Deaths in Hong Kong linked to COVID-19 infections reached 100 cases on Saturday, with official data showing that one in five of the deceased was asymptomatic while carrying the coronavirus.

At least 92 of the 100 deaths occurred during the third wave of the pandemic, which began in early July. The youngest was a 39-year-old man and the oldest a woman aged 98. Hong Kong recorded its first COVID-19 death in February.

Among the 100 were at least 20 without symptoms, of whom four deteriorated quickly in a short period of time. The other 15 died within a week of contracting the virus.

In one cluster at Pamela Youde Nethersole Eastern Hospital, three out of the four infected people died. A 78-year-old man who was sent to the hospital for a separate health condition initially tested negative on Aug. 5 and was believed to have caught COVID-19 from a fellow patient in the same ward. He tested positive three days later and died another four days after.

In another case, an 85-year-old man with chronic heart disease was admitted to hospital because his feet were swelling. He was discharged after three days as he did not have a fever and X-rays of his lungs came out clear. On Aug. 2, he developed a fever and pneumonia and was declared dead after two days.

Leung Chi-chiu, who specialized in respiratory illnesses, said the percentage of asymptomatic patients was not considered high, meaning the disease had yet to develop into a serious condition.

One of the possible reasons for the rapid deterioration in a patient’s condition could be due to the sudden shock to the immune system, which would then scramble to respond to fight the disease, Leung said.

A strong reaction from the immune system, such as a cytokine storm — which happens when the body releases too many small proteins all at once — can result in multiple organ failure and become life threatening, Leung said.

While the number of daily new infections had slowed, Leung urged families with senior members to stay at home and to see a doctor even if they had minor symptoms.

The city recorded 13 new cases on Saturday, pushing the total tally to 4,938. More than 28.3 million people have been infected with the coronavirus globally, with over 910,000 related deaths. China has recorded 90,637 infections with 4,740 deaths.

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