Evidence map›Paper›PMID 42634088›Full record

ArticlePharmacoepidemiology and drug safety2026

Pediatric Use of Off-Label Medicines and Nonevidence-Based Supplements for COVID-19: Findings From the 2015 Pelotas Birth Cohort Study (Brazil).

Andréa Dâmaso Bertoldi, Fernando Silva Guimarães, Alexandra Crispim Boing, Marysabel Pinto Telis Silveira, Pedro Curi Hallal, Mariângela Freitas da Silveira

Abstract read
In one paragraph

Article in Pharmacoepidemiology and drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Andréa Dâmaso BertoldiPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.ORCID https://orcid.org/0000-0002-4680-3197
Fernando Silva GuimarãesPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.ORCID https://orcid.org/0000-0002-7812-2660
Alexandra Crispim BoingFederal University of Santa Catarina, Florianópolis, Brazil.ORCID https://orcid.org/0000-0001-7792-4824
Marysabel Pinto Telis SilveiraMulticenter Postgraduate Program in Physiological Sciences, Federal University of Pelotas, Pelotas, Brazil.ORCID https://orcid.org/0000-0002-6453-8534
Pedro Curi HallalPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.ORCID https://orcid.org/0000-0003-1470-6461
Mariângela Freitas da SilveiraPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.ORCID https://orcid.org/0000-0002-2861-7139

Funding

Celer BiotecnologiaConselho Nacional de Desenvolvimento Científico e Tecnológico 406582/2021-1Conselho Nacional de Desenvolvimento Científico e Tecnológico 407813/2021-7Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorDepartment of Science and Technology of the Ministry of Health (Department of Science and Technology (DECIT/Brazilian Ministry of Health)Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul PqG 21/2551-0002004-0Instituto Todos pela Saúde
6 · The paper itself

Abstract

purposePediatric off-label medicine use increased during the COVID-19 pandemic, exposing children to nonevidence-based treatments. We described the use of nonevidence-based COVID-19 medicines and supplements among children from the 2015 Pelotas Birth Cohort, according to sociodemographic and health-related characteristics.

methodsData from the 6-7-year follow-up were analyzed. Mothers/caregivers reported children's use of nonevidence-based medicines (azithromycin, chloroquine/hydroxychloroquine, ivermectin, nitazoxanide) and supplements (vitamin C, vitamin D, and zinc) along with sociodemographic and health-related characteristics. Two scores were analyzed: (1) child's COVID-19 burden score (considering negative experiences such as death or separation from a close person due to COVID-19, and risk factors such as living with older adults or having asthma, bronchitis, or obesity) and (2) preventive behavior score (limited outdoor exposure during COVID-19 and vaccine uptake against COVID-19). Hierarchical logistic regression analyses were used to identify factors associated with nonevidence-based medicine and supplement use.

resultsAmong 3098 children interviewed after COVID-19 vaccines became available in the municipality, 13.9% (95% CI 12.7-15.2) used nonevidence-based medicines and supplements for COVID-19. Overall, the use of nonevidence-based medicines and supplements increased with higher COVID-19 burden scores and decreased with higher preventive behavior scores. Unvaccinated children had 2.57-fold higher odds of using off-label medicines than vaccinated children.

conclusionsThese findings highlight behavioral responses during a health emergency and suggest that public health policies should strengthen evidence-based risk communication and discourage inappropriate medicine use during future health emergencies.

Indexed as

COVID-19COVID-19 Drug TreatmentDietary SupplementsOff-Label UseAdolescentBirth CohortBrazilChildChild, PreschoolCohort StudiesFemaleFollow-Up StudiesHumansInfantMalecohort studiesCOVID‐19off‐label drug usepediatrics

Identifiers

PMID42634088
PMCPMC13500738

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.