The burden of respiratory viruses in adults is mainly due to influenza viruses, COVID-19 and syncytial respiratory virus (VRS). The data concerning the human metapneumovirus (HMPV), RNA virus belonging to the same family as the VRS, are few. Which of these viruses has more risk of complications?
The objective of this study was to compare the profile and the future of hospitalized patients for an HMPV, VRS or flu virus infection, in 5 French CHU between 2012 and 2022.
It was a post-hoc analysis of the Fluvac study initially created to assess the efficiency of antigrippal vaccines. All patients, for whom the result of the search for respiratory viruses by PCR “Polymerase chain Reaction” in English or chain reaction by polymerase in French. It is a method of molecular biology of in vitro DNA amplification (concentration and gene amplification by chain polymerization reaction), used in screening tests. Multiplex on nasopharyngeal swabs were available, were included.
In total, 143 patients in HMPV, 216 of VRS and 1453 influenza were compared. HMPV + patients were older than Patients flu + (78 vs 71) and more vaccinated against flu. The frequency of comorbidities, equivalent between groups, was high (80%). HMPV + patients more often had a chronic cardiac pathology than influenza + patients.
-HMPV + patients had more complications during their hospitalization than patients flu + (60% vs 50%) mainly from heart decompensations (22% vs 11%). The complications of HMPV+ and VRS+ patients were similar. Intra-hospital mortality was equivalent between groups (4%).
When the comparison of HMPV+ and influenza+ patients was restricted to influenza vaccinated patients, the occurrence of complications was equivalent, emphasizing the benefit of the vaccine on the reduction of complications even in the event of infection despite vaccination.
The main limit of this study was the inclusion period which corresponded to the circulation of the influenza virus, which underestimates the prevalence Number of people affected by an infection or other disease given in a determined population. From HMPV since their circulation is not exactly superimposable.
In conclusion, the HMPV is responsible for hospitalization in elderly adults and bearers of comorbidity and frequently leads to complications, in particular cardiovascular, in the same proportions as the VRS or the flu. VRS/HMPV combined vaccines are under development and may, in the future, widen the prevention options for the burden of respiratory viruses in adults.
