Human bocavirus and human metapneumovirus in children with lower respiratory tract infections: effects on clinical, microbiological features and disease severity

Background

We aimed to compare the clinical findings of Human bocavirus (HBoV) and human metapneumovirus (HMPV) infections clinically, and to analyze the effects of coinfections on clinical features and disease severity in children with HBoV and HMPV infections

Methods

Data of 125 children with LRTI due to HBoV or HMPV which was detected from nasal swap by real-time PCR during Jan2013-Dec2017 were collected. In total, there were 101 HBoV (group1) and 23 HMPV (group2) infections in our data. The patients were further divided into four subgroups according to the coinfection status: HoBV only (subgroup1, n=41), HMPV only (subgroup2, n=19), HBoV and coinfection with other respiratory viruses (subgroup3, n=60), and HMPV and coinfection with other respiratory viruses (subgroup4, n=4).

Results

The majority (88.8%) of the patients was aged 5 years or younger. Coinfections with other respiratory viruses were significantly more common in group1 (p:0.001). Among patients who had nosocomial pneumonia, patients with HBoV infections had significantly longer mean length of hospital stay (LOS) than those with HMPV infections (p=0.032). The hospitalization and antibiotic requirements were significantly higher in subgroup1 than subgroup3 (p: 0.005, 0.039, resp.) According to the logistic regression analyses, the risk of LOS increased by 21.7 times with HBoV infections (p:0.006).

Conclusion

HBoV and HMPV infections are serious etiologic pathogens mostly seen in children and usually requiring hospitalization regardless of co-infection status. HBoV infections caused longer LOS than HMPV infections in patients with nosocomial infections.

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