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

J Neuroimmunol. 2021 Oct 15:359:577674. doi: 10.1016/j.jneuroim.2021.577674. Epub 2021 Jul 27.


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.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Adult
  • COVID-19 / complications*
  • COVID-19 / diagnostic imaging*
  • COVID-19 Drug Treatment
  • Encephalomyelitis, Acute Disseminated / diagnostic imaging*
  • Encephalomyelitis, Acute Disseminated / drug therapy
  • Encephalomyelitis, Acute Disseminated / etiology*
  • Global Health*
  • Humans
  • Male
  • Methylprednisolone / therapeutic use
  • Observational Studies as Topic / methods


  • Methylprednisolone