The infectious disease team recommended to manage him as a case of severe COVID-19 pneumonia complicated by ARDS, which might be due to a cytokine storm. Therefore, they added ritonavir plus lopinavir 500 mg orally daily for 14 days, tocilizumab 400 mg i.v. single dose, and methylprednisolone 40 mg i.v. every 12 h for 5 days, and BiPAP has been applied to improve his SpO2 level. After a few hours, he started to improve with this regimen, so he was shifted back to a simple face mask, and gradually the amount of oxygen has decreased. The repeated ABG showed an improvement in pO2 (100 mm Hg).