Evidence map›Paper›PMID 40775306›Full record

ArticleBMC infectious diseases2025

Acute haemorrhagic necrotizing encephalopathy and inflammatory demyelinating encephalopathy associated with COVID-19 in adults in Southern China.

Sha Tan, Chunping Cui, En-Peng Song, Yilong Shan, Yanyu Chang, Wei Qiu, Zhengqi Lu

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sha Tan *Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, China.
Chunping Cui *Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, China.
En-Peng Song *Department of Neurosurgery, Lingnan Hospital, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Yilong ShanDepartment of Rehabilitation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Yanyu ChangDepartment of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, China.
Wei QiuDepartment of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, China. qiuwei@mail.sysu.edu.cn.
Zhengqi LuDepartment of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, China. luzhq@mail.sysu.edu.cn.

Funding

Guangdong Science and Technology Department-Regional Joint Fund 2020A1515111133National Natural Science Foundation of China 82201496
6 · The paper itself

Abstract

backgroundCOVID-19 manifests with diverse systemic symptoms, including central nervous system involvement. Acute necrotizing encephalopathy (ANE), acute hemorrhagic leukoencephalitis (AHLE), and acute disseminated encephalomyelitis (ADEM) exhibit overlapping clinical features, creating diagnostic challenges. This study characterizes COVID-19-associated neuroinflammatory syndromes in patients without apparent respiratory symptoms.

methodsWe conducted a retrospective case series analysis of four patients with confirmed COVID-19 and acute neurological decline. Diagnostic evaluation included brain MRI, cerebrospinal fluid analysis, autoimmune/paraneoplastic antibody panels, and exclusion of alternative etiologies through microbiological/metabolic testing.

resultsFour cases were identified: two with ANE, one with ADEM, and one with AHLE. All patients tested SARS-CoV-2-positive by RT-PCR despite absent respiratory symptoms. Magnetic resonance imaging revealed characteristic patterns: Symmetric thalamic lesions in ANE (Cases 1-2), hemorrhagic lesions in basal ganglia and bilateral cerebellar hemispheres in AHLE (Case 3), widespread cortical and subcortical demyelination in ADEM (Case 4).

conclusionsANE, AHLE, and ADEM are critical neuroinflammatory complications of COVID-19 requiring urgent differentiation. It is imperative to maintain a high level of clinical suspicion when patients present with acute encephalopathy in the absence of respiratory symptoms, as this enables timely intervention.

Indexed as

COVID-19Encephalomyelitis, Acute DisseminatedLeukoencephalitis, Acute HemorrhagicAdultAgedBrainChinaFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesSARS-CoV-2Acute disseminated encephalomyelitisAcute hemorrhagic leukoencephalitisAcute necrotizing encephalopathyCoronavirusCOVID-19

Identifiers

PMID40775306
PMCPMC12330108

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.