Patterns of medication use among individuals with Covid-19 in Brazil: Epicovid 2.0

Authors

DOI:

https://doi.org/10.11606/s1518-8787.2026060007542

Keywords:

SARS-CoV-2, Coronavirus, Epidemiology, Drug Use, Cross-Sectional Study

Abstract

OBJECTIVE: To describe the patterns of medication use among individuals with Covid-19 to treat the disease in Brazil, according to area of residence, demographic and socioeconomic characteristics, religion, and level of trust in scientists. METHODS: Epicovid 2.0 National Survey (2024) in 133 municipalities. The analysis included participants who reported having had an episode of Covid-19. The use of antibiotics, azithromycin, antipyretics, chloroquine, and ivermectin was assessed, in addition to the composite outcomes: use of chloroquine and/or ivermectin; chloroquine, ivermectin, and/or azithromycin (CIA); and use of any medication. The frequency of use and 95% confidence intervals were estimated, considering the complex sampling design and sample weighting RESULTS: The frequency of use of any medication to treat Covid-19 was 63.0%  (95%CI 60.0–65.9). Antipyretics were the most commonly used (53.7%), followed by antibiotics (36.2%) and azithromycin (27.2%). The isolated use of ivermectin was reported by 23.6% and that of chloroquine by 12.1%; the use of ivermectin and/or chloroquine reached 27.8% and that of CIA, 39.0%. Overall, medication use was more frequent in the North, Northeast, and Central-West regions and among women. Use was concentrated among adults aged 40–59, people with low educational attainment, and those with lower incomes. Self-identified black and brown individuals reported higher use of chloroquine. Use of chloroquine, ivermectin, and combinations of these medications was more common among evangelicals (0.05 < p < 0.1) and among people who consulted doctors (p < 0.001). Participants who reported distrusting scientists reported higher use of chloroquine and chloroquine/ivermectin compared to those who reported trusting scientists. CONCLUSION: Four out of ten people who reported episodes of Covid-19 consumed medications not recommended by science to treat the disease. Medication use tended to be more frequent among women, in the northern half of Brazil, among evangelicals, and among people with lower income and education levels. These groups should be prioritized in future campaigns on the appropriate use of medications.

References

1. World Health Organization. Medication Without Harm. Geneva: World Health Organization; 2017 [citado 2026 maio 7]. Disponível em: https://www.who.int/initiatives/medicationwithout-harm

2. Siemieniuk RA, Bartoszko JJ, Zeraatkar D, Kum E, Qasim A, Martinez JPD et al. Drug treatments for covid-19: living systematic review and network meta-analysis. BMJ. 2020;370:m2980. https://doi.org/10.1136/bmj.m2980

3. Perico N, Cortinovis M, Suter F, Remuzzi G. Home as the new frontier for the treatment of COVID-19: the case for anti-inflammatory agents. Lancet Infect Dis. 2023;23(1):e22-33. https://doi.org/10.1016/S1473-3099(22)00433-9

4. Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LC, Veiga VC, Avezum A et al. Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19. N Engl J Med. 2020;383(21):2041-52. https://doi.org/10.1056/NEJMoa2019014

5. Popp M, Stegemann M, Metzendorf MI, Gould S, Kranke P, Meybohm P et al. Ivermectin for preventing and treating COVID-19. Cochrane Database Syst Rev. 2021;7(7):CD015017. https://doi.org/10.1002/14651858.CD015017.pub2

6. RECOVERY Collaborative Group; Horby P, Mafham M, Linsell L, Bell JL, Staplin N et al. Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. N Engl J Med. 2020;383(21):2030-40. https://doi.org/10.1056/NEJMoa2022926

7. Singh B, Ryan H, Kredo T, Chaplin M, Fletcher T. Chloroquine or hydroxychloroquine for prevention and treatment of COVID-19. Cochrane Database Syst Rev. 2021;2(2):CD013587. https://doi.org/10.1002/14651858.CD013587.pub2

8. Melo JRR, Duarte EC, Moraes MV, Fleck K, Silva ASN, Arrais PSD. Reações adversas a medicamentos em pacientes com COVID-19 no Brasil: análise das notificações espontâneas do sistema de farmacovigilância brasileiro. Cad Saude Publica. 2021;37(1):e00245820. https://doi.org/10.1590/0102-311X00245820

9. Lasco G, Loreche AM, Aguilar MAD, Yu VG. Miracle cures, wonder drugs, and unproven treatments for COVID-19: a global database. Soc Sci Med. 2026;391:118901. https://doi.org/10.1016/j.socscimed.2025.118901

10. Machado C, Santos J, Santos N, Bandeira L. International trends in misinformation and the departure from the scientific debate, Salvador: Instituto Nacional de Ciência & Tecnologia em Democracia Digital; 2020.

