Resurgence of human metapneumovirus in the post-COVID-19 era: pathogenesis, epidemiological shifts, clinical impact, and future challenges.

Publication date: Jun 20, 2025

Human metapneumovirus (hMPV), a respiratory pathogen identified in 2001, is a substantial cause of community-acquired respiratory infections across all age groups. This Review explores the impact of hMPV after the COVID-19 pandemic, emphasising its resurgence as a public health concern. Epidemiological shifts, as well as unusual seasonal patterns, increased co-infection rates, and altered age distributions, have been observed globally. Phylogenetic analysis has shown the variation across three distinct periods, especially before and after the COVID-19 pandemic, in terms of genotypic distribution. Clinical manifestations of hMPV infection range from asymptomatic to severe lower respiratory tract infections, particularly in vulnerable populations. Specific antivirals or vaccines are currently unavailable; consequently, treatment remains supportive. The development of monoclonal antibodies and vaccines leveraging cross-protective strategies against hMPV and related viruses is underway. This Review advocates prioritising research and public health measures to address the evolving epidemiological and clinical challenges associated with hMPV in the post-COVID-19 era.

Original Article