{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T22:09:41Z","timestamp":1788300581067,"version":"build-2803163510"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Human metapneumovirus (hMPV) is a significant respiratory pathogen in infants and young children. Although most infections present as nonsevere cases in outpatient settings, severe courses can lead to hospitalization. Few potential risk factors for hospitalization have already been identified, but studies comparing the clinical presentation of children with hMPV in inpatient versus outpatient settings are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective analysis used data from the Pediatric Airway Pathogen Incidence study, a multicenter surveillance study of lower respiratory tract infections, conducted in Germany during winter seasons 2021\/22 and 2022\/23 (weeks 40\u201317 each season). We compared 102 hospitalized and 114 outpatient pediatric cases with laboratory-confirmed hMPV infection after excluding coinfections with respiratory syncytial virus. Detailed clinical and demographic data were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Hospitalized patients were significantly younger (median age 9 vs. 14 months,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003) than outpatients. Prematurity was notably higher in severe cases (25% vs. 6.2%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and extreme prematurity (gestational age &lt;28 weeks) was present only in hospitalized patients. Hospitalized cases were independently associated with a history of recurrent wheezing, but not with neonatal invasive and noninvasive respiratory support, inhalative steroids and bronchopulmonary dysplasia. On clinical examination, hospitalized children more often exhibited wheezing, crackles, tachypnea, hypoxemia and reduced fluid intake. Hypoxemia in hMPV was independently associated with gestational age at birth, but not with age at diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The clinical presentation of hMPV in hospitalized young children differed from that observed in outpatient settings. We identified multiple factors that were independently associated with hMPV-related hospitalization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/inf.0000000000005166","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T05:00:17Z","timestamp":1770786017000},"page":"578-582","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Disease Spectrum of Human Metapneumovirus Infections in Infants and Young Children: Data From a Prospective Multicenter Study in Germany"],"prefix":"10.1097","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1211-5069","authenticated-orcid":false,"given":"Johannes","family":"Borgmann","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Pediatric Intensive Care, Pulmonology and Allergology, Klinikum Oldenburg, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cordula","family":"Koerner-Rettberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Marien-Hospital Wesel, Wesel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kiefer","sequence":"additional","affiliation":[{"name":"Children\u2019s University Clinic of Eastern Bavaria (KUNO), St. Hedwig Clinic of the Brothers of Mercy, University of Regensburg, Regensburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"D\u00f6rdelmann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, DIAKO Hospital, Flensburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Armbrust","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dietrich-Bonhoeffer Hospital, Neubrandenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hufnagel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology and Clinical Infectious Diseases, Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center and Medical Faculty, University of Freiburg, Freiburg im Breisgau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Spielberger","sequence":"additional","affiliation":[{"name":"Division of Pediatric Rheumatology and Clinical Infectious Diseases, Department of General Pediatrics, Adolescent Medicine and Neonatology, Center for Pediatrics, Medical Center and Medical Faculty, University of Freiburg, Freiburg im Breisgau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Pediatric Pneumology, University Hospital Jena, Jena"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Bode","sequence":"additional","affiliation":[{"name":"Division of Pediatric Pulmonology, Department of Pediatrics, Allergology and Cystic Fibrosis, University Hospital Ulm, Ulm"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Teichmann","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, KRH Hospital Neustadt am R\u00fcbenberge, Neustadt am R\u00fcbenberge"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Eberhardt","sequence":"additional","affiliation":[{"name":"CAPNETZ STIFTUNG"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Behrens","sequence":"additional","affiliation":[{"name":"Pediatrician\u2019s office Dr. med. Clemens Behrens\/Dr. med. Marc Bohn\/Dr. med. Carolin Lorentzen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Buck","sequence":"additional","affiliation":[{"name":"Pediatrician\u2019s office Dr. med. Thomas