11. Guimarães A, Carvalho WRG. Desinformação, negacionismo e automedicação: a relação da população com as drogas “milagrosas” em meio à pandemia da COVID-19. Interam J Med Health. 2020;3:e202003050. https://doi.org/10.31005/iajmh.v3i0.147

12. Arrais PSD, Fernandes MEP, Pizzol TSD, Ramos LR, Mengue SS, Luiza VL et al. Prevalência da automedicação no Brasil e fatores associados. Rev Saúde Pública. 2016;50(supl.2):13s. https://doi.org/10.1590/S1518-8787.2016050006117

13. Conselho Federal de Farmácia. Quase metade dos brasileiros que usaram medicamentos nos últimos seis meses se automedica até uma vez por mês. Brasília: CFF; 2023 [citado 2026 maio 7]. Disponível em: https://crfse.org.br/noticia/906/quase-metade-dos-brasileiros-que-usarammedicamentos-nos-ultimos-seis-meses-se-automedica-ate-uma-vez-por-mes

14. Pan American Health Organization. Entenda a infodemia e a desinformação na luta contra a COVID-19. Washington: PAHO; 2020.

15. Associação Médica Brasileira. Uso de cloroquina e outros medicamentos sem comprovação científica contra a COVID-19 deve ser banido. São Paulo: AMB; 2021 [citado 2026 maio 7]. Disponível em: https://amb.org.br/noticias/associacao-medica-brasileira-diz-que-uso-decloroquina-e-outros-remedios-sem-eficacia-contra-covid-19-deve-ser-banido/

16. Merck & Co. Merck statement on ivermectin use during the COVID-19 pandemic. Kenilworth: Merck & Co.; 2021 [citado 2026 maio 7]. Disponível em: https://www.merck.com/news/merckstatement-on-ivermectin-use-during-the-covid-19-pandemic/

17. US Food and Drug Administration. FDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial. Silver Spring: FDA; 2020 [citado 2026 maio 7]. Disponível em: https://www.fda.gov/drugs/drug-safety-andavailability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outsidehospital-setting-or

18. COVID-19 Treatment Guidelines Panel. Coronavirus disease 2019 (COVID-19) treatment guidelines. Bethesda: National Institutes of Health; 2025.

19. Roy-García IA, Moreno-Noguez M, Rivas-Ruiz R, Zapata-Tarres M, Perez-Rodriguez M, Ortiz-Zamora MA et al.Efficacy of hydroxychloroquine with azithromycin in mild COVID-19: randomized clinical trial. Cir Cir. 2026;94(1):65-73. https://doi.org/10.24875/CIRU.23000265

20. Caponi S, Brzozowski FS, Hellmann F, Bittencourt SC. O uso político da cloroquina: COVID-19, negacionismo e neoliberalismo. Rev Bras Sociol. 2021;9(21):78-102. https://doi.org/10.20336/rbs.774

21. Santana OMB, Prado MAR. Negacionismo à brasileira: os impactos da desordem informacional para o fenômeno da (des) infodemia no Brasil durante a pandemia da COVID-19. Rev Comun Midiática. 2024;19(1):e202401. https://doi.org/10.5016/hjmrdj34

22. Silva H. Medical misinformation and unproven COVID-19 treatments in Brazil: analyzing the impact of misguided health policies. Pharmacologia. 2024;15(1):11. https://doi.org/10.17311/pharmacologia.2024.11.14

23. Bandeira O, Carranza B. Reactions to the pandemic in Latin America and Brazil: are religions essential services? Int J Latin Am Relig. 2020;4(2):170-93. https://doi.org/10.1007/s41603-020-00116-0

24. Ferrari IW, Grisotti M, Amorim LC, Rodrigues LZ, Ribas MT, Silva CU. “Tratamento precoce”, antivacinação e negacionismo: quem são os Médicos pela Vida no contexto da pandemia de COVID-19 no Brasil? Cienc Saude Colet. 2022;27(11):4213-24. https://doi.org/10.1590/1413-812320222711.09282022

25. Melo JRR, Duarte EC, Moraes MV, Fleck K, Arrais PSD. Automedicação e uso indiscriminado de medicamentos durante a pandemia da COVID-19. Cad Saúde Pública. 2021;37(4):e00053221. https://doi.org/10.1590/0102-311X00053221

