text: SARS CoV 2 associated acute disseminated encephalomyelitis a systematic review of the literature 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 