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Article: Clinical characteristics and transmission of COVID-19 in children and youths during 3 waves of outbreaks in Hong Kong

TitleClinical characteristics and transmission of COVID-19 in children and youths during 3 waves of outbreaks in Hong Kong
Authors
Issue Date2021
PublisherAmerican Medical Association: JAMA Network Open. The Journal's web site is located at https://jamanetwork.com/journals/jamanetworkopen
Citation
JAMA Network Open, 2021, v. 4 n. 5, p. article no. e218824 How to Cite?
AbstractImportance: 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.
Persistent Identifierhttp://hdl.handle.net/10722/301405
ISSN
2020 Impact Factor: 8.483
2020 SCImago Journal Rankings: 3.278
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorChua, GT-
dc.contributor.authorWong, JSC-
dc.contributor.authorLam, I-
dc.contributor.authorHo, PPK-
dc.contributor.authorChan, WH-
dc.contributor.authorYau, FYS-
dc.contributor.authorRosa Duque, JS-
dc.contributor.authorHo, ACC-
dc.contributor.authorSiu, KK-
dc.contributor.authorCheung, TWY-
dc.contributor.authorLam, DSY-
dc.contributor.authorChan, VCM-
dc.contributor.authorLee, KP-
dc.contributor.authorTsui, KW-
dc.contributor.authorWong, TW-
dc.contributor.authorYau, MM-
dc.contributor.authorYau, TY-
dc.contributor.authorChan, KCC-
dc.contributor.authorYu, MWL-
dc.contributor.authorChow, CK-
dc.contributor.authorChiu, WK-
dc.contributor.authorChan, KC-
dc.contributor.authorWong, WHS-
dc.contributor.authorHo, MHK-
dc.contributor.authorTso, WWY-
dc.contributor.authorTung, KTS-
dc.contributor.authorWong, CS-
dc.contributor.authorKwok, J-
dc.contributor.authorLeung, WH-
dc.contributor.authorYam, JC-
dc.contributor.authorWong, ICK-
dc.contributor.authorTam, PKH-
dc.contributor.authorChan, GCF-
dc.contributor.authorChow, CB-
dc.contributor.authorTo, KKW-
dc.contributor.authorLau, YL-
dc.contributor.authorYuen, KY-
dc.contributor.authorIp, P-
dc.contributor.authorKwan, MYW-
dc.date.accessioned2021-07-27T08:10:34Z-
dc.date.available2021-07-27T08:10:34Z-
dc.date.issued2021-
dc.identifier.citationJAMA Network Open, 2021, v. 4 n. 5, p. article no. e218824-
dc.identifier.issn2574-3805-
dc.identifier.urihttp://hdl.handle.net/10722/301405-
dc.description.abstractImportance: 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.-
dc.languageeng-
dc.publisherAmerican Medical Association: JAMA Network Open. The Journal's web site is located at https://jamanetwork.com/journals/jamanetworkopen-
dc.relation.ispartofJAMA Network Open-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleClinical characteristics and transmission of COVID-19 in children and youths during 3 waves of outbreaks in Hong Kong-
dc.typeArticle-
dc.identifier.emailChua, GT: cgt560@hku.hk-
dc.identifier.emailRosa Duque, JS: jsrduque@hku.hk-
dc.identifier.emailHo, ACC: accho@hku.hk-
dc.identifier.emailSiu, KK: katkksiu@hku.hk-
dc.identifier.emailWong, WHS: whswong@hku.hk-
dc.identifier.emailHo, MHK: marcoho@hku.hk-
dc.identifier.emailTso, WWY: wytso@hku.hk-
dc.identifier.emailTung, KTS: ktung@hku.hk-
dc.identifier.emailKwok, J: kwoksy@hkucc.hku.hk-
dc.identifier.emailLeung, WH: leungwhf@hku.hk-
dc.identifier.emailWong, ICK: wongick@hku.hk-
dc.identifier.emailTam, PKH: paultam@hku.hk-
dc.identifier.emailChan, GCF: gcfchan@hku.hk-
dc.identifier.emailChow, CB: chowcb@hku.hk-
dc.identifier.emailTo, KKW: kelvinto@hku.hk-
dc.identifier.emailLau, YL: lauylung@hku.hk-
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hk-
dc.identifier.emailIp, P: patricip@hku.hk-
dc.identifier.authorityChua, GT=rp02684-
dc.identifier.authorityRosa Duque, JS=rp02340-
dc.identifier.authorityTso, WWY=rp01517-
dc.identifier.authorityLeung, WH=rp02760-
dc.identifier.authorityWong, ICK=rp01480-
dc.identifier.authorityTam, PKH=rp00060-
dc.identifier.authorityChan, GCF=rp00431-
dc.identifier.authorityTo, KKW=rp01384-
dc.identifier.authorityLau, YL=rp00361-
dc.identifier.authorityYuen, KY=rp00366-
dc.identifier.authorityIp, P=rp01337-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1001/jamanetworkopen.2021.8824-
dc.identifier.pmid33938934-
dc.identifier.pmcidPMC8094012-
dc.identifier.scopuseid_2-s2.0-85105181425-
dc.identifier.hkuros323769-
dc.identifier.volume4-
dc.identifier.issue5-
dc.identifier.spagearticle no. e218824-
dc.identifier.epagearticle no. e218824-
dc.publisher.placeUnited States-

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