title: Human Metapneumovirus Infection is Associated with Severe Respiratory Disease in Preschool Children with History of Prematurity.
abstract: BACKGROUND
  Human metapneumovirus (HMPV) is a recently discovered respiratory pathogen of the family Paramyxoviridae, the same family as that of respiratory syncytial virus (RSV). Premature children are at high risk of severe RSV infections, however, it is unclear whether HMPV infection is more severe in hospitalized children with a history of severe prematurity.
  
  
  METHODS
  We conducted a retrospective analysis of the clinical respiratory presentation of all polymerase chain reaction-confirmed HMPV infections in preschool-age children (≤5 years) with and without history of severe prematurity (<32 weeks gestation). Respiratory distress scores were developed to examine the clinical severity of HMPV infections. Demographic and clinical variables were obtained from reviewing electronic medical records.
  
  
  RESULTS
  A total of 571 preschool children were identified using polymerase chain reaction-confirmed viral respiratory tract infection during the study period. HMPV was identified as a causative organism in 63 cases (11%). Fifty-eight (n = 58) preschool-age children with HMPV infection were included in this study after excluding those with significant comorbidities. Our data demonstrated that 32.7% of children admitted with HMPV had a history of severe prematurity. Preschool children with a history of prematurity had more severe HMPV disease as illustrated by longer hospitalizations, new or increased need for supplemental O2, and higher severity scores independently of age, ethnicity, and history of asthma.
  
  
  CONCLUSIONS
  Our study suggests that HMPV infection causes significant disease burden among preschool children with a history of prematurity leading to severe respiratory infections and increasing health care resource utilization due to prolonged hospitalizations.
authors.affiliation: Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC, USA.
authors.forename: Krishna
authors.initials: K
authors.lastname: Pancham
authors.affiliation: Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC, USA.
authors.forename: Iman
authors.initials: I
authors.lastname: Sami
authors.affiliation: Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC, USA.
authors.forename: Geovanny F
authors.initials: GF
authors.lastname: Perez
authors.affiliation: Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC, USA.
authors.forename: Shehlanoor
authors.initials: S
authors.lastname: Huseni
authors.affiliation: Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
authors.forename: Bassem
authors.initials: B
authors.lastname: Kurdi
authors.affiliation: Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC, USA; Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Integrative Systems Biology and Center for Genetic Medicine Research, George Washington University, Washington, DC, USA; Center for Genetic Research Medicine, Children's National Medical Center, Washington, DC, USA.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Rose
authors.affiliation: Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia; Research Unit, Military Hospital of Colombia, Bogota, Colombia.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Rodriguez-Martinez
authors.affiliation: Division of Pulmonary and Sleep Medicine, Children's National Medical Center, Washington, DC, USA; Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Department of Integrative Systems Biology and Center for Genetic Medicine Research, George Washington University, Washington, DC, USA; Center for Genetic Research Medicine, Children's National Medical Center, Washington, DC, USA. Electronic address: gnino@childrensnational.org.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Nino
mesh_terms: D002673:Child, Hospitalized; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D029121:Metapneumovirus; D018184:Paramyxoviridae Infections / Q000150:complications*; D047928:Premature Birth / Q000453:epidemiology; D018357:Respiratory Syncytial Virus Infections / Q000150:complications; D012141:Respiratory Tract Infections / Q000209:etiology*; D012189:Retrospective Studies
keywords: asthma; human metapneumovirus; prematurity; wheezing