Metapneumovirus infection in children

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access


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.

Full Text

Restricted Access

About the authors

Elena V. Sharipova

Pediatric Research and Clinical Center for Infectious Diseases

Author for correspondence.

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


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


Russian Federation, Saint Petersburg

Resident Doctor, Department of Respiratory Infections


  1. Соколовская В.В., Грекова А.И., Жилина Е.А., и др. Особенности течения метапневмовирусной инфекции у детей // Журнал инфектологии. – 2018. – Т. 10. – № 4, приложение 1. – С. 133–134. [Sokolovskaja VV, Grekova AI, Zhilina EA, et al. Osobennosti techenija metapnevmovirusnoj infekcii u detej [Features of the course of metapneumovirus infection in children]. Journal Infectology. 2018;10(4S1):133-134. (In Russ.)]
  2. Харламова Ф.С., Кладова О.В., Учайкин В.Ф., и др. Клиническая эффективность индуктора интерферонов при метапневмовирусной и бокавирусной респираторных инфекциях у детей // Журнал инфектологии. – 2017. – Т. 9. – № 1, приложение. – С. 17–21. [Harlamova FS, Kladova OV, Uchajkin VF, et al. Klinicheskaja jeffektivnost’ induktora interferonov pri metapnevmovirusnoj i bokavirusnoj respiratornyh infekcijah u detej. Journal Infectology. 2017;9(1S):17-21. (in Russ.)]
  3. Хмилевская С.А., Зрячкин Н.И., Михайлова В.Е. Клинико-эпидемиологические особенности острых респираторных инфекций у детей и оценка эффективности противовирусной терапии // Журнал инфектологии. – 2019. – Т. 11. – № 3. – С. 38–45. [Khmilevskaya SA, Zryachkin NI, Mikhailova VE. Clinical-epidemiological peculiarities of acute respiratory infections in children from 3 to 12 years and evaluation of effectiveness of antivirus therapy. Journal Infectology. 2019;11(3):38-45. (In Russ.)]
  4. Шарипова Е.В., Бабаченко И.В., Левина А.С., Григорьев С.Г. Противовирусная терапия ОРВИ и гриппа у детей в стационарных условиях // Журнал инфектологии. – 2018. – Т. 10. – № 4. – С. 82–88. [Sharipova EV, Babachenko IV, Levina AS, Grigoriev SG. Antiviral therapy of acute respiratory viral infection and influenza in children in a hospital. Journal Infectology. 2018;10(4):82-88. (In Russ.)]
  5. Яцышина С.Б. Пневмовирусы в инфекционной патологии человека // Журнал микробиологии, эпидемиологии и иммунобиологии. – 2017. – № 6. – С. 95–105. [Yatsyshina S.B. Pnevmovirusy v infekcionnoj patologii cheloveka. Zhurnal mikrobiologii, jepidemiologii i immunobiologii. 2017;(6):95-105. (In Russ.)]
  6. Barr R, McGalliard R, Drysdale S. Human metapneumovirus in paediatric intensive care unit (PICU) admissions in the United Kingdom (UK) 2006-2014. J Clin Virol. 2019;112:15-19.
  7. De Graaf M, Osterhaus ADME, Fouchier RAM, Holmes EC. Evolutionary dynamics of human and avian metapneumoviruses. J Gen Virol. 2008;89(Pt 12): 2933-2942. 006957-0.
  8. Haas LEM, Thijsen SFT, van Elden L, Heemstra KA. Human metapneumovirus in adults. Viruses. 2013;5(1): 87-110.
  9. Holzemer N, Hasvold JJ, Pohl KJ, et al. Human metapneumovirus infection in hospitalized children. Respir Care. 2020;65(5):650-657.
  10. Lefebvre A, Manoha C, Bour J-B, et al. Human metapneumovirus in patients hospitalized with acute respiratory infections: A meta-analysis. J Clin Virol. 2016;81:68-77.
  11. Panda S, Mohakud NK, Pena L, Kumar S. Human metapneumovirus: review of an important respiratory pathogen. Int J Infect Dis. 2014;25:45-52.
  12. Schildgen V, van den Hoogen B, Fouchier R, et al. Human Metapneumovirus: Lessons Learned over the First Decade. Сlin Microbiol Rev. 2011;24(4):734-754.
  13. Shafagati N., Williams J. Human metapneumovirus — what we know now. F1000Res. 2018;7:135.
  14. Ting Sh, McAllister DA, O’Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946-958.
  15. Van den Hoogen BG, de Jong JC, Groen J, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001;7(6):719-724.

Supplementary files

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

Download (121KB) Indexing metadata
Fig. 2. Age structure of children admitted to hospital with metapneumovirus (hMPV) infection

Download (110KB) Indexing metadata
Fig. 3. The frequency of lesions of the lower respiratory tract with metapneumovirus infection, depending on age

Download (103KB) Indexing metadata
Fig. 4. Frequency and severity of acute respiratory failure in etapneumovirus infection (n = 31)

Download (129KB) Indexing metadata



Abstract - 16

PDF (Russian) - 0

PDF (English) - 0


Article Metrics

Metrics Loading ...



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

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies