At present, the pathogenesis of the novel coronavirus disease 2019 (COVID‑19) has not been fully elucidated. Clinical and experimental findings from studies investigating COVID‑19 have suggested that the immune‑inflammatory response has a crucial role in severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection. The present article aimed to systematically review the available literature on the pathogenesis of COVID‑19. Severe COVID‑19 is characterized by organ dysfunction, hypercytokinemia and lymphopenia. It is assumed that the direct cytopathological damage of host cells and the dysregulated immune response caused by SARS‑CoV‑2 may be the primary underlying mechanisms of COVID‑19. Based on the published literature, this review attempts to provide an integrated view of the immunological mechanisms and the potential pathogenesis of COVID‑19, providing an in‑depth summary of the host‑pathogen interaction and host immune responses. It is of great importance to elucidate the possible pathogenesis of COVID‑19 to determine the direction of future research.