Background: The current COVID-19 pandemic has attracted great attention from the medical world. In the past year, there have been reports of missed or delayed treatments for conditions that mimic COVID-19. The main symptoms caused by SARS-CoV-2, such as fever and cough, belong to different clinical conditions. It is of the utmost importance that the diagnostic thinking used to analyze data and information to reach a COVID-19 diagnosis does not overlook the plethora of different diagnoses related to these symptoms.

Case Report: The aim of this work is to present the clinical case of a patient having unrecognized HIV infection with a 4-week history of fever, cough, and hypoxia. When tests were allowed to highlight HIV-related immunodeficiency status, a CMV assay was performed in order to evaluate opportunistic pneumonia. Through this, diagnosis of HIV combined with CMV pneumonia was made, thus excluding COVID-19 respiratory insufficiency.

Conclusion: The diagnosis of the two conditions in the COVID-19 era is challenging due to overlapping clinical and radiological features and limitations of current diagnostic assays. This causes clinical implications due to diagnostic delays.

背景：当前的 COVID-19 大流行引起了医学界的极大关注。在过去的一年中，有报道称对类似 COVID-19 的疾病的治疗错过或延迟。SARS-CoV-2 引起的主要症状，如发烧和咳嗽，属于不同的临床情况。最重要的是，用于分析数据和信息以得出 COVID-19 诊断的诊断思维不能忽视与这些症状相关的大量不同诊断。

病例报告：这项工作的目的是介绍一名患有无法识别的 HIV 感染的患者的临床病例，该患者有 4 周的发烧、咳嗽和缺氧史。当允许测试突出 HIV 相关的免疫缺陷状态时，进行 CMV 检测以评估机会性肺炎。通过这种方式，诊断出 HIV 合并 CMV 肺炎，从而排除了 COVID-19 呼吸功能不全。

结论：由于临床和放射学特征重叠以及当前诊断分析的局限性，COVID-19 时代这两种疾病的诊断具有挑战性。由于诊断延迟，这会导致临床影响。