{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:49:49Z","timestamp":1792183789686,"version":"4.4.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1K23AI141621"],"award-info":[{"award-number":["1K23AI141621"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Human metapneumovirus (HMPV) is a leading cause of respiratory tract infections. Few studies have compared the clinical characteristics and severity of HMPV-associated pneumonia with other pathogens.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Active, population-based surveillance was previously conducted for radiographically confirmed, community-acquired pneumonia hospitalizations among children and adults in 8 United States hospitals. Clinical data and specimens for pathogen detection were systematically collected. We described clinical features of all HMPV-associated pneumonia and, after excluding codetections with other pathogen types, we compared features of HMPV-associated pneumonia with other viral, atypical, and bacterial pneumonia and modeled the severity (mild, moderate, and severe) and length of stay using multivariable proportional odds regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>HMPV was detected in 298\/2358 (12.6%) children and 88\/2320 (3.8%) adults hospitalized with pneumonia and was commonly codetected with other pathogens (125\/298 [42%] children and 21\/88 [24%] adults). Fever and cough were the most common presenting symptoms of HMPV-associated pneumonia and were also common symptoms of other pathogens. After excluding codetections in children (n\u2005=\u20051778), compared to HMPV (reference), bacterial pneumonia exhibited increased severity (odds ratio [OR], 3.66; 95% confidence interval [CI], 1.43\u20139.40), respiratory syncytial virus (RSV; OR, 0.76; 95% CI, .59\u2013.99) and atypical (OR, 0.39; 95% CI, .19\u2013.81) infections exhibited decreased severity, and other viral pneumonia exhibited similar severity (OR, 0.88; 95% CI, .55\u20131.39). In adults (n\u2005=\u20052145), bacterial (OR, 3.74; 95% CI, 1.87\u20137.47) and RSV pneumonia (OR, 1.82; 95% CI, 1.32\u20132.50) were more severe than HMPV (reference), but all other pathogens had similar severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Clinical features did not reliably distinguish HMPV-associated pneumonia from other pathogens. HMPV-associated pneumonia was less severe than bacterial and adult RSV pneumonia, but was otherwise as or more severe than other common pathogens.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa088","type":"journal-article","created":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T21:44:32Z","timestamp":1580247872000},"page":"108-117","source":"Crossref","is-referenced-by-count":49,"title":["Clinical Features of Human Metapneumovirus-Associated Community-acquired Pneumonia Hospitalizations"],"prefix":"10.1093","volume":"72","author":[{"given":"Leigh M","family":"Howard","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University Medical Center , Nashville, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn M","family":"Edwards","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University Medical Center , Nashville, 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Georgia,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krow","family":"Ampofo","sequence":"additional","affiliation":[{"name":"University of Utah Health Sciences Center , Salt Lake City, Utah,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T","family":"Pavia","sequence":"additional","affiliation":[{"name":"University of Utah Health Sciences Center , Salt Lake City, Utah,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra R","family":"Arnold","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Sciences Center , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A","family":"McCullers","sequence":"additional","affiliation":[{"name":"University of Tennessee Health Sciences Center , Memphis, Tennessee,","place":["USA"]},{"name":"St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan J","family":"Anderson","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Medicine, Emory University School of Medicine , Atlanta, Georgia,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G","family":"Wunderink","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine , Chicago, Illinois,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek J","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vanderbilt University Medical Center , Nashville, 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