A 78-year-old man known case of hypertension, ischemic heart disease, chronic obstructive pulmonary disease, and myasthenia gravis was brought into the emergency department with suspected myasthenia crisis. He presented with complaints of worsening shortness of breath and decreasing oxygen saturation. On presentation, he had a temperature of 38C, was tachypneic, with an SA02 of 90% on room air. Due to the ongoing COVID-19 pandemic, he was kept in isolation and tested for COVID 19. His COVID RT PCR came out positive. Based on his radiological and investigation findings he was diagnosed with moderate COVID pneumonia according to the Government of Pakistan guidelines for COVID 19. His condition continued to deteriorate, after the recommendation of the infectious disease team, he was managed with Tocilizumab and convalescent plasma. Both of which are at the time of administration are under clinical trial for the treatment of COVID pneumonia. The case demonstrates the possible need for early intubation in COVID-19 patients diagnosed with myasthenia gravis.