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Human Metapneumovirus: An Underestimated Cause of Severe Respiratory Infection

Catia Cilloniz1,2,3, Antonia Ho4, Chanu Rhee5,6

  • 1Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

Annals of the American Thoracic Society
|June 21, 2026
PubMed

Insights

Human metapneumovirus (hMPV) causes significant respiratory illness, especially in high-risk groups. The COVID-19 pandemic has altered its typical patterns, highlighting the need for better diagnosis and prevention strategies.

Area of Science:

  • * Virology and Epidemiology
  • * Public Health and Infectious Diseases

Background:

  • * Human metapneumovirus (hMPV), identified in 2001, is a major cause of acute respiratory tract infections across all age groups.
  • * While often mild in healthy adults, hMPV can lead to severe lower respiratory tract disease, including pneumonia, in vulnerable populations like young children, the elderly, and immunocompromised individuals.
  • * hMPV is a substantial contributor to hospitalizations, ICU admissions, and mortality in high-risk populations.

Purpose of the Study:

  • * To review current evidence on hMPV virology, epidemiology, clinical manifestations, outcomes, diagnosis, and prevention.
  • * To focus on hMPV's impact on adults and other high-risk populations.
  • * To examine post-COVID-19 epidemiological trends and the status of hMPV vaccine development.

Main Methods:

  • * Comprehensive literature review of existing evidence on hMPV.
  • * Analysis of epidemiological data, including seasonal circulation and pandemic-related shifts.
  • * Evaluation of clinical presentations, diagnostic challenges, and prevention strategies.

Main Results:

  • * hMPV exhibits seasonal circulation, typically in late winter and spring, but COVID-19 has disrupted these patterns, causing shifts in timing and increased co-circulation with other viruses.
  • * Clinical symptoms of hMPV overlap with other respiratory viruses, leading to under-recognition and under-testing due to selective diagnostic practices.
  • * No specific antiviral therapies or licensed vaccines are currently available for hMPV.

Conclusions:

  • * Accurate identification of hMPV is crucial for diagnosis, prognosis, antimicrobial stewardship, and infection control, especially in healthcare settings.
  • * Understanding hMPV's evolving epidemiology and clinical impact is essential for public health.
  • * Ongoing vaccine development holds promise for future clinical practice and disease prevention.
Keywords:
human metapneumoviruspneumoniarespiratory infectionrespiratory virus

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