The management of acute hypoxemic respiratory failure and the effect of antiviral drugs in patients with severe COVID-19 have been debated. This case presents the management of a 64-year-old man COVID-19 patient admitted to the Intensive Care Unit with fever. fatigue. shortness of breath and hemophagocytic lymphohistiocytosis syndrome. https://www.roneverhart.com/Mako-Shark-Toy/