Risk Factors for Pediatric Intensive Care Unit Admission in Children with Human Metapneumovirus Infections

Background: Human metapneumovirus (hMPV) frequently causes respiratory tract infections in children. Although hMPV infections are usually mild and self-limited, they may cause significant morbidity and mortality. However, data on pediatric hospitalizations due to hMPV infection are limited. Materials and Methods: We retrospectively analyzed the data of patients aged 18 or younger hospitalized due to hMPV infection at a tertiary hospital between 2014 and 2019. Results: In total, 266 pediatric patients were admitted for hMPV infection. The incidence of hospitalizations due to hMPV infections was 6.4 per 1,000 hospitalized children, and the incidence of pediatric intensive care unit (PICU) admissions due to hMPV was 4.1 per 1,000 PICU-admitted children. The median age was 2.2 years (42 days–18.5 years), with 125 patients (47.0%) younger than two years old. Twenty-eight patients (10.5%) were treated in the PICU, and five of them (17.9%) died. The proportion of patients with underlying diseases was higher in the PICU group than in the general ward group (85.7% vs. 63.4%, P=0.02). The proportions of cardiologic diseases (21.4% vs. 8.8%, P=0.048) and genetic diseases (35.7% vs. 5.5%, P<0.001) were higher in the PICU group. Conclusion: hMPV can cause severe infections that lead to PICU admission, particularly in patients with underlying conditions and fatal outcomes. Further data on hMPV infection in children admitted to the PICU and the overall disease burden in society are required.