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Characteristics of Human Metapneumovirus-Related Acute Respiratory Infections in Children - A Four-Year Single Center
Sevliya Öcal Demir1, Seyhan Yılmaz1, Aylin Dizi Işık1
1Department of Pediatrics, Division of Pediatric Infectious Diseases, Marmara University Faculty of Medicine, Türkiye.
Insights
Human metapneumovirus (hMPV) significantly impacts young children, causing severe respiratory infections, especially in winter and spring. Comorbidities in children increase the risk of severe hMPV illness and the need for respiratory support.
Area of Science:
- Pediatrics
- Infectious Diseases
- Virology
Background:
- Human metapneumovirus (hMPV) is a notable cause of acute respiratory infections (ARIs) in children.
- Data on hMPV infection characteristics and severity predictors in pediatric populations remain limited.
Purpose of the Study:
- To characterize pediatric hMPV infections.
- To identify predictors of hMPV infection severity in children admitted with ARIs.
Main Methods:
- Retrospective analysis of pediatric patients admitted with ARI symptoms between 2021 and 2025.
- Diagnosis of hMPV confirmed by molecular testing.
- Evaluation of clinical data, comorbidities, symptoms, laboratory values, radiographic findings, and clinical outcomes.
Main Results:
- Seventy-eight children (48.7% female, median age 14.9 months) were included; 84.6% were under 5 years old.
- Most admissions occurred during winter/spring (92.3%).
- Comorbidities (41%) were linked to increased respiratory support needs (p=0.025).
- Common symptoms included cough (83.1%), rhinorrhea (61%), fever (59.2%), and stridor (41.6%).
- Hospitalization (55.1%), respiratory support (21.8%), and PICU admission (6.4%) were reported.
- Mortality rate was 2.6%.
Conclusions:
- hMPV is a significant pathogen causing ARIs in young children, particularly during colder months.
- Underlying comorbidities are associated with increased severity and adverse outcomes in pediatric hMPV infections.
- Further research is warranted to understand hMPV epidemiology and inform clinical management.
Abstract:
This study aimed to increase the data on characteristics and predictors of pediatric hMPV infection severity. Children admitted with ARI symptoms between 2021 and 2025 and diagnosed with hMPV by molecular testing were included. Seventy-eight children were included, of whom 48.7% were female. Most admissions occurred during winter and spring (92.3%). The median age was 14.9 months (IQR, 7.5-54.7), and 84.6% were younger than 5 years. At least one underlying comorbidity was present in 41% of patients, most commonly chronic lung disease. Major symptoms were cough (83.1%), rhinorrhea (61%), fever (59.2%), and stridor (41.6%), and tachypnea/dyspnea was observed in 31.2%. Median leukocyte count was 10,020/mm³ (IQR, 6,200-13,860), and median C-reactive protein level was 7.5 mg/dL (IQR, 1.1-26). Infiltration on chest radiographic (58.7%) were predominantly reticulonodular. About half of the patients (55.1%) required hospitalization; 21.8% needed respiratory support, and 6.4% were admitted to the pediatric intensive care unit. The need for respiratory support was significantly higher in children with comorbidities (p = 0.025), mortality was 2.6%. HMPV is a significant cause of ARIs in small children, particularly during winter and spring. Underlying comorbidities are associated with increased disease severity.
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