Methylprednisolone
Methylprednisolone is a synthetic corticosteroid with inflammatory and immunomodulating properties which could be beneficial in reducing the massive inflammatory response that SARS-CoV-2 induces. It binds to and activates specific nuclear receptors which have α and β isoforms. The complex formed binds to specific glucocorticoid response elements (GREs) resulting in altered gene expression and inhibition of pro-inflammatory and cytokine production. This agent also decreases the number of circulating lymphocytes, induces cell differentiation and stimulates apoptosis in sensitive tumour cell populations thereby increasing survival and accumulation of neutrophils at inflammatory sites as well as induction of basophil apoptosis (Ferrara et al., 2009; Williams, 2018; Ponticelli & Locatelli, 2018).
The clinical indications include scleroderma, ulcerative colitis, asthma, vitiligo, autoimmune cytopenia and nephritic syndrome.
The adverse effects are cataract, glaucoma, hypertension, pancreatitis, myopathy, osteoporosis, psychosis, hyperglycaemia, hypocalcaemia, metabolic acidosis and secondary adrenal insufficiency (Wang, Y et al., 2020; Zhou et al., 2020).