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COVID-19-associated ischaemic stroke despite use of anticoagulation
  1. Shyam Sharma1,
  2. Michael Wood2 and
  3. Giosue Gulli3
  1. 1The University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK
  2. 2Respiratory Department, Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, UK
  3. 3Stroke Unit, Ashford and Saint Peter's Hospitals NHS Trust, Chertsey, UK
  1. Correspondence to Shyam Sharma; S.Sharma-28{at}


A 64-year-old female nurse was admitted to hospital following fever, cough, shortness of breath and low blood pressure. She tested positive for COVID-19 and was treated on a high-dependency unit and prescribed enoxaparin, a prophylactic anticoagulant. Eight days later, she suffered a left middle cerebral artery ischaemic stroke. Over the next 2 weeks, her condition fluctuated, eventually leading to her death. We report her case from clinical history to investigations and outcomes, and explore the potential link between coronavirus, the use of anticoagulation and ischaemic stroke.

  • covid-19
  • stroke
  • warfarin therapy

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  • Contributors SS wrote the first draft. MW was clinically in charge of the patient from the respiratory perspective and GG was clinically in charge from the stroke perspective. All authors contributed to the final version of the manuscript. GG takes overall responsibility for the work.

  • 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.

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