Clinical Efficacy of Creatine Phosphate Sodium And/or Vitamin C in the Treatment of Children with Viral Myocarditis: A Meta-Analysis

Background: This study performed a meta-analysis to explore the clinical efficacy of creatine phosphate sodium (CPS) and/or vitamin C for viral myocarditis (VMC) in children, to provide guidance for its clinical treatment.

Methods: A literature search was performed on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases to obtain published clinical randomized controlled trials (RCTs) on CPS and/or vitamin C for VMC in children, with a time span from 2013 to 2022. Relevant data was extracted and meta-analysis was performed using the statistical software Stata 16.0.

Results: A total of 723 studies were retrieved and 19 studies were finally included for meta-analysis, with a total of 1,957 patients. The meta-analysis results showed that the observation group (conventional treatment + CPS and/or vitamin C) was superior to the control group (conventional treatment alone) in treatment effective rate (OR = 3.60, 95% CI (2.55, 5.07), and < 0.001). Additionally, the observation group had lower levels of cardiac troponin-I (SMD = - 2.63, 95% CI (- 3.51, - 1.76), and < 0.001), creatine kinase isoenzyme (SMD = -2.78, 95% CI (- 3.53, - 2.03), and < 0.001), lactate dehydrogenase (SMD = -1.95, 95% CI (- 2.49, - 1.42), and < 0.001), aspartate aminotransferase (SMD = -0.87, 95% CI (- 1.84, 0.09), and = 0.076), tumor necrosis factor- (SMD = -3.90, 95% CI (- 4.47, - 3.06), and < 0.001), and higher superoxide dismutase levels (SMD = 2.48, 95% CI (1.64, 3.33), and < 0.001). Except aspartate aminotransferase, there were significant differences between the two groups in the other parameters.

Conclusion: CPS and/or vitamin C treatment could greatly improve the treatment, protect myocardial function, and relieve inflammatory response in children with VMC.