Publication date: Jun 01, 2025

Low physical activity and poor dietary quality can negatively influence Covid-19 recovery and increase the risk and duration of post-Covid-19 condition (PCC). This proof-of-concept nested intervention study aimed to evaluate the feasibility of a digital personalised combined lifestyle intervention (CLI) in patients with PCC using a mixed-methods design, assessing compliance, experiences and perceived effectiveness. A nested intervention study, incorporating motivational interviewing aiming to enhance physical activity and dietary quality, was conducted within a multicentre prospective cohort study including 95 post-Covid-19 patients (aged 40-60) between May 2021 and September 2022. Patients in the intervention and control groups were followed at +/-3-6 and +/-12-15 months post Covid-19. The intervention consisted of nine monthly individual counselling sessions (30 min), two interactive-group sessions (60 min), and three educative webinars (45 min). Additionally, a nutritional supplement (NS; Remune, Smartfish, Oslo, Norway) high in omega-3 fatty acids, vitamin D and protein was provided to facilitate recovery. After the intervention, a process evaluation was conducted, comprising an evaluation questionnaire and semi-structured in-depth interviews. The intervention-to-treat group consisted of 47 patients (age 54. 7 +/- 6. 0 years; 40% males; BMI 30. 6 +/- 5. 8 kg/m) of whom 74% had ≥ 8 individual sessions via telephone (66%) or video call (34%). Over half of the group (55%) attended the educative webinars, while attendance was lower in the interactive-group sessions, with 32% attending one session and 15% two sessions. The process evaluation indicated that patients were satisfied with the digital coaching and the frequency, duration and content of the sessions. Half of the patients reported perceived improvements in physical activity levels and dietary quality throughout the intervention, with the majority also reporting sustainment of these lifestyle changes post-intervention. A digital personalised CLI was well-received among patients with PCC regarding compliance, experiences and perceived effectiveness. These findings will guide the development and implementation of tailored interventions to enhance overall well-being among patients with PCC. Patients’ experiences regarding the design and implementation of the study were retrieved. Although participants were not directly involved in the initial design of the study, their experiences were actively incorporated into the refinement and implementation of the study procedures, thereby ensuring meaningful patient involvement.

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