Patient 3:
A 41-year-man was previously healthy and has been in home-based quarantine after being in close contact with a COVID-19 patient before presenting to the E.D. with complaints of severe headache, dizziness, and vomiting 1-day duration. He was drowsy but following simple commands and moving all his limbs. CT-head showed a sizable ill-defined hypodense area noted in the right cerebellar hemisphere/medulla suggestive of acute stroke in the right posterior inferior cerebellar artery (PICA) territory with corresponding edema and mild mass effect. With no evidence of hemorrhagic transformation. MRI and MRA confirmed multiple areas of late acute infarcts along with the posterior circulation territory in the right cerebellar hemisphere [Figure 3] .
A nasopharyngeal swab of COVID-19 real time-PCR turned out positive; we started the patient on azithromycin, hydroxychloroquine, ritonavir/lopinavir, steroid, and enoxaparin on day 3. The patient’s condition deteriorated rapidly with a decreased conscious level, requiring intubation, without an interval changes on a repeat CT-head. 7-days later, his neurological deficit progressed to bilateral upper and lower limb weakness, and an MRI spine revealed spinal cord infarct at T1-T3 vertebral levels, C2-C3 disk-levels, and C4 vertebral level. Further workup to identify a possible source for the thrombus, including a transthoracic echocardiogram, was unremarkable. On day 20, and after multiple failed weaning trials, we inserted a percutaneous tracheostomy and then transferred him to a rehabilitation facility.