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COVID-19 infection: case report A 42-year-old man developed COVID-19 infection following treatment with fluticasone-propionate for asthma. The man was diagnosed with asthma when he was child and his asthma had which improved eventually. Later, in 2017, he experienced cough and he was diagnosed with cough-variant asthma. Hence, he started receiving fluticasone-propionate [fluticasone] HFA 44 µg/day in 2017, which was then increased to fluticasone-propionate HFA 88 µg/day. Subsequently, he had improvement in his asthma. Hid comorbidity included gastroesophageal reflux disease. Thereafter, he developed myalgia, fever and cough on 13 March 2020 after returning from to Madrid, Spain. He underwent PCR testing for COVID-19 and the PCR showed positive result for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) [duration of treatment to reaction onset not stated]. on 15 March 2020, he was admitted to the hospital due to dehydration. The man was treated with supportive care during admission and discharged on 17 March 2020. One day later, 18 March 2020, he developed marked dyspnoea that required admission to the ICU due to acute hypoxemic respiratory failure. He had quick decompensation. Therefore, mechanical ventilation and intubation were provided. Subsequently, he required prone positioning due to respiratory distress syndrome. His laboratory parameter showed increased level of C-reactive protein, erythrocyte sedimentation rate and ferritin value. He received off label treatments with lopinavir/ritonavir 400mg twice a day day 10 of the illness to day 17 of the illness, IV immune-globulin [immunoglobulin], methylprednisone 100mg on day 11 of the illness and methylprednisolone [methylprednisone] 125mg on days 12 and 13 of the illness. Additionally, he received treatment with remdesivir. He had elevation in interleukin 6 due to medical history of latent tuberculosis. He remained severely lymphopenic during his stay in the ICU. Thereafter, he had improvement. His nasopharyngeal swab PCR showed negative result on day 12 of illness; however, SARS-CoV-2 was still noted in PCR of tracheal secretions on day 13 of illness. Investigation showed lymphopenia along with decrease in his CD3, CD8 and CD4 T cells. Normal counts of the B-cell and the natural killer–cell were noted. Eventually, his lymphocyte count had normalised. Subsequently, he was discharged after 20 days of hospitalisation. Due to lymphopenia and the lack of information regarding to corticosteroids and COVID-19, he was prescribed with tiotropium-bromide [Tiotropium] on 1 April 2020. Clearance of the infection was investigated using PCR testing. His nasopharyngeal SARS-CoV-2 testing showed negative result on days 26 and 27 of the illness. He was discharged to home on 6 April 2020. He underwent COVID-19 IgG antibody test on the day of discharge that returned positive at 11.2. On 12 April 2020, the man was resumed on fluticasone-propionate. It was considered that COVID-19 infection was secondary to fluticasone-propionate use. Joshi AY, et al. Successful tr