Veronese Airin, Uršič Tina, Bizjak Vojinovič Simona, Rodman Berlot Jasna
Department of Paediatric Pulmonology, University Children's Hospital, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
Microorganisms. 2024 Mar 23;12(4):641. doi: 10.3390/microorganisms12040641.
Human metapneumovirus (hMPV) is an important pathogen that causes both upper (URTIs) and lower respiratory tract infections (LRTIs) in children. The virus can be implicated in severe bronchiolitis and pneumonia, necessitating hospitalization, with certain cases requiring intensive care unit intervention. As part of a retrospective observational study, we aimed to identify indicators of severe hMPV respiratory tract infections in children referred to the University Children's Hospital Ljubljana and the Department of Infectious Diseases Ljubljana, Slovenia, during a recent outbreak. We analyzed clinical data from November 2022 to January 2023 and compared the characteristics of children presenting with URTIs and LRTIs. We also examined the characteristics of children with hMPV LRTIs, distinguishing between children with and without LRTI-associated hypoxemia. Of 78 hMPV-PCR-positive pediatric patients (mean age 3.1 years; 60.3% boys), 36% had a URTI, and 64% had an LRTI. Hospitalization was required in 64% (50/78), with 42% (21/50) requiring oxygen therapy. LRTI-associated hypoxemia was more common in patients with atopy who showed dyspnea, tachypnea, crackles, and wheezing on lung auscultation. In a multivariable logistic regression analysis, wheezing detected on lung auscultation was a significant predictive factor for hypoxemic hMPV-LRTI. Specifically, children presenting with wheezing were found to be ten times more likely to experience hypoxemia. Prematurity and chronic conditions did not influence the presentation or severity of hMPV infection. This study highlights wheezing and atopy as crucial indicators of severe hMPV LRTI in children, emphasizing the importance of early recognition and intervention.
人偏肺病毒（hMPV）是一种重要的病原体，可导致儿童上呼吸道感染（URTIs）和下呼吸道感染（LRTIs）。该病毒可引发严重的细支气管炎和肺炎，需要住院治疗，某些病例还需要重症监护病房干预。作为一项回顾性观察研究的一部分，我们旨在确定在最近一次疫情期间转诊至斯洛文尼亚卢布尔雅那大学儿童医院和卢布尔雅那传染病科的儿童严重hMPV呼吸道感染的指标。我们分析了2022年11月至2023年1月的临床数据，并比较了出现URTIs和LRTIs的儿童的特征。我们还检查了患有hMPV-LRTIs的儿童的特征，区分了有和没有LRTI相关低氧血症的儿童。在78例hMPV-PCR阳性的儿科患者（平均年龄3.1岁；60.3%为男孩）中，36%患有URTI，64%患有LRTI。64%（50/78）的患者需要住院治疗，42%（21/50）的患者需要吸氧治疗。LRTI相关低氧血症在患有特应性疾病且肺部听诊有呼吸困难、呼吸急促、湿啰音和哮鸣音的患者中更为常见。在多变量逻辑回归分析中，肺部听诊发现的哮鸣音是低氧血症性hMPV-LRTI的一个重要预测因素。具体而言，出现哮鸣音的儿童发生低氧血症的可能性是其他儿童的十倍。早产和慢性病并未影响hMPV感染的表现或严重程度。这项研究强调哮鸣音和特应性疾病是儿童严重hMPV-LRTI的关键指标，强调了早期识别和干预的重要性。
