Department of Respiratory Medicine, Jiangxi Provincial Children's Hospital, Nanchang, Jiangxi, China.
Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, Zhejiang, China.
J Med Virol. 2022 Nov;94(11):5401-5408. doi: 10.1002/jmv.28024. Epub 2022 Aug 5.
Human metapneumovirus (HMPV), which is distributed worldwide, is a significant viral respiratory pathogen responsible for causing acute respiratory tract infections (ARTIs) in children. The aim of the present study was to investigate the epidemiological and genetic characteristics of HMPV in pediatric patients in Hangzhou China following the peak of onset of coronavirus disease 2019 (COVID-19). A total of 1442 throat swabs were collected from the pediatric patients with a diagnosis of ARTI from November 2020 to March 2021. The following viruses were detected by real-time polymerase chain reaction analysis: HMPV, RSV, adenovirus, hPIV1-3, influenza A, and influenza B. A two-step method was used to amplify the F genes of the HMPV-positive samples. Following sequencing, phylogenetic analyses were conducted using the MEGA version 7 software package. Among the 1442 samples, 103 (7.14%) were positive for HMPV. No significant differences were observed in the gender distribution. The highest incidence of HMPV occurred in children older than 6 years and the lowest was noted in children younger than 6 months. Lower respiratory tract infections were diagnosed at a higher rate than upper respiratory tract infections in HMPV-infected children. Only 10 HMPV-infected children (5.41%) were inpatients compared with 93 outpatients (7.39%). Co-infection was observed in 31 HMPV-positive samples including 24 samples of double infection and seven samples of triple infection. A total of 61F gene fragments of HMPV, which were approximately 727 bp in length were successfully sequenced. All the HMPVs belonged to the genotype B and were clustered into subgenotypes B1 (1.6%, 1/61) and B2 (98.4%, 60/61). A total of four specific amino acid substitutions were noted as follows: aa280, aa296, aa392, and aa396. These substitutions were present between sequences derived from the subgenotypes B1 and B2 in the fusion open reading frame from position 244 to 429. In conclusion, the present study provided significant information regarding the epidemiological and genetic characteristics of HMPV in children living in Hangzhou. Following the first peak of the COVID-19 pandemic, HMPV was considered an important viral respiratory pathogen present in children with ARTI.
人偏肺病毒（HMPV）分布广泛，是一种重要的病毒性呼吸道病原体，可导致儿童急性呼吸道感染（ARTI）。本研究旨在调查 2019 年冠状病毒病（COVID-19）发病高峰后杭州儿科患者中 HMPV 的流行和遗传特征。2020 年 11 月至 2021 年 3 月，共采集了 1442 例经诊断为 ARTI 的儿科患者的咽拭子。采用实时聚合酶链反应分析检测以下病毒：HMPV、RSV、腺病毒、hPIV1-3、流感 A 和流感 B。采用两步法扩增 HMPV 阳性样本的 F 基因。测序后，使用 MEGA 版本 7 软件包进行系统发育分析。在 1442 例样本中，103 例（7.14%）HMPV 阳性。HMPV 阳性患儿的性别分布无显著差异。HMPV 发病率最高的是年龄大于 6 岁的儿童，发病率最低的是年龄小于 6 个月的儿童。与上呼吸道感染相比，下呼吸道感染在 HMPV 感染患儿中诊断率更高。与 93 例门诊患儿（7.39%）相比，仅 10 例 HMPV 感染患儿（5.41%）为住院患儿。31 例 HMPV 阳性样本中存在混合感染，其中 24 例为双重感染，7 例为三重感染。成功测序了 61 株 HMPV 的全长约 727bp 的 61F 基因片段。所有 HMPV 均属于基因型 B，分为亚基因型 B1（1.6%，1/61）和 B2（98.4%，60/61）。共有 4 个特定的氨基酸取代，分别位于 aa280、aa296、aa392 和 aa396。这些取代位于融合开放阅读框 244 至 429 位的亚基因型 B1 和 B2 之间的序列。综上所述，本研究提供了杭州地区儿童中 HMPV 的流行和遗传特征的重要信息。在 COVID-19 大流行的第一个高峰之后，HMPV 被认为是导致儿童 ARTI 的重要病毒性呼吸道病原体。
