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Since the World Health Organization (WHO) announced coronavirus 2019 (COVID-19) as a pandemic in March 2020, it has been wreaking havoc across countries, affecting people’s lives. Corticosteroids have proven to provide a mortality benefit in patients with COVID-19. Although dexamethasone is the most commonly used glucocorticoid and have shown to have mortality benefit in COVID-19 patients, it cannot be used in patients with adrenal insufficiency due to its lack of mineralocorticoid activity. Herein, we discuss a case of challenging corticosteroid management in a patient with COVID-19 complicated by her medical history of bilateral adrenalectomy.