Human metapneumovirus (HMPV) is a significant cause of acute respiratory tract infections (ARTIs) in young children. This study aimed to describe the clinical characteristics, co-infection patterns, and seasonal trends of HMPV in children under 5 years of age.

This retrospective study included pediatric patients under 5 years old admitted to Jordan University Hospital (JUH) between October 2014 and May 2024 with PCR-confirmed HMPV infection. Demographic, clinical, laboratory, and outcome data were extracted from medical records.

A total of 109 pediatric patients were diagnosed with HMPV. The most frequent symptoms were fever (75%), difficulty breathing (72%), and feeding difficulties (68%), while common clinical signs included dyspnea (63%), abnormal chest sounds (60%), and retractions (45%). Co-infection was significantly associated with prematurity ( p = 0.039). Patients with isolated HMPV infections were more likely to receive nebulized therapy ( p = 0.020), whereas those with co-infections more frequently required high-flow nasal cannula support ( p = 0.007). Rhinovirus, RSV, and bocavirus were the most commonly detected co-pathogens. Most HMPV cases occurred between January and April.

HMPV represents a significant cause of pediatric respiratory illness. Co-infections were frequent and associated with increased respiratory support requirements. These findings enhance understanding of HMPV’s clinical presentation and outcomes.