To our knowledge, this is a novel description of COVID-19 related pleural effusion describing the pleural fluid analysis of virus detection confirmed by RT-PCR and behaving as a complicated parapneumonic effusion. There is a paucity of data describing the pleural complications in relation to the viral infections in general. A prior study by Cohen and Sahn,1 reported an 8% incidence of pleural effusions in patients with acute viral infection, while using lateral decubitus chest X-rays incidence is reported to be 18%. However, the true incidence of viral related pleural effusion may be even higher if pleural ultrasonography is used as a screening tool for pleural fluid presence. In a review by Nestor et al., 2 the pleural fluid analysis in viral related pleural effusion is variable and typically exudative. Pleural fluid appearance can range from serous, serosanguineous, to hemorrhagic.