NEW YORK (Reuters Health) - An online program to help those with breathing issues due to long COVID improved participants' quality of life, but not their breathlessness, a new study finds.
The 150 participants were randomly assigned to usual care or an intervention that leaned on signing techniques to retrain breathing revealed that while the program improved mental health composite (MHC) scores, it did not improve physical health composite (PHC) scores, researchers report in The Lancet Respiratory Medicine.
"Our findings suggest that mind-body and music-based approaches, including practical, enjoyable symptom-management techniques have a role in supporting recovery for people with persisting breathlessness following COVID-19," said Dr. Keir Phillip, a respiratory SpR/clinical research fellow at the National Heart and Lung Institute at Imperial College London.
"All diseases affect us biologically, psychologically, and socially, so it's important that we develop approaches to address all these impacts," Dr. Phillip told Reuters Health by email. "Improving dialogue and collaboration between evidence-based medicine and complementary and alternative medicine has great potential to improve health."
To explore whether signing techniques delivered through an online program could improve long-COVID patients' breathlessness, Dr. Phillip and his colleagues conducted a parallel-group, single-blind, randomized controlled trial in patients who had been referred from one of the 51 UK-based collaborating long-COVID clinics in which multidisciplinary team assessment and management took place.
Evaluation of the patients included investigations such as lung-function testing, echocardiography and further imaging deemed appropriate for each individual. The team identified treatable pathology and managed it based on current knowledge, the researchers note.
Adult patients with chronic breathlessness syndrome as a result of COVID-19 were invited to participate in the trial. The 150 who participated were randomly assigned to receive either usual care or were enrolled in the English National Opera (ENO) Breathe program that focused on breathing retraining using singing techniques.
The impact of the program was assessed using the RAND 36-item short-form survey instrument MHC and PHC scores. Secondary outcome measures were the chronic obstructive pulmonary disease assessment test score, visual analogue scales (VAS) for breathlessness, and scores on the dyspnea-12, the generalized anxiety disorder 7-item scale, and the short-form-6D.
Compared with usual care, ENO Breathe was associated with a significant improvement in MHC score (regression coefficient, 2.42), but not PHC score (RC, 0.60). The VAS for breathlessness (running) favored ENO Breathe participation (-10.48) but there were no other statistically significant between-group differences in secondary outcomes.
It's not surprising that the therapy did not improve breathlessness because "it does not address the underlying disease processes driving long-COVID," Dr. Phillip said. "Further randomized controlled trials of interventions targeting both symptoms and underlying pathology are required to create a portfolio of evidence-based management options adaptable to the specific needs of individual patients. Currently the best approach is to work with a long-COVID specialist to create a personalized approach, based on the best available evidence in the context of the patient and physician's experience."
SOURCE: https://bit.ly/3ssPDsC and https://bit.ly/3suTx4m The Lancet Respiratory Medicine, online April 27, 2022
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