Early descriptions about the presentation of covid-19 focused primarily on respiratory symptoms. However, we now know that covid-19 can also present with one or more atypical symptom(s). With this case-report we want to draw attention to atypical presentations of covid-19 that can occur in psychiatric practice, especially in the elderly. We report the case of an elderly woman with an atypical presentation of a covid-19 pneumonia, namely without the often mentioned respiratory symptoms, gastrointestinal symptoms or fever, but with acute confusion. It is important to swiftly consider the possibility of a covid-19 infection in (elderly) patients who present with delirium, as missing an infection can have important negative consequences, both for the treatment of the patient and for further spread within the (hospital) environment.