BMC pediatrics · 2026
Comparison of human metapneumovirus and respiratory syncytial virus in children with acute lower respiratory infections in Wenzhou, China from 2021 to 2022: a retrospective study.
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Zhu Lili, Zeng Luyao, Zhang Manjun, Chen Xinyu, Li Yilin, Yu Jian, Wen Shunhang, Zhang Hailin, Yu Gang
Аннотация
OBJECTIVE: To compare the clinical characteristics of human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) infections in children hospitalized with acute lower respiratory infections (ALRI).
METHODS: Children hospitalized with ALRI in Wenzhou, China from 2021 to 2022 were detected for HMPV and RSV in sputum or nasopharyngeal secretions by multiplex reverse transcription polymerase chain reaction (RT-PCR). A comparative analysis of demographic, clinical, laboratory, and radiological characteristics was performed retrospectively for patients in the HMPV and RSV groups.
RESULTS: A total of 15,772 hospitalized children were screened and tested by multiplex RT-PCR. 889 (5.6%) were HMPV-positive and 2,196 (13.9%) were RSV-positive. Compared with the RSV-associated ALRI group, the HMPV-associated ALRI group exhibited a lower proportion of males (55.2% vs. 62.2%, P = 0.002), an older median age (2.5 years vs. 1.6 years, P < 0.001), and a higher proportion of underlying medical conditions (9.9% vs. 6.0%, P = 0.001). The HMPV group exhibited significantly longer duration of fever (P < 0.001) and higher peak temperature (P < 0.001) compared with the RSV group. In contrast, the RSV group were more likely to present with respiratory distress, including retractions (P = 0.006) and nodding breathing (P = 0.032). Levels of C-reactive protein (14.18 mg/L vs. 7.80 mg/L, P < 0.001), procalcitonin (P = 0.001), lactate dehydrogenase (422.0 U/L vs. 381.0 U/L, P < 0.001), and neutrophil percentage (60.6% vs. 56.5%, P = 0.007) in the HMPV group were significantly higher than the RSV group. Children with HMPV-associated ALRI were more likely to exhibit patchy or linear opacities (71.5% vs. 65.1%, P = 0.016), pulmonary consolidation (4.1% vs. 2.1%, P = 0.047), and atelectasis (1.8% vs. 0%, P = 0.001) compared with those in the RSV group.
CONCLUSION: In hospitalized children, those with HMPV infection may be more common in older children and more likely to have underlying medical conditions than those with RSV infection. Children with HMPV-associated ALRI may present with prolonged, higher-grade fever, more pronounced systemic inflammatory responses, and an increased risk of developing pulmonary consolidation and atelectasis.
METHODS: Children hospitalized with ALRI in Wenzhou, China from 2021 to 2022 were detected for HMPV and RSV in sputum or nasopharyngeal secretions by multiplex reverse transcription polymerase chain reaction (RT-PCR). A comparative analysis of demographic, clinical, laboratory, and radiological characteristics was performed retrospectively for patients in the HMPV and RSV groups.
RESULTS: A total of 15,772 hospitalized children were screened and tested by multiplex RT-PCR. 889 (5.6%) were HMPV-positive and 2,196 (13.9%) were RSV-positive. Compared with the RSV-associated ALRI group, the HMPV-associated ALRI group exhibited a lower proportion of males (55.2% vs. 62.2%, P = 0.002), an older median age (2.5 years vs. 1.6 years, P < 0.001), and a higher proportion of underlying medical conditions (9.9% vs. 6.0%, P = 0.001). The HMPV group exhibited significantly longer duration of fever (P < 0.001) and higher peak temperature (P < 0.001) compared with the RSV group. In contrast, the RSV group were more likely to present with respiratory distress, including retractions (P = 0.006) and nodding breathing (P = 0.032). Levels of C-reactive protein (14.18 mg/L vs. 7.80 mg/L, P < 0.001), procalcitonin (P = 0.001), lactate dehydrogenase (422.0 U/L vs. 381.0 U/L, P < 0.001), and neutrophil percentage (60.6% vs. 56.5%, P = 0.007) in the HMPV group were significantly higher than the RSV group. Children with HMPV-associated ALRI were more likely to exhibit patchy or linear opacities (71.5% vs. 65.1%, P = 0.016), pulmonary consolidation (4.1% vs. 2.1%, P = 0.047), and atelectasis (1.8% vs. 0%, P = 0.001) compared with those in the RSV group.
CONCLUSION: In hospitalized children, those with HMPV infection may be more common in older children and more likely to have underlying medical conditions than those with RSV infection. Children with HMPV-associated ALRI may present with prolonged, higher-grade fever, more pronounced systemic inflammatory responses, and an increased risk of developing pulmonary consolidation and atelectasis.