A 72-year-old woman with a history of hypertension, hyperlipidemia, smoking, and depression presented on early April 2020 with delirium and fever. A cranial CT scan was normal. A chest X-ray showed bilateral interstitial pneumonia, and nasopharyngeal exudate polymerase chain reaction (PCR) testing was positive to SARS-CoV-2. Cerebrospinal fluid (CSF) was normal. She was admitted and started on hydroxychloroquine, azithromycin, ceftriaxone, and IV methylprednisolone. A few days later she was transferred to the intensive care unit due to a cardiogenic shock caused by a myocardial infarction. Further hemodynamic and respiratory evolution was good, and she was discharged without delirium or cognitive impairment on day 22 after admission. She was readmitted eight days later due to a 48-h history of dizziness, oscillopsia, and unsteadiness. Her vital signs were normal, and she was afebrile. Systemic examination was unremarkable. She was conscious, and her language and speech were normal, but slight inattention and disorientation were present. A downbeat nystagmus in all gaze positions and impairment of smooth pursuit eye movements were present. Horizontal and vertical eye movements showed no limitation. Motor and sensory examinations were normal, and deep tendon reflexes were all present and symmetrical. The left plantar response was extensor. There was no limb dysmetria, but severe truncal ataxia was present. Reflex