Coronavirus disease 2019 (COVID-19), an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was initially not attributed to serious maternal or neonatal morbidities [
1,
2]. However, with the evolving literature, it has been reported to increase the risk for adverse pregnancy outcomes, causing higher rates of preterm birth, preeclampsia, cesarean delivery, and perinatal death especially among women with severe disease [
3,
4]. COVID-19 is primarily a respiratory infection that, like preeclampsia in pregnancy, causes significant vascular changes through direct endothelial damage leading to hypertension and renal diseases, and affecting multiple organs [
5]. The overlap in clinical features of COVID-19 and preeclampsia presents a challenge in differentiating them [
6]. Mendoza and colleagues coined the concept of preeclampsia-like syndrome associated with severe COVID-19, which could be distinguished from actual preeclampsia by raised soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio, lactate dehydrogenase (LDH), and uterine artery pulsatility index (UtAPI) [
6], although these tests may not be readily available in many hospital settings. However, Papageorghiou
et al. demonstrate that vascular changes that occur in preeclampsia, like in essential hypertension, predispose to susceptibility to contracting COVID-19 [
4]. The interplay between the two conditions remains an area of interest for further research. Therefore, as we improve our understanding of the relationship, precautions for hypertensive disorders of pregnancy such as preeclampsia should be undertaken while monitoring pregnant women with COVID-19 infection [
7]. Furthermore, although COVID-19 is not routinely tested for among pregnant women in most countries, it is prudent to rule it out among differentials in women presenting with preeclampsia–eclampsia clinical spectrum. In this case study, we present the case of a primigravida who was referred to our hospital with features of eclampsia and turned out to be COVID-19 positive.