Feasibility and preliminary effects of a yoga program developed for adults with post COVID-19 condition (Breathe Easy): pilot randomized controlled trial

Effective medical management of post COVID-19 condition (post COVID) remains challenging. Symptoms are heterogenous, debilitating, and impact health-related quality of life (HR-QoL). Complementary treatments are needed that can be self-managed and improve health. Yoga is a promising strategy that may help reduce post-COVID symptoms but remains understudied. We co-designed a unique yoga intervention for adults with post COVID and evaluated its feasibility and preliminary effects. Two-group parallel, pilot randomized controlled trial with blinded follow-up. Participants were randomized (1:1) to the 12-week yoga program or a health promotion (HP) intervention. All participants received usual medical treatment for post COVID. Twenty-nine participants aged 30-65 years were recruited and randomized (86% follow-up). The primary outcome was feasibility and the secondary outcome was HR-QoL (SF-36). Data were analysed as intention-to-treat using linear mixed modelling. The trial was prospectively registered and approved by the Swedish Ethical Review Authority (2023/06518-01). Through a consensus development process involving yoga experts in India and Sweden, post COVID researchers, and patient advocates, we successfully co-designed and pilot tested a yoga program developed for adults with post COVID. The intervention was feasible with high adherence (≥2 sessions/week = 65%; ≥1 session/week = 95%) and no serious adverse events reported. Preliminary (underpowered) analyses showed no pre-to-post intervention group differences (SF-36 physical health: B = -1.30, 95% CI = -3.60, 1.00, p =.269; mental health: B = 3.49, 95% CI = -0.06, 7.04, p =.054). Participation in a yoga program developed for patients with post COVID was feasible. Adequately powered trials are needed to assess whether yoga may help to improve symptoms associated with the condition. • We led a consensus development process involving yoga experts in India and Sweden; • We pilot tested a yoga program developed specifically for adults with post COVID-19 condition; • The intervention was feasible with high adherence (≥2 sessions/week) and no serious adverse events reported; • Larger randomized controlled trials of yoga for post COVID-19 patients are warranted.