Classes of medications prescribed for pediatrics and neonatology during COVID-19
DOI:
https://doi.org/10.15343/0104-7809.202549e17382025IKeywords:
COVID-19, SARS-CoV-2, Critical Care, PandemicAbstract
COVID-19 was a global pandemic that affected millions of people, including children and adolescents. Although several therapies were proposed, the scarcity of therapeutic options for the pediatric population was evident, resulting in the use of off-label medications. This study aimed to analyze the prescription of medications for pediatric patients diagnosed with COVID-19 and admitted to neonatal and pediatric intensive care units. This was a retrospective cross-sectional study conducted in two intensive care units at the São João de Deus Health Complex, in Divinópolis, Minas Gerais, Brazil, between 2020 and 2021. The study involved 68 patients diagnosed with COVID-19, of whom 35 required admission to intensive care. Data collection included information on prescribed drugs, route of administration, sociodemographic characteristics, and clinical outcomes. A total of 643 prescriptions were analyzed, comprising 3,026 prescribed medications. Results showed that most patients diagnosed with COVID-19 required intensive care support, with 51.5% admitted to the ICU and a mortality rate of 20% among those requiring intensive therapy. The most prescribed drugs were electrolytes (26.3%), analgesics (14.0%), and antimicrobials (13.4%). The scarcity of effective treatments for COVID-19 led to the use of unlicensed medications, posing a risk of adverse effects. It is concluded that most prescriptions were for symptomatic management, with high mortality rates among critically ill patients.
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Classes de medicamentos prescritos para pediatria e neonatologia durante a COVID-19
References
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Soares FR, Dadalto L. Responsabilidade médica e prescrição off-label de medicamentos no tratamento da COVID-19. Rev IBERC. 2020;3(2):1-22. doi: 10.37963/iberc.v3i2.112
Rodrigues-Santos G, Lima-Setta F, Lima-Setta F, et al. Performance do Pediatric Risk of Mortality IV em unidades de terapia intensiva pediátrica brasileiras durante a pandemia de COVID-19. Crit Care Sci. 2025;36:e20240068. doi:10.62675/2965-2774.20240068-em.
Ministério da Saúde. Painel Coronavírus [Internet]. Brasília: Ministério da Saúde; 2025. Disponível em: https://covid.saude.gov.br/. Acesso em: 06 de março de 2025.
World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. Geneva: World Health Organization; 2025. Disponível em: https:// data.who.int/dashboards/covid19/deaths?n=c. Acesso em: 06 de março de 2025.
Cui X, Zhao Z, Zhang T, Guo W, Guo W, Zheng J, Zhang J, Dong C, Na R, Zheng L, Li W, Liu Z, Ma J, Wang J. A systematic review and meta-analysis of children with coronavirus disease 2019 (COVID-19). J Med Virol. 2020;92(9):1915-1917. doi: 10.1002/jmv.26398.
Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, Dahal S, Kumar H, KV D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J. 2020 Jun 20;96(1142):753-58. doi: 10.1136/postgradmedj-2020-138234.
Paumgartten FJR, de Oliveira ACAX. Off label, compassionate and irrational use of medicines in covid-19 pandemic, health consequences and ethical issues. Cien Saude Colet. 2020;25(9):3413-19. doi: 10.1590/1413-81232020259.16792020.
Castro R. Vacinas contra a Covid-19: o fim da pandemia? Physis Rev Saude Colet. 2021;31(1):e310100. doi: 10.1590/S0103-73312021310100.
Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ; COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020 Jun 27;395(10242):1973-1987. doi: 10.1016/S0140-6736(20)31142-9.
Souza AS Jr, Santos DB, Rey LC, Medeiros MG, Vieira MG, Coelho HLL. Off-label use and harmful potential of drugs in a NICU in Brazil: A descriptive study. BMC Pediatr. 2016;16(1):13. doi: 10.1186/s12887-016-0560-1.
Peterlini MAS, Chaud MN, Pedreira MLG. Órfãos de terapia medicamentosa: a administração de medicamentos por via intravenosa em crianças hospitalizadas. Rev Latino-am Enfermagem. 2003 jan-fev;11(1):88-95. doi: https://doi.org/10.1590/S0104-11692003000100013.
Conselho Federal de Medicina. Parecer CFM nº 2/16. Assunto: Prescrição de medicamentos off label e Resolução CFM nº 1.982/12. Relator: Cons. Emmanuel Fortes Silveira Cavalcanti. Brasília: Conselho Federal de Medicina; 2016. Publicado em 20 de janeiro de 2016.
