Human metapneumovirus infection in the cardiac paediatric ICU before and during COVID-19 pandemic: a retrospective cohort analysis

Abstract

Introduction: This study investigates the hygiene standards in the context of the COVID-19-pandemic and their impact on the perioperative incidence of hMPV as well as the typical symptom burden of hMPV-infected children with congenital heart defects. Materials and Methods: Between March 2018 and July 2021 all patients of a cardiac paediatric intensive care unit (cPICU) of a German university hospital were included in this retrospective cohort analysis. Results: A total of 589 patients with congenital heart disease were included in the analysis. 352 patients (148 females and 204 males) were admitted before the introduction of social distancing and face masks between March 2018 and April 15, 2020 (cohort A). 237 patients (118 females and 119 males) were admitted after the introduction between April 16 and July 2021 (cohort B). In cohort A, hMPV was detected in 11 out of 352 patients (3.1 %) during their stay at cPICU. In cohort B, one patient out of 237 (0.4 %) tested positive for hMPV. Patients who tested positive for hMPV stayed in cPICU for a median of 17.5 days (range, 2 – 45 days). Patients without a detected hMPV-infection stayed in the cPICU for a median of 4 days (range, 0.5 – 114 days). 9 out of 12 (75 %) hMPV-positive patients showed atelectasis. Conclusion: Peri-operative hMPV infections prolong cPICU stay in paediatric patients with congenital heart disease. In affected patients, pulmonary impairment with typical symptoms appears. Under certain circumstances, a complication-rich perioperative infection with hMPV could be prevented in paediatric cardiac high-risk patients by prophylactic hygiene intervention.