Metapneumovirus infection in children

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Abstract


Objective: to study the clinical features of metapneumovirus infection in children of different ages in a hospital.

Materials and methods. A retrospective analysis of medical records of 142 patients aged 1 month to 14 years inclusive who were hospitalized in the period from January 2012 to April 2019. Metapneumovirus infection was confirmed by hMPV nucleic acid isolation by PCR in nasopharyngeal smears.

Results. Metapneumovirus infection is detected among hospitalized children with acute respiratory viral infections in 4,4% of cases. In the age structure, 72,2% are children under 4 years old, and the maximum incidence rate is among children aged 3 years of life. The leading clinical symptoms are cough in 93,0% of cases and rhinitis in 96,5% of cases.
In 88,2% of children, the disease proceeds with an increase in temperature >38 °C, including in 34,6% – 39,5 °C and above. Symptoms of gastrointestinal dysfunction in the form of vomiting and diarrhea develop in 26,1% and 22,5% of children, respectively. 78,2% of patients requiring hospitalization suffer hMPV infection with damage to the lower respiratory tract, including in the form of bronchitis in 85,6% of cases and pneumonia in 14,4% of cases. The disease is complicated by the development of bronchial obstructive syndrome in 38,7% and acute respiratory failure in 22,3% of cases. ARF and BOS are significantly more likely to develop in children of the first 3 years of life – 71,0% versus 29,0% in children of the older age group (p = 0.038) and 69,8% against 30,2% (p = 0.007), respectively. In a clinical blood test for hMPV infection, leukopenia and leukocytosis are detected only in 3,5% and 12,7% of cases, respectively, as well as an increase in ESR in 23,9% of children. The level of CRP in the 93,0% of children was less than 20 mg/l.

Conclusions. Virological confirmation of metapneumovirus infection in hospitalized children with lower respiratory tract infections contributes to the formation of an adequate therapeutic tactic.


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About the authors

Elena V. Sharipova

Pediatric Research and Clinical Center for Infectious Diseases

Author for correspondence.
Email: lenowna2000@yandex.ru

Russian Federation, Saint Petersburg

MD, PhD, Senior Researcher, Department of Respiratory Infections

Irina V. Babachenko

St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation

Email: babachenko-doc@mail.ru

Russian Federation, Saint Petersburg

MD, PhD, Dr. Sci. (Med.), Professor, Department of Infectious Diseases in Children, Faculty of Postgraduate Education

Elizaveta D. Orlova

Pediatric Research and Clinical Center for Infectious Diseases

Email: lenowna2000@yandex.ru

Russian Federation, Saint Petersburg

Resident Doctor, Department of Respiratory Infections

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Dynamics of detection by years of metapneumovirus (hMPV) infection in hospitalized children in the period 2012–2019

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2.
Fig. 2. Age structure of children admitted to hospital with metapneumovirus (hMPV) infection

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3.
Fig. 3. The frequency of lesions of the lower respiratory tract with metapneumovirus infection, depending on age

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4.
Fig. 4. Frequency and severity of acute respiratory failure in etapneumovirus infection (n = 31)

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Copyright (c) 2020 Sharipova E.V., Babachenko I.V., Orlova E.D.

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