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Parvovirus B19-associated fulminant acute myocarditis in children during the fifth disease outbreak in 2024: What

Mattia Pasquinucci1,2,3, Marco Scaglione1, Alessandra Siboldi4

  • 1Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Annals of Pediatric Cardiology
|February 23, 2026
PubMed

Insights

Pediatric myocarditis cases linked to Parvovirus B19 (PVB19) infections are rising post-COVID-19. This study of 5 children found severe heart dysfunction and variable outcomes with immunomodulatory therapy.

Area of Science:

  • Pediatric Cardiology
  • Viral Infections
  • Immunology

Background:

  • Myocarditis is a serious heart condition in children, often caused by viral infections.
  • Parvovirus B19 (PVB19) is a key culprit, with recent reports indicating increased incidence post-COVID-19.
  • This surge raises concerns about severe pediatric myocarditis cases.

Purpose of the Study:

  • To retrospectively analyze clinical, laboratory, and imaging data of pediatric patients diagnosed with PVB19-associated myocarditis in 2024.
  • To investigate the clinical presentation, severity, and outcomes of this condition.
  • To explore potential links with viral coinfections and treatment responses.

Main Methods:

  • Retrospective analysis of 5 pediatric patients with acute myocarditis and confirmed PVB19 DNA.
  • Review of clinical symptoms, laboratory results, echocardiography findings, and treatment regimens.
  • Assessment of disease severity, need for advanced support (ECMO), and patient outcomes.

Main Results:

  • Patients (median age 6.4 years, 80% male) often presented with cardiogenic shock; two required ECMO.
  • Echocardiography showed severely reduced ejection fraction (median 25%), atrial enlargement, and mitral insufficiency.
  • PVB19 DNA load did not correlate with severity; immunomodulatory therapy showed variable results. Three patients had viral coinfections.

Conclusions:

  • PVB19-associated myocarditis in children can lead to severe cardiac dysfunction, including fulminant cases.
  • Immunomodulatory therapies (IVIG, corticosteroids) had variable efficacy.
  • Further large-scale multicenter studies are essential to understand PVB19's role and the impact of coinfections in pediatric myocarditis.

Keywords:
Cardiogenic shockoutbreakparvovirus B19pediatric myocarditis

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