What is the clinical evidence from this study?

Study design: Observational. Population: Human parechovirus (HPeV)-related meningitis (n=8). Primary outcome: Clinical presentation, laboratory data, respiratory support requirements, and treatment courses.

February 14, 2026Open Access

Differences in Clinical Manifestations of Human Parechovirus–Related Meningitis in Neonates After the COVID‐19 Pandemic: A Single‐Center Exploratory Study

Key Result

Neonatal HPeV meningitis after the COVID-19 pandemic presented with prolonged fever (mean 4.3 days) and 50% of patients required high-flow nasal cannula support for respiratory symptoms.

Key Points

The research aims to describe the clinical manifestations of human parechovirus-related meningitis in neonates following the COVID-19 pandemic.
Retrospective review of neonates admitted with fever and HPeV in cerebrospinal fluid.
Data collection included demographic variables, clinical presentation, and laboratory findings.
Assessment of respiratory support needs and treatment courses throughout hospitalization.
Fever was the primary symptom reported in all cases.
Mean fever duration was prolonged at 4.3 days despite normal white blood cell counts.
50% of patients required high-flow nasal cannula support due to respiratory symptoms.
Two neonates exhibited hyponatremia without neurological symptoms, a novel observation.

Study Design

Type

Observational (n=8)

Multicenter

Structured PICO

Population

8 neonates admitted between June 1, 2023, and September 30, 2023, with fever and Human parechovirus (HPeV) detected in cerebrospinal fluid (CSF) using the FilmArray Meningitis/Encephalitis Panel. Mean gestational age 37.5 weeks, mean birth weight 2940 g, mean age at symptom onset 23.3 days, 87.5% female.

Outcome

Clinical manifestations, laboratory data, respiratory support requirements, and treatment courses

Neonatal HPeV meningitis after the COVID-19 pandemic may present with prolonged fever, increased need for respiratory support, and hyponatremia without typical symptoms like rash or seizures.

Limitations

Small, single-center series
Findings are preliminary and hypothesis-generating
Lacks subtype analysis and long-term neurodevelopmental follow-up

Abstract

Purpose Human parechovirus (HPeV) is one of the major causes of viral meningitis in neonates. Following the COVID‐19 pandemic, a resurgence of HPeV infections was reported worldwide. This exploratory case series is aimed at describing the symptoms of neonatal HPeV meningitis occurring after the lifting of large‐scale quarantine measures. Methods We retrospectively reviewed eight neonates admitted between June 1, 2023, and September 30, 2023, with fever and HPeV detected in cerebrospinal fluid (CSF) using the FilmArray Meningitis/Encephalitis Panel. Demographic variables, clinical presentation, laboratory data, respiratory support requirements, and treatment courses were analyzed. Results Fever was the primary presenting symptom. Despite the absence of leukocytosis or pleocytosis, fever duration was prolonged (mean 4.3 days). Four patients (50%) exhibited respiratory symptoms requiring high‐flow nasal cannula support. Hyponatremia occurred in two neonates without neurological manifestations—an observation not commonly described in previous cohorts. No patients required invasive ventilation. Conclusion This small, single‐center series suggests possible variations in neonatal HPeV presentation after the COVID‐19 pandemic; however, findings are preliminary and hypothesis‐generating. Larger multicenter studies with subtype analysis and long‐term neurodevelopmental follow‐up are essential.

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