A12-year-old female was admitted to our hospital with a complaint of a 2-weeks period of pallor, fatigue, fever, headache, and myalgia and a 2-day duration of high-colored urine after a 2-week duration of respiratory infection. The patient was treated upper respiratory infection with improvement until she was developed hematuria, so she was referred to our hospital for a detailed evaluation. At admission, she was pale, febrile, and hemodynamically stable with the following vital signs: temperature, 38.7°C; blood pressure, 110/65 mmHg; heart rate, 120 beats/minute; respiratory rate, 20 min; and oxygen saturation, 99% at room air. She had no clubbing, cyanosis, lymphadenopathy, edema, arthritis, or rash. Cutaneous stigmata of chronic liver disease were not present. The respiratory, cardiovascular, gastrointestinal, and central nervous systems were normal on examination. No other abnormalities were found in the physical examination. Results of blood tests showed decreased hemoglobin (5.4 g/dl), hematocrit (18.8%), mean corpuscular volume (82 fI), haptoglobin (<7.38 μmol/l) associating reticulocytosis (5%). Erythrocyte sedimentation rate 34 mm /h, C-reactive protein=0,2 mg /l Increased lactate dehydrogenase (458 U/l) and hyperbilirubinemia (3.5 mg/dl) with indirect predominance (2.25 mg/dl), serum aspartate aminotransferase comparatively higher than serum alanine aminotransferase. Platelets and leukocytes counts, serum electrolytes and renal function levels, and serum irons were within normal range. Ferritin (148.6 ng/ml) was normal. A direct Coombs test was performed with a positive result (positive immunoglobulin G and C3 and negative C4). Family, medical, and drug histories were unremarkable, Due to the pandemic situation, and the personal history of respiratory infection, SARS‑COV‑2 infection was confirmed by RT-PCR of the nasopharyngeal swab, and she was treated with antipyretics. Hypochromia, some polychromatic macrocytes, anisocytosis, red cell fragmentation with moderate numbers of micro-spherocytes and nucleated red cell compatible with hemolytic anemia features were detected at the peripheral blood smear [Fig. ]. Urine analysis showed dark urine with a positive hemoglobin. The chest radiography was unremarkable [Fig. ]. AIHA was diagnosed and the treatment with methylprednisolone pulses (30 mg/kg daily) was given for the first 72 h. Afterward, the maintenance dose of prednisolone 1 mg/kg daily was administered. Two weeks later, hemolysis was reduced, and hemoglobin value increased to 8.2 g/dl without the need for blood transfusions. After 2 months, at follow-up the patient, the laboratory tests showed that the hemoglobin and reticulocyte levels were be normalized slowly, with a negative Coombs value, with improvement the vitality, and general condition.