Pott Henrique, LeBlanc Jason J, ElSherif May, Hatchette Todd F, Andrew Melissa K, McNeil Shelly A
Canadian Center for Vaccinology, IWK Health, Nova Scotia Health, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Medicine, Universidade Federal de São Carlos, Brazil.
J Infect Dis. 2025 Jul 16;232(Supplement_1):S69-S77. doi: 10.1093/infdis/jiaf083.
Human metapneumovirus (hMPV) significantly impacts young children, older adults, and those with preexisting conditions. This study examines frailty and clinical outcomes in middle-aged and older adults hospitalized due to hMPV infections.
Data from the Canadian Immunization Research Network's Serious Outcomes Surveillance Network were analyzed. Included were adults aged ≥50 with lab-confirmed hMPV infection. Severe infection was marked by pneumonia, oxygen need, intensive care unit admission, mechanical ventilation, or death within 30 days. The Frailty Index (FI) categorized individuals as nonfrail (FI < 0.08), prefrail (FI ≥ 0.08, FI < 0.21), and frail (FI ≥ 0.21). Multivariate ridge regression identified factors linked to disease severity.
Among 212 patients (median age 76), 85.4% had severe disease and 61.3% were frail. Frail patients had higher rates of severe disease (80.8% vs. 63.4%), oxygen therapy need (80.8% vs. 63.4%), and longer hospital stays (median 8 vs. 4 days) than patients who were nonfrail. Any cardiac illness (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.02-3.09), congestive heart failure (OR, 1.91; 95% CI, 1.12-3.09), chronic obstructive pulmonary disease (OR, 1.93; 95% CI, 1.14-3.35), and frailty (OR, 1.99; 95% CI, 1.18-3.38) were significantly associated with increased odds of severe disease.
Frailty, assessable with standardized tools, is associated with severe hMPV infections in middle-aged and older adults. Recognizing frailty in clinical management and as a vaccination criterion is necessary as hMPV vaccines become available.
NCT01517191 (ClinicalTrials.gov).
人偏肺病毒（hMPV）对幼儿、老年人以及患有基础疾病的人群有显著影响。本研究调查了因hMPV感染住院的中老年人的虚弱状况和临床结局。
分析了加拿大免疫研究网络严重结局监测网络的数据。纳入对象为年龄≥50岁且实验室确诊为hMPV感染的成年人。严重感染的标志为肺炎、需要吸氧、入住重症监护病房、机械通气或在30天内死亡。虚弱指数（FI）将个体分为非虚弱（FI < 0.08）、虚弱前期（FI≥0.08，FI < 0.21）和虚弱（FI≥0.21）。多变量岭回归确定了与疾病严重程度相关的因素。
在212例患者（中位年龄76岁）中，85.4%患有严重疾病，61.3%为虚弱患者。与非虚弱患者相比，虚弱患者的严重疾病发生率更高（80.8%对63.4%）、需要吸氧治疗的比例更高（80.8%对63.4%）且住院时间更长（中位8天对4天）。任何心脏病（比值比[OR]，1.76；95%置信区间[CI]，1.02 - 3.09）、充血性心力衰竭（OR，1.91；95% CI，1.12 - 3.09）、慢性阻塞性肺疾病（OR，1.93；95% CI，1.14 - 3.35）和虚弱（OR，1.99；95% CI，1.18 - 3.38）均与严重疾病发生几率增加显著相关。
使用标准化工具可评估的虚弱状况与中老年人严重hMPV感染相关。随着hMPV疫苗的问世，在临床管理中认识到虚弱状况并将其作为疫苗接种标准是必要的。
NCT01517191（ClinicalTrials.gov）。
