Betta Pasqua, Leonardi Roberta, Mattia Carmine, Saporito Alessandro, Gentile Silvia, Trovato Laura, Palermo Concetta Ilenia, Scalia Guido
Neonatal Intensive Care Unit, University Hospital Policlinico "G. Rodolico San Marco", University of Catania, 95123 Catania, Italy.
Postgraduate Training Programme in Pediatrics, Department of Clinical and Esperimental Medicine, University of Catania, 95123 Catania, Italy.
Pathogens. 2025 Aug 9;14(8):798. doi: 10.3390/pathogens14080798.
Parvovirus B19 (B19V) re-emerged across Europe in 2024, raising concerns about vertical transmission and neonatal morbidity. We undertook a prospective, single-centre cohort study to characterise the early clinical course of congenitally infected neonates born between April and December 2024. Seventy-one pregnancies with serologically or PCR-confirmed maternal infection were enrolled; seven neonates met laboratory criteria for congenital B19V infection and were followed with serial clinical, biochemical and imaging assessments through the first year of life. Troponin I and CK-MB were measured on days 1, 3, 7 and 15; electrocardiogram (ECG) and echocardiography were repeated in parallel, and cranial ultrasound (US), ophthalmologic and audiologic screening were scheduled prospectively. Mean troponin rose from 50.7 ng L on day 1 to a peak of 120.7 ng L on day 7 ( < 0.01), normalising by one month, while echocardiograms remained structurally normal, and only one transient arrhythmia was recorded. CK-MB exceeded the reference range in 29% of infants but showed no clinical sequelae. Multiple periventricular hyperechogenicities were identified in 8/70 neonates (11%), and moderate anaemia (Hb ≤ 9.8 g/dL) occurred in 2 cases. Serum PCR detected high-level viraemia (>10 genome equivalents mL) in 40% of those tested; saliva and urine were consistently negative. No instances of myocarditis or hydrops were observed. Our findings indicate that congenital B19V infection during the current outbreak is marked by transient biochemical myocardial stress and subtle neurosonographic changes rather than overt cardiac disease, supporting an outpatient-focused follow-up strategy incorporating serial biomarkers and targeted neuroimaging.
细小病毒B19（B19V）于2024年在欧洲再度出现，引发了对垂直传播和新生儿发病率的担忧。我们开展了一项前瞻性、单中心队列研究，以描述2024年4月至12月出生的先天性感染新生儿的早期临床病程。纳入了71例血清学或PCR确诊的母亲感染的妊娠病例；7例新生儿符合先天性B19V感染的实验室标准，并在出生后第一年接受了系列临床、生化和影像学评估。在第1、3、7和15天测量肌钙蛋白I和肌酸激酶同工酶（CK-MB）；同时重复进行心电图（ECG）和超声心动图检查，并前瞻性安排头颅超声（US）、眼科和听力筛查。肌钙蛋白平均值从第1天的50.7 ng/L升至第7天的峰值120.7 ng/L（<0.01），1个月时恢复正常，而超声心动图结构始终正常，仅记录到1例短暂性心律失常。29%的婴儿CK-MB超过参考范围，但未出现临床后遗症。70例新生儿中有8例（11%）发现多个脑室周围高回声区，2例出现中度贫血（血红蛋白≤9.8 g/dL）。40%的检测者血清PCR检测到高水平病毒血症（>10基因组当量/mL）；唾液和尿液始终为阴性。未观察到心肌炎或水肿病例。我们的研究结果表明，当前疫情期间的先天性B19V感染以短暂的生化性心肌应激和细微的神经超声改变为特征，而非明显的心脏疾病，支持采用以门诊为重点的随访策略，包括系列生物标志物和针对性神经影像学检查。
