上海人偏肺病毒感染住院儿童重症社区获得性肺炎的临床特征和危险因素：一项回顾性队列研究
Clinical characteristics and risk factors for severe community-acquired pneumonia in hospitalized children with human metapneumovirus infection in Shanghai: a retrospective cohort study.
摘要(中文译文)
人偏肺病毒（HMPV）是儿童下呼吸道感染的主要病因之一，在导致儿童重症肺炎方面仅次于呼吸道合胞病毒。其临床表现与其他常见呼吸道病毒高度相似，给诊断带来挑战。本研究旨在描述住院儿童人偏肺病毒（HMPV）感染相关社区获得性肺炎（CAP）的临床特征，并识别重症CAP的独立危险因素。我们开展了一项回顾性队列研究，纳入2021年至2024年期间在上海市儿童医院因HMPV阳性CAP住院的878例患儿。根据既定CAP标准，将患者分为轻症组（n=632）和重症组（n=246）。收集人口学资料、临床特征、实验室检查结果及合并病原体检出情况。采用多因素logistic回归分析识别重症疾病的独立危险因素。重症组占队列的28.0%。主要临床表现为发热（98.0%）、咳嗽（97.6%）、喘息（56.5%）及肺部湿啰音（84.6%）。与轻症组相比，重症组早产、喘息、炎症标志物升高（NLR>1、PCT>1 ng/mL、CRP≥50 mg/L）及合并肺炎支原体（MP）感染的比例显著更高（均P<0.05）。多因素分析确定早产（比值比[OR]=2.43，95% CI：1.45-4.07）、喘息（OR=3.47，95% CI：2.51-4.80）、NLR>1（OR=1.75，95% CI：1.26-2.43）、PCT>1 ng/mL（OR=2.38，95% CI：1.42-3.99）、CRP≥50 mg/L（OR=2.20，95% CI：1.19-4.06）及合并MP感染（OR=2.17，95% CI：1.53-3.08）为HMPV感染患儿重症CAP的独立危险因素。约28%的HMPV阳性CAP住院患儿进展为重症疾病。早产、喘息、炎症标志物升高及合并MP感染是独立危险因素，有助于早期风险分层和针对性临床管理。
Abstract
HMPV is a leading cause of pediatric lower respiratory tract infections, second only to respiratory syncytial virus in causing severe pneumonia in children. Its clinical presentation closely mimics other common respiratory viruses, making diagnosis challenging. This study aimed to characterize the clinical profile and identify independent risk factors for severe community-acquired pneumonia (CAP) in hospitalized children with human metapneumovirus (HMPV) infection. We conducted a retrospective cohort study of 878 children hospitalized with HMPV-positive CAP at Shanghai Children's Hospital from 2021 to 2024. Patients were classified into mild ( = 632) and severe ( = 246) groups based on established CAP criteria. Data on demographics, clinical features, laboratory findings, and concomitant pathogen detection were collected. Multivariate logistic regression was used to identify independent risk factors for severe disease. The severe group comprised 28.0% of the cohort. Key clinical manifestations included fever (98.0%), cough (97.6%), wheezing (56.5%), and pulmonary crackles (84.6%). Compared to the mild group, the severe group had significantly higher rates of premature birth, wheezing, elevated inflammatory markers (NLR > 1, PCT > 1 ng/mL, CRP ≥ 50 mg/L), and co-infection with (MP) (all < 0.05). Multivariate analysis identified premature birth (odds ratio [OR] = 2.43, 95% CI: 1.45-4.07), wheezing (OR = 3.47, 95% CI: 2.51-4.80), NLR > 1 (OR = 1.75, 95% CI: 1.26-2.43), PCT > 1 ng/mL (OR = 2.38, 95% CI: 1.42-3.99), CRP ≥ 50 mg/L (OR = 2.20, 95% CI: 1.19-4.06), and co-infection with MP (OR = 2.17, 95% CI: 1.53-3.08) as independent risk factors for severe CAP in children with HMPV infection. Approximately 28% of hospitalized children with HMPV-positive CAP progress to severe disease. Premature birth, wheezing, elevated inflammatory markers, and co-infection with MP are independent risk factors, which can facilitate early risk stratification and targeted clinical management.
如何引用
AMA
Lijiao Liu, Jing Wang, Weiqin Jiang, Yuzhe Guo, Anna Cheng, Yujuan Huang. Clinical characteristics and risk factors for severe community-acquired pneumonia in hospitalized children with human metapneumovirus infection in Shanghai: a retrospective cohort study.. Frontiers in medicine. 2026; doi:10.3389/fmed.2026.1813199.
APA
Lijiao Liu, Jing Wang, Weiqin Jiang, Yuzhe Guo, Anna Cheng, Yujuan Huang (2026). Clinical characteristics and risk factors for severe community-acquired pneumonia in hospitalized children with human metapneumovirus infection in Shanghai: a retrospective cohort study.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1813199
GB/T 7714
Lijiao Liu, Jing Wang, Weiqin Jiang, Yuzhe Guo, Anna Cheng, Yujuan Huang. Clinical characteristics and risk factors for severe community-acquired pneumonia in hospitalized children with human metapneumovirus infection in Shanghai: a retrospective cohort study.[J]. Frontiers in medicine, 2026 doi:10.3389/fmed.2026.1813199.
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