Clinical Characteristics and Transmission of COVID-19 in Children and Youths During 3 Waves of Outbreaks in Hong Kong.
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Chua Gilbert T, Wong Joshua Sung Chih, Lam Ivan, Ho Polly Po Ki, Chan Wai Hung, Yau Felix Yat Sun, Rosa Duque Jaime S, Ho Alvin Chi Chung, Siu Ka Ka, Cheung Tammy W Y, Lam David Shu Yan, Chan Victor Chi Man, Lee Kwok Piu, Tsui Kwing Wan, Wong Tak Wai, Yau Man Mut, Yau Tsz Yan, Chan Kate Ching Ching, Yu Michelle Wai Ling, Chow Chit Kwong, Chiu Wah Keung, Chan Kwok Chiu, Wong Wilfred H S, Ho Marco Hok Kung, Tso Winnie W Y, Tung Keith T S, Wong Christina S, Kwok Janette, Leung Wing Hang, Yam Jason C, Wong Ian C K, Tam Paul Kwong Hang, Chan Godfrey Chi Fung, Chow Chun Bong, To Kelvin K W, Lau Yu Lung, Yuen Kwok Yung, Ip Patrick, Kwan Mike Yat Wah
Аннотация
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.