Bharat A, Machuca TN, Querrey M, et al. - In the present study, the researchers sought to describe the course of disease and early post-transplantation outcomes in critically ill COVID-19 patients who failed to show lung recovery despite optimal medical management and were deemed to be at imminent risk of dying due to pulmonary complications. They established a multi-institutional case series that included the first consecutive transplants for severe COVID-19-associated acute respiratory distress syndrome (ARDS) known to us in the USA, Italy, Austria, and India. Between May 1 and September 30, 2020, 12 COVID-19-associated ARDS patients underwent bilateral lung transplantation at six high-volume transplant centres in the USA (eight recipients at three centres), Italy (two recipients at one centre), Austria (one recipient), and India (one recipient). The report's findings show that lung transplantation is the only option for survival in some patients with severe, unresolving COVID-19-associated ARDS, and that the procedure can be done successfully in carefully selected patients, with good early post-transplantation outcomes.