Abstract
Abstract 
 During COVID-19 infection, virus and host cell interactions lead to the acute production of very strong immune mediators. The clinical status caused by damage throughout the body is mostly due to excessive pro-inflammatory cytokine production from virus-induced macrophages and granulocytes. Under infectious and inflammatory conditions, clinical and experimental studies have demonstrated that hepatic and extrahepatic cytochrome P450 (CYP) enzymes and carrier proteins responsible for drug metabolism are specifically regulated by many cytokines. Downregulation of these enzymes by cytokines can cause an elevation in plasma drug levels and/or lead to adverse drug reactions and/or toxicity. Based on the knowledge of cytokine-drug interactions occurring in the infection and inflammation stage, the aim of this review was to ascertain the influence of uncontrolled cytokine release on the metabolism of drugs used alone or in combination to treat COVID-19 patients and predict drug-drug interactions causing adverse effects.
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