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

Abstract

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 ( $\text{OR}=3.60$ , 95% CI (2.55, 5.07), and $P<0.001$ ). Additionally, the observation group had lower levels of cardiac troponin-I (SMD = − 2.63, 95% CI (− 3.51, − 1.76), and $P<0.001$ ), creatine kinase isoenzyme ( $\text{SMD}=-2.78$ , 95% CI (− 3.53, − 2.03), and $P<0.001$ ), lactate dehydrogenase ( $\text{SMD}=-1.95$ , 95% CI (− 2.49, − 1.42), and $P<0.001$ ), aspartate aminotransferase ( $\text{SMD}=-0.87$ , 95% CI (− 1.84, 0.09), and $P=0.076$ ), tumor necrosis factor-α ( $\text{SMD}=-3.90$ , 95% CI (− 4.47, − 3.06), and $P<0.001$ ), and higher superoxide dismutase levels ( $\text{SMD}=2.48$ , 95% CI (1.64, 3.33), and $P<0.001$ ). 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.