Objectives : COVID-19 accompanied by a fungal infection can exacerbatethe severity and complicate patient treatment. Assessment of the severity of plain chest radiographs using the mRALE scoring system can assist radiologists in identifying the patients degree of severity. In addition, NLR can also be used as a parameter of the severity of a disease or a worse prognosis so that it can provide an objective basis for early identification and management of patients. This study aims to assess the severity of plain chest X-rays of COVID-19 patients accompanied by fungal infection using mRALE and its correlation with NLR values, as well as to determine the radiological appearance and distribution of lesions in COVID-19 patients accompanied by fungal infection.  Material and Methods : An analytical observational study with a retrospective design was conducted with 140 confirmed COVID-19 patients accompanied by fungal infections compare with 140 confirmed COVID-19 without fungal infections who are hospitalized at Dr. Soetomo and has chest radiography results at RSUD Dr. Soetomo, NLR value and sputum culture. The scoring system uses the RSUD mRALE. We evaluated the severity of lung disease based on the mRALE which is assassed by two observers. Result : The realationship between the mRALE severity rating system and the NLR score was statistically significant and also between radiological infiltrates and consolidation with the presence of COVID-19 accompanied with fungal infection was statistically significant(p < 0.05),