Neurological Complications of Human Metapneumovirus (Hmpv) Infection: A Narrative Review Publisher



Emami Meybodi T ; Paraandavaji E ; Raiseabdullahi P ; Naderian R
Source: Heliyon Published:2026

Abstract

Background Human metapneumovirus (HMPV), a member of the Pneumoviridae family, is a globally prevalent respiratory pathogen that primarily affects young children, older adults, and immunocompromised individuals. While HMPV is well known for causing acute respiratory tract infections such as bronchiolitis and pneumonia, increasing evidence suggests it may also exhibit neuroinvasive potential, leading to complications including encephalitis, seizures, status epilepticus, and hypoxic–ischemic brain injury. Methods This narrative review was conducted through a comprehensive search of PubMed, Scopus, and Embase databases up to 2024. Clinical case reports and experimental studies were included if they addressed HMPV-associated neurological complications. Non-peer-reviewed and duplicate studies were excluded. The review emphasizes mechanisms of neuropathogenesis, diagnostic approaches, and therapeutic strategies. Results Findings suggest that HMPV can affect the central nervous system (CNS) through direct viral invasion, blood–brain barrier disruption, cytokine-driven neuroinflammation, and autoimmune responses mediated by molecular mimicry. Accurate diagnosis requires integration of molecular methods such as PCR and serology, cerebrospinal fluid (CSF) analysis, and neuroimaging techniques, including EEG, MRI, and CT. Currently, there are no licensed antivirals or vaccines for HMPV. However, preliminary studies indicate potential benefits of monoclonal antibodies, intravenous immunoglobulin (IVIG), and ribavirin. In addition, mRNA-based and virus-like particle vaccines are under clinical evaluation. Conclusion HMPV is increasingly recognized as a virus with significant neurotropic potential. Greater awareness, early detection, and further investigation into its neuropathological mechanisms are essential for improving clinical outcomes and guiding the development of targeted therapies and preventive strategies. © 2026 The Authors.