Epidemiology and genotypic diversity of human metapneumovirus in paediatric patients with acute respiratory infection in Beijing, China

Abstract

Background Acute respiratory tract infections (ARTIs) causes high amounts of morbidity and mortality worldwide every year. Human metapneumovirus (HMPV) is a major pathogen of ARTIs in children. In this study, we aimed to investigate the epidemiology and genotypic diversity of HMPV in children hospitalized with ARTIs in Beijing, China. Methods Hospitalized children aged < 14 years with ARTIs were enrolled from April 2017 to March 2018; nasopharyngeal aspirates were collected and subjected to real-time polymerase chain reaction tests for HMPV. HMPV-positive samples were genotyped based on a partial N gene. Whole genome sequences were determined for samples with high viral loads. Results 4.08% (52/1276) enrolled paediatric patients were identified as having HMPV infection. The epidemic season is winter and early spring, children aged ≤ 4 years were more susceptible to HMPV infection (47/52, 90.38%). The co-infection rate were 36.54% (19/52), the most common co-infected virus were influenza and respiratory syncytial virus. The main diagnoses of HMPV infection were pneumonia (29/52, 55.77%) and bronchitis (23/52, 44.23%), while the main clinical manifestations were cough, fever, rhinorrhoea, and sneeze. Among 48 HMPV-positive specimens, A2b (19/48, 39.58%) and B1 (26/48, 54.17%) were the main epidemic subtypes. Patients with HMPV genotype A infection had a higher viral load compared to genotype B patients (6.07 vs. 5.37 log10 RNA copies/ml). Five complete sequences of HMPV were obtained. This is the first report of a whole genome sequence of HMPV-B1 isolated in China. Conclusions HMPV is an important respiratory pathogen in paediatric patients. Cases of HMPV infection could burden hospitals in the epidemic season. HMPV viral loads and genotypes have no correlation with co-infection or clinical characteristics.

The A2c111nt‐dup variants of human metapneumovirus predominantly circulating in Qingdao, China, during 2018 and 2019

“…The epidemic season of HMPV was in spring, with a peak mainly in March. This was similar to other reports in China and other countries 14,26 …”

“…This was similar to other reports in China and other countries. 14,26 Three different genotypes, namely, A2c, B1, and B2, were cocirculating in Qingdao during 2018~2019. In addition, 78.13% of them were clustered in the A2c predominant genotype.…”

Epidemiology and genetic characterization of human metapneumovirus in pediatric patients from Hangzhou China

“…The respiratory viruses coinfected with HMPV included the following: Adenovirus, RSV, and hPIV‐3; the cases with adenoviral infections were the most common. This finding is different from the data reported in previous studies, which indicated that RSV and IFV were the most frequently coinfected viruses with HMPV 31,32 . Furthermore, certain studies reported that HMPV co‐infections led to an increased rate of ICU admission and duration of hospitalization; however, other studies have found that coinfections exhibit no significant differences in clinical symptoms, baseline characteristics, diagnoses, and disease severity 4,33–35 .…”

“…This finding is different from the data reported in previous studies, which indicated that RSV and IFV were the most frequently coinfected viruses with HMPV. 31,32 Furthermore, certain studies reported that HMPV co-infections led to an increased rate of ICU admission and duration of hospitalization; however, other studies have found that coinfections exhibit no significant differences in clinical symptoms, baseline characteristics, diagnoses, and disease severity. 4,[33][34][35] The present study demonstrated lack of severe acute respiratory infection cases including co-infections and no association was noted between the co-infections and the hospitalization rate.…”

Human metapneumovirus in hospitalized children with acute respiratory tract infections in Beijing, China

“…Some studies have shown that the prevalence of HMPV is different in different regions and years. The detection rate of HMPV in Chinese hospitalized children with ARTIs is about 2%-18.2% 18,24,25 , and the detection rate of HMPV in ARTIs inpatients in other countries is 1.2%-20.3% 12,26,27 . In this study, we mainly explored the molecular epidemiology and clinical characteristics of HMPV infection in hospitalized children with ARTIs in Beijing from April 2018 to March 2019 and September 2020 to August 2021, and the impact of the COVID-19 epidemic on HMPV infection.…”