The Lancet Regional Health. Western Pacific (May 2021)

Phylogenomic analysis of COVID-19 summer and winter outbreaks in Hong Kong: An observational study

  • Wan-Mui Chan,
  • Jonathan Daniel Ip,
  • Allen Wing-Ho Chu,
  • Herman Tse,
  • Anthony Raymond Tam,
  • Xin Li,
  • Mike Yat-Wah Kwan,
  • Yat-Sun Yau,
  • Wai-Shing Leung,
  • Thomas Shiu-Hong Chik,
  • Wing-Kin To,
  • Anthony Chin-Ki Ng,
  • Cyril Chik-Yan Yip,
  • Rosana Wing-Shan Poon,
  • Kwok-Hung Chan,
  • Sally Cheuk-Ying Wong,
  • Garnet Kwan-Yue Choi,
  • David Christopher Lung,
  • Vincent Chi-Chung Cheng,
  • Ivan Fan-Ngai Hung,
  • Kwok-Yung Yuen,
  • Kelvin Kai-Wang To

Journal volume & issue
Vol. 10
p. 100130

Abstract

Read online

Background: Viral genomic surveillance is vital for understanding the transmission of COVID-19. In Hong Kong, breakthrough outbreaks have occurred in July (third wave) and November (fourth wave) 2020. We used whole viral genome analysis to study the characteristics of these waves. Methods: We analyzed 509 SARS-CoV-2 genomes collected from Hong Kong patients between 22nd January and 29th November, 2020. Phylogenetic and phylodynamic analyses were performed, and were interpreted with epidemiological information. Findings: During the third and fourth waves, diverse SARS-CoV-2 genomes were identified among imported infections. Conversely, local infections were dominated by a single lineage during each wave, with 96.6% (259/268) in the third wave and 100% (73/73) in the fourth wave belonging to B.1.1.63 and B.1.36.27 lineages, respectively. While B.1.1.63 lineage was imported 2 weeks before the beginning of the third wave, B.1.36.27 lineage has circulated in Hong Kong for 2 months prior to the fourth wave. During the fourth wave, 50.7% (37/73) of local infections in November was identical to the viral genome from an imported case in September. Within B.1.1.63 or B.1.36.27 lineage in our cohort, the most common non-synonymous mutations occurred at the helicase (nsp13) gene. Interpretation: Although stringent measures have prevented most imported cases from spreading in Hong Kong, a single lineage with low-level local transmission in October and early November was responsible for the fourth wave. A superspreading event or lower temperature in November may have facilitated the spread of the B.1.36.27 lineage.

Keywords