SARS-CoV-2, a novel coronavirus that causes the human disease COVID-19, was determined to be the cause of a cluster of pneumonia cases in Wuhan, China which began in December 2019
[1]. The first case in the United States reportedly occurred on 20 January 2020 in Washington state in a patient with a history of travel to Wuhan
[2]. We report an earlier case of COVID-19 in Queens, New York in November 2019. While it is not perfectly clear from the initial November 2019 emergency department case presentation, if the patient had influenza alone, COVID-19 alone, or combined influenza and COVID-19 infection, presenting lung lesions and constitutional symptoms, later follow-up antibody and immune cell analyses, and the possibility of false-positive RIDT, do strongly suggest initial COVID-19 infection (with or without initial influenza infection). This clinical paper becomes important, because it may describe the earliest now-reported COVID-19 case in the United States, and because emergency department and post-emergency department treatments contributed to a successful patient outcome.