IntroductionDiverse disease courses, each corresponding to a unique pathophysiological mechanism, characterize the coronavirus 2019 disease (COVID-19). Intensive research on discovering specificity targets for treating COVID-19 has significant implications for understanding pathogenesis mechanisms in disease evolution. Traditional Chinese medicine (TCM) has shown distinctive advantages in treating COVID-19 in different periods, which may provide new clues for target discovery. In order to accomplish the goal of providing a Disease Evolution-based Specificity Target Discovery (DESTD), the purpose of this paper was to conduct an analysis of the difference in target weighted value during each cycle of COVID-19. MethodsOur study employed a comprehensive methodology combining TCM pharmacology with modern biological techniques. Three Jiawei-Maxing-Shigan Decoctions (MS Decoction), were selected as samples, including Hanshi-Yufei decoction (HY Decoction), Shidu-Yufei decoction (SY Decoction), and Yidu-Bifei decoction (YB Decoction). The core components of these decoctions are the same, while the differences correspond to different periods of COVID-19. The DESTD approach consists of several parts: network pharmacology analysis to identify potential targets, molecular docking simulation to investigate TCM components acting on potential targets, and biological validation. This study employed several cell line models, including RAW264.7 (Mouse Mononuclear Macrophages Cells), 16HBE (Human Bronchial Epithelial Cells), and HUVECC (Human Umbilical Vein Endothelial Cells), to explore new approaches for key target discovery. ResultsDuring the mild phase of COVID-19, HY Decoction exhibited anti-inflammatory effects by specifically down-regulating the expression of heat shock protein HSP 90-alpha (HSP90AA1), transcription factor JUN (JUN) and other five genes in RAW264.7. In the common phrase, inflammation and fibrosis could be specifically alleviated by down-regulating the expression of interleukin-10 (IL10) and mitogen-activated protein kinase 14 (MAPK14) by SY Decoction respectively acting on RAW264.7 and 16HBE cell lines. In severe cases, YB Decoction specifically down-regulated the expression of prostaglandin endoperoxide synthase-2 (PTGS2), caspase-3 (CASP3), and three other genes to protect vascular endothelial cells from oxidative damage. Moreover, YB also played a role in anti-fibrosis by specifically down-regulating the expression of estrogen receptor beta (ESR2), vascular cell adhesion protein 1 (VCAM1), and other three genes, and up-regulating the expression of prostaglandin endoperoxide synthase-1 (PTGS1) in the severe period. These targeted actions align with a holistic treatment approach and provide tailored therapies for different stages of COVID-19. ConclusionThis research proposed a novel strategy for Disease Evolution-based Specificity Target Discovery (DESTD) to identify specific targets of different stages of disease and specific targets and mechanisms throughout the evolution of COVID-19.