This case is a rare case in terms of development of a serious and unpredictable complication: spinal subdural hematoma and paraparesis, in a patient of severe COVID 19 disease. Patient was being treated with prophylactic dose of anticoagulant therapy as standard care for moderate COVID 19 disease. This complication posed a challenging therapeutic decision for clinicians to decide on the timing of surgical intervention, inability to use anticoagulation despite the high risk of thromboembolic complications in this disease, and on the use of immune-modulators in cytokine release syndrome, as it causes increase in risk of secondary bacterial sepsis in such bedbound paraparetic patients.