PD524 - BALANCING ENERGY INTAKE AND TREATMENT BURDEN IN LONG COVID: INSIGHTS FROM A QUALITATIVE STUDY

PD524

BALANCING ENERGY INTAKE AND TREATMENT BURDEN IN LONG COVID: INSIGHTS FROM A QUALITATIVE STUDY

B. G. Jimenez Garcia^1,2,3,*, L. Leemans^1,2, S. Roggeman⁴, P. Janssens^5,6, D. Beckwée³, S. Six^7,8,9, E. De Waele^1,2

¹Metabolism and Nutrition (MENU) Research Unit, Vitality Research Group, Vrije Universiteit Brussel (VUB), Brussels Health Campus/Faculty of Medicine and Pharmacy, ²Department of Clinical Nutrition and Dietetics, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels Health Campus, ³Rehabilitation Research Group (RERE), Vrije Universiteit Brussel (VUB), Brussels Health Campus/Faculty of Physical Education and Physiotherapy, ⁴Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels Health Campus, ⁵Kidney Diseases, Dialysis and Transplantation (NIER) Research Unit, Vitality Research Group, Vrije Universiteit Brussel (VUB), Brussels Health Campus/Faculty of Medicine and Pharmacy, ⁶Department of Nephrology and Arterial Hypertension, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels Health Campus, ⁷Mental Health & Wellbeing Research Group (MENT), ⁸Department of Public Health, Vrije Universiteit Brussel (VUB), Brussels Health Campus/Faculty of Medicine and Pharmacy, ⁹Healthcare Stimulation & Excellence Research Group, VIVES University of Applied Sciences, Brussels, Belgium

Rationale: Multidisciplinary rehabilitation, including nutritional support to optimize energy availability, is recommended for long COVID. However, patient and provider experiences with integrating nutritional counselling into multimodal therapy remain poorly understood.

Methods: A qualitative study using reflexive thematic analysis was conducted in adults with long COVID receiving personalised multimodal therapy (PMT), combining pacing-based physiotherapy and nutritional counselling. Data were collected through one focus group (n=6), individual interviews with patients (n=5), and healthcare providers (dietitians n=4; physiotherapists n=3).

Results: Six themes were identified. The perceived value of PMT was shaped by the balance between therapeutic benefit and the energy cost of participation. Nutritional counselling supported energy availability and rehabilitation but generated tensions between patient expectations and evidence-based practice. Patients frequently sought personalised or “medicalised” dietary approaches, while dietitians emphasised balanced nutrition and adequate energy intake. Conflicting goals between increasing energy intake and weight management further complicated adherence. Low-burden delivery formats, such as teleconsultations, and a validating therapeutic relationship facilitated participation. Symptom unpredictability, intervention burden, and protocol constraints limited perceived effectiveness. Recovery was experienced as non-linear, requiring flexibility.

Conclusion: The effectiveness of combined nutritional counselling and physiotherapy depends on balancing energy intake with treatment burden. Interventions should prioritise energy adequacy and be delivered through flexible, low-intensity approaches to improve adherence and clinical outcomes.

Disclosure of Interest: B. Jimenez Garcia: None declared, L. Leemans: None declared, S. Roggeman: None declared, P. Janssens: None declared, D. Beckwée: None declared, S. Six: None declared, E. De Waele Other: former Executive Board Member of ESPEN, reviewer for Clinical Nutrition, received honoraria for advisory board meetings, lectures, and travel expenses from Baxter Healthcare, Danone-Nutricia, Cardinal Health, Fresenius Kabi, GE Healthcare, ART Medical, and Ferring Pharmaceuticals.