Yogic Breathing and Guided Meditation Practices Address the Mental Fear Associated with Breathing, Fostering a Sense of Self-Stability among Long COVID Patients: A Mixed Methods Study

Background: Evidence-based treatments for Long COVID are emerging, with support for mind-body approaches in aiding recovery. We assessed the feasibility of simple online yogic breathing and meditation practices and whether they could improve the quality of life of Long COVID patients.

Methods: This six-week waitlisted, mixed-methods randomized controlled trial recruited participants from US Long COVID clinics and self-referrals. Participants were randomized into an intervention or waitlisted control (WC) group. The intervention group learned three practices via webinars in week one, while the WC group learned in week 3. Weekly logs tracked compliance, and secondary outcomes including perceived stress (PSS), mood (POMS), quality of life (SF-12), multidimensional dyspnea (MDP), and somatic symptom burden (SS8), were assessed at three time points. Quantitative data were analyzed using intention-to-treat principles, and qualitative insights were derived from content analysis of 1:1 interviews.

Findings: Between September 15, 2021, and February 7, 2024, 557 participants were assessed for eligibility out of 758 referrals. Of these, 188 were randomized (n=146 females and n=38 males) to either the intervention group (n=96) or WC group (n=92). Compliance trends showed participants who completed the study practiced daily. While PSS outcomes remained unchanged, the intervention group showed improvements in POMS (n2 = 0·05, p = 0·02), the immediate perception domain (n2 = 0·06, p= 0·02) and sensory domain of MDP (n2 = 0·09, p < 0·01), and in SS8 (n2 = 0·06, p = 0·016). Content analysis of 1:1 interviews identified three key themes: (1) a journey of uncertainty, (2) yoga building resilience, and (3) alternative treatments to a standard of care.

Interpretation: These findings suggest that the practices are associated with improved mood, breathlessness, and somatic symptom burden in those with Long COVID, offering practical tools for managing symptoms with potential for scalability.