key: cord-0934621-dggtsfyb
authors: Sarwal, Rakesh; Dhamija, Rajinder K.; Jain, Khushbu; Basavaraddi, Ishwar V.
title: Efficacy of Pranayama in Preventing COVID-19 in Exposed Healthcare Professionals: A Quasi-Randomized Clinical Trial
date: 2022-05-06
journal: J Ayurveda Integr Med
DOI: 10.1016/j.jaim.2022.100586
sha: 13dcb15123bc3c02cb4038028a277e96b4c81274
doc_id: 934621
cord_uid: dggtsfyb

Background The global outbreak of COVID-19 has created a challenging situation, especially for the frontline Health Care Professionals (HCPs), who are routinely exposed and thus are at a higher risk of infection. Pranayama, a component of Yoga, is known to improve immune function and reduce infection. However, no clinical trial on the efficacy of Pranayama in preventing COVID-19 has yet been conducted. Aim & Objective This quasi-randomized clinical trial assessed the efficacy of Pranayama in preventing COVID-19 infection in HCPs routinely exposed to COVID-19. Methodology The study was conducted at 5 different COVID-19 hospitals, India in year 2020. The inclusion criteria were being an HCP exposed to COVID-19 patients and being negative on antibody tests. 280 HCPs were recruited sequential and assigned to intervention and control groups. Of these, 250 HCPs completed the study. The intervention was twice daily practice, for 28 days, of specially designed Pranayama modules under the online supervision of Yoga instructors. The HCPs in the control group were advised to continue their normal daily routine, but no pranayama sessions. Participants who developed symptoms suggestive of COVID-19 were subjected to Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) or Point of Care Rapid Antigen Test (RAT) for confirmation of the diagnosis. All the participants were tested for antibodies to COVID-19 on 28th day of the intervention to detect any asymptomatic infection. Results The intervention (123) and control (127) groups had comparable demographics and baseline characteristics. At end of 28 days of intervention, nine participants in the control group and one in the intervention group developed COVID-19 (P-value: 0.01, Odds Ratio: 0.107, 95% CI: 0.86; Risk Ratio: 0.11, 95% CI: 0.89). Conclusion The intervention of twice daily practice of the Pranayama module for 28 days in HCPs might have made a noteworthy contribution and may have helped in preventing COVID-19 infection. CTRI Number CTRI/2020/07/026667.

COVID-19 pandemic is a global challenge to public health 1 . Among other measures, most 33 countries have enforced lock-downs or stay-at-home orders 1 as a mitigation measure. Health Care 34 Professionals (HCPs) being exposed to cases as a part of their professional duties have been in 35 particular susceptible to COVID-19 infection. 36 HCPs being on the front lines of COVID-19 crisis, have reported psychological stress 2 , tiredness, 37 sleep problems 2 because of fear, and interruption of normal life due to heavy patient loads 3 . HCPs Interventions which have an immune-modulatory effect, could serve as a preventive as well as a 45 therapeutic measure for patients with COVID-19 infection 10, 11, 12, 13, 14 . During this outbreak, 46 numerous herbal products have also been explored as alternative therapies 15, 16 . 47 Yoga, which originated in ancient India, is also recognized as a form of a Complementary Therefore, the present study was conducted to assess the efficacy of Pranayama, which 63 is a part of yoga, in preventing COVID 19 infection in the HCPs exposed to COVID-19 infection. Two groups of HCPs had comparable age, socio demographic characteristics, exposure status 157 and comparable co-morbidities (Table-4 ).

During the period of the study, three participants from the control group developed symptoms (Table 6 ) . They belonged to both genders, diverse age and professional 168 groups with 80% of them being middle-aged. Of the 10 HCPs (4 females, 6 males) who contracted 169 COVID-19 infection, nine were from the highly exposed group and 8 were healthy with no 170 comorbidities ( Table 6 ). The lone participant from the experimental group who tested positive 171 on antibody testing at the end of intervention probably had asymptomatic COVID 19 infections. Pranayama modules to prevent COVID-19 in HCPs routinely exposed to the virus.

The intervention of twice daily practice of Pranayama administered by trained Yoga instructors 252 in HCPs exposed to active cases might have helped and made a noteworthy contribution in Note: Each breathing comprises 6 seconds inhalation and 6 seconds exhalation.

*Initially the practice of all 4 breathing practices started with 10 rounds each and gradually over a period of 5-7 days increased to 15 rounds each.

There is no retention of breathing in the evening session. For the breathing practices in the evening yoga sessions were designed as follows:

Day 1& 2: subjects were practiced Inhalation (4 seconds): Exhalation ratio (4 seconds) Day 3& 4: Inhalation (5 seconds): Exhalation ratio (5 seconds) Day 5 & 6: Inhalation (6 seconds): Exhalation ratio (6 seconds)

Rest/gap has been given between each pranayama J o u r n a l P r e -p r o o f 

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Exhalation (4 seconds) Day 2: I: E ratio (5 seconds :5 seconds) Day 3: I: E ratio (6 seconds :6 seconds) Day 4 & 5: I: RI:E ratio (6 seconds :3 seconds :6 seconds) Day 6 & 7: I: RI: E: RO ratio

th day onwards they continuously practiced with 6 seconds of inhalations: 3 seconds of retentions: 6 seconds of exhalations: 3 seconds of retention ratios