IntroductionHuman metapneumovirus (hMPV) and respiratory syncytial virus (RSV) are significant contributors to the burden of acute respiratory infections in children, but data on hMPV from Southeast Asia are limited despite its potential for serious disease. This study aimed to compare the clinical presentation, resource utilisation and outcomes between hMPV and RSV infections in hospitalised Malaysian children.MethodsThis retrospective, observational study included children aged ≤12 years old hospitalised with hMPV or RSV, confirmed via direct fluorescent antibody (DFA) methods, between 1 July to 30 October 2022 at Hospital Tuanku Ja'afar Seremban, Malaysia. Demographic, clinical presentation, resource utilisation and outcome data were analysed. Propensity score matching was used to balance cohorts based on key demographic and clinical characteristics.ResultsThis study included 192 patients, comprising 112 with hMPV and 80 with RSV. hMPV patients were older (median age 20.5 vs. 9.4 months, p < 0.001) and had a higher incidence of comorbidities (24.1% vs. 7.5%, p = 0.003). Fever was more common in the hMPV group (97.3% vs. 73.8%, p < 0.001), but the other clinical manifestations were similar. Postmatching analysis showed higher corticosteroid use in the hMPV group (p = 0.01). No significant differences were observed in the use of other resources, PICU admissions, duration of hospitalisation or mortality rates between both groups.ConclusionhMPV and RSV infections in children share similar clinical manifestations and outcomes, with hMPV affecting older children and showing higher corticosteroid usage. These findings emphasise the need for equal clinical vigilance for both hMPV and RSV in paediatric respiratory infections.

中文翻译：

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马来西亚住院儿童 HMPV 和 RSV 感染的临床比较：倾向评分匹配研究

简介人类偏肺病毒 (hMPV) 和呼吸道合胞病毒 (RSV) 是造成儿童急性呼吸道感染负担的重要因素，但东南亚有关 hMPV 的数据有限，尽管它可能导致严重疾病。本研究旨在比较马来西亚住院儿童 hMPV 和 RSV 感染的临床表现、资源利用和结果。方法这项回顾性观察性研究包括年龄≤12 岁的 hMPV 或 RSV 住院儿童，并通过直接荧光抗体 (DFA) 方法证实，于 2022 年 7 月 1 日至 10 月 30 日期间在马来西亚芙蓉端姑嘉化医院 (Hospital Tuanku Ja'afar Seremban) 进行。分析了人口统计、临床表现、资源利用和结果数据。倾向评分匹配用于根据关键人口统计学和临床​​特征来平衡队列。结果本研究包括 192 名患者，其中 112 名 hMPV 患者和 80 名 RSV 患者。 hMPV 患者年龄较大（中位年龄 20.5 个月 vs. 9.4 个月，p <0.001）并且合并症的发生率较高（24.1% vs. 7.5%，p =0.003）。 hMPV 组发烧更为常见（97.3% vs. 73.8%，p <0.001），但其他临床表现相似。匹配后分析显示 hMPV 组皮质类固醇的使用量较高（p =0.01）。两组之间在其他资源的使用、PICU 入院率、住院时间或死亡率方面没有观察到显着差异。 结论 儿童 hMPV 和 RSV 感染具有相似的临床表现和结果，其中 hMPV 影响年龄较大的儿童，并显示出较高的皮质类固醇使用量。这些发现强调临床上需要对小儿呼吸道感染中的 hMPV 和 RSV 保持同等警惕。