Acute respiratory distress syndrome (ARDS) is a common clinical syndrome in intensive care unit. Sepsis is a clinical syndrome

which is with life-threatening organ function damage caused by infection. As an important part of local microcirculation

the structure of alveolar-capillary membrane is easily damaged in the course of sepsis. So sepsis is the most prime and important inducing factor of ARDS

and it has higher mortality and fatality. As an important constitution of renin-angiotensin system (RAS)

angiotensin-converting enzyme-2 (ACE-2) has the function of protecting endothelium and regulating the expression of inflammatory factors

so it has received additional attention in recent years. Through the intervention of ACE-2

ARDS and the severity of COVID-19 can be affected to a certain extent

so the role of ACE-2 in septic ARDS is worth discussing. This paper summarizes the biological characteristics and main mechanism of ACE-2

discusses the possible role of ACE-2 in septic ARDS

and finally explores the significance of ACE-2 in the evaluation and treatment of septic ARDS

in order to provide reference and inspiration for clinical treatment of sepsis-related ARDS.