The term "Xuanfu" first appeared in the "Huangdi Neijing", Xuanfu‘s theory was gradually improved through additions by doctors of the past dynasties. Xuanfu is found throughout the body, it serves as a channel for the ascending and descending of the body‘s vital energy, exhibiting a wide-ranging and facilitating as a switch. The pulmonary alveolar capillary barrier of modern medicine is related to the function of Xuanfu, which provides a modern scientific basis for the application of Xuanfu theory in the prevention and treatment of coronavirus disease (COVID-19). The TCM pathologic mechanism of COVID-19 is mainly dampness and toxicity in the lungs and Xuanfu stagnation and blockage. Therefore, opening the Xuanfu is a fundamental principle in the prevention and treatment of COVID-19. This article, drawing from clinical practices in Austria, elucidates five strategies for the prevention and treatment of COVID-19 based on Xuanfu theory: dispelling pathogenic factors and opening Xuanfu, regulating qi and opening Xuanfu, unblocking meridians and opening Xuanfu, resolving dampness and opening Xuanfu, and strengthening the body‘s defense and consolidating Xuanfu. Clinical evidence from over a hundred cases demonstrates the efficacy of opening the Xuanfu in the prevention and treatment of COVID-19. This article offers an analysis of the mechanism of COVID-19 from the perspective of Xuanfu‘s opening and integrates both traditional Chinese and Western medical concepts to formulate preventive and treatment strategies. It holds significance for the management of COVID-19 and future "epidemic diseases."