The respiratory system is the first pathogenic place for SARS-CoV-2 virus. According to the experimental evidence, the virus enters into the lung cells through type-2 isoform of angiotensin converting enzyme (ACE2), which is expressed at high level in the alveolar cells. The disease induced by the virus was officially named as COVID-19 that by development of the diffused injuries in lung results in acute respiratory failure. Histopathological findings obtained from lung biopsy in patients with COVID-19 showed the diffuse alveolar damage, chronic inflammatory exudates and severe edema in the lung. Accordingly, during severe state of disease, which the diffuse damages are observed in respiratory membrane in accompany by reduction of lung diffusing capacity, gases transfer is not even possible by using mechanical ventilator. In this situation, using extracorporeal membrane oxygenation (ECMO) could be a helpful method for the respiratory gases exchange and blood oxygenation. ECMO as a rescue therapy could prevent long-term hypoxia and the tissues damages when a decrease in the respiratory gases transfer in respiratory membrane is observed in severe state of COVID-19.