INS and Hyperglycemia: It is possible that systemic sepsis might have induced the state of hyperglycemia in those patients because alteration in hepatic metabolism and insulin resistance was stimulated in response to viral infection.2,44,45 It has also been suggested that stimulation of the sympathetic nervous system might induce the loss of blood glucose homeostasis.33 On the other hand, it is possible that non-severe cases with missing values of blood glucose levels in our study had hyperglycemia.