Epidemiological characteristics and clinical correlations of human metapneumovirus (HMPV) infection in children aged 0–14 years in China: a systematic review and meta-analysis

To systematically evaluate the human metapneumovirus (HMPV) detection status in Chinese children (0–14 years) via meta-analysis, clarify its epidemiological and clinical correlations, and support childhood respiratory infection prevention. Following PRISMA guidelines, we searched CNKI, Wanfang, VIP, PubMed, and Web of Science for studies (January 2015–July 2025) on childhood HMPV infection in China. Statistical analysis was performed with R 4.5.1’s Meta package. Seventy-eight eligible studies (334,901 participants; 15,612 HMPV-positive) were included. The overall HMPV detection rate was 4.56% (95% CI: 3.83%–5.43%). Subgroup analysis revealed the highest rate in 1–year-olds (6.02%), no significant sex difference (boys: 4.93%, girls: 4.86%), epidemic peaks in spring (4.48%) and winter (4.12%), a higher rate of acute lower respiratory tract infection (4.58%) than upper respiratory tract infection (2.92%), with bronchiolitis having the highest rate (14.11%, 95% CI: 7.73%–24.37%), similar rates in outpatients (4.70%) and inpatients (4.59%), and higher rates in Northeast China (10.84%) and Southwest China (10.16%). The overall HMPV-other respiratory virus coinfection rate was 28.72% (95% CI: 20.17%–39.13%), most commonly with RSV (21.87%) and HRV (21.44%).​ The overall HMPV detection rate in Chinese children (0–14 years) is 4.56%. The high-risk groups included 1–year-olds; the epidemic seasons were spring/winter; and the high-incidence regions were Northeast China/Southwest China. The HMPV coinfection rate was 28.72% (mainly RSV/HRV), and its strong association with bronchiolitis (14.11%) provides a reference for targeted prevention.