Two Swords in the Storm: Parvovirus B19 and COVID-19 Clash in a Myocardial Mayhem of Arrhythmias
Shaikh A. Khalil A. Khalikh *
Department of Cardiology, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India.
Kalyan S. Munde
Department of General Medicine, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India.
*Author to whom correspondence should be addressed.
Abstract
Myocarditis can be caused by a variety of infectious and non-infectious illnesses [1]. Although viral infection remains the most commonly identified cause of myocarditis, the role of parvovirus B19 (B19V) from the Erythrovirus genus in the pathogenesis of myocarditis has been identified as a potentially important contributor to myocarditis because of the high prevalence of Parvovirus B 19 (B19V) DNA in hearts of patients with myocarditis [2]. Co-infections of cardiotropic viruses are rarely reported and the mechanisms of viral interactions remain unknown [3]. In this report, we present a case of acute myocarditis in a young male, precipitated by a co-infection of Parvovirus B19 and COVID-19, characterized by fulminant progression and the development of multiple arrhythmias.
Keywords: Myocarditis, viral infection, parvovirus B19, cardiotropic viruses
How to Cite
References
Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Heliö T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss HP, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron P, Elliott PM; European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013 Sep;34(33):2636-48, 2648a-2648d. DOI: 10.1093/eurheartj/eht210. Epub 2013 Jul 3. PMID: 23824828.
Braunwald’s Heart Disease Textbook of Cardiovascular Medicine, 13th edition, Page number 1078.
Bock CT, Klingel K, Kandolf R. Human parvovirus B19-associated myocarditis. N. Engl. J. Med. 2010;362:1248–1249. DOI: 10.1056/NEJMc0911362.
Braunwald’s Heart Disease Textbook of Cardiovascular Medicine, 13th edition, Page number 1077.
Escher F, Kuhl U, Sabi I, et al. Immunohistological detection of parvovirus B19 capsid proteins in endomyocardial biopsies from dilated cardiomyopathy patients. Med Sci Monit. 2008; 14:CR333-CR338.
Schultheiss HP, Kuhl U, Cooper LT. The management of myocarditis. Eur Heart J. 2011;32:2616–2625.
Sala S, Peretto G, Gramegna M, Palmisano A, Villatore A, Vignale D, de Cobelli F, Tresoldi M, Cappelletti AM, Basso C, Godino C, Esposito A. Acute myocarditis presenting as a reverse Tako-Tsubo syndrome in a patient with SARS-CoV-2 respiratory infection. Eur Heart J 2020; 41: 1861–1862.
Tschöpe C, Ammirati E, Bozkurt B, Caforio ALP, Cooper LT, Felix SB, Hare JM, Heidecker B, Heymans S, Hübner N, Kelle S, Klingel K, Maatz H, Parwani AS, Spillmann F, Starling RC, Tsutsui H, Seferovic P, Van Linthout S. Myocarditis and inflammatory cardiomyopathy: current evidence and future directions. Nat Rev Cardiol. 2021 Mar;18(3):169-193.
DOI: 10.1038/s41569-020-00435-x. Epub 2020 Oct 12. PMID: 33046850; PMCID: PMC7548534.
Karrasch M., Felber J., Keller P.M., Kletta C., Egerer R., Bohnert J., Hermann B., Pfister W., Theis B., Petersen I., et al. Primary Epstein-Barr Virus Infection and Probable Parvovirus B19 Reactivation Resulting in Fulminant Hepatitis and Fulfilling Five of Eight Criteria for Hemophagocytic Lymphohistiocytosis. Int. J. Infect. Dis. 2014;28:143–146. DOI: 10.1016/j.ijid.2014.08.003.
Shehi E, Ghazanfar H, Fortuzi K, Gonzalez E, Zeana C. A rare case of parvovirus B19 Infection manifesting as chronic aplastic anemia and neutropenia in a human immunodeficiency virus-infected patient. Cureus. 2020;12:e12174. DOI: 10.7759/cureus.12174.
Ganaie SS, Qiu J. Recent advances in replication and infection of human parvovirus B19. Front Cell Infect Microbiol. 2018;8:166.
Yu MY, Alter HJ, Virata-Theimer ML, et al. Parvovirus B19 infection transmitted by transfusion of red blood cells confirmed by molecular analysis of linked donor and recipient samples. Transfusion. 2010;50:1712–1721.
Marano G, Vaglio S, Pupella S, et al. Human Parvovirus B19 and blood product safety: a tale of twenty years of improvements. Blood Transfus. 2015;13:184–196. [PMC free article]
Cohen BJ, Buckley MM. The prevalence of antibody to human parvovirus B19 in England and Wales. J Med Microbiol. 1988 Feb;25(2):151-3. DOI: 10.1099/00222615-25-2-151. PMID: 3339634.
