Influenza Myopericarditis and Pericarditis: A Literature Review

Radovanovic, Milan; Petrović, Marija; Barsoum, Michel K.; Nordstrom, Charles W.; Calvin, Andrew D.; Dumić, Igor; Jevtic, Djordje; Hanna, Richard D.

doi:10.3390/jcm11144123

Cited by 23 publications

(31 citation statements)

References 103 publications

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“…We could only find two published reports of pericarditis caused by influenza virus B [ 20 , 21 ]. We have also found a case report linking pericarditis to influenza vaccination [ 22 ], a linkage that has been supported by other literature [ 23 ]. To the best of our knowledge, this is the first case report of pericarditis exacerbation due to influenza B infection.…”

Section: Case Presentationsupporting

confidence: 85%

Influenza Type B Complicates a Previously Undiagnosed Case of Pericarditis

Ivaturi¹,

Tsukhai²,

Hassan³

2022

Cureus

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We report the first case of pericarditis exacerbation due to influenza B viral infection while emphasizing the importance of cardiac magnetic resonance (CMR) for the timely diagnosis and ruling out of non-effusive pericarditis in a patient with compatible, unexplained chest pain. The patient presented with left-sided chest pain that was partially relieved by leaning backward and noted persistent fatigue for several days. Pericardial friction rub, electrocardiogram (ECG), and echocardiogram abnormalities were not detected. After discharge on the morning following admission, fatigue and fever several minutes after physical exertion continued. The patient contracted influenza type B, leading to pneumonia and a second hospitalization, during which echocardiography showed moderate pericardial effusion. We conclude that the patient had pericarditis on the first admission because other compatible causes of chest pain were ruled out, symptoms were compatible with non-effusive pericarditis and could not be ruled out since CMR was not done, and the patient tested positive during his second admission for multiple known etiologic agents of pericarditis. We highlight the importance of CMR in screening patients presenting with chest pain of unknown origin to facilitate early detection and intervention.

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Section: Case Presentationsupporting

confidence: 85%

Influenza Type B Complicates a Previously Undiagnosed Case of Pericarditis

Ivaturi¹,

Tsukhai²,

Hassan³

2022

Cureus

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“…Cardiac involvement was also associated with influenza infection, often only with a mild course of the disease [ 19 ]. Different pericardial conditions with variable severity have also been reported in patients with influenza infection, including acute pericarditis and cardiac tamponade with obstructive shock [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic Cardiac Tamponade—An Unusual Threat in the COVID-19 Recovery Phase

et al. 2022

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Cardiac tamponade is a rare presentation in patients with COVID-19, which may be induced by the associated exacerbated inflammatory response. The onset of cardiac tamponade may be concomitant with the acute phase of the disease or may develop subsequently as a new health condition secondary to the disease. We report four cases of cardiac tamponade that occurred late after the acute phase of the disease. One of them may be considered a post-acute complication of the disease, and three of them may be classified as a new health condition induced by COVID-19. Only two cases had a history of severe respiratory distress due to COVID-19. In all four cases, pericardiocentesis was imposed, and surprisingly, in every case, hemorrhagic fluid was evacuated. In this case, series, immune-mediated etiology is supported by histopathological results, where the main identified feature was fibrous pericarditis with inflammatory infiltrate. Only one patient included in this report died, and three of them were discharged after anti-inflammatory treatment was initiated.

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“…Advance to severe disease is marked by virus invasion of the small airways and viral pneumonia, which can lead to sepsis due to a hyperinflammatory systemic response (10). Other serious complications include myocarditis, encephalitis, myositis, and multi-organ failure (11,12). At greatest risk of life-threatening influenza are children less than 2 years of age, older adults, pregnant women, and patients with pre-existing conditions such as asthma, diabetes, or chronic heart disease (13).…”

Section: Introductionmentioning

confidence: 99%

4’-Fluorouridine mitigates lethal infection with pandemic human and highly pathogenic avian influenza viruses

Lieber

Aggarwal

Yoon

et al. 2022

Preprint

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Influenza outbreaks are associated with substantial morbidity, mortality and economic burden. Next generation antivirals are needed to treat seasonal infections and prepare against zoonotic spillover of avian influenza viruses with pandemic potential. Having previously identified oral efficacy of the nucleoside analog 4-Fluorouridine (4-FlU, EIDD-2749) against SARS-CoV-2 and respiratory syncytial virus, we explored activity of the compound against seasonal and highly pathogenic influenza (HPAI) viruses in cell culture, human airway epithelium organoids, and/or two animal models, ferrets and mice, that assess IAV transmission and lethal viral pneumonia, respectively. 4-FlU inhibited a panel of relevant influenza A and B viruses with nanomolar potency in organoids. In vitro polymerase assays revealed immediate chain termination of IAV polymerase after 4-FlU incorporation, in contrast to delayed chain termination of SARS-CoV-2 and RSV polymerase. Once-daily oral treatment of ferrets with 2 mg/kg 4-FlU initiated 12 hours after infection rapidly stopped virus shedding and prevented direct-contact transmission to untreated sentinels. Treatment of mice infected with a lethal inoculum of pandemic A/CA/07/2009 (H1N1) (Ca09) with 2 mg/kg 4-FlU alleviated pneumonia. Three doses mediated complete survival when treatment was initiated up to 60 hours after infection, indicating an unusually broad window for effective intervention. Therapeutic oral 4-FlU ensured survival of animals infected with HPAI A/VN/12/2003 (H5N1) and of immunocompromised mice infected with pandemic Ca09. Recoverees were fully protected against homologous reinfection. This study defines the mechanistic foundation for high sensitivity of influenza viruses to 4-FlU and supports 4-FlU as developmental candidate for the treatment of seasonal and pandemic influenza.

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Influenza Myopericarditis and Pericarditis: A Literature Review

Cited by 23 publications

References 103 publications

Influenza Type B Complicates a Previously Undiagnosed Case of Pericarditis

Influenza Type B Complicates a Previously Undiagnosed Case of Pericarditis

Hemorrhagic Cardiac Tamponade—An Unusual Threat in the COVID-19 Recovery Phase

4’-Fluorouridine mitigates lethal infection with pandemic human and highly pathogenic avian influenza viruses

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