Probe-based confocal laser endomicroscopy (pCLE) is a method that produces microscopic imaging of a lung tissue during bronchoscopy. We report a case ot a patient with negative nasopharyngeal swabs and suspected lung cancer who underwent pCLE. The diagnosis of COVID-19 was confirmed by PCR analyses of lavage fluid and transbrohial biopsy. The pCLE image shows density of alveolar thickened fibres, disorganization of elastin network, and multiple large drops of intraalveolar secretions. As far as we know, this is the first pCLE image discribed in patient with COVID-19 at that moment. © 2021.