BACKGROUND: Coronaviruses are ribonucleic acid viruses, in humans the viruses may infect the respiratory, gastrointestinal, hepatic, and central nervous systems. Infection with four of the most common coronaviruses strains. usually lead to mild, self-limiting upper respiratory tract infections However, other corona viruses, are associated with severe acute respiratory syndrome (SARS-CoV) and the Middle East respiratory syndrome (MERS-CoV). Aim: to assess the use of systemic steroid either pulse steroid or regular dose of steroid in patient with severe form of covid 19 as regard hospital stay, need for mechanical ventilation. Methods: a cross sectional study, carried out on 50 patients who were suspected with covid 19 by history, laboratory investigation, chest imaging and confirmed with PCR selected from the critical care unit and isolation critical care unit at Benha university Hospital. And were classified into two groups, Group1: 25 patients were received dexamethasone (8 mg per day) and Group 2: 25 patients were received solumedrol (2mg per Kg). All data will be tabulated and statistically analyzed. Results: the mean ICU length of stay in critically ill patients who received Dexamethasone was 12.5±4.286 versus 14.68±7.851 in critically ill patients who received Methylprednisolone (p-value=0.08). Patients in Dexamethasone group, by the 10th day, had a significantly better D dimer (1153.04±725.34 vs 1633.12±1244.8, p=0.020), ferritin, (899.14±344.22 vs 1523.8±994.44, p