Abstract Rationale Respiratory Syncytial Virus (RSV) and Human Metapneumovirus (hMPV) are common respiratory pathogens causing respiratory illnesses. Their impact is well-established in paediatrics and both are increasingly recognised as causing morbidity and mortality in adults, where the burden of RSV is regarded as greater. This study aims to characterise and compare the incidence of underlying lung disease in those seeking medical attention with RSV and hMPV infection. Methods Prevalence of chronic obstructive pulmonary disease (COPD), emphysema, asthma, bronchiectasis, interstitial lung disease (ILD) and lung cancer in hMPV and RSV positive adults was assessed in three cohorts: regional (n = 994,961, CHW), European (n = 16,635,205, EMEA) and global (n = 160,771,247, GCN) network. hMPV and RSV cases were identified using ICD-10 codes. Human immunodeficiency virus (HIV) positivity and antimicrobial usage (identified using VA codes) over 24 months were also calculated. This was facilitated using TriNetX Live, allowing identification of cases, co-morbidities and medications. Statistical analysis was performed using TriNetX Live; categorical variables compared using Chi-square test and continuous variables using Welch’s t-test. Results Characteristics of all three cohorts and relative frequencies of each co-morbidity are displayed in Table 1. The incidence of COPD, emphysema and bronchiectasis was greater in those with hMPV in the GCN cohort only (p 0.0001). In the EMEA and GCN cohorts asthma was more common in those with RSV (EMEA p = 0.003, GCN p 0.0001). Across all cohorts ILD and HIV were more common among hMPV patients (CHW p 0.05, EMEA/ GCN (p 0.0001). Antimicrobial usage was greater for hMPV (CHW p 0.05, EMEA p 0.001, GCN p 0.0001). Conclusion Our findings indicate hMPV infection could be linked to a greater prevalence of chronic lung disease in adults than RSV, though asthma was more common in RSV cases. This association may be influenced by detection bias, whereby vulnerable patients are tested for hMPV more readily. Alternatively, our findings may stem from differing pathophysiology; RSV initiates an acute inflammatory response whereas hMPV is characterized by immune evasion and viral persistence. Irrespective, these results indicate hMPV is a pathogen of concern in vulnerable populations, underscoring the need for further research into disease burden and prevention strategies. This abstract is funded by: None
Sethi et al. (Fri,) studied this question.