Rivaroxaban Failure in a SARS-CoV-2 (COVID-19) Positive Patient

Atrial fibrillation is the most common sustained arrhythmia in clinical practice. Patients with atrial fibrillation are at increased risk of hospitalization, death, heart failure, and thromboembolic event [1]. Development and embolization of thrombus can occur with atrial fibrillation. Ischemic stroke is most common location of embolization of thrombus, although it can embolize to other locations [2]. Chronic oral anticoagulation is recommended in most of the valvular and non-valvular atrial fibrillation and should be started after careful consideration for embolic risk, bleeding risk and overall risks verses benefit should be assessed. Novel anticoagulants (NOAC) such as rivaroxaban, apixaban, dabigatran is recommended and are being increasingly used over warfarin for patients with non-valvular atrial fibrillation [3].