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Case report
Massive bilateral stroke in a COVID-19 patient
  1. Iskandar Zulqarnain Bin Mohamed,
  2. Laura Balson and
  3. Shyam Madathil
  1. Respiratory Medicine Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Shyam Madathil; Shyam.madathil{at}


Coronavirus disease 2019 (COVID-19) is a novel infection of which we still have much to learn. Microvascular and macrovascular complications are increasingly recognised as being among the drivers of morbidity and mortality in patients with this condition. Here we present a case of a woman with COVID-19 who suffered massive and bilateral middle cerebral artery strokes, which presented as reduced consciousness several days into admission. Clinicians need to be aware of possible causes of reduced consciousness in COVID-19 patients, particularly as delirium appears to be a common complication, and revisit working diagnoses if the clinical picture does not fully fit. Studies into both anticoagulation and the management of stroke in the context of COVID-19 are urgently needed to help inform future practice.

  • infections
  • pneumonia (respiratory medicine)
  • stroke
  • end of life decisions (geriatric medicine)

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  • IZBM and LB are joint first authors.

  • IZBM and LB contributed equally.

  • Contributors IZBM was involved in the care of the patient, and drafted the initial case report. LB drafted the discussion section. SM was the consultant in charge of her care at the time of the events and provided oversight and input into discussion and flow of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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