The literature on cases of acute disseminated encephalomyelitis (ADEM) associated with SARS-CoV-2 infection has been rapidly increasing. However, the specific clinical features of ADEM associated with SARS-CoV-2 (SARS-CoV-2-ADEM) have not been previously evaluated. We screened all articles resulting from a search of PubMed and Web of Science databases looking for reports of ADEM published between December 01, 2019, and June 5, 2021. Of the 48 ADEM cases identified from 37 studies, 34 (71%) had ADEM while 14 (29%) were of AHLE. RT-PCR for SARS-CoV-2 was positive in 83% (n = 19) of patients. 26 patients (54%) were male, and 18 patients (38%) were female, with a male to female sex ratio of 1.4:1; median age was 44 (1.4-71) years. 9 patients (19%, 9/48) were children. Of the 9 children patients, their median age was 9 years (range 1.4-13 years), 6 patients (67%) were female, and 2 patients (22%) were male, with a female to male sex ratio of 3:1.39 patients (81%) was performed CSF analysis. PCR for SARS-CoV-2 tested positive in 3 patients (14%, 3/22) on CSF sample. 31 (64%) of patients had a poor outcome on discharge from hospital. Five (10%) patients died in hospital. Compared to classic ADEM, SARS-CoV-2-ADEM have a more longer duration between the onset of the antecedent infective symptoms and the start of ADEM symptoms, the older age distribution of the patients, relatively poor outcome, a lower full recovery rate, a more frequently brain lesions involved the periventricular white matter and corpus callosum, and less frequently affected the deep gray matter. Taken together, the present comprehensive review reveals that although rare, ADEM can be associated with SARS-CoV-2 infection. SARS-CoV-2-ADEM seems to share most features of classic ADEM, with moderate discrepancies from the classical ADEM.

中文翻译：

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SARS-CoV-2 相关的急性播散性脑脊髓炎：对文献的系统评价。

关于与 SARS-CoV-2 感染相关的急性播散性脑脊髓炎 (ADEM) 病例的文献迅速增加。然而，之前尚未评估与 SARS-CoV-2 (SARS-CoV-2-ADEM) 相关的 ADEM 的特定临床特征。我们筛选了通过搜索 PubMed 和 Web of Science 数据库获得的所有文章，以寻找 2019 年 12 月 1 日至 2021 年 6 月 5 日期间发表的 ADEM 报告。在 37 项研究中确定的 48 例 ADEM 病例中，34 例 (71%) 患有 ADEM而 14 (29%) 是 AHLE。83%（n = 19）的患者 SARS-CoV-2 的 RT-PCR 呈阳性。男性26例（54%），女性18例（38%），男女性别比为1.4：1；中位年龄为 44 (1.4-71) 岁。9 名患者 (19%, 9/48) 是儿童。在 9 名儿童患者中，他们的中位年龄为 9 岁（范围 1.4-13 岁），6例（67%）为女性，2例（22%）为男性，女性与男性的性别比为3：1.39例（81%）进行了脑脊液分析。3 名患者 (14%, 3/22) 的 SARS-CoV-2 的 PCR 检测结果为 CSF 样本呈阳性。31 名（64%）患者出院时预后不佳。五名（10%）患者在医院死亡。与经典 ADEM 相比，SARS-CoV-2-ADEM 从前期感染症状发作到 ADEM 症状开始的持续时间更长，患者年龄分布较大，预后相对较差，完全康复率较低， a 脑部病变较常累及脑室周围白质和胼胝体，较少累及深部灰质。综上所述，目前的综合综述表明，尽管 ADEM 很少见，但它可能与 SARS-CoV-2 感染有关。