The pathogenesis of Coronavirus disease 2019 is still obscure, indeed it’s only few months since it has been first reported on December 2019, yet the need for exploration of possible mechanisms, suggestion of new drugs should never be delayed. In this communication, the author proposes an integrated pathophysiological as well as pharmacological COVID-19 approach to recommend using anti-inflammatory drugs, other than glucocorticoids, suggesting ibuprofen as an example, to be added to his recently published suggested COVID-19 early management protocol. A possible explanation for the potential failure of hydroxychloroquine for COVID-19 is also explained according to the suggested concept. The author is fully aware of the ibuprofen contradictory hypothesis; as discussed and argued against in this report.