Clinical course of community-acquired pneumonia of coronavirus etiology in patients with metabolic dysfunction-associated steatotic liver disease

Authors

DOI:

https://doi.org/10.14739/2310-1210.2026.2.340409

Keywords:

community-acquired pneumonia, acute coronavirus disease, metabolic dysfunction-associated steatotic liver disease, steatotic liver disease, metabolic dysfunction, obesity

Abstract

Aim. To determine the clinical features of moderate community-acquired pneumonia (CAP) associated with COVID-19 in patients without comorbidities compared to those with comorbid metabolic dysfunction-associated steatotic liver disease (MASLD).

Material and methods. A retrospective analysis was performed including 200 hospitalized patients with moderate CAP associated with SARS-CoV-2. Two groups (n = 100 each) were defined: Group 1 included patients with CAP without liver comorbidity and with normal body weight; Group 2 comprised patients with CAP and comorbid MASLD associated with being overweight or having class I–II obesity.

Results. Patients in Group 2 demonstrated a significantly higher prevalence of intense chest pain (1.7-fold), fever (1.7-fold), anosmia (2.3-fold), sore throat with odynophagia (2.0-fold), and progressive inspiratory dyspnea (1.7-fold) compared to Group 1 (p < 0.05). Systemic and gastrointestinal symptoms were also more frequent in Group 2, including myalgia (4.2-fold), asthenia and headache (both 1.6-fold), syncope (2.5-fold), nausea (2.3-fold), and diarrhea (3.9-fold) (p < 0.05). Hyperthermia >38.5 °C (1.6-fold), tachycardia >90/min (2.0-fold), tachypnea >25/min (2.2-fold), and oxygen saturation (SpO2) of 90–92 % (1.8-fold) were significantly more common in the comorbid group (p < 0.05). Laboratory findings in Group 2 revealed a higher incidence of leukopenia (52.0 % vs. 39.0 %), lymphopenia (77.0 % vs. 37.0 %, p < 0.05), and thrombocytopenia (61.0 % vs. 29.0 %, p < 0.05), alongside pronounced hyperfibrinogenemia and hyperferritinemia. Radiologically, Group 2 patients predominantly exhibited bilateral lung involvement (67.0 % vs. 38.0 %, p < 0.05), consolidation, ground-glass opacities, fibrotic changes, and pleuritis. Co-infections and superinfections were significantly more frequent in Group 2 (45.0 % vs. 18.0 %), with S. pneumoniae (27.0 %), K. pneumoniae (17.0 %), S. aureus (18.0 %), Aspergillus spp. (10.0 %), and Candida spp. (6.0 %) identified as the primary pathogens.

Conclusions. The presence of MASLD is associated with a more severe clinical course of COVID-19-related CAP. Patients with MASLD exhibit more pronounced respiratory and systemic manifestations, significant immune disturbances, higher rates of secondary co-infections, and more extensive bilateral radiological lung involvement (p < 0.05).

Author Biographies

O. S. Khukhlina, Bukovinian State Medical University, Chernivtsi

MD, PhD, DSc, Professor, Head of the Department of Internal Medicine, Clinical Pharmacology and Occupational Diseases

I. V. Rachynska, Bukovinian State Medical University, Chernivtsi

MD, PhD student, Department of Internal Medicine, Clinical Pharmacology and Occupational Diseases

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Published

2026-04-23

How to Cite

1.
Khukhlina OS, Rachynska IV. Clinical course of community-acquired pneumonia of coronavirus etiology in patients with metabolic dysfunction-associated steatotic liver disease. Zaporozhye Medical Journal [Internet]. 2026Apr.23 [cited 2026May13];28(2):124-9. Available from: https://zmj.zsmu.edu.ua/article/view/340409

Issue

Vol. 28 No. 2 (2026)

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Original research

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Copyright (c) 2026 O. S. Khukhlina, I. V. Rachynska

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