Coronavirus disease 2019 (COVID‑19) is an acute infectious pneumonia caused by a novel type of coronavirus infection. There are currently no clinically available specific drugs for the treatment of this virus. The process of host invasion is the key to viral infection, and it is a mechanism that needs to be considered when exploring antiviral drugs. At present, studies have confirmed that angiotensin‑converting enzyme II (ACE2) is the main functional receptor through which severe acute respiratory syndrome coronavirus (SARS‑CoV‑2) invades host cells. Therefore, a number of studies have focused on this field. However, as ACE2 may play a dual role in mediating susceptibility and immunity to SARS‑CoV‑2 infection, the role of ACE2 in viral infection is controversial. Beginning with the physiological function of ACE2, the present review article summarizes the influence of the ACE2 content on the susceptibility to the virus and acute lung injury. Drug mechanisms were taken as the starting point, combined with the results of clinical trials, specifically elaborating upon and analyzing the efficacy of several ACE2‑centered therapeutic drugs and their potential effects. In addition, the current status of ACE2 as a targeted therapy for COVID‑19 is discussed in order to provide new insight into the clinical prevention and treatment of COVID‑19.
Keywords: SARS‑CoV‑2; COVID‑19; spike protein; ACE2; RAS; therapeutics; mechanism.