Carvalho CG, Ribeiro MR, Bonilha MM, Fernandes MJ, Procianoy RS, Silveira RC. Use of off-label and unlicensed drugs in the neonatal intensive care unit and its association with severity scores. J Pediatr (Rio J). 2012;88(6):465-470. doi: 10.2223/JPED.2231.
Koszma EIA, Bispo AJB, Santana IAO, Santos CNDB. Uso de medicamentos off-label em unidade de terapia intensiva neonatal. Rev Paul Pediatr. 2021;39:1-7. doi: 10.1590/1984-0462/2021/39/2020063.
Patel NA. Pediatric COVID-19: Systematic review of the literature. Am J Otolaryngol. 2020;41:102573. doi: 10.1016/j.amjoto.2020.102573.
Eghbali A, Shokrollahi S, Mahdavi NS, Mahdavi SA, Dabbagh A. COVID-19 in pediatric patients: A case series. J Cell Mol Anesth. 2020;5(1):3-5. doi: 10.22037/jcma.v5i1.29690.
Paumgartten FJR, de Oliveira ACAX. Off label, compassionate and irrational use of medicines in covid-19 pandemic, health consequences and ethical issues. Cien Saude Colet. 2020;25(9):3413-3419. doi: 10.1590/1413-81232020259.16792020.
World Health Organization. Anatomical Therapeutic Chemical Code [Internet]. Geneva: World Health Organization; 2021. Disponível em: https:// www.whocc.no/atc_ddd_index/?code=N06AA09. Acesso em: 2021.
Prata‐Barbosa A, Lima‐Setta F, Rodrigues dos Santos G, Lanziotti VS, Vieira de Castro RE, de Souza DC, Raymundo CE, Caino de Oliveira FR, Peixoto de Lima LF, Tonial CT, Colleti J Jr, Bellinat APN, Lorenzo VB, Zeitel RS, Pulcheri L, Monte da Costa FC, Ferreira La Torre FP, das Neves Figueiredo EA, Peres da Silva T, Marins Riveiro P, de Magalhães‐Barbosa MC. Pediatric patients with COVID‐19 admitted to intensive care units in Brazil: a prospective multicenter study. J Pediatr (Rio J). 2020;96(5):582-592. doi: 10.1016/j.jpedp.2020.07.002.
Silva ACCA, Luiz RR, Moraes JR, Rocha PHV, Zeitoune RCG, Barbosa AP, Moreira JPL. Mortalidade hospitalar por covid-19 em crianças e adolescentes no Brasil em 2020–2021. Rev Saude Publica. 2023;57:56. doi: 10.11606/s1518-8787.2023057005172.
Marques JCB, Bhering M, Guimarães RM, Lima APS, França EB, Teixeira R. Severe Acute Respiratory Syndrome due to COVID-19 among children and adolescents in Brazil: profile of deaths and hospital lethality as at Epidemiological Week 38, 2020. Epidemiol Serv Saude. 2021;30(1):e2020835. doi:10.1590/S1679-49742021000100023.
Feld LG, Neuspiel DR, Foster BA, Leu MG, Garber MD, Austin K, Basu RK, Conway EE Jr, Fehr JJ, Hawkins C, Kaplan RL, Rowe EV, Waseem M, Moritz ML; SUBCOMITÊ DE TERAPIA DE FLUIDOS E ELETROLITOS. Diretriz de prática clínica: Fluidos intravenosos de manutenção em crianças. Pediatria. 2018 Dez;142(6):e20183083. doi: 10.1542/peds.2018-3083.
Ferreira TR, Lopes LC. Analysis of analgesic, antipyretic, and nonsteroidal anti-inflammatory drug use in pediatric prescriptions. J Pediatr (Rio J). 2016;92(1):81-87. doi: 10.1016/j.jpedp.2020.07.002.
Soares FR, Dadalto L. Responsabilidade médica e prescrição off-label de medicamentos no tratamento da COVID-19. Rev IBERC. 2020;3(2):1-22. doi: 10.37963/iberc.v3i2.112
Rodrigues-Santos G, Lima-Setta F, Lima-Setta F, et al. Performance do Pediatric Risk of Mortality IV em unidades de terapia intensiva pediátrica brasileiras durante a pandemia de COVID-19. Crit Care Sci. 2025;36:e20240068. doi:10.62675/2965-2774.20240068-em.
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2025-12-05
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Melo, A. E., Baldoni, A. O., Souza, I. G. L. de, Silva, R. A. dos S., Pizzol, T. da S. D., Nogueira, T. A., & Pereira, M. L. (2025). Classes of medications prescribed for pediatrics and neonatology during COVID-19. O Mundo Da Saúde, 49. https://doi.org/10.15343/0104-7809.202549e17382025I
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