Emerging coronavirus-related respiratory disease started from Wuhan, China in December 2019 resulted in numerous mortality following acute respiratory distress syndrome (ARDS) named COVID-19 disease. The incubation period of COVID-19 is varied from 2 days to 2 weeks; therefore oral transmission is the most hazardous issue in this incubation period. Scientists are trying to find a specific drug to treat COVID-19 disease, however there is no specific therapy yet. One of the challenging issues in the treatment process of these patients is ARDS. In the development of any type of pneumonia or ARDS, Covid-19 should be considered as an option for differential diagnosis and the first critical organ in these patients is lung. In this paper, we discussed ARDS in patients with COVID-19.