Role of Ayurveda and Yoga-Based lifestyle in the COVID-19 Pandemic - A Narrative Review

Usefulness of Yoga in the management of tinnitus during COVID-19: A narrative review

The emergence of Coronavirus disease 2019 (COVID- 19) has resulted in an unprecedented global health crisis. Tinnitus is the most commonly reported symptom when the COVID-19 impacts the auditory-vestibular system. There are a variety of management strategies for amelioration of tinnitus including Yoga. The present review deals with three issues: one, occurrence of tinnitus in persons affected by COVID-19; two, the impact of COVID-19 situation on tinnitus severity; and three, the potential of Yoga as an intervention strategy. Literature search was carried out through search engines like PubMed, Cochrane, Web of Science and Google scholar using keywords like 'tinnitus', 'COVID-19' and 'Yoga'. The relