不同于其他病毒，人类副流感病毒（hMPV）在成人中的致病性仍然不明确。为了解决这个问题，我们进行了一项回顾性单中心队列研究，包括所有在2010年1月1日至2018年6月30日期间因hMPV感染而入住ICU的患者。研究了hMPV感染患者的特点并与匹配的流感感染患者进行了比较。随后，进行了一项系统回顾和荟萃分析，涉及PUBMED、EMBASE和COCHRANE数据库的hMPV成人感染情况（PROSPERO编号：CRD42018106617）。包括了2008年1月1日至2019年8月31日期间发表的研究、病例系列和队列，记录了出现hMPV感染的成人情况。排除了儿童研究。从已发表的报告中提取数据。主要终点是所有hMPV感染患者中低呼吸道感染（LRTIs）的比例。在研究期间，402名患者检测结果为hMPV阳性。其中26名（6.5%）患者入住ICU，19名（4.7%）因急性呼吸衰竭。92%的患者免疫功能受损。细菌共感染率很高，为53.8%。医院死亡率为30.8%。在病例对照分析中，hMPV感染和流感感染患者的临床和影像特征没有差异。系统回顾识别出156项研究，其中有69项（1849名患者）符合分析条件。虽然研究之间存在异质性，但hMPV LRTIs的发病率为45%（95% CI 31-60%；I2 = 98%）。需要入住重症监护室的比例为33%（95% CI 21-45%；I2 = 99%）。医院死亡率为10%（95% CI 7-13%；I2 = 83%），ICU死亡率为23%（95% CI 12-34%；I2 = 65%）。潜在的恶性肿瘤与增加死亡率独立相关。这项初步研究表明，hMPV可能与潜在恶性肿瘤患者的严重感染和高死亡率相关。但由于队列的规模较小，回顾分析的异质性，更多的队列研究是必要的。©2023年，作者。

Unlike other viruses, the pathogenicity of human metapneumovirus (hMPV) in adults remains uncertain. To address this question, a retrospective monocentric cohort including all patients admitted to ICU with hMPV infection between January 1, 2010, and June 30, 2018 was performed. The characteristics of hMPV infected patients were studied and compared to matched influenza infected patients. Consecutively, a systematic review and meta-analyses investigating PUBMED, EMBASE and COCHRANE databases was conducted to explore the hMPV infections in adult patients (PROSPERO number: CRD42018106617). Trials, case series, and cohorts published between January 1, 2008 and August 31, 2019 compiling adults presenting hMPV infections were included. Pediatric studies were excluded. Data were extracted from published reports. Primary endpoint was the rate of low respiratory tract infections (LRTIs) among all hMPV infected patients.During the study period, 402 patients were tested positive for hMPV. Among them 26 (6.5%) patients were admitted to the ICU, 19 (4.7%) for acute respiratory failure. Twenty-four (92%) were immunocompromised. Bacterial coinfections were frequent 53.8%. Hospital mortality rate was 30.8%. In the case-control analysis, the clinical and imaging characteristics were not different between hMPV and influenza infected patients. The systematic review identified 156 studies and 69 of them (1849 patients) were eligible for analysis. Although there was heterogeneity between the studies, the rate of hMPV LRTIs was 45% (95% CI 31-60%; I2 = 98%). Intensive care unit (ICU) admission was required for 33% (95% CI 21-45%; I2 = 99%). Hospital mortality rate was 10% (95% CI 7-13%; I2 = 83%) and ICU mortality rate was 23% (95% CI 12-34%; I2 = 65%). Underlying malignancy was independently associated with increased mortality rate.This preliminary work suggested that hMPV may be associated with severe infection and high mortality in patients with underlying malignancies. However, regarding the small size of the cohort and the heterogeneity of the review, more cohort studies are warranted.© 2023. The Author(s).