{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T12:24:14Z","timestamp":1787660654996,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Inflammatory\u2010biomarker, cycle\u2010threshold (Ct) and co\u2010detection data on human metapneumovirus (hMPV) in the pediatric emergency department remain scarce. We retrospectively studied 203 children with multiplex RT\u2010PCR\u2013confirmed respiratory virus positivity at a tertiary pediatric emergency department (January\u2013May 2025). Inflammatory indices, C\u2010reactive protein (CRP) and per\u2010target Ct were compared between hMPV and RSV; predictors of antibiotic prescribing were assessed by ROC and multivariable regression. hMPV (17.7%) and RSV (28.6%) were dominant detections; co\u2010detection 24.1%. Compared with RSV, hMPV affected older children with higher comorbidity, more pneumonia and neutrophil\u2010driven inflammation (neutrophil\u2010to\u2010lymphocyte ratio [NLR], systemic immune\u2010inflammation index [SII], CRP higher;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.006). Dominant Ct differed across pathogens (Kruskal\u2013Wallis\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); rhinovirus carried the lowest viral load. Paired non\u2010dominant Ct exceeded dominant Ct (median \u0394Ct +3.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). CRP independently predicted antibiotic prescribing (AUC 0.78, cut\u2010off 3.9\u2009mg\/L). hMPV showed a neutrophil\u2010dominant inflammatory phenotype in older, more comorbid children than RSV. Per\u2010target Ct supports the lowest\u2010Ct\u2010dominant convention. CRP\u2014not white\u2010cell indices\u2014drove antibiotic prescribing; a 3.9\u2009mg\/L cut\u2010off supports stewardship in PCR\u2010confirmed pediatric viral respiratory infection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmv.71099","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:09:07Z","timestamp":1786356547000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Human Metapneumovirus Versus Respiratory Syncytial Virus in the Pediatric Emergency Department: Inflammatory Indices, Cycle\u2010Threshold Profiles and Outcomes"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2195-3551","authenticated-orcid":false,"given":"Y\u0131lmaz","family":"Se\u00e7ilmi\u015f","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Faculty of Medicine, Erciyes University Kayseri T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4276-8560","authenticated-orcid":false,"given":"G\u00fcl\u015fah","family":"Kartal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Faculty of Medicine, Erciyes University Kayseri T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2321-808X","authenticated-orcid":false,"given":"Muhammet Sami","family":"Kayan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Emergency Faculty of Medicine, Erciyes University Kayseri T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7806-6397","authenticated-orcid":false,"given":"Mesut","family":"Kara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine, Erciyes University Kayseri 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