Korean J Crit Care Med.  2017 May;32(2):182-189. 10.4266/kjccm.2017.00038.

A Retrospective Study Investigating Risks of Acute Respiratory Distress Syndrome and Mortality Following Human Metapneumovirus Infection in Hospitalized Adults

• Hwang H
• Kim Y
• Park JW
• Jeong SH
• Kyung SY

• KMID: 2384043
• DOI: http://doi.org/10.4266/kjccm.2017.00038

Abstract

BACKGROUND
Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported.
METHODS
We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group.
RESULTS
In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment.
CONCLUSIONS
These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.

Keyword

metapneumovirus; mortality; nosocomial infection; respiratory distress syndrome, adult

MeSH Terms

Adult*
Aged
Blood Urea Nitrogen
C-Reactive Protein
Child
Comorbidity
Cross Infection
Heart Failure
Hospitalization
Humans*
Korea
Metapneumovirus*
Mortality*
Pneumonia
Real-Time Polymerase Chain Reaction
Respiratory Distress Syndrome, Adult*
Respiratory Syncytial Viruses
Retrospective Studies*
Risk Factors
Tertiary Care Centers
Thorax
C-Reactive Protein

Reference

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