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Severe Presentations and Outcomes in Hospitalized Pediatric Patients With Parvovirus B19 Infection During the 2024
Elisabetta Venturini1, Agnese Maria Tamborino1, Giusy Arrichiello2,3
1From the Infectious Diseases Unit, Meyer Children's Hospital IRCCS, Florence.
Insights
Parvovirus B19 (B19V) infections in children can lead to severe outcomes like myocarditis and neurological issues. Early detection is crucial for managing these serious pediatric B19V complications.
Area of Science:
- Pediatric Infectious Diseases
- Viral Pathogenesis
- Clinical Epidemiology
Background:
- Increased incidence of Parvovirus B19 (B19V) infections reported across Europe since March 2024.
- While typically self-limiting in healthy children, B19V poses risks for severe disease in vulnerable pediatric populations.
Purpose of the Study:
- To characterize the clinical presentation of B19V infection in hospitalized children.
- To identify risk factors associated with severe outcomes in pediatric B19V cases.
Main Methods:
- Multicenter prospective study conducted across 10 Italian centers (INF-ACT network).
- Data collected from 135 hospitalized children with confirmed B19V infection between January and December 2024.
- Surveillance data utilized from the INF-ACT pediatric surveillance system.
Main Results:
- Acute myocarditis (20.7%) and neurologic complications (17.8%) were the most frequent severe manifestations in hospitalized children.
- Myocarditis was significantly linked to younger age, prolonged hospital stays, and higher intensive care unit (ICU) admission rates.
- Myocardial involvement independently increased the risk of ICU admission over 20-fold (P < 0.001).
Conclusions:
- Parvovirus B19 infection can result in severe pediatric complications, including myocarditis and neurological involvement, despite often being mild.
- Prompt clinical recognition of B19V, even without classic symptoms, is vital for timely management of severe outcomes.
Background:
Since March 2024, the European Center for Disease Prevention and Control has reported increased Parvovirus B19 (B19V) infections across 14 European countries. While often self-limiting in healthy children, B19V may cause severe disease in vulnerable populations.
Methods:
This multicenter prospective study aimed to characterize the clinical presentation of B19V infection in hospitalized children and identify risk factors for severe outcomes. Data were collected through the INF-ACT pediatric surveillance system, as part of the National Recovery and Resilience Plan. Children hospitalized with confirmed B19V infection were enrolled from January to December 2024 in 10 Italian INF-ACT centers.
Results:
A total of 135 children were included (median age 7.6 years, interquartile range 4.4-9.9), with 78.5% of cases occurring between April and July 2024. Acute myocarditis (20.7%) and neurologic complications (17.8%) were the most frequent severe manifestations. Myocarditis was significantly associated with younger age ( P < 0.001), longer hospital stays (median 19.5 vs. 6.5 days; P = 0.0018) and higher intensive care unit (ICU) admission rates (71.4% vs. 20.8%; P < 0.001). Multivariate analysis showed myocardial involvement increased the risk of ICU admission over 20-fold ( P < 0.001).
Conclusions:
Although often mild, B19V infection can cause severe complications in children, particularly myocarditis and neurologic involvement. Prompt recognition is essential, even in the absence of classic features like erythema infectiosum, to ensure timely monitoring and management of potentially life-threatening outcomes.
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