Abstract: Received: 21 September 2021 Revised: 3 November 2021 Accepted: 16 November 2021 DOI: 10.1111/bcpt.13690 MINI REVIEW Home pharmacological therapy in early COVID-19 to prevent hospitalization and reduce mortality: Time for a suitable proposal Sergio Pandolfi1,2 | Salvatore Chirumbolo3 | Giovanni Ricevuti4 | 1 5 6 Luigi Valdenassi | Geir Bjørklund | Roman Lysiuk | Monica Daniela Doşa7 | Larysa Lenchyk8 | Serafino Fazio9 1 High School of Oxygen Ozone Therapy, University of Pavia, Pavia, Italy 2 Unit of Neurosurgery, Villa Mafalda Health Clinics, Rome, Italy 3 Abstract The COVID-19 pandemic is a highly dramatic concern for mankind. In Italy, the pandemic exerted its major impact throughout the period of February to Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy June 2020. To date, the awkward amount of more than 134,000 deaths has been reported. Yet, post-mortem autopsy was performed on a very modest 4 number of patients who died from COVID-19 infection, leading to a first con- 5 firmation of an immune-thrombosis of the lungs as the major COVID-19 pathogenesis, likewise for SARS. Since then (June–August 2020), no targeted early Department of Drug Science, University of Pavia, Pavia, Italy Department of Direction Board, Council for Nutritional an Environmental Medicine (CONEM), Mo i Rana, Norway 6 CONEM Ukraine Life Science Research Group, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine 7 Department of Pharmacology, Faculty of Medicine, Ovidius University, Constanta, Romania 8 CONEM Ukraine Pharmacognosy and Natural Product Chemistry Research Group, National University of Pharmacy, Kharkiv, Ukraine 9 Department of Internal Medicine, University of Naples Federico II, Naples, Italy Correspondence Salvatore Chirumbolo, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie 9, Verona 37134, Italy. Email: salvatore.chirumbolo@univr.it therapy considering this pathogenetic issue was approached. The patients treated with early anti-inflammatory, anti-platelet, anticoagulant and antibiotic therapy confirmed that COVID-19 was an endothelial inflammation with immuno-thrombosis. Patients not treated or scarcely treated with the most proper and appropriate therapy and in the earliest, increased the hospitalization rate in the intensive care units and also mortality, due to immunethrombosis from the pulmonary capillary district and alveoli. The disease causes widespread endothelial inflammation, which can induce damage to various organs and systems. Therapy must be targeted in this consideration, and in this review, we demonstrate how early anti-inflammatory therapy may treat endothelia inflammation and immune-thrombosis caused by COVID-19, by using drugs we are going to recommend in this paper. KEYWORDS immunopharmacology, immunotoxicology, infection, inflammation, pharmacoepidemiology © 2021 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society). Published by John Wiley & Sons Ltd Basic Clin Pharmacol Toxicol. 2022;130:225–239. wileyonlinelibrary.com/journal/bcpt 225 226 1 | INTRODUCTION ON THE IMMUNO-THROMB OTI C E T I O P A T H O G E N E S I S O F CO V I D - 1 9 The coronavirus disease 2019 (COVID-19) had a huge impact on health management worldwide. It generated controversial issues and great concerns even on authorized and agreed therapeutic protocols for SARS-CoV2 pandemic,..