AUTHOR=Rain Manjari , Puri Goverdhan Dutt , Bhalla Aashish , Avti Pramod , Subramaniam Balachundhar , Kaushal Vipin , Srivastava Vinod , Mahajan Pranay , Singh Mini , Pandey Navin , Malhotra Pankaj , Goel Sonu , Kumar Krishan , Sachdeva Naresh , Maity Kalyan , Verma Prashant , Dixit Nishant , Gupta Sheetal Jindal , Mehra Priya , Nadholta Pooja , Khosla Radhika , Ahuja Shweta , Anand Akshay 

TITLE=Effect of breathing intervention in patients with COVID and healthcare workers

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.945988

DOI=10.3389/fpubh.2022.945988

ISSN=2296-2565

ABSTRACT=Background: Regulated breathing facilitates ventilation and reduces breathlessness. However, the effect of Yogic breathing on COVID-patients remains unclear. We aimed to evaluate the efficacy of two breathing protocols i.e. Short breathing technique (SBT) and long duration breathing techniques (LBDT). 
Methods: Three groups including COVID-positive, COVID-recovered patients and health care workers (HCWs) were included in the study and segregated into Yoga and control groups.
SBT was administered to COVID-positive patients. SBT and LBDT were administered to COVID-recovered and HCWs. Eighteen biochemical parameters, 6-minute walk test and 1-minute sit-stand test were assessed on 0, 7th and 15th day, where biochemical parameters were the primary outcome. Pre-post estimation of neuropsychological parameters (9 questionnaires) and heart rate variability was carried out. Paired t-test or Wilcoxon rank test was applied for pre-post comparison and Student t-test or Mann-Whitney U test was used for group comparison. Repeated measures test was applied for data recorded at 3-time points.
Results: A significant elevation in WBC count was observed in COVID-positive intervention (p<0.001) and control groups (p=0.003), indicating no role of intervention on change in WBC number. WBC count (p=0.002) and D-dimer (p=0.002) significantly decreased in COVID-recovered intervention group. D-dimer was also reduced in HCWs practicing Yogic breathing as compared to controls (p=0.01). D-dimer was the primary outcome, which remained below 0.50 µg/ml (a cut-off to define severity) in CYG and decreased in RYG and HYG after intervention. Six-minute walk test showed an increase in distance covered among the COVID-positive (p=0.01) and HCWs (p=0.002) after intervention. The high-frequency power (p=0.01) was found reduced in the COVID-positive intervention group. No significant change in neuropsychological parameters was observed.
Conclusion: Yogic breathing lowered D-dimer, which is helpful in reducing thrombosis and venous thromboembolism in COVID-19 patients besides lowering the chances of vaccine-induced thrombotic thrombocytopenia in vaccinated individuals. The breathing intervention improved exercise capacity in mild to moderate cases of COVID-19. Further studies can show if such breathing techniques can influence immunity-related genes, as reported recently in a study. We suggest that Yogic breathing may be considered an integrative approach for management of COVID-patients.
Trial Registration: Clinical Trials Registry – India, CTRI/2020/10/028195
http://ctri.nic.in/Clinicaltrials/login.php