Coronavirus disease 2019 (COVID-19) is a global health emergency caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The rapid worldwide spread of SARS-CoV-2 infection has necessitated a global effort to identify effective therapeutic strategies in the absence of vaccine. Among the re-purposed drugs being tested currently, hydroxychloroquine (HCQ), without or with zinc ion (Zn⁺⁺) and the antibiotic azithromycin (AZM), has been administered to prevent or treat patients with COVID-19. The outcome of multiple clinical studies on HCQ has been mixed. Zn⁺⁺ interferes with viral replication by inhibiting replicative enzymes and its entry into cells may be facilitated by HCQ. Another immunomodulatory drug, methotrexate (MTX), is well known for its ability to mitigate overactive immune system by upregulating the anti-inflammatory protein, A20. However, its beneficial effect in treating COVID-19 has not drawn much attention. This review provides an overview of the virology of SARS-CoV-2 and an analysis of the mechanisms by which these anti-inflammatory agents may act in the treatment of COVID-19 patients. We propose a rationale for the combinatorial use of these re-purposed drugs that may help to combat this ongoing pandemic health emergency.

2019 年冠状病毒病 (COVID-19) 是由严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 引起的全球卫生紧急事件。SARS-CoV-2 感染在全球范围内迅速传播，需要全球共同努力，在缺乏疫苗的情况下寻找有效的治疗策略。目前正在测试的重新用途药物中，羟氯喹 (HCQ)（不含或含锌离子 (Zn ⁺⁺ )）和抗生素阿奇霉素 (AZM) 已用于预防或治疗 COVID-19 患者。多项关于 HCQ 的临床研究结果好坏参半。Zn ⁺⁺通过抑制复制酶来干扰病毒复制，并且 HCQ 可能会促进其进入细胞。另一种免疫调节药物甲氨蝶呤 (MTX) 因其通过上调抗炎蛋白 A20 来缓解过度活跃的免疫系统的能力而闻名。然而，其治疗 COVID-19 的有益作用并未引起太多关注。本综述概述了 SARS-CoV-2 的病毒学，并分析了这些抗炎药在治疗 COVID-19 患者中可能发挥作用的机制。我们提出了组合使用这些重新调整用途的药物的理由，这可能有助于应对这一持续的大流行性卫生紧急情况。