Abstract
Clinical features of human metapneumovirus (HMPV) infection have not been well documented for adults. We investigated clinical and radiologic features of HMPV infection in 849 adults in a tertiary hospital in South Korea. We classified patients into groups on the basis of underlying diseases: immunocompetent patients, solid tumor patients, solid organ transplantation recipients, hematopoietic stem cell transplant recipients, hematologic malignancy patients, and patients receiving long-term steroid treatment. Of 849 HMPV-infected patients, 756 had community-acquired infections, 579 had pneumonia, and 203 had infections with other pathogens. Mortality rates were highest in hematopoietic stem cell transplantation recipients (22% at 30 days). Older age, current smoking, and underlying disease were associated with HMPV pneumonia. Body mass index and an immunocompromised state were associated with 30-day mortality rates in HMPV-infected patients. Bronchial wall thickening, ground-glass opacity, and ill-defined centrilobular nodules were common computed tomography findings for HMPV pneumonia. Macronodules and consolidation were observed in <50% of patients.
Highlights
Clinical features of human metapneumovirus (HMPV) infection have not been well documented for adults
Radiologic Evaluation For patients given a diagnosis of HMPV infection, we evaluated the presence of pneumonic infiltrates on chest radiographs to detect pneumonia
Patient Characteristics For the study period, January 2010–February 2016, we identified 850 adults infected with HMPV (Figure 1)
Summary
Clinical features of human metapneumovirus (HMPV) infection have not been well documented for adults. Body mass index and an immunocompromised state were associated with 30-day mortality rates in HMPV-infected patients. Clinical characteristics such as host immunity in patients with HMPV infection and radiologic findings of HMPV pneumonia are needed for early detection of HMPV infection and for studies of HMPV pneumoniarelated outcomes [14,20,21]. A recent study of 3 long-term care facilities in Japan reported clinical and radiologic characteristics of HMPV pneumonia, that study did not assess the proportion of URIs, included only immunocompetent persons, and did not determine overall outcomes of HMPV pneumonia. We conducted a study that included a large consecutive cohort of adults infected with HMPV and assessed the proportions of HMPV-associated URI and pneumonia in patients with various underlying disease, and laboratory findings, radiologic findings, including computed tomography (CT) images, and overall outcomes
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