Acute bronchiolitis is a leading cause of hospitalization in infants. In this retrospective study, 645 patients with acute bronchiolitis diagnosed as respiratory syncytial virus (RSV; n = 538) or human metapneumovirus (HMPV; n = 107) were compared in terms of demographic, clinical, and laboratory findings. The HMPV patients presented later in the winter, were older (20 vs 7.55 months; P < .001)), had higher levels of C-reactive protein (4.55 vs 3.03 mg/dL; P = .007), and a higher prevalence of complications (43.9% vs 32.7%; P = .03). This study highlights the similarities and differences between these 2 common respiratory viral pathogens and shows that HMPV has a slightly more severe disease course than RSV. These findings can help guide approaches to these 2 common viruses that cause bronchiolitis.
NicolaiAFerraraMSchiavarielloC, et al. Viral bronchiolitis in children: a common condition with few therapeutic options. Early Hum Dev. 2013;89:S7-S11. doi:10.1016/j.earlhumdev.2013.07.016.
MeissnerHC. Viral bronchiolitis in children. N Engl J Med. 2016;374(1):62-72. doi:10.1056/NEJMra1413456.
5.
WilliamsJVHarrisPATollefsonSJ, et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med. 2004;350(5):443-450. doi:10.1056/NEJMoa025472.
6.
PurcellKFergieJ. Driscoll Children’s Hospital respiratory syncytial virus database: risk factors, treatment and hospital course in 3308 infants and young children, 1991 to 2002. Pediatr Infect Dis J. 2004;23(5):418-423. doi:10.1097/01.inf.0000126273.27123.33.
7.
PapenburgJBoivinG. The distinguishing features of human metapneumovirus and respiratory syncytial virus. Rev Med Virol. 2010;20(4):245-260. doi:10.1002/rmv.651.
8.
van den HoogenBGde JongJCGroenJ, et al. A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med. 2001;7(6):719-724. doi:10.1038/89098.
9.
ManohaCEspinosaSAhoSLHuetFPothierP. Epidemiological and clinical features of hMPV, RSV and RVs infections in young children. J Clin Virol. 2007;38(3):221-226. doi:10.1016/j.jcv.2006.12.005.
10.
KahnJS. Epidemiology of human metapneumovirus. Clin Microbiol Rev. 2006;19(3):546-557. doi:10.1128/CMR.00014-06.
11.
ShahdaSCarlosWGKielPJKhanBAHageCA. The human metapneumovirus: a case series and review of the literature. Transpl Infect Dis. 2011;13(3):324-328. doi:10.1111/j.1399-3062.2010.00575.x.
12.
HenricksonKJHooverSKehlKSHuaW. National disease burden of respiratory viruses detected in children by polymerase chain reaction. Pediatr Infect Dis J. 2004;23(suppl 1):S11-S18. doi:10.1097/01.inf.0000108188.37237.48.
13.
MullinsJAErdmanDDWeinbergGA, et al. Human Metapneumovirus infection among children hospitalized with acute respiratory illness. Emerg Infect Dis. 2004;10(4):700-705. doi:10.3201/eid1004.030555.
14.
CattoirLVankeerberghenABoelAVan VaerenberghKDe BeenhouwerH. Epidemiology of RSV and hMPV in Belgium: a 10-year follow-up. Acta Clin Belg. 2019;74(4):229-235. doi:10.1080/17843286.2018.1492509.
15.
GauntEMcWilliam-LeitchECTempletonKSimmondsP. Incidence, molecular epidemiology and clinical presentations of human metapneumovirus; assessment of its importance as a diagnostic screening target. J Clin Virol. 2009;46(4):318-324. doi:10.1016/j.jcv.2009.09.016.
16.
OrdásJBogaJAAlvarez-ArgüM, et al. Role of metapneumovirus in viral respiratory infections in young children. J Clin Microbiol. 2006;44(8):2739-2742. doi:10.1128/JCM.00164-06.
17.
WolfDGGreenbergDKalksteinD, et al. Comparison of human metapneumovirus, respiratory syncytial virus and influenza a virus lower respiratory tract infections in hospitalized young children. Pediatr Infect Dis J. 2006;25(4):320-324. doi:10.1097/01.inf.0000207395.80657.cf.
18.
AkhrasNWeinbergJBNewtonD. Human metapneumovirus and respiratory syncytial virus: subtle differences but comparable severity. Infect Dis Rep. 2010;2(2):e12. doi:10.4081/idr.2010.e12.
19.
ToikkaPIrjalaKJuvénT, et al. Serum procalcitonin, C-reactive protein and interleukin-6 for distinguishing bacterial and viral pneumonia in children. Pediatr Infect Dis J. 2000;19(7):598-602. doi:10.1097/00006454-200007000-00003.
20.
McCrackenJPArveloWOrtízJ, et al. Comparative epidemiology of human metapneumovirus- and respiratory syncytial virus-associated hospitalizations in Guatemala. Influenza Other Respir Viruses. 2014;8(4):414-421. doi:10.1111/irv.12251.
21.
CuevasLENasserAMDoveWGurgelRQGreensillJHartCA. Human metapneumovirus and respiratory syncytial virus, Brazil. Emerg Infect Dis. 2003;9(12):1626-1628. doi:10.3201/eid0912.030522.
22.
von LinstowMLLarsenHHEugen-OlsenJ, et al. Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection. Scand J Infect Dis. 2004;36(8):578-584. doi:10.1080/00365540410018166.
23.
National Institute for Health and Care Excellence. Bronchiolitis in children: diagnosis and management. Published 2015. Accessed January 9, 2023. https://www.nice.org.uk/guidance/ng9.
24.
RalstonSLLieberthalASMeissnerHC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014;134(5):e1474-e1502. doi:10.1542/peds.2014-2742.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Fontana, WI: Global Initiative for Asthma; 2022.
27.
SteinRTMartinezFD. Asthma phenotypes in childhood: lessons from an epidemiological approach. Paediatr Respir Rev. 2004;5(2):155-161. doi:10.1016/j.prrv.2004.01.007.
