Acute Disseminated Encephalomyelitis in COVID-19: presentation of two cases and review of the literature

Abstract: Background: Neurological manifestations of COVID-19 are still incompletely understood. Neurological manifestations may be due to direct viral effect on neurons and glial cells, to an immune-mediated response to the virus, or to a hypercoagulable state and associated endothelial damage, as well as to severe systemic disease with prolonged intensive care unit stay. Objective: To describe two patients with severe SARS-CoV-2 infection and delayed recovery of consciousness after sedation withdrawal, in whom MRI disclosed multifocal white matter brain lesions, compatible with the diagnosis of acute disseminated encephalomyelitis. Methods: Observational report of two cases of severe COVID-19 infection in patients from two tertiary hospitals in São Paulo, Brazil. Results: These patients underwent neurologic and systemic evaluation for delayed awakening after sedation withdrawal. MRI displayed multifocal centrum semiovale lesions, suggestive of demyelinating inflammation. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) for SARS-CoV-2 was negative in both cases. Conclusion: A recurrent pattern of multifocal white matter lesions can occur in COVID-19 patients, possibly associated with delayed awakening. Additional studies are necessary to elucidate the role of the viral infection and of inflammatory and immune-mediated associated changes in neurological manifestations of COVID-19.

Object Details

• Alternative title: Encefalomielite disseminada aguda associada a COVID-19: relato de dois casos e revisão de literatura
• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Acute Disseminated Encephalomyelitis in COVID-19: presentation of two cases and review of the literature ; volume:78 ; number:12 ; year:2020 ; pages:805-810 ; Arquivos de neuro-psiquiatria ; 78, Heft 12 (2020), 805-810

Contributors, Places and Time

• Contributor: Lopes, Cesar Castello Branco ; Brucki, Sonia Maria Dozzi ; Passos, Carlos Eduardo Borges ; Corazza, Luiza Alves ; Baima, José Pedro Soares ; Fiorentino, Matheus Dalben ; Tatsch, João Fellipe Santos ; Martin, Maria da Graça Morais ; Lucato, Leandro Tavares ; Gomes, Hélio Rodrigues ; Rocha, Maria Sheila Guimarães ; Fortini, Ida ; Nitrini, Ricardo ; Castro, Luiz H.

Further information

• DOI: 10.1590/0004-282X20200186
• URN: urn:nbn:de:101:1-2023072012142655799654
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.08.2025, 10:58 AM CEST