Case Presentation: A 41-year male with prior history of hypogonadism presented 11-days after positive COVIDtest with shortness of breath and no prior Covid vaccination. On presentation, patient wastachypneic with breathing rate 32/minute and was observed to be in acute hypoxic respiratoryfailure with oxygen saturation <50%, arterial blood gases showing Ph-6.93, partial pressure ofoxygen-53mmHg, and carbon-dioxide-85mmHg. [...]