26. Santos-Pinto CDB, Miranda ES, Castro CGSO. O “kit-covid” e o programa farmácia popular do Brasil. Cad Saúde Pública. 2021;37(2):e00348020. https://doi.org/10.1590/0102-311X00348020

27. Machado LZ, Marcon CEM. Carta às Editoras sobre o artigo de Melo et al. Cad Saude Publica. 2021;37(4):e00028721. https://doi.org/10.1590/0102-311x00028721

28. Galhardi CP, Freire NP, Minayo MCS, Fagundes MCM. Fato ou fake? Uma análise da desinformação frente à pandemia da COVID-19 no Brasil. Cienc Saude Colet. 2020;25(supl.2):4201-10. https://doi.org/10.1590/1413-812320202510.2.28922020

29. Pimentel MR, Souza WM. Avaliação do uso de medicamentos em estudantes durante a pandemia da COVID-19. Cad ESP. 2024;18(1):e2017. https://doi.org/10.54620/cadesp.v18i1.2017

30. Alves DKB, Barbosa EDS, Santos MMH, Silva AD, Nóbrega IMF, Medeiros FPM et al. Impacto da pandemia da COVID-19 nas práticas de automedicação: um estudo descritivo com professores da rede pública de Pernambuco. Rev Eletron Acervo Saude. 2022;15(8):e10744. https://doi.org/10.25248/REAS.e10744.2022

31. Cecilio SG, Vargas MEC, Silveira APV, Coelho JCO, Silva DRG et al. Impacto da COVID-19 na prática de automedicação em estudantes universitários. Trab Educ Saude. 2024;22:e02368235. https://doi.org/10.1590/1981-7746-ojs236

32. Branco LL, Lobato MYF, Borges JFT, Oliveira RCS. Automedicação durante a pandemia de COVID-19 e fatores associados. Res Soc Dev. 2023;12(2):e11212239924. https://doi.org/10.1590/2317-6369/06522pt2023v48e14

33. Pitta MGR, Lima LP, Carvalho JS, Teixeira DRC, Nunes TRS, Moura JAS et al. Análise do perfil de automedicação em tempos de COVID-19 no Brasil. Res Soc Dev. 2021;10(11):e28101119296. https://doi.org/10.33448/rsd-v10i11.19296

34. Santos CVB, Coelho LE, Luz PM, Goedert GT, Csillag D, Gennari J et al. History of self-reported COVID-19 cases and hospitalizations in the Brazilian population: a countrywide survey. Int J Epidemiol. 2026 Jan 1;55(Suppl.1):i1-i12. https://doi.org/10.1093/ije/dyaf153

35. Mitjà O, Corbacho-Monné M, Ubals M, Alemany A, Suñer C, Tebé C et al. A cluster-randomized trial of hydroxychloroquine for prevention of COVID-19. N Engl J Med. 2021;384(5):417-27. https://doi.org/10.1056/NEJMoa2021801

36. Wehrmeister FC, Menezes AM, Dalcolmo M, Prendergast EC, Batista TG, Leão OAA et al. A countrywide study on post-COVID-19 condition in Brazil: the Epicovid 2.0. Int J Epidemiol. 2026;55(Suppl.1):i31-i40. https://doi.org/10.1093/ije/dyaf143

37. Bertoldi AD, Pizzol TSD, Ramos LR, Mengue SS, Luiza VL, Tavares NUL et al. Sociodemographic profile of medicines users in Brazil: results from the 2014 PNAUM survey. Rev Saúde Pública. 2016;50(suppl.2):5s. https://doi.org/10.1590/S1518-8787.2016050006119

38. Fonseca AB, Dias J. Caminhos da desinformação: evangélicos, fake news e WhatsApp no Brasil. Rio de Janeiro: Instituto de Estudos da Religião; 2021.

39. Recuero R, Soares FB, editores. O discurso desinformativo sobre a cura da COVID-19 no Twitter: estudo de caso. E-Compós. 2021;24:e202111. https://doi.org/10.30962/ec.212

Published

2026-07-08

Issue

Section

Original Articles

How to Cite

Buffarini, R., Victora, C. G., Hallal, P. C., & Silveira, M. F. da. (2026). Patterns of medication use among individuals with Covid-19 in Brazil: Epicovid 2.0. Revista De Saúde Pública, 60, e252338. https://doi.org/10.11606/s1518-8787.2026060007542

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