Kerr S, O'Keeffe G, Kilty C, Doyle S. Undenatured parvovirus B19 antigens are essential for the accurate detection of parvovirus B19 IgG. J Med Virol. 1999 Feb;57(2):179-85. DOI: 10.1002/(sici)1096-9071(199902)57:2<179::aid-jmv16>3.0.co;2-t. PMID: 9892405
Sterpu R, Ichou H, Mahé I, Mortier E. Réactivation d’une infection à parvovirus B19 chez une patiente infectée par le VIH [Reactivation of parvovirus B19 infection in an HIV-infected woman]. Rev Med Interne. 2014 Jun;35(6):396-8. French. DOI: 10.1016/j.revmed.2013.05.009. Epub 2013 Jun 20. PMID: 23791089.
Inciardi RM, Lupi L, Zaccone G, et al. Cardiac Involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020; 5:819.
Zeng JH, Liu YX, Yuan J, et al. First case of COVID-19 complicated with fulminant myocarditis: a case report and insights. Infection 2020; 48:773.
Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis treated with glucocorticoid and human immunoglobulin. Eur Heart J 2021; 42:206.
Fried JA, Ramasubbu K, Bhatt R, et al. The variety of cardiovascular presentations of COVID-19. Circulation 2020; 141:1930.
Tavazzi G, Pellegrini C, Maurelli M, et al. Myocardial localization of coronavirus in COVID-19 cardiogenic shock. Eur J Heart Fail. 2020;22:911.
Kim IC, Kim JY, Kim HA, Han S. COVID-19-related myocarditis in a 21-year-old female patient. Eur Heart J. 2020;41:1859.
Daniels CJ, Rajpal S, Greenshields JT, et al. Prevalence of clinical and subclinical myocarditis in competitive athletes with recent SARS-CoV-2 infection: Results from the Big Ten COVID-19 Cardiac Registry. JAMA Cardiol. 2021;6:1078.
Escher F, Pietsch H, Aleshcheva G, et al. Detection of viral SARS-CoV-2 genomes and histopathological changes in endomyocardial biopsies. ESC Heart Fail. 2020;7:2440.
Salah HM, Mehta JL. Takotsubo cardiomyopathy and COVID-19 infection. Eur Heart J Cardiovasc Imaging. 2020;21:1299.
Nicol M, Cacoub L, Baudet M, et al. Delayed acute myocarditis and COVID-19-related multisystem inflammatory syndrome. ESC Heart Fail. 2020;7:4371.
Caforio ALP, Baritussio A, Basso C, Marcolongo R. Clinically Suspected and Biopsy-Proven Myocarditis Temporally Associated with SARS-CoV-2 Infection. Annu Rev Med. 2022;73:149.
Kawakami R, Sakamoto A, Kawai K, et al. Pathological Evidence for SARS-CoV-2 as a Cause of Myocarditis: JACC Review Topic of the Week. J Am Coll Cardiol. 2021;77:314.
Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Heliö T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss HP, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron P, Elliott PM; European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013 Sep;34(33):2636-48, 2648a-2648d. DOI: 10.1093/eurheartj/eht210. Epub 2013 Jul 3. PMID: 23824828.
Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 3-6 May 2021 [Internet]. Available:https://www.ema.europa.eu/en/news/meeting-highlights-pharmacovigilance-risk-assessment-committe prac-3-6-may-2021 (Accessed on May 26, 2021).
Gargano JW, Wallace M, Hadler SC, et al. Use of mRNA COVID-19 Vaccine After Reports of Myocarditis Among Vaccine Recipients: Update from the Advisory Committee on Immunization Practices - United States, June 2021. MMWR Morb Mortal Wkly Rep. 2021; 70:977.
Vaccines and Related Biological Products Advisory Committee Meeting. FDA Briefing Document: Novavax COVID-19 Vaccine. June 7, 2022. Available:https://www.fda.gov/media/158912/download (Accessed on June 16, 2022).
US Food and Drug Administration. Emergency use authorization (EUA) of the Janssen COVID-19 vaccine to prevent coronavirus disease 2019 (COVID-19). Available:https://www.fda.gov/media/146304/download (Accessed on March 27, 2023).
Callon D, Berri F, Lebreil AL, Fornès P, Andreoletti L. Coinfection of parvovirus B19 with influenza a/H1n1 causes fulminant myocarditis and Pneumonia. an autopsy case report. Pathogens. 2021 Jul 29;10(8):958.