Systematic Review and Meta-Analysis of Clinical Severity and Population-Specific Outcomes of Human Metapneumovirus Infection.
5 affiliations
- 1Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia, USA.
- 2Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA.
- 3Department of Biostatistics, University of Florida, Gainesville, Florida, USA.
- 4Silver Spring, Maryland, USA.
- 5Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
Abstract
Background
Human metapneumovirus (HMPV) is a prevalent respiratory pathogen, but comprehensive estimates of severe clinical outcomes across populations are lacking. We synthesized the proportion of severe outcomes among people with laboratory-confirmed HMPV infection.Method
We searched PubMed, Embase, Web of Science, Scopus, Cochrane Library, medRxiv, bioRxiv, and Google Scholar from inception to 20 January 2026, without language restrictions. Observational studies reporting severe outcomes (hospitalization, intensive care unit [ICU] admission, respiratory support, mechanical ventilation, mortality) in laboratory-confirmed HMPV infection were eligible; studies enrolling only people who are immunocompromised without comparators were excluded. Two reviewers independently extracted data and assessed quality using Joanna Briggs Institute checklists. Pooled proportions were estimated using random-effects generalized linear mixed models with logit transformation. Subgroup analyses examined healthcare setting and age.Results
Ninety-four studies (∼26 000 people who are HMPV positive) were included. Pooled proportions were 48% (95% CI, 20%-78%; 8 studies, n = 1445) for hospitalization; 12% (95% CI, 8%-16%; 26 studies, n = 14 522; Egger P = .03) for ICU admission; 40% (95% CI, 26%-56%; 18 studies, n = 4328) for respiratory support; 8% (95% CI, 5%-13%; 16 studies, n = 5543) for mechanical ventilation; and 3% (95% CI, 2%-5%; 29 studies, n = 13 657; I² = 78.5%) for in-hospital mortality. Mortality was highest among adults (6%).Conclusions
Human metapneumovirus causes substantial hospitalization, ICU admission, and mortality, supporting strengthened surveillance, integration into respiratory virus prevention strategies, and accelerated vaccine development.
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BibTeX
@article{miao2026systematic,
title = {{Systematic Review and Meta-Analysis of Clinical Severity and Population-Specific Outcomes of Human Metapneumovirus Infection.}},
author = {Yu Miao and Shangchen Song and Zachary J Madewell and Zhumengmeng Jin and Yumiao Lei and Evelyn Shi and Yixuan Zeng and Mingjing Liu and Ira M Longini and Yang Yang},
journal = {Open forum infectious diseases},
year = {2026},
month = oct,
doi = {10.1093/ofid/ofag634},
url = {https://europepmc.org/article/MED/42921488},
note = {CC BY},
}
RIS
TY - JOUR
TI - Systematic Review and Meta-Analysis of Clinical Severity and Population-Specific Outcomes of Human Metapneumovirus Infection.
AU - Yu Miao
AU - Shangchen Song
AU - Zachary J Madewell
AU - Zhumengmeng Jin
AU - Yumiao Lei
AU - Evelyn Shi
AU - Yixuan Zeng
AU - Mingjing Liu
AU - Ira M Longini
AU - Yang Yang
PY - 2026
DA - 2026/10/08
JO - Open forum infectious diseases
DO - 10.1093/ofid/ofag634
UR - https://europepmc.org/article/MED/42921488
AB - Background Human metapneumovirus (HMPV) is a prevalent respiratory pathogen, but comprehensive estimates of severe clinical outcomes across populations are lacking. We synthesized the proportion of severe outcomes among people with laboratory-confirmed HMPV infection.Method We searched PubMed, Embase, Web of Science, Scopus, Cochrane Library, medRxiv, bioRxiv, and Google Scholar from inception to 20 January 2026, without language restrictions. Observational studies reporting severe outcomes (hospitalization, intensive care unit [ICU] admission, respiratory support, mechanical ventilation, mortality) in laboratory-confirmed HMPV infection were eligible; studies enrolling only people who are immunocompromised without comparators were excluded. Two reviewers independently extracted data and assessed quality using Joanna Briggs Institute checklists. Pooled proportions were estimated using random-effects generalized linear mixed models with logit transformation. Subgroup analyses examined healthcare setting and age.Results Ninety-four studies (∼26 000 people who are HMPV positive) were included. Pooled proportions were 48% (95% CI, 20%-78%; 8 studies, n = 1445) for hospitalization; 12% (95% CI, 8%-16%; 26 studies, n = 14 522; Egger P = .03) for ICU admission; 40% (95% CI, 26%-56%; 18 studies, n = 4328) for respiratory support; 8% (95% CI, 5%-13%; 16 studies, n = 5543) for mechanical ventilation; and 3% (95% CI, 2%-5%; 29 studies, n = 13 657; I² = 78.5%) for in-hospital mortality. Mortality was highest among adults (6%).Conclusions Human metapneumovirus causes substantial hospitalization, ICU admission, and mortality, supporting strengthened surveillance, integration into respiratory virus prevention strategies, and accelerated vaccine development.
SN - 2328-8957
ER -