At presentation to the emergency department, she had been feeling progressively dyspneic for two days. On physical examination, her oxygenation was 82%, with 28 breaths per minute in room air, pulmonary wheezing and an extended expiration. Oxygenation improved to 94% with 5 L O2 via a nasal cannula, but she desaturated during speech. Her BMI was 27.7 (80 kg) and her temperature 37.8 °C. No other aberrant observations on physical examination were made. Her Glasgow Coma Scale was 15 and her ECG was normal. Her C-reactive protein (CRP) was 214 mg/L, and other laboratory findings included slightly elevated leucocytes (12.6 × 109 /L) and neutrophils (8.4 × 109 /L), elevated liver enzymes (alkaline phosphatase 528 U/L; GGT 376 U/L; AST 76 U/L; LD 745 U/L), slightly elevated pro-calcitonin (0.25 µg/L; <0.5 µg/L not suggestive of bacterial infection), increased ferritin (1442 µg/L), and normal electrolyte, glucose and renal function. SARS-CoV-2 nasopharyngeal and throat swabs were taken. A low-dose chest CT demonstrated extensive centralized and peripheral bilateral ground glass opacities with left-sided consolidations and bilateral fibrotic bands without pleural effusions and vascular enlargement (Figure 1). The CO-RADS score was 5 and CT-severity score was 24 out of 25 [11].