Acute disseminated encephalomyelitis and COVID-19: A systematic synthesis of worldwide cases

Abstract

Acute disseminated encephalomyelitis (ADEM) has been reported after coronavirus disease 2019 (COVID-19). In this review, we systematically included worldwide reported cases on this association. We included 30 case reports (pediatric and adults) and explored epidemiological and clinical evidence. We described time to diagnosis, clinical, imaging, and laboratory features, response to treatment regimens, and differences regarding severity. Also, an original case report was presented. Neurologists must be alert to the occurrence of multifocal neurological symptoms with or without encephalopathy in patients recovered from COVID-19. Timely MRI studies should be performed to establish the diagnosis and to consider early corticosteroid-based treatment.

Keywords: Acute disseminated encephalomyelitis (ADEM); Autoimmune disease; Central nervous system (CNS); Coronavirus disease 2019 (COVID-19); Demyelinating disease; SARS-Cov-2.