The table not only highlights the risks of getting severe CMV viremia but also shows the management strategy and their outcomes. Our patient was not immunocompromised, however due to severe COVID 19 infection leading to dysregulated immunity and further management with steroids and Tocilizumab leading to immunosuppressive state might have contributed to CMV viremia. This concern needs a standard and effective management strategy. Currently, there are no recommended guidelines for initiating empiric anti-fungal therapy in CMV viremia in COVID 19 patients. From the literature, CMV viremia in covid-19 patients have being treated with predominantly IV ganciclovir, in some cases valganciclovir and in one case with foscarnet. However, the duration of the treatment is not clear. Patients have improved with days to weeks [12]. In our perspective, patient with severe COVID 19 disease that have delayed recovery, partial or no response to supportive/local management, must be investigated for superseded co-infections and reactivations of infections like CMV viremia with initiation of empiric therapy [23].