65 y/o uncontrolled type 2 diabetic with HgbA1c 12.8% and hypothyroidism was on cruise ship, developed cough and altered mental status. Diagnosed with pneumonia and developed significant respiratory decline requiring mechanical ventilation and was transferred to my hospital. Labs showed diabetic ketoacidosis, which has now resolved. Initial chest x-ray as above with acute respiratory distress syndrome (ARDS). Found to be #COVID-19 positive. Patient paralyzed, sedated, ventilated and in RotoProne bed without improvement. Progression of diffuse bilateral infiltrates is shown in the subsequent chest x-rays over the course of the week. And she is now developing oliguric renal failure. Has been experimentally tried on Kaletra by our infectious disease physician and is now on Azithromycin and Hydroxychloroquine. Unfortunately, grim prognosis. #COVID-19 is not a joke.