الفهرس 
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Abstract
Deadly pandemics and disease emergences are not new phenomena: they have been challenging human existence throughout recorded history. Some have killed sizeable percentages of humanity, but humans have always searched for, and often found, ways of mitigating their deadly effects
new pandemic disease, coronavirus (CoV) disease 2019. caused high mortality rate in-spite of all efforts done to contain the disease
Phases of disease:
1. Stage I: The early infection or viral replication phase during which symptoms of upper respiratory tract infection dominate.
2. Stage II: The pulmonary phase when the patients develop full-blown pneumonia with all its associated symptoms.
3. Stage III: The hyper-inflammation phase when patients develop acute respiratory distress syndrome, sepsis, and kidney and other organ failures.
Corticosteroids suppress inflammation of the lungs during the cytokine storm, weaken immune responses, and inhibit the elimination of pathogen. For this reason, in COVID-19 corticosteroid therapy, systemic inhibition of inflammation is observed with a wide range of side effects.
Methylprednisolone is a synthetic corticosteroid with anti-inflammatory and immunomodulating properties. Methylprednisolone binds to and activates specific nuclear receptors, resulting in altered gene expression and inhibition of proinflammatory cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation, and stimulates apoptosis in sensitive tumor cell populations.
The aim of this study is to compare between standard dose methyl prednisolone (1-2 mg/kg) and mega dose methyl prednisolone (0.5 g to 1g) as regards outcome reflected by mortality rate, percentage of mechanically ventilated patients and ICU length of stay of COVID 19 patients admitted in ICU
group A:
Patients admitted in ICU, COVID PCR positive and requiring oxygen therapy who received methyl prednisolone standard dose (1-2 mg/kg)
group B:
Patients admitted in ICU, COVID PCR positive and requiring oxygen therapy who received methyl prednisolone mega dose (0.5-1 g per day)
Results:
This study showed that there is no significant statistical difference between receiving standard dose and mega dose methyl prednisolone as regards mortality rate or need for mechanical ventilation
But showed significant statistical difference as regards ICU length of stay denoting that patients received mega dose methyl prednisolone showed increased ICU stay.