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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Human Metapneumovirus-associated Acute Lower Respiratory Hospitalizations in Children <5 Years Pre-, During and
Md Ariful Islam1, Mei Chan1, Jahidur Rahman Khan1
1From the Discipline of Pediatrics and Child Health, School of Clinical Medicine, UNSW Sydney, Sydney, New South Wales, Australia.
Background:
To evaluate disease severity, age distribution, and seasonal patterns of human metapneumovirus (hMPV) infection among hospitalized children <5 years across pre-, during and post-coronavirus disease 2019 pandemic.
Methods:
We conducted a retrospective study using electronic medical records of acute lower respiratory infection (ALRI) hospitalizations in children <5 years at the Sydney Children's Hospitals Network from 2015 to 2023. Analyses were restricted to hospitalizations for only laboratory-confirmed hMPV. Severity outcomes-extended length of stay (>median), intensive care unit admission and/or mechanical ventilation-were compared across pre-pandemic (2015-2019), pandemic (2020-2021) and post-pandemic (2022-2023) using multivariable logistic regression. Seasonal patterns were assessed using monthly hMPV positivity rates.
Results:
Among 32,618 ALRI hospitalizations, 1081 (3.3%) were hMPV-positive. hMPV hospitalizations declined during the pandemic (4.3% pre-pandemic, 2.0% pandemic and 3.2% post-pandemic ( P < 0.001). Median age of hMPV hospitalization shifted from 1.1 years (interquartile range [IQR] 0.5-2.3) pre-pandemic to 1.5 years (IQR 0.5-2.6) during and 1.6 years (IQR 0.6-2.8) post-pandemic ( P < 0.001). Odds of extended length of stay were lower during (adjusted odds ratio [aOR] 0.61, 95% confidence interval [CI] 0.39-0.93) and post-pandemic (aOR 0.53, 95% CI 0.40-0.69) compared with pre-pandemic. Odds of intensive care unit admission and/or mechanical ventilation were lower during (aOR 0.70, 95% CI 0.33-1.49; P = 0.358) and post-pandemic (aOR 0.65, 95% CI 0.40-1.05; P = 0.080). Pre-pandemic, hMPV peaked in July-October; circulation disappeared in 2020, re-emerged in 2021 and returned to near pre-pandemic seasonality in 2023.
Conclusions:
Post-pandemic hMPV accounted for 3.2% of ALRI hospitalizations in children <5 years, highlighting the need for prevention, treatment and continued surveillance.
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