Pediatrics

RSV and human metapneumovirus show distinct age and risk profiles in pediatric hospitalizations

August 11, 2025

Study details: Active, prospective surveillance at 7 U.S. pediatric hospitals/EDs (2016–2020) enrolled children <18 years with acute respiratory illness. Midturbinate swabs underwent molecular testing for RSV and human metapneumovirus (HMPV). Clinical features were abstracted, and adjusted odds ratios (aORs) estimated severe outcomes comparing RSV with HMPV; risk factors were assessed via logistic regression.

Results: Among 8,605 encounters, 4,398 RSV and 931 HMPV hospitalizations and 2,371 RSV and 905 HMPV ED visits were analyzed. Median age for hospitalization was younger in RSV than HMPV (7 vs. 16 months; P <0.0001). In the ED cohort, RSV cases had higher odds of hospitalization than HMPV (aOR, 1.68; 95% confidence interval [CI], 1.50–1.87), greatest in infants <6 months (aOR, 3.27; 95% CI, 2.53–4.23). Underlying conditions were over twice as prevalent among infants hospitalized with HMPV (26%) vs. RSV (11%).

Clinical impact: RSV drives earlier-life hospitalizations and higher admission risk from the ED, especially in young infants; prioritize RSV prevention and early escalation pathways in this age group. HMPV hospitalizations concentrate in older children and those with comorbidities; anticipate complexity, resource needs, and consider comorbidity-informed risk stratification. These age- and risk-specific patterns can refine triage, counseling, and prophylaxis targeting as RSV and potential future HMPV interventions evolve.

Source:

Goldstein LA, et al. (2025, August 6). Pediatrics. Human Metapneumovirus and Respiratory Syncytial Virus in Children: A Comparative Analysis. https://pubmed.ncbi.nlm.nih.gov/40763933/