SERPINA1 and hyperinsulinemic hypoglycemia, familial, 4: It is uncertain if there is any causative relationship between COVID-19 infection and the development of paraseptal emphysema and we describe a case of the incidental finding of paraseptal lucencies that mimicked emphysema in a COVID-19 patient with no history of active or passive smoking, connective tissue disease, alpha-1 antitrypsin deficiency, surfactant deficiency or occupational exposure.