Background The SARS-CoV2 virus has been an emerging virus since December 2019 and is the cause of a global pandemic whose clinical manifestations extend far beyond respiratory disease. Case summary A patient with severe COVID 19 respiratory infection, carrying a mechanical mitral valve and under anticoagulation, was admitted in our cardiology department because of a new atrial fibrillation, which turned out to be related to thrombosis of the mitral mechanical valve. Conclusion The pro-coagulant effect of the SARS-CoV2 virus does not spare patients at risk of thrombosis, even under effective anticoagulation. In patients with mechanical valves under vitamin K antagonist treatment, there is a high risk of thrombus formation. The treatment is based on thrombolysis by therapeutic anticoagulation, fibrinolysis or surgery depending on the size, composition of thrombus and clinical manifestation.

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