The global COVID-19 pandemic emerged at the end of December 2019.Acute respiratory distress syndrome(ARDS)and acute lung injury(ALI)are common lethal outcomes of bacterial lipopolysaccharide(LPS),avian influenza virus,and SARS-CoV-2 infection.Toll-like receptor 4(TLR4)is a key target in the pathological pathway of ARDS and ALI.Previous studies have reported that herbal small RNAs(sRNAs)are a functional medical component.BZL-sRNA-20(Accession number:B59471456;Family ID:F2201.Q001979.B11)is a potent inhibitor of Toll-like receptor 4(TLR4)and pro-inflammatory cytokines.Furthermore,BZL-sRNA-20 reduces intracellular levels of cytokines induced by lipoteichoic acid(LTA)and polyinosinic-polycytidylic acid(poly(I∶C)).We found that BZL-sRNA-20 rescued the viability of cells infected with avian influenza H5N1,SARS-CoV-2,and several of its variants of concern(VOCs).Acute lung injury induced by LPS and SARS-CoV-2 in mice was significantly ameliorated by the oral medical decoctosome mimic(bencaosome;sphinganine(d22∶0)+BZL-sRNA-20).Our findings suggest that BZL-sRNA-20 could be a pan-anti-ARDS/ALI drug.