The review presents the modern concept of the pathogenesis of diffuse alveolar damage, including acute respiratory distress syndrome in coronavirus infection. It has been established that the so-called “cytokine storm”, which consists in the increased release of substances that are biologically active against the vascular wall and effector cells, leading to the progressive damage to endothelio-cytes and alveolocytes, the development of alveolar and interstitial pulmonary edema with fatal respiratory failure and coagulopathy. An important factor in interstitial aggression is the appearance of autoreactive clones of plasma cells, dissemination of virus-infected leucocytes throughout the body with the involvement of various organs and systems, which exacerbates multiple organ failure. A poor prognosis for patients, the likelihood of developing pulmonary fibrosis after infection, according to several research-ers, can be corrected by cell therapy. Allogeneic multipotent mes-enchymal stromal cells (mesenchymal stem cells) are considered as first-line therapeutic cells. The accumulated experience of pre-clinical experiments made it possible to urgently proceed to con-duct clinical trials of the safety of their use in patients with ARDS and to search for optimal indications to obtain maximum benefits for patients after transplantation. The combined efforts of many research groups can lead to reliable information on the cell therapy benefit and the need to include it in the standards of treatment of patients with this extremely severe pathology.