title: Incidence, Morbidity, and Costs of Human Metapneumovirus Infection in Hospitalized Children.
abstract: BACKGROUND
  Human metapneumovirus (HMPV) causes acute respiratory tract infections in infants and children. We sought to measure the clinical and economic burden of HMPV infection in hospitalized children.
  
  
  METHODS
  We conducted a retrospective cohort study from 2007 to 2013 at Primary Children's Hospital in Salt Lake City, Utah. Children <18 years of age with laboratory-confirmed HMPV infection were included. Demographic, clinical, and financial data were abstracted from the electronic medical record.
  
  
  RESULTS
  During the study period, 815 children were hospitalized with laboratory-confirmed HMPV infection: 16% <6 months, 50% 6-23 months, 23% 2-4 years, and 11% 5-17 years of age. A complex chronic condition was identified in 453 (56%) children hospitalized with HMPV infection; this proportion increased with increasing age (P < .001). There was marked variation in annual HMPV hospitalization rates, ranging from 9 of 100 000 person-years in 2012-2013 to 79 of 100 000 in 2009-2010. Hospitalization rates were highest among children <2 years (200 of 100 000 person-years) and lowest among children 5-17 years of age (5 of 100 000). Of hospitalized children, 18% were treated in the intensive care unit and 6% required mechanical ventilation. The median length of stay was 2.8 days (interquartile range [IQR], 1.8-4.6) and did not vary by age. The median total hospital cost per patient was $5513 (IQR, $3850-$9946) with significantly higher costs for patients with chronic medical conditions (P < .001).
  
  
  CONCLUSIONS
  Human metapneumovirus infection results in a large number of hospitalizations with substantial morbidity, resource utilization, and costs. The development of a safe and effective vaccine could reduce the clinical and economic burden of HMPV.
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Carly R
authors.initials: CR
authors.lastname: Davis
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Chris
authors.initials: C
authors.lastname: Stockmann
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Pavia
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Byington
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Anne J
authors.initials: AJ
authors.lastname: Blaschke
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Hersh
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Thorell
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City Intermountain Healthcare, Salt Lake City, Utah.
authors.forename: Kent
authors.initials: K
authors.lastname: Korgenski
authors.affiliation: Intermountain Healthcare, Salt Lake City, Utah.
authors.forename: Judy
authors.initials: J
authors.lastname: Daly
authors.affiliation: Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City.
authors.forename: Krow
authors.initials: K
authors.lastname: Ampofo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay / Q000191:economics; D008297:Male; D029121:Metapneumovirus / Q000302:isolation & purification; D018184:Paramyxoviridae Infections / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D010507:Periodicity; D012189:Retrospective Studies; D012621:Seasons; D014589:Utah / Q000453:epidemiology
keywords: HMPV; complications; disease severity; hospital cost; human metapneumovirus