Coronaviruses are non-segmented and single stranded positive-sense RNA (+ssRNA) viruses. To date, 06 human coronaviruses (HCoVs) are reported; α-CoVs (HCoVs-NL63 and HCoVs-229E) and β-CoVs (HCoVs-OC43, HCoVs-HKU1, SARS-CoV, MERS-CoV). While, novel coronavirus (SARS-CoV-2) is the most recent member. The genome sequence of SARS-CoV-2 is 82% similar to SARS–COV-1. The compelling evidences link the progression of viral infection of SARS-CoV-2 with excessive inflammation as a result of the exaggerated immune response and elevated production of “immunocytokines” resulting in cytokine storm (CS); followed by a series of events, like acute organ damage, acute respiratory distress syndrome (ARDS) as well as death. Hence attempts to reduce cytokine storm are now being considered as a new paradigm shift in the clinical management of SARS-CoV-2. Tocilizumab (IL-6 blocker), Baricitinib (JAKs and AAK1 inhibitor), TNFα inhibitors (Infliximab, Adalimumab, Certolizumab) are currently being evaluated for possible block of the CS. Hence, rationalizing anti-inflammatory therapeutics would be the most judicious approach for significant reduction in COVID-19 mortality. In order to elucidate optimized and rationaled use of different therapeutics in COVID-19, we collated latest available information from emerging scientific evidences, integrated previous attempts as well as clinical successes, and various adopted approaches to mitigate past outbreaks with of SARS-CoV and MERS CoV.

冠状病毒是不分节段的单链正链RNA（+ssRNA）病毒。迄今为止，已报告 06 种人类冠状病毒 (HCoV)；α-冠状病毒（HCoVs-NL63 和 HCoVs-229E）和 β-冠状病毒（H冠状病毒-OC43、H冠状病毒-HKU1、SARS-冠状病毒、中东呼吸综合征冠状病毒）。而新型冠状病毒（SARS-CoV-2）是最新的成员。SARS-CoV-2 的基因组序列与 SARS-COV-1 相似度为 82%。令人信服的证据表明，SARS-CoV-2 病毒感染的进展与过度炎症有关，这是由于免疫反应过度和“免疫细胞因子”产生增加导致细胞因子风暴（CS）所致；随后发生一系列事件，如急性器官损伤、急性呼吸窘迫综合征（ARDS）以及死亡。因此，减少细胞因子风暴的尝试现在被认为是 SARS-CoV-2 临床管理的新范式转变。目前正在评估托珠单抗（IL-6 阻滞剂）、Baricitinib（JAK 和 AAK1 抑制剂）、TNFα 抑制剂（英夫利昔单抗、阿达木单抗、Certolizumab）是否可能阻滞 CS。因此，合理化抗炎治疗将是显着降低 COVID-19 死亡率的最明智方法。为了阐明针对 COVID-19 的不同疗法的优化和合理使用，我们整理了来自新兴科学证据的最新可用信息，整合了之前的尝试和临床成功，以及缓解过去 SARS-CoV 和 MERS 疫情爆发所采用的各种方法冠状病毒。