Cox pulled off the feat five years ago in Rio and won two titles at the velodrome last week.
But she finished just outside the medals in the defence of her T38 400m title.
However, given she’s been struggling with a double Achilles injury – which kept her off the track for most the season – her season’s best time of 1:00.71 was noteworthy and it took Germany’s Lindy Ave to set a world record to dethrone her.
“I’ve had a really turbulent time but that’s the fastest I’ve run since Rio, which is pretty incredible,” said the Leeds athlete.
“Fourth place is hard but I’m proud of myself but as an athlete you always want a medal and something to show for it.
“I came in really not sure how I’d perform but you want to be the athlete you know and I wanted to defend my title.
“I spent a week training on the golf course at the cycling venue, which isn’t ideal. I’m not disappointed, that time is amazing considering the challenges I had to get here.”
Cox, 30, won the C4-5 time trial and mixed team sprint on the bike, where her training has been focussed in recent months at British Cycling’s Manchester base. And she admitted the mental anguish of trying to make two teams in Tokyo – and defend two titles – did take its toll.
“I’m very emotional right now, that was hard,” she added.
“I had an injury that dug at me and I spent every athletics session crying and that lasted a few weeks. Eventually our head coach Paula Dunn stepped in and said she feared I’d be mentally broken. I only started running on the track a week before selection so to turn it around and come fourth in a second season’s best, I’ve got to be happy with that.
“I’s very tough to take seeing someone else stand up there with your gold medal.”
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