Abstract
BACKGROUND: Identified in 2001, human metapneumovirus (hMPV) infection can lead to hospitalization and death, especially in older adults and children. METHODS: This retrospective, propensity-matched study compared cases of hMPV infection with cases of influenza virus and respiratory syncytial virus (RSV) infection for hospitalization and death outcomes in older adults living in Community Living Centers (CLCs), nursing homes operated by the US Department of Veterans Affairs. We evaluated electronic medical records from July 2017 to June 2024. We included CLC residents with laboratory-confirmed hMPV, influenza virus, or RSV infections. The propensity-matched analysis balanced demographic and clinical characteristics. Proportional hazards models estimated the risk of hospitalization, death or the combined outcome over the 90 days after diagnosis. RESULTS: We identified 178 hMPV, 1379 influenza virus, and 681 RSV laboratory-confirmed infections. In the propensity analysis. Residents with hMPV infection (n = 173) were well matched to those with influenza virus infection (n = 746). The matched cohort proportional hazard analysis (hMPV vs influenza virus infection) showed similar hazards for 90-day outcomes of hospitalization (adjusted hazard ratio, 1.00 [95% confidence interval, .67-1.49]), death (0.79 [.48-1.29]), or both combined (0.81 [.58-1.12]). With use of similar methods, residents with hMPV (n = 170) were well matched to those with RSV (n = 437). The matched cohort proportional hazard analysis showed similar 90-day outcomes of hospitalization (adjusted hazard ratio, 1.00 [95% confidence interval, .66-1.51)], death (0.93 [.58-1.56], or both combined (0.97 [.68-1.37]). CONCLUSIONS: Resident infection with hMPV produced similar likelihoods of hospitalization and death as infection with influenza virus or RSV. Increased understanding of hMPV and appropriate testing are needed to accurately detect, prevent, and manage hMPV in nursing homes.