A 62‐year‐old woman was admitted to our ICU. She was intubated and developed severe ARDS with a Horowitz‐Index of 53 mm Hg. At the contrast‐enhanced CT a combination of emphysema, bilateral ground‐glass opacities with crazy paving and some peripheral nodular consolidations were seen (Video S1, patient #1, Figure 1A). Despite prone positioning, the patient required rescue veno‐venous extracorporeal membrane oxygenation (ECMO). PCR for SARS‐CoV‐2 and human metapneumovirus (hMPV) was positive in BALF. The patient developed severe intrapulmonary bleeding from the right main bronchus, which was stanched by cold lavages and instillation of tranexamic acid. BALF culture grew Aspergillus fumigatus, was positive for galactomannan, and intravenous voriconazole treatment was commenced.