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Cold agglutinin syndrome (CAS) is a rare disorder associated with infection, autoimmune disorders, and lymphoid malignancies. We are present a case of CAS associated with SARS-CoV-2 that causes COVID-19. A 46-year-old female presented with severe anemia and positive SARS-CoV-2 RNA PCR. Direct Coombs test was positive to IgG and complement. LDH was elevated and haptoglobin was undetectable. Peripheral smear revealed RBC agglutination, marked polychromasia, and many nucleated RBCs. Unfortunately, as a result of her severe hypoxemia, patie
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