Clinical characteristics and risk factors for severe human metapneumovirus pneumonia in children: A single-center retrospective study

Background Human metapneumovirus (HMPV) is an important etiological agent of pediatric acute respiratory tract infections, with the potential to cause severe pneumonia. Understanding the clinical characteristics and identifying risk factors of severe case is critical for timely intervention and improved clinical outcomes. Methods A retrospective study of children with HMPV pneumonia hospitalized in Guangzhou Women and Children’s Medical Center between January 2022 and December 2023 was performed. Binary logistic regression analysis was used to identify independent risk factors for severe HMPV pneumonia after univariate analysis. Results Our study included 159 patients (87 males and 72 females). Among them, 104 patients were in mild group and 55 in severe group. Compared to the mild group, children with severe pneumonia were younger, had a longer duration of fever, and more likely to present with wheezing, anemia (HGB < 90g/L), elevated level of CRP (CRP > 50mg/L), elevated level of LDH (LDH > 350U/L), hypoalbuminemia (ALB < 35g/L) as well as pulmonary consolidation/atelectasis (all p < 0.05). Furthermore, multivariate analysis shows that the independent risk factors associated with severe HMPV pneumonia in children were wheezing (OR = 18.233, CI: 5.559–59.807, p < 0.001), elevated level of CRP (CRP > 50mg/L) (OR = 6.162, CI: 1.501–25.299, p = 0.012), elevated level of LDH (LDH > 350U/L) (OR = 3.514, CI: 1.202–10.275, p = 0.022) and pulmonary consolidation/atelectasis (OR = 13.836, CI: 1.646-116.299, p = 0.016). Conclusion Children with HMPV pneumonia who have wheezing, elevated level of CRP (CRP > 50mg/L), elevated level of LDH (LDH > 350U/L) or pulmonary consolidation/atelectasis are more easily developing to severe condition. Clinical trial number: Not applicable.