There are various mechanisms of SARS-CoV-2 infection and COVID-19 immunopathogenesis. Therapies inhibiting viral infection and regulation of dysfunctional immune responses may synergize to block pathologies at multiple steps. Immune dysfunction and disease severity in COVID-19 patients should be considered when developing and evaluating vaccines. Further research is needed on the host immune response to SARS-CoV-2, particularly the drivers of healthy versus dysfunctional outcomes. These will assist identify immunological correlates of protection and disease severity for optimal patient triage.