Severe myocarditis increase in children associated with parvovirus B19 infection: MYKKE registry and german surveillance data
Background - Following a surge in myocarditis in Germany since August 2023, many with parvovirus B19 (B19V) detection, concerns arose about causes and countermeasures. - Objectives - The authors aimed to verify the association among B19V, myocarditis increase, and severity. - Methods - Data from the...
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| Autori principali: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Natura: | Article (Journal) |
| Lingua: | inglese |
| Pubblicazione: |
May 2026
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| In: |
JACC Heart failure
Year: 2026, Volume: 14, Fascicolo: 5, Pages: 1-16 |
| ISSN: | 2213-1787 |
| DOI: | 10.1016/j.jchf.2025.102854 |
| Accesso online: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.jchf.2025.102854 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S221317792500784X 
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| Note sull'autore: | Franziska Seidel, MD, Teresa M. Nygren, PHD, Bernd Opgen-Rhein, MD, Tobias Hecht, MD, Martin Boehne, MD, Johannes Weickmann, MD, Felix Anderheiden, MD, Katja Reineker, MD, Dorothée Böcker, MD, Axel Rentzsch, MD, Gesa Wiegand, MD, Marcus Fischer, MD, Daniela Kiski, MD, Wiebke Frede, MD, Bettina Ruf, MD, Gleb Tarusinov, MD, Konstantin Papakostas, MD, Thushiha Logeswaran, MD, Assunta Schiebel, MD, Inga Voges, MD, Michael Kaestner, MD, Jennifer Kramp, MD, Gunter Kerst, MD, Malika Khedim, MD, Eva Gatzweiler, MD, Bardo Wannenmacher, MD, Walter Knirsch, MD, Lars Meyer-Dobkowitz, MD, Birgit Donner, MD, Johanna Klingner, MD, Cornelius Rau, MD, Sebastian Haller, MD, Annika Brinkmann, PHD, Andreas Nitsche, MD, Martin Noldt, MD, Gesine Schmoock, MD, Christian Herzmann, MD, Ulrike Degenhardt, MD, Silja Bühler, MD, Martin Enders, MD, Julia Hermes, MD, Nele Rolfs, MD, Tatiana Manuylova, MD, Eicke Schwarzkopf, MA, Jens Beudt, Claudia Siffczyk, MPH, Stephan Schubert, MD, Mirco Sandfort, PHD, Karin Klingel, MD |
| Riassunto: | Background - Following a surge in myocarditis in Germany since August 2023, many with parvovirus B19 (B19V) detection, concerns arose about causes and countermeasures. - Objectives - The authors aimed to verify the association among B19V, myocarditis increase, and severity. - Methods - Data from the pediatric multicenter registry (MYKKE) from 27 centers were analyzed. B19V myocarditis cases were defined by polymerase chain reaction (PCR) positivity in blood or myocardium with clinical or histopathologic myocarditis evidence. Comprehensive clinical, histopathologic, and epidemiologic analyses were conducted. Past patients were hospitalized from 2013 to July 2023, current from August 2023 to November 2024. Registry data were compared with surveillance and consultant laboratory data. Specimens of current cases underwent metagenomic analysis and B19V sequencing. - Results - Since 2013, 922 myocarditis patients including 126 (13.6%) with B19V myocarditis were enrolled. With 57 of 126 (45.2%) current cases, B19V myocarditis increased, compared with other myocarditis causes. Most current cases were patients who were <2 years of age (64.9%), 56.1% were female. The ratio of B19V myocarditis to incidence did not increase compared with the earlier period. Current cases presented with more reduced ejection fraction (29.0% vs 34.5%; P = 0.007), linked to severe cardiac T-cell infiltration and high numbers of B19V copies. Increased severity was associated with younger age. Phylogenetic analysis identified B19V genotype 1A, without sequence variants indicating increased virulence. - Conclusions - The increase in pediatric myocarditis since August 2023 was associated with B19V, more likely explained by disproportionately young current cases and young children’s vulnerability than a virulent strain. Raising clinicians’ awareness and proactive, interdisciplinary approaches are essential for improving prevention of B19V infection, management of myocarditis, and treatment strategies in this vulnerable cohort. (Myocarditis Registry for Children and Adolescents [MYKKE]; NCT02590341) |
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| Descrizione del documento: | Gesehen am 24.07.2026 |
| Descrizione fisica: | Online Resource |
| ISSN: | 2213-1787 |
| DOI: | 10.1016/j.jchf.2025.102854 |