Buck, Hannover"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gerber","sequence":"additional","affiliation":[{"name":"Pediatrician\u2019s office Dr. med. Andrea Gerber, Niederro\u00dfla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Rosewich","sequence":"additional","affiliation":[{"name":"Pediatrician\u2019s office PD Dr. med. Martin Rosewich, Oberursel (Taunus)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Schaaff","sequence":"additional","affiliation":[{"name":"Pediatrician\u2019s office Dr. med. Franziska Schaaff, Dr. med. Jan-Helge H\u00f6pner, Eckental"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Panning","sequence":"additional","affiliation":[{"name":"Institute of Virology, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Hamprecht","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology and Virology, Carl von Ossietzky University Oldenburg, Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Lex","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Division of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, G\u00f6ttingen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-3272","authenticated-orcid":false,"given":"Christine","family":"Happle","sequence":"additional","affiliation":[{"name":"Pediatric Pneumology, Allergology, Neonatology of Hannover Medical School, Hannover"},{"name":"German Center for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"K\u00f6ster","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Pediatric Intensive Care, Pulmonology and Allergology, Klinikum Oldenburg, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wetzke","sequence":"additional","affiliation":[{"name":"Pediatric Pneumology, Allergology, Neonatology of Hannover Medical School, Hannover"},{"name":"German Center for Lung Research, Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Lange","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Pediatric Intensive Care, Pulmonology and Allergology, Klinikum Oldenburg, School of Medicine and Health Sciences, University of Oldenburg, Oldenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"R1-20260609","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1038\/89098","article-title":"A newly discovered human pneumovirus isolated from young children with respiratory tract disease.","volume":"7","author":"van den Hoogen","year":"2001","journal-title":"Nat Med"},{"key":"R2-20260609","doi-asserted-by":"crossref","first-page":"e0242302","DOI":"10.1371\/journal.pone.0242302","article-title":"Systematic review and meta-analysis of the prevalence of common respiratory viruses in children < 2 years with bronchiolitis in the pre-COVID-19 pandemic era.","volume":"15","author":"Kenmoe","year":"2020","journal-title":"PLoS One"},{"key":"R3-20260609","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/infdis\/jix262","article-title":"The burden of human metapneumovirus and respiratory syncytial virus infections in hospitalized Norwegian children.","volume":"216","author":"Moe","year":"2017","journal-title":"J Infect Dis"},{"key":"R4-20260609","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12985-021-01508-0","article-title":"Epidemiology and genotypic diversity of human metapneumovirus in paediatric patients with acute respiratory infection in Beijing, China.","volume":"18","author":"Wang","year":"2021","journal-title":"Virol J"},{"key":"R5-20260609","doi-asserted-by":"crossref","first-page":"e2090","DOI":"10.1002\/rmv.2090","article-title":"A review on epidemiology and impact of human metapneumovirus infections in children using TIAB search strategy on PubMed and PubMed Central articles.","volume":"30","author":"Divarathna","year":"2020","journal-title":"Rev Med Virol"},{"key":"R6-20260609","doi-asserted-by":"crossref","first-page":"116809","DOI":"10.1016\/j.diagmicrobio.2025.116809","article-title":"Global impact of hMPV virus: transmission, pathogenesis, diagnostic and treatment.","volume":"112","author":"Porwal","year":"2025","journal-title":"Diagn Microbiol Infect Dis"},{"key":"R7-20260609","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1056\/NEJMoa1204630","article-title":"Burden of human metapneumovirus infection in young children.","volume":"368","author":"Edwards","year":"2013","journal-title":"N Engl J Med"},{"key":"R8-20260609","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1056\/NEJMoa025472","article-title":"Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children.","volume":"350","author":"Williams","year":"2004","journal-title":"N Engl J Med"},{"key":"R9-20260609","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1056\/NEJMoa1405870","article-title":"Community-acquired pneumonia requiring hospitalization among U.S. children.","volume":"372","author":"Jain","year":"2015","journal-title":"N Engl J Med"},{"key":"R10-20260609","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.cmi.2024.10.023","article-title":"Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the Pneumonia Etiology Research for Child Health (PERCH) study experience.","volume":"31","author":"Miyakawa","year":"2025","journal-title":"Clin Microbiol Infect"},{"key":"R11-20260609","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/S0140-6736(19)30721-4","article-title":"Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study.","volume":"394","year":"2019","journal-title":"Lancet