A severe maternal presentation of COVID-19 is described in a 41-year-old woman with a history of three previous cesarean sections and diabetes mellitus. The patient developed respiratory failure that required mechanical ventilation on day 5 of the onset of the disease, for which she underwent caesarean section. Neonatal isolation was implemented immediately after birth, without delayed cord clamping or skin-to-skin contact. Neonatal baseline and follow-up serology obtained at birth was performed and a solid phase immunochromatographic assay was analyzed, which yielded negative immunoglobulin (Ig) -G and IgM titers. However, the nasopharyngeal swab of the newborn for SARS-CoV-2 RT-PCR, obtained 16 hours after delivery, gave a positive result as well as the repeated RT-PCR 48 hours later for confirmation. Given the low probability of infection during cesarean or postpartum due to the sterility of the procedure and the isolation measures implemented immediately after birth, a strong suspicion of intrauterine transmission of SARS-CoV-2 is generated.