Khales Pegah, Razizadeh Mohammad Hossein, Ghorbani Saied, Tameshkel Fahimeh Safarnezhad, Saadati Hassan, Vazirzadeh Masoud, Moattari Afagh, Tavakoli Ahmad
Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Genetics, Genomics and Cancer Sciences, University of Leicester, Leicester, United Kingdom.
EClinicalMedicine. 2025 Aug 30;88:103480. doi: 10.1016/j.eclinm.2025.103480. eCollection 2025 Oct.
Human metapneumovirus (hMPV) is a significant respiratory pathogen, yet its global prevalence and epidemiological patterns remain poorly characterized. This study presents the first comprehensive systematic review and meta-analysis of hMPV prevalence among patients with respiratory tract infections (RTIs), addressing a critical gap in the literature, and clarifying the association between hMPV infection and RTIs.
We conducted a systematic search across PubMed, Scopus, and Web of Science, from 2002 to 2024. Studies reporting hMPV prevalence detected by Polymerase chain reaction-based methods in respiratory samples were included. Data was analyzed using random-effects models, with subgroup analyses by age, region, diagnostic methods, and patient's demographic. The main outcome was hMPV prevalence among patients with RTIs.
The global pooled prevalence of hMPV among 2,236,820 patients with RTIs was 5.3% (95% CI: 5.0%-5.6%). Prevalence was highest in children under 5 years (6.7%) and lowest in adults (2.5%). Lower respiratory infections showed the highest prevalence (8.2%), with bronchiolitis (7.0%) and pneumonia (5.5%) being prominent. Inpatients exhibited a significantly higher prevalence of hMPV (6.1%) compared to outpatients (3.3%). Among hMPV-positive samples, type A was more prevalent than type B. A meta-analysis of 41 case-control datasets revealed a significant association between hMPV infection and respiratory infections (pooled odds ratio [OR] = 4.6; 95% CI: 3.7-5.6; I = 14.4%).
This first-of-its-kind meta-analysis highlights hMPV as a major contributor to RTIs, particularly in young children and severe respiratory conditions. The findings show the need for improved diagnostic strategies, targeted surveillance, and vaccine development to mitigate hMPV's global burden.
This study was financially supported by the Iran University of Medical Sciences (Grant Number: 1402-2-75-25881).
人偏肺病毒（hMPV）是一种重要的呼吸道病原体，但其全球流行情况和流行病学模式仍未得到充分描述。本研究首次对呼吸道感染（RTIs）患者中hMPV的流行情况进行了全面的系统评价和荟萃分析，填补了文献中的关键空白，并阐明了hMPV感染与RTIs之间的关联。
我们在2002年至2024年期间对PubMed、Scopus和Web of Science进行了系统检索。纳入了报告通过基于聚合酶链反应的方法在呼吸道样本中检测到的hMPV流行情况的研究。使用随机效应模型进行数据分析，并按年龄、地区、诊断方法和患者人口统计学进行亚组分析。主要结果是RTIs患者中hMPV的流行情况。
在2236820例RTIs患者中，hMPV的全球合并流行率为5.3%（95%CI：5.0%-5.6%）。5岁以下儿童的流行率最高（6.7%），成人最低（2.5%）。下呼吸道感染的流行率最高（8.2%），其中细支气管炎（7.0%）和肺炎（5.5%）最为突出。住院患者的hMPV流行率（6.1%）显著高于门诊患者（3.3%）。在hMPV阳性样本中，A型比B型更常见。对41个病例对照数据集的荟萃分析显示，hMPV感染与呼吸道感染之间存在显著关联（合并比值比[OR]=4.6；95%CI：3.7-5.6；I²=14.4%）。
这项首创的荟萃分析强调hMPV是RTIs的主要促成因素，尤其是在幼儿和严重呼吸道疾病中。研究结果表明，需要改进诊断策略、进行针对性监测和开发疫苗，以减轻hMPV的全球负担。
本研究得到伊朗医科大学的资助（资助编号：1402-2-75-25881）。
