At the end of 2019, a cluster of patients with severe pneumonia of unknown origin were reported from Wuhan City of China. In February 2020, The World Health Organization identified the infection as Coronavirus 19 disease (COVID-19). Recently there are an increasing number of cases reported throughout the World and more than 10.000.000 people have been confirmed as infected with Coronavirus 19. The Covid-19 infection is characterized by a large variability of clinical symptoms, from asymptomatic to severe acute respiratuary distress syndrome. In 5-10% of patients with COVID-19 severe ARDS develops. As this disease can severely effect the respiratory, cardiovascular, gastrointestinal, central nervous and renal systems, the intensive care unit management is essential. Pandemic requires a multidisciplinary approach for patient care. The intensivists and intensive care units are very important to manage the most severe cases. This led to the saturation of existing ICU beds and creates a serious burden on healthcare systems and providers. This article provides recommendations to support intensive care physicians who manage patients with COVID-19 infection in the intensive care unit (ICU). We have summarized the literature and recommendations on clinical practice for the treatment of Covid-19 patients in intensive care units.