Doctors also outlined several factors contributing to health challenges during the holy month
But officials said a thrifty camp of wealthy northern states led by the Netherlands stood its ground on access to the recovery fund, in the face of opposition from Germany, France, southern nations Italy and Spain, and eastern European states.
Diplomats said the 27 remained at odds over the overall size of the package, the split between grants and repayable loans in the recovery fund and rule-of-law strings attached to it.
But the main stumbling block was over vetting procedures to access aid, an EU official said, with Dutch Prime Minister Mark Rutte demanding that one country could block payouts from the fund if member states backslide on economic reform.
As the leaders broke up for the day, he tweeted that they were divided by a bundle of issues and said it was "highly probable" that they would fail to reach a deal on Saturday or even on Sunday if the summit drags past its scheduled two days.
German Chancellor Angela Merkel, who celebrated her 66th birthday around the negotiating table in Brussels, was also cautious on chances for an agreement, envisaging "very, very difficult negotiations".
After initial elbow bumps between the leaders - all wearing face masks - and birthday gifts for Merkel and Portuguese Prime Minister Antonio Costa, tense meetings followed in the evening with Rutte and Hungarian Prime Minister Viktor Orban.
The world is watching
With EU economies deep in recession and immediate relief measures such as short-time work schemes running out, the spectre of an autumn of hardship and discontent is looming.
Another economic shock could expose it to more eurosceptic, nationalist and protectionist forces, and weaken its standing against China, the United States or Russia.
"The stakes couldn't be higher," said European Commission President Ursula von der Leyen. "The whole world is watching us."
Despite wrangling over medicines, medical gear, border closures and money, the EU has managed to agree a half-a-trillion-euro scheme to cushion the first hit of the crisis.
Mediterranean countries now want the recovery financing to prevent their economies taking on ever-greater burdens of debt.
"The big picture is that we are faced with the biggest economic depression since World War Two," Greek Prime Minister Kyriakos Mitsotakis said. "We need ... an ambitious solution because our citizens expect nothing less from us."
Doctors also outlined several factors contributing to health challenges during the holy month
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