Introduction COVID-19 infection is generally characterized by the presence of respiratory symptoms. However, a small percentage of these patients also have gastrointestinal symptoms and complications that are associated with high morbidity and mortality. Presentation of case A 50-year-old male patient with COVID-19 infection was being treated for COVID-19 and pneumonia in the ICU. He presented with gastrointestinal symptoms, and the computed tomography (CT) scan revealed a hollow viscus perforation. Ultimately, the patient was taken to surgery, where a spontaneous perforation was found in the right colon. The defect was sutured with separate stitches. There were no complications postoperatively. Discussion Although respiratory symptoms are the most common presentation of COVID-19, about 18% of these patients may present with gastrointestinal symptoms. However, an even smaller percentage of critically ill patients may develop serious gastrointestinal complications such as perforation of the large intestine. This unusual complication requires immediate diagnosis and surgical management. Conclusion At the time of the COVID-19 pandemic, physicians must recognize COVID-19 in patients presenting gastrointestinal symptoms. A high degree of clinical suspicion enables timely diagnosis and management, thereby preventing major complications.