Abstract
Human metapneumovirus (HMPV) is a significant respiratory pathogen that contributes to acute respiratory infections, particularly in vulnerable populations such as children, the elderly, and immunocompromised individuals. Since its discovery in 2001, HMPV has become a global health concern, with epidemiological data revealing seasonal peaks and notable genetic diversity. The virus is associated with a wide range of respiratory illnesses, including bronchiolitis, pneumonia, and asthma exacerbations, leading to substantial hospitalization rates and healthcare costs. This review examines the epidemiology of HMPV, focusing on pre- and post-coronavirus disease 2019 (COVID-19) trends, transmission patterns, and the impact on at-risk populations. Notably, the COVID-19 pandemic has influenced the seasonality of HMPV, with altered patterns of viral circulation and co-infection with other respiratory pathogens, such as respiratory syncytial virus and influenza. Despite its considerable impact, HMPV remains under-recognized and lacks specific antivirals or vaccines, leaving management largely supportive. Advances in molecular diagnostics, including RT-PCR and potential serological methods, offer hope for improved detection and epidemiological tracking. Moreover, research into monoclonal antibodies, antiviral treatments, and vaccines is ongoing, with promising results in preclinical models. Enhanced surveillance systems and integrated approaches to monitor co-circulating viruses are essential for mitigating the burden of HMPV. This review underscores the need for continued research, public health strategies, and global collaboration to address the challenges posed by HMPV, particularly in high-risk populations and regions with limited healthcare infrastructure.