The COVID-19 infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major public health issue worldwide, as no vaccines or drugs for prevention and treatment have been approved so far, except remdesivir that has been recently authorized for use in the USA and Japan [1]. Many clinical studies are ongoing. Most of them evaluate established antiviral drugs such as lopinavir/ritonavir, and chloroquine (CQ) or its derivative hydroxychloroquine (HCQ), which have shown in vitro antiviral activity against SARS-CoV-2 [2]. Because SARS coronavirus infections are known to induce inflammation and subsequent tissue damage in the lungs in moderate-to-severe cases [3], using immunomodulating drugs could provide a benefit in the treatment of COVID-19. Drugs with the most relevant immunomodulatory profile remain to be found. We believe the antibacterial macrolide azithromycin (AZM) has a special and interesting profile in this search for drug therapy for COVID-19. We discuss below the arguments for this claim.