In the late December 2019 an outbreak of a novel coronavirus termed as SARS- CoV-2 has emerged in Wuhan city, China then spread worldwide to cause serious life threatening pandemic that seriously affect the economics and daily life. The classical picture of COVID-19 is described as fever, cough and dyspnea. However, different atypical presentations have been described in the literature. We confronted by a patient 49 years old without respiratory manifestation who sought medical advice for swabbing for COVID-19, with refusal from the local governmental center for swabbing, two days later, the patient become dyspneic, desaturated with positive COVID-19 swab. We recommend that care givers should not wait the full typical respiratory manifestations of COVID-19.We also realize that there is a big shortage in swabbing and examination tools especially in the developing countries like ours, however, caregivers in swabbing center should have a high index of suspicion with patients who have persistent symptoms.