title: A multicenter outcomes analysis of children with severe viral respiratory infection due to human metapneumovirus.
abstract: OBJECTIVE
  To investigate the impact of human metapneumovirus on morbidity and mortality outcomes in children with severe viral respiratory infection.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  ICU, either PICU or cardiac ICU, at three urban academic tertiary care children's hospitals.
  
  
  METHODS
  All patients admitted to an ICU with laboratory-confirmed human metapneumovirus infection between January 2010 and June 2011.
  
  
  METHODS
  We captured demographic and clinical data and analyzed associated morbidity and mortality outcomes.
  
  
  RESULTS
  There were 111 patients with laboratory-confirmed human metapneumovirus admitted to an ICU at one of the three participating institutions during the period of study. The median hospital length of stay was 7 days (interquartile range 4-18 days) and median ICU length of stay was 4 days (interquartile range 1-10 days). Ten patients (9%) did not survive to discharge. Predisposing factors associated with increased mortality included female gender (p = 0.002), presence of a chronic medical condition (p = 0.04), and hospital acquisition of human metapneumovirus infection (p = 0.006). Adjusting for female gender, chronic medical conditions, hospital acquisition of infection and severity of illness score, logistic regression analysis demonstrated that female gender, hospital acquisition of infection, and chronic medical conditions each independently increased the odds of mortality (odds ratios 14.8, 10.7, and 12.7, respectively).
  
  
  CONCLUSIONS
  Analysis of our results suggests that there is substantial morbidity and mortality associated with severe viral respiratory infection due to human metapneumovirus in children. Female gender, hospital acquisition of human metapneumovirus infection, and presence of chronic medical conditions each independently increases mortality. The burden of illness from human metapneumovirus on the ICU in terms of resource utilization may be considerable.
authors: Division of Critical Care Medicine, Children's National Medical Center, Washington, DC, USA. mspaeder@childrensnational.org
authors: Michael C
authors: MC
authors: Spaeder
authors: Jason W
authors: JW
authors: Custer
authors: Melania M
authors: MM
authors: Bembea
authors: Devon O
authors: DO
authors: Aganga
authors: Xiaoyan
authors: X
authors: Song
authors: Susanna
authors: S
authors: Scafidi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D003422:Critical Care; D003428:Cross Infection / Q000150:complications / Q000401:mortality / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D029121:Metapneumovirus; D018184:Paramyxoviridae Infections / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult