Goldstein Leah A, Michaels Marian G, Salthouse Abigail, Toepfer Ariana P, Musa Samar, Hickey Robert W, Johnson Monika, Wang-Erickson Anna F, Weinberg Geoffrey A, Szilagyi Peter G, Schlaudecker Elizabeth P, Staat Mary A, Sahni Leila C, Boom Julie A, Klein Eileen J, Englund Janet A, Schuster Jennifer E, Selvarangan Rangaraj, Harrison Christopher J, Halasa Natasha B, Stewart Laura S, Dawood Fatimah S, Moline Heidi L, Williams John V
US Centers for Disease Control and Prevention, Atlanta, Georgia.
UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Pediatrics. 2025 Sep 1;156(3). doi: 10.1542/peds.2024-070218.
Human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) are genetically related viruses and major causes of medically attended acute respiratory illness in children. Research comparing the severity of illnesses resulting from these infections lacks consensus.
Children younger than 18 years with acute respiratory illness were enrolled through active, prospective surveillance from 2016 to 2020 at 7 US pediatric hospitals and emergency departments (EDs). Clinical information was obtained from parent interviews and medical records. Midturbinate nasal swabs were collected and tested for RSV and HMPV using molecular diagnostic assays at each site. We compared descriptive and clinical features of children with RSV or HMPV and calculated adjusted odds ratios (aOR) for severe outcomes comparing RSV with HMPV. Risk factors for severe outcomes were assessed in children with RSV or HMPV using logistic regression models.
A total of 5329 children hospitalized with RSV (n = 4398) or HMPV (n = 931) and 3276 children with RSV-associated (n = 2371) or HMPV-associated (n = 905) ED visits were enrolled. The median age of children hospitalized with RSV was lower than that of children with HMPV (7 months vs 16 months, P < .0001). Children presenting to the ED with RSV-associated acute respiratory illness had higher odds of being hospitalized than children with HMPV (aOR, 1.68; 95% CI, 1.50-1.87), with the highest odds in infants younger than 6 months (aOR, 3.27; 95% CI, 2.53-4.23). Underlying conditions were more than twice as common among infants hospitalized with HMPV (26%) than those with RSV (11%).
Children with HMPV-associated hospitalization tend to be older and more likely to have underlying medical conditions compared with children with RSV-associated hospitalization.
人偏肺病毒（HMPV）和呼吸道合胞病毒（RSV）是基因相关病毒，是儿童就医急性呼吸道疾病的主要病因。比较这些感染所致疾病严重程度的研究缺乏共识。
2016年至2020年期间，通过主动前瞻性监测，在美国7家儿科医院和急诊科招募了18岁以下的急性呼吸道疾病儿童。临床信息通过家长访谈和病历获得。在每个地点采集中鼻甲鼻拭子，并用分子诊断检测法检测RSV和HMPV。我们比较了RSV或HMPV患儿的描述性和临床特征，并计算了RSV与HMPV相比严重结局的校正比值比（aOR）。使用逻辑回归模型评估RSV或HMPV患儿严重结局的危险因素。
共纳入5329例因RSV（n = 4398）或HMPV（n = 931）住院的儿童，以及3276例因RSV相关（n = 2371）或HMPV相关（n = 905）急诊就诊的儿童。RSV住院患儿的中位年龄低于HMPV住院患儿（7个月对16个月，P <.0001）。因RSV相关急性呼吸道疾病到急诊科就诊的儿童住院几率高于HMPV相关儿童（aOR，1.68；95%CI，1.50 - 1.87），6个月以下婴儿几率最高（aOR，3.27；95%CI，2.53 - 4.23）。HMPV住院婴儿潜在疾病的发生率是RSV住院婴儿的两倍多（26%对11%）。
与RSV相关住院儿童相比，HMPV相关住院儿童往往年龄更大，更可能有潜在疾病。
