Demographics, Clinical Presentation and Outcome of Metapneumovirus Infection in Adults: A Case Series Analysis at Scarborough General Hospital, United Kingdom.

Introduction: Human metapneumovirus (hMPV) was first discovered in 2001 in Netherlands as a leading cause of respiratory infections. hMPV infection is more common in kids, elderly (age ≥ 65) and immuno-compromised adults. Treatment is mainly symptomatic.

Methodology:  We collected retrospective data from 31-8-2022 to 01-09-2023 from Microbiology for patients who tested positive for hMPV by polymerase chain reaction (PCR). Only patients aged 18 years and above and admitted to Scarborough General Hospital (SGH) were included in the study.

Results: Total patients who tested positive were 38, out of which 73% (n=24) of patients were ≥ 65 years of age. 76.3% (n=29) of these adults were living in their own residence and 53% (n=20) patients never smoked. The most common presentation of these patients was shortness of breath and cough. Fifty-eight percent (n=22) patients had no radiological findings and 74% (n=28) had raised C-reactive protein (CRP). hMPV management was analyzed based on six modalities, we found out that 76% (n=29) patients received antibiotics, 47% (n=18) received nebulizers, 45% (n=17) required oxygen, 37% (n=14) were treated with steroids, 21% (n=8) patients were given inhalers and only one received antivirals. Majority of the patients were discharged and 13% (n=5) of patients died during their inpatient stay. All the deceased patients were aged 65 and above and 80% (n=4) of deceased (n=5) had pre-existing co-morbidities or other acute diagnoses at admission.

Conclusion: The patients who tested positive for hMPV were mostly aged ≥ 65 years, 76.3% (n=28) were from personal residence and there was no association of smoking history with hMPV infection. Patients who tested positive for hMPV would mostly present with flu-like symptoms with raised CRP and no radiological manifestation. All these patients were managed conservatively with antibiotics, nebulizers, oxygen, inhalers and antivirals (only one patient). Most of the patients were discharged home and five died during the inpatient stay, all of them were >65 of age and 80% had pre-existing co-morbidities and other acute diagnoses at the time of admission. We could not conclude or hypothesize anything due to small sample size.

Limitations: This data was collected over a one-year period only, and the sample size was very small. Another limitation was that we did not follow up patients after discharge.