Key study findings and message • AST/ALT elevation rates associated with disease severity (P < 0.05)
• Possibly beneficial to suppress cytokine storm in early stage Liver may also be target of infection besides lungs Liver damage likely by virus directly Total protein remained normal despite albuminemia • No association found between liver damage, and oxygen saturation or degree of fever or immune dysfunction
• Liver damage likely by virus directly
• Hepatotoxic drugs may contribute • Spleen damage most likely due to direct viral attack
• Steroid medication may contribute
• Indirect viral mechanism, perhaps vascular, causing spleen injury • Higher mortality in patients with hyperglycemia, ↑ AST (P < 0.0001)
• Mortality not higher in patients with ↑ ALT (P = 0.35)
• SARS-CoV may cause acute insulin dependent diabetes mellitus
• 5% (2/39) still had diabetes 3 years after discharge