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Peer-reviewedCC BY 4.0Nutrients

Macronutrient Intake and Clinical Manifestations in Adults with Long COVID-19: A Cross-Sectional Analysis of the BioICOPER Study

  • David Rodríguez-García1,2,3
  • Marta Gómez-Sánchez4
  • Elena Navarro-Matías1,2,3,5
  • Silvia Arroyo-Romero1,2,3
  • Alicia Navarro-Cáceres1,2,3
  • Nuria Suárez-Moreno1,2,3
  • Andrea Domínguez-Martín1,2,3
  • Manuel A. Gómez-Marcos1,2,3,5
  • David Arjol1,2,3,5
  • Leticia Gómez-Sánchez6
  • BioICOPER Investigators Group
6 affiliations
  1. 1Primary Care Research Unit of Salamanca (APISAL), Salamanca Primary Care Management, Regional Health Authority of Castilla y León (SACyL), Avenida de Portugal 83, 37005 Salamanca, Spain
  2. 2Institute of Biomedical Research of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007 Salamanca, Spain
  3. 3Department of Medicine, University of Salamanca, Calle Alfonso X el Sabio s/n, 37007 Salamanca, Spain
  4. 4Home Hospitalization Service, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
  5. 5Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Avenida de Portugal 83, 37005 Salamanca, Spain
  6. 6Emergency Department, Hospital Universitario Príncipe de Asturias Alcalá, Carretera de Meco, s/n (University of Alcalá Outer Campus), 28805 Madrid, Spain
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Abstract

Background/Objectives: The relationship between macronutrient intake and the clinical manifestations of long COVID-19 remains poorly understood. This study examined these associations in adults from the BioICOPER cohort. Methods: This cross-sectional study included 290 adults with long COVID-19 from the BioICOPER cohort who had complete seven-day dietary records collected using the EVIDENT application. Twelve clinical outcomes were assessed using linear regression with robust standard errors, ordinal logistic regression for frailty, and multinomial logistic regression for dyspnea. Model 1 examined eight exposures (total energy and seven nutrient intake variables), adjusting for age and sex. Model 2 examined seven exposures expressed as energy percentages or fiber density, additionally adjusting for total energy intake. Benjamini–Hochberg correction was applied separately to the 96 and 84 tests, respectively. Results: In Model 1, higher intakes of total fat (odds ratio [OR]: 0.983; 95% confidence interval [CI]: 0.974–0.992), saturated fatty acids (OR: 0.956; 95% CI: 0.932–0.981), and monounsaturated fatty acids (OR: 0.967; 95% CI: 0.948–0.987), per additional g/day, were associated with lower odds of being in a higher frailty category (q: 0.034, 0.034, and 0.038, respectively). No primary association in Model 2 remained significant after correction for multiple testing. Exploratory analyses identified quadratic relationships between the energy percentages from protein and polyunsaturated fatty acids and Montreal Cognitive Assessment (MoCA) scores (q = 0.0163 and 0.0111, respectively). Conclusions: Absolute intakes of certain fats were inversely associated with frailty, whereas the primary analyses of energy-adjusted dietary composition showed no significant associations after correction for multiple testing. These findings do not support recommending a specific macronutrient distribution. The exploratory cognitive findings require replication in longitudinal studies.

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Cite

BibTeXRIS
BibTeX
@article{rodriguezgarcia2026macronutrient,
  title = {{Macronutrient Intake and Clinical Manifestations in Adults with Long COVID-19: A Cross-Sectional Analysis of the BioICOPER Study}},
  author = {David Rodríguez-García and Marta Gómez-Sánchez and Elena Navarro-Matías and Silvia Arroyo-Romero and Alicia Navarro-Cáceres and Nuria Suárez-Moreno and Andrea Domínguez-Martín and Manuel A. Gómez-Marcos and David Arjol and Leticia Gómez-Sánchez and BioICOPER Investigators Group},
  journal = {Nutrients},
  year = {2026},
  month = nov,
  doi = {10.3390/nu18213716},
  url = {https://www.mdpi.com/2072-6643/18/21/3716},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Macronutrient Intake and Clinical Manifestations in Adults with Long COVID-19: A Cross-Sectional Analysis of the BioICOPER Study
AU  - David Rodríguez-García
AU  - Marta Gómez-Sánchez
AU  - Elena Navarro-Matías
AU  - Silvia Arroyo-Romero
AU  - Alicia Navarro-Cáceres
AU  - Nuria Suárez-Moreno
AU  - Andrea Domínguez-Martín
AU  - Manuel A. Gómez-Marcos
AU  - David Arjol
AU  - Leticia Gómez-Sánchez
AU  - BioICOPER Investigators Group
PY  - 2026
DA  - 2026/11/09
JO  - Nutrients
DO  - 10.3390/nu18213716
UR  - https://www.mdpi.com/2072-6643/18/21/3716
AB  - Background/Objectives: The relationship between macronutrient intake and the clinical manifestations of long COVID-19 remains poorly understood. This study examined these associations in adults from the BioICOPER cohort. Methods: This cross-sectional study included 290 adults with long COVID-19 from the BioICOPER cohort who had complete seven-day dietary records collected using the EVIDENT application. Twelve clinical outcomes were assessed using linear regression with robust standard errors, ordinal logistic regression for frailty, and multinomial logistic regression for dyspnea. Model 1 examined eight exposures (total energy and seven nutrient intake variables), adjusting for age and sex. Model 2 examined seven exposures expressed as energy percentages or fiber density, additionally adjusting for total energy intake. Benjamini–Hochberg correction was applied separately to the 96 and 84 tests, respectively. Results: In Model 1, higher intakes of total fat (odds ratio [OR]: 0.983; 95% confidence interval [CI]: 0.974–0.992), saturated fatty acids (OR: 0.956; 95% CI: 0.932–0.981), and monounsaturated fatty acids (OR: 0.967; 95% CI: 0.948–0.987), per additional g/day, were associated with lower odds of being in a higher frailty category (q: 0.034, 0.034, and 0.038, respectively). No primary association in Model 2 remained significant after correction for multiple testing. Exploratory analyses identified quadratic relationships between the energy percentages from protein and polyunsaturated fatty acids and Montreal Cognitive Assessment (MoCA) scores (q = 0.0163 and 0.0111, respectively). Conclusions: Absolute intakes of certain fats were inversely associated with frailty, whereas the primary analyses of energy-adjusted dietary composition showed no significant associations after correction for multiple testing. These findings do not support recommending a specific macronutrient distribution. The exploratory cognitive findings require replication in longitudinal studies.
SN  - 2072-6643
ER  -