A description of a clinical case of a severe, protracted course of coronavirus infection (COVID-19) in a patient with advanced stage HIV infection, characterized by prolonged release of the SARS-CoV-2 virus and the formation of pulmonary fibrosis against the background of an active viral infection, is presented. COVID-19 infection occurred in an immunosuppressed patient without ART. During the period of inpatient treatment, a comprehensive examination was carried out to exclude HIV-associated lung lesions; no evidence of viral, fungal, or bacterial pathology was obtained; mycobacterial infections were also excluded. Despite two courses of antiviral therapy, the use of anti-Covid plasma and complex pathogenetic therapy, persistence of SARS-CoV-2 replication was observed for eight months, with a steady progression of the disease, ending in death.