Lond Engl"},{"key":"R12-20260609","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1093\/infdis\/jis333","article-title":"Comparison of risk factors for human metapneumovirus and respiratory syncytial virus disease severity in young children.","volume":"206","author":"Papenburg","year":"2012","journal-title":"J Infect Dis"},{"key":"R13-20260609","doi-asserted-by":"crossref","first-page":"507","DOI":"10.3390\/v16040507","article-title":"Disease burden and inpatient management of children with acute respiratory viral infections during the pre-COVID Era in Germany: a cost-of-illness study.","volume":"16","author":"Alchikh","year":"2024","journal-title":"Viruses"},{"key":"R14-20260609","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1093\/jpids\/piv027","article-title":"Incidence, morbidity, and costs of human metapneumovirus infection in hospitalized children.","volume":"5","author":"Davis","year":"2016","journal-title":"J Pediatric Infect Dis Soc"},{"key":"R15-20260609","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s00431-007-0643-4","article-title":"A community study of clinical traits and risk factors for human metapneumovirus and respiratory syncytial virus infection during the first year of life.","volume":"167","author":"von Linstow","year":"2008","journal-title":"Eur J Pediatr"},{"key":"R16-20260609","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/imm.13844","article-title":"Advancement in the development of mRNA-based vaccines for respiratory viruses.","volume":"173","author":"Troncoso-Bravo","year":"2024","journal-title":"Immunology"},{"key":"R17-20260609","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/infdis\/jiu307","article-title":"A broadly neutralizing human monoclonal antibody exhibits in vivo efficacy against both human metapneumovirus and respiratory syncytial virus.","volume":"211","author":"Schuster","year":"2015","journal-title":"J Infect Dis"},{"key":"R18-20260609","doi-asserted-by":"crossref","first-page":"105405","DOI":"10.1016\/j.antiviral.2022.105405","article-title":"Antiviral strategies against human metapneumovirus: targeting the fusion protein.","volume":"207","author":"Van Den Bergh","year":"2022","journal-title":"Antiviral Res"},{"key":"R19-20260609","doi-asserted-by":"crossref","first-page":"6270","DOI":"10.1038\/s41467-024-50659-5","article-title":"Efficacious human metapneumovirus vaccine based on AI-guided engineering of a closed prefusion trimer.","volume":"15","author":"Bakkers","year":"2024","journal-title":"Nat Commun"},{"key":"R20-20260609","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1007\/s15010-025-02484-1","article-title":"RSV is the main cause of severe respiratory infections in infants and young children in Germany - data from the prospective, multicenter PAPI study 2021\u20132023.","volume":"53","author":"Wetzke","year":"2025","journal-title":"Infection"},{"key":"R21-20260609","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/crj.13261","article-title":"Human bocavirus and metapneumovirus in acute wheezing in children-is there a link with atopy?","volume":"14","author":"Sobkowiak","year":"2020","journal-title":"Clin Respir J"},{"key":"R22-20260609","doi-asserted-by":"crossref","first-page":"00832-2023","DOI":"10.1183\/23120541.00832-2023","article-title":"Bronchial reactivity and asthma at school age after early-life metapneumovirus infection.","volume":"10:","author":"Myklebust","year":"2024","journal-title":"ERJ Open Res"},{"key":"R23-20260609","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/s00431-014-2277-7","article-title":"Clinical and epidemiologic factors related to subsequent wheezing after virus-induced lower respiratory tract infections in hospitalized pediatric patients younger than 3 years.","volume":"173","author":"Takeyama","year":"2014","journal-title":"Eur J Pediatr"},{"key":"R24-20260609","doi-asserted-by":"crossref","first-page":"8560","DOI":"10.1128\/JVI.00699-08","article-title":"T Lymphocytes contribute to antiviral immunity and pathogenesis in experimental human metapneumovirus infection.","volume":"82","author":"Kolli","year":"2008","journal-title":"J Virol"},{"key":"R25-20260609","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1042\/CS20160011","article-title":"Role of human metapneumovirus and respiratory syncytial virus in asthma exacerbations: where are we now?","volume":"131","author":"Rudd","year":"2017","journal-title":"Clin Sci (Lond)"},{"key":"R26-20260609","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1128\/CVI.00230-15","article-title":"New approaches for immunization and therapy against human metapneumovirus.","volume":"22","author":"Wen","year":"2015","journal-title":"Clin Vaccine Immunol"}],"container-title":["Pediatric Infectious Disease Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000005166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:01:40Z","timestamp":1780977700000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/INF.0000000000005166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/inf.0000000000005166","relation":{},"ISSN":["0891-3668","1532-0987"],"issn-type":[{"value":"0891-3668","type":"print"},{"value":"1532-0987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,11]]}}}