Telehealth-Based Ketogenic Metabolic Therapy With Lifestyle Interventions for Post-viral Illness: A Research Brief of Patients' Experiences.

Abstract

Background/objectives: Infection-associated chronic illnesses are associated with substantial functional impairment that limits participation in traditional in-person research. A fully remote, multicomponent intervention that combines ketogenic metabolic therapy (KMT) with behavioral interventions targets several proposed biological mechanisms underlying these conditions. This study aimed to characterize patient-reported experiences with a fully remote intervention that integrated KMT and thiamine supplementation with behavioral strategies, including circadian entrainment and mindfulness-based resilience coaching.

Methods: In this cross-sectional study, quantitative data were collected via online REDCap surveys. Feasibility and acceptability benchmarks included perceived treatment suitability, relevance, safety, and reported treatment adherence. Optimization items evaluated preferred program duration, dosing, and structure, as well as components that respondents identified as most important for future refinement.

Results: Among an international sample (n=41), all feasibility and acceptability benchmarks were met: 96% reported the intervention was helpful, 96% recommended it, and 75% felt "a lot better" after completion. Respondents provided patient-centered perspectives to optimize the intervention.

Conclusions: Incorporating patient perspectives is essential for guiding the development of safe, acceptable, and effective treatment strategies for infection-associated chronic illness, including Long COVID. Strong indicators of feasibility, acceptability, and perceived benefits support the rationale for larger controlled trials to investigate clinical efficacy and the underlying mechanistic pathways of multicomponent metabolic interventions.