A therapeutic thoracentesis with ultrasound was performed with complete drainage and removal of 1200 ml of serosanguinous fluid. Pleural fluid culture and cytology were negative. The fluid met criteria for exudative plueral fluid and the total nucleated cell count was 993 (/mm3) with 89% lymphocytes. An RT-PCR (Xpert® Xpress SARS-CoV-2, Cepheid, Sunnyvale, CA, USA) was performed on the pleural fluid and was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sputum and blood cultures were negative. He was treated supportively for acute respiratory distress syndrome with high flow nasal cannula, dexamethasone and hydroxychloroquine. There was no reccurrence of the pleural effusion during his hospital course.