There are some reports revealing that pulmonary fibrosis can be triggered by the cytokine storm activated by the viral antigens, toxicity posed by drugs, high airway pressure and hypoxia-induced acute lung injury secondary to mechanical ventilation [53]. While interstitial pulmonary fibrosis per se does not predispose to development of IPA, a small subset of these COVID-19 survivors may require long term corticosteroid treatment, which may predispose them to CAPA years after the acute phase of the viral infection. Overall, 29% of the CAPA cases published to date (10/35) had received systemic corticosteroids (Table 1). In those with ARDS, systemic corticosteroids are used to alleviate the immune responses and prevent cytokine storm [6,54,55,56], but may at the same time increase vulnerability for developing secondary infections [4,5].