Case Presentation: 70-year-old female with past medical history of vascular dementia, recent COVID infection (three weeks before) was brought from nursing home for altered mental status, one episode of vomiting and hypoxia as per the records. On arrival she was hypotensive to 71/43 mm Hg requiring norepinephrine, heart rate 118 beat/minute, saturating 94% on 2L, [...]