Chun Bong Chow1, Kelvin K W To18, Yu Lung Lau1, Kwok Yung Yuen18, Patrick Ip1, Mike Yat Wah Kwan2. 1. Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China. 2. Paediatric Infectious Disease Unit, Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region, China. 3. Department of Paediatrics and Adolescent Medicine, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China. 4. Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China. 5. Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, Hong Kong Special Administrative Region, China. 6. Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, China. 7. Department of Paediatrics and Adolescent Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong Special Administrative Region, China. 8. Department of Paediatrics and Adolescent Medicine, Tseung Kwan O Hospital, Hong Kong Special Administrative Region, China. 9. Department of Paediatrics, Prince of Wales Hospital, Hong Kong Special Administrative Region, China. 10. Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong Special Administrative Region, China. 11. Division of Dermatology, Department of Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China. 12. Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong Special Administrative Region, China. 13. Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. 14. Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong Special Administrative Region, China. 15. Research Department of Practice and Policy, UCL School of Pharmacy, University College, London, United Kingdom. 16. Division of Paediatric Surgery, Department of Surgery, University of Hong Kong, Hong Kong Special Administrative Region, China. 17. Dr Li Dak-Sum Research Centre, University of Hong Kong-Karolinska, Institutet Collaboration in Regenerative Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China. 18. Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China.
Abstract
Importance: Schools were closed intermittently across Hong Kong to control the COVID-19 outbreak, which led to significant physical and psychosocial problems among children and youths. Objective: To compare the clinical characteristics and sources of infection among children and youths with COVID-19 during the 3 waves of outbreaks in Hong Kong in 2020. Design, Setting, and Participants: This cross-sectional study involved children and youths aged 18 years or younger with COVID-19 in the 3 waves of outbreaks from January 23 through December 2, 2020. Data were analyzed from December 2020 through January 2021. Main Outcomes and Measures: Demographic characteristics, travel and contact histories, lengths of hospital stay, and symptoms were captured through the central electronic database. Individuals who were infected without recent international travel were defined as having domestic infections. Results: Among 397 children and youths confirmed with COVID-19 infections, the mean (SD) age was 9.95 (5.34) years, 220 individuals (55.4%) were male, and 154 individuals (38.8%) were asymptomatic. There were significantly more individuals who were infected without symptoms in the second wave (59 of 118 individuals [50.0%]) and third wave (94 of 265 individuals [35.5%]) than in the first wave (1 of 14 individuals [7.1%]) (P = .001). Significantly fewer individuals who were infected in the second and third waves, compared with the first wave, had fever (first wave: 10 individuals [71.4%]; second wave: 22 individuals [18.5%]; third wave: 98 individuals [37.0%]; P < .001) or cough (first wave: 6 individuals [42.9%]; second wave: 15 individuals [12.7%]; third wave: 52 individuals [19.6%]; P = .02). Among all individuals, 394 individuals (99.2%) had mild illness. One patient developed chilblains (ie, COVID toes), 1 patient developed multisystem inflammatory syndrome in children, and 1 patient developed post-COVID-19 autoimmune hemolytic anemia. In all 3 waves, 204 patients with COVID-19 (51.4%) had domestic infections. Among these individuals, 186 (91.2%) reported having a contact history with another individual with COVID-19, of which most (183 individuals [90.0%]) were family members. In the third wave, 18 individuals with domestic infections had unknown contact histories. Three schoolmates were confirmed with COVID-19 on the same day and were reported to be close contacts. Conclusions and Relevance: This cross-sectional study found that nearly all children and youths with COVID-19 in Hong Kong had mild illness. These findings suggest that household transmission was the main source of infection for children and youths with domestic infections and that the risk of being infected at school was small.
Importance: Schools were closed intermittently across Hong Kong to control the COVID-19 outbreak, which led to significant physical and psychosocial problems among children and youths. Objective: To compare the clinical characteristics and sources of infection among children and youths with COVID-19 during the 3 waves of outbreaks in Hong Kong in 2020. Design, Setting, and Participants: This cross-sectional study involved children and youths aged 18 years or younger with COVID-19 in the 3 waves of outbreaks from January 23 through December 2, 2020. Data were analyzed from December 2020 through January 2021. Main Outcomes and Measures: Demographic characteristics, travel and contact histories, lengths of hospital stay, and symptoms were captured through the central electronic database. Individuals who were infected without recent international travel were defined as having domestic infections. Results: Among 397 children and youths confirmed with COVID-19infections, the mean (SD) age was 9.95 (5.34) years, 220 individuals (55.4%) were male, and 154 individuals (38.8%) were asymptomatic. There were significantly more individuals who were infected without symptoms in the second wave (59 of 118 individuals [50.0%]) and third wave (94 of 265 individuals [35.5%]) than in the first wave (1 of 14 individuals [7.1%]) (P = .001). Significantly fewer individuals who were infected in the second and third waves, compared with the first wave, had fever (first wave: 10 individuals [71.4%]; second wave: 22 individuals [18.5%]; third wave: 98 individuals [37.0%]; P < .001) or cough (first wave: 6 individuals [42.9%]; second wave: 15 individuals [12.7%]; third wave: 52 individuals [19.6%]; P = .02). Among all individuals, 394 individuals (99.2%) had mild illness. One patient developed chilblains (ie, COVID toes), 1 patient developed multisystem inflammatory syndrome in children, and 1 patient developed post-COVID-19autoimmune hemolytic anemia. In all 3 waves, 204 patients with COVID-19 (51.4%) had domestic infections. Among these individuals, 186 (91.2%) reported having a contact history with another individual with COVID-19, of which most (183 individuals [90.0%]) were family members. In the third wave, 18 individuals with domestic infections had unknown contact histories. Three schoolmates were confirmed with COVID-19 on the same day and were reported to be close contacts. Conclusions and Relevance: This cross-sectional study found that nearly all children and youths with COVID-19 in Hong Kong had mild illness. These findings suggest that household transmission was the main source of infection for children and youths with domestic infections and that the risk of being infected at school was small.
Authors: Rosa S Wong; Keith T S Tung; Nirmala Rao; Ko Ling Chan; King-Wa Fu; Jason C Yam; Winnie W Y Tso; Wilfred H S Wong; Terry Y S Lum; Ian C K Wong; Patrick Ip Journal: Int J Environ Res Public Health Date: 2022-06-27 Impact factor: 4.614
Authors: Vivek B Kute; Hari Shankar Meshram; Vijay V Navadiya; Sanshriti Chauhan; Dev D Patel; Sudeep N Desai; Nauka Shah; Ruchir B Dave; Subho Banerjee; Divyesh P Engineer; Himanshu V Patel; Syed Jamal Rizvi; Vineet V Mishra Journal: Nephrology (Carlton) Date: 2021-08-21 Impact factor: 2.358
Authors: Hing Wai Tsang; Gilbert T Chua; Kelvin K W To; Joshua S C Wong; Wenwei Tu; Janette S Y Kwok; Wilfred H S Wong; Xiwei Wang; Yanmei Zhang; Jaime S Rosa Duque; Godfrey C F Chan; Wai Kit Chu; C P Pang; Paul K H Tam; Yu Lung Lau; Ian C K Wong; W H Leung; Kwok-Yung Yuen; Mike Y W Kwan; Patrick Ip Journal: Front Immunol Date: 2021-12-17 Impact factor: 7.561
Authors: Gilbert T Chua; Mike Yat Wah Kwan; Celine S L Chui; Robert David Smith; Edmund Chi Lok Cheung; Tian Ma; Miriam T Y Leung; Sabrina Siu Ling Tsao; Elaine Kan; Wing Kei Carol Ng; Victor Chi Man Chan; Shuk Mui Tai; Tak Ching Yu; Kwok Piu Lee; Joshua Sung Chih Wong; Ying Kit Lin; Chi Chiu Shek; Agnes Sze Yin Leung; Chit Kwong Chow; Ka Wah Li; Johnny Ma; Wai Yuk Fung; Daniel Lee; Ming Yen Ng; Wilfred Hing Sang Wong; Hing Wai Tsang; Janette Kwok; Daniel Leung; Kin Lai Chung; Chun Bong Chow; Godfrey Chi Fung Chan; Wing Hang Leung; Kelvin Kai Wang To; Kwok Yung Yuen; Yu Lung Lau; Ian Chi Kei Wong; Patrick Ip Journal: Clin Infect Dis Date: 2022-09-10 Impact factor: 20.999
Authors: Jennifer Conway; Scott R Auerbach; Marc E Richmond; Brandon Sharp; Elfriede Pahl; Brian Feingold; Estela Azeka; William J Dryer; Ryan S Cantor; James K Kirklin Journal: J Heart Lung Transplant Date: 2021-11-19 Impact factor: 10.247