Breathing program for long COVID symptoms may improve breathlessness

Reference

Philip KEJ, Owles H, McVey S, et al. An online breathing and wellbeing programme (ENO Breathe) for people with persistent symptoms following COVID-19: a parallel-group, single-blind, randomised controlled trial. Lancet Respir Med 2022 Apr 27. doi: 10.1016/S2213-2600(22)00125-4. Epub ahead of print.

Synopsis

These investigators enrolled 150 adults who presented at 1 of 51 long COVID clinics in the United Kingdom. Eligible patients had ongoing symptoms for at least 4 weeks after the onset of COVID-19 and had ongoing breathlessness. They were assigned, using concealed allocation, to continuing care as usual or to participate in the English National Opera (ENO) Breathe program, which at the time of this writing is only available to patients referred by a post-COVID clinic in England. The program starts with an initial assessment followed by weekly 1-hour group online sessions and self-directed resources for 6 weeks. Briefly, the intervention comprises basic singing techniques --posture and breath control, including using a straw to lessen vocal fold pressure -- and lullabies to practice the techniques and to lessen anxiety. Patients practiced on their own and were not part of a singing group. Using intention-to-treat analysis, health-related quality of life was measured by the RAND 36-item short form survey instrument. Mental health, but not physical health, composite scores were significantly better at the end of the trial and were better, as would be expected, in patients who adhered to the program. Breathlessness, using a 100-mm visual analog scale, changed similarly in both groups over time, except for breathlessness while running, which was significantly improved with treatment. Dyspnea and anxiety measures were not different between the groups. More than 20% of the patients in the ENO Breathe group dropped out of the study, mostly because they couldn't meet at the assigned group times.