SUMMARY The impact of human metapneumovirus (HMPV) in children older than 5 years of age and the risk factors associated with disease severity for all ages have not been well characterized. A retrospective cohort study of 238 children 0–15 years hospitalized over a 3-year period was performed. Medical records were reviewed for demographic, clinical parameters and outcomes. Multivariable analyses were performed to identify independent factors associated with worse disease severity assessed by length of hospitalization (LOS), need for ICU care, respiratory support, and a disease severity score. Pulmonary diseases were associated with all outcomes of care, while congenital heart disease (CHD) and neuromuscular disorders were associated with longer LOS, and CHD and trisomy 21 were associated with worse severity scores independent of other covariables. Fever, retractions, use of steroids and albuterol were also associated with enhanced disease severity. Understanding the determinants of HMPV disease in children may help design targeted preventive strategies.

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