INTRODUCTION: Adipose-derived stromal cells (ADSCs) can be an important alternative in COVID-19 prevention, treatment, and subsequent sequelae repair. However, ACE-2 plays a common role in the pathogenesis of adipocyte hypertrophy and COVID 19. AREAS COVERED: In this 'Perspective,' the author would like to emphasize the use of adipose tissue-derived stromal cells in COVID 19 and the issues that clinicians should pay attention to in fat graft applications in terms of adipose tissue-RAS relationship. The new normal for adipose tissue in COVID 19 will be highlighted. EXPERT OPINION: ADSCs may potentially be used in COVID-19. However, it has been speculated that ACE2 receptors are responsible for the pathogenesis of adipose tissue overgrowth and may be a potential danger in terms of the relationship between ACE2 receptors and COVID19. We speculate that reducing the size of overgrown fat tissue by ultra-sharp blades and using near-normal adipocytes will create a 'new normal.'