Characteristics and burden of human metapneumovirus infection in older patients: Clinico-radiological patterns and impact on survival from a retrospective cohort study.

OBJECTIVES

This study aimed to assess the burden and outcomes of human metapneumovirus (hMPV) infection in older patients.

METHODS

This is a monocentric, retrospective cohort study that included all patients aged ≥65 years who were diagnosed with an hMPV infection between December 2017 and March 2024. The primary outcome was overall mortality at 12 months.

RESULTS

We identified 155 patients; the median age was 79 years (interquartile range 71-87 years). At baseline, upper respiratory tract infections (URTI) were diagnosed in 81 patients (52.3%). Sixty-seven (43.2%), 14 (9%), and 37 (23.8%) episodes of cardiac, respiratory, and renal decompensation occurred, respectively, following hMPV infection. Overall survival rates were 83% (76-88) at 3 months and 71% (61-78) at 12 months. Survival at 3 and 12 months was 68%/57% in lower respiratory tract infection (LRTI) with an organ decompensation, 87%/82% in LRTI without organ decompensation, 84%/62% in URTI with an organ decompensation, and 92%/83% in URTI patients without organ decompensation (log-rank P = 0.0159). The Charlson Comorbidity Index (1.20 [1.01-1.41]), chronic renal disease requiring dialysis (4.04 [1.07-15.25]), and loss of autonomy reflected by an Activities of Daily Living score <4 (2.87 [1.30-6.35]) were independently associated with 12-month mortality beyond LRTI and decompensation (2.95 [1.12-7.79]).

CONCLUSION

The burden of hMPV infections in the elderly is significant, particularly due to decompensation of comorbidities.