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Observational Study
. 2025 Jul 16;232(Supplement_1):S69-S77.
doi: 10.1093/infdis/jiaf083.

Human Metapneumovirus Epidemiology Among Middle-aged and Older Adults Hospitalized With Acute Respiratory Infection

Henrique Pott  1   2 , Jason J LeBlanc  1   3   4 , May ElSherif  1 , Todd F Hatchette  1   3   4 , Melissa K Andrew  1   5 , Shelly A McNeil  1   4
Affiliations
Observational Study

Human Metapneumovirus Epidemiology Among Middle-aged and Older Adults Hospitalized With Acute Respiratory Infection

Henrique Pott et al. J Infect Dis. .

Abstract

Background: Human metapneumovirus (hMPV) significantly impacts young children, older adults, and those with preexisting conditions. This study examines frailty and clinical outcomes in middle-aged and older adults hospitalized due to hMPV infections.

Methods: Data from the Canadian Immunization Research Network's Serious Outcomes Surveillance Network were analyzed. Included were adults aged ≥50 with lab-confirmed hMPV infection. Severe infection was marked by pneumonia, oxygen need, intensive care unit admission, mechanical ventilation, or death within 30 days. The Frailty Index (FI) categorized individuals as nonfrail (FI < 0.08), prefrail (FI ≥ 0.08, FI < 0.21), and frail (FI ≥ 0.21). Multivariate ridge regression identified factors linked to disease severity.

Results: Among 212 patients (median age 76), 85.4% had severe disease and 61.3% were frail. Frail patients had higher rates of severe disease (80.8% vs. 63.4%), oxygen therapy need (80.8% vs. 63.4%), and longer hospital stays (median 8 vs. 4 days) than patients who were nonfrail. Any cardiac illness (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.02-3.09), congestive heart failure (OR, 1.91; 95% CI, 1.12-3.09), chronic obstructive pulmonary disease (OR, 1.93; 95% CI, 1.14-3.35), and frailty (OR, 1.99; 95% CI, 1.18-3.38) were significantly associated with increased odds of severe disease.

Conclusions: Frailty, assessable with standardized tools, is associated with severe hMPV infections in middle-aged and older adults. Recognizing frailty in clinical management and as a vaccination criterion is necessary as hMPV vaccines become available.

Clinical trials registration: NCT01517191 (ClinicalTrials.gov).

Keywords: frailty; human metapneumovirus; older adult; respiratory tract infections.

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Conflict of interest statement

Potential conflicts of interest. H. P. reports grant funding from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brasil, finance code 001. T. F. H. reports grants from Pfizer and GSK outside of the submitted work and payments from Roche and Hologic outside of the submitted work. S. A. M. reports grants from GlaxoSmithKline Biologicals, SA, and Icosavax, Inc, to her institutions for conducting this study's elements and payments from GSK, Merck, Novavax, Abbott, Moderna, and Sanofi outside of the submitted work. M. K. A. reports grant funding from the GSK group of companies, Pfizer, Merck, and Sanofi Pasteur unrelated to the present manuscript. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Percentage of patients diagnosed with pneumonia due to human metapneumovirus infection, categorized by underlying comorbidities. Abbreviations: CHF, congestive heart failure; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; DM, diabetes mellitus; LD, liver disease.
See this image and copyright information in PMC

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