The coronavirus disease 2019 (COVID 19) has caused a worldwide pandemic. Approximately 5% of victims develop severe acute respiratory distress syndrome (ARDS), and some require extracorporeal membrane oxygenation (ECMO). However, weaning patients with COVID 19 related ARDS from ECMO are challenging. Here, we report a COVID 19 case with severe ARDS that received venovenous ECMO to maintain adequate gas exchange for more than 4 weeks. We performed prolonged prone position ventilation and airway pressure release ventilation, and the patient was successfully weaned off ECMO.