SARS-CoV-2 infection can present either an asymptomatic or symptomatic; the spectrum of symptomatic infection ranges from mild to critical. A majority of patients have experienced mild symptoms with a good prognosis. But, approximately 14% of them have severe infection presenting with hypoxemia and extensive lung involvement. The current mini-review describes the dysregulation of immune response for SARS-CoV-2 viral pneumonia and virus-induced lung injury. Also, many confounding factors can increase lung injury, in addition to virus-induced lung injury. Especially in critically ill patients, confounding factors can cause the inflammatory cascade, ARDS, and mortality.