Functional performance recovery after individualized nutrition therapy combined with a patient-tailored physical rehabilitation program versus standard physiotherapy in patients with long COVID: a pilot study

Long COVID is suggested to be present in 14 to 43% of COVID 19-survivors. Literature on this new condition states a need for a multidisciplinary approach including physical exercise and nutrition. 

The hypothesis is that an individualized nutritional therapy, combined with individualized physical rehabilitation program may lead to a faster improvement of functional performance compared to a standard physiotherapy program in patients suffering from long-term effects of COVID-19. 

The study compares 2 treatment options for patients with long COVID: standard care consisting of 18 physiotherapy sessions with a physiotherapist of choice and the personalized multimodal treatment (PMT) consisting of a combination of individualized nutritional therapy and a physical training program. 

The focus of the individual nutritional therapy will be to match energy and protein intake with the individualized needs, to support the physical rehabilitation and the maintenance of increase of muscle mass. 

The caloric target is defined by the Resting Energy Expenditure (REE) in kcal/day measured with COSMED Q-NRG™ Metabolic Monitor multiplied by a physical activity level (PAL). The Q-NRG showed prolonged hypermetabolism in COVID-19 ICU patients up to 7 weeks, showing a need to accurately measure the REE.

The use of adequacy of feeding based on indirect calorimetry is a well-known concept in the world of Intensive Care where it proved a survival benefit in a recent meta-analysis. This concept was translated by the Nutritional Research Team in a prospective randomized control trial to battle cancer-related cachexia. It proved a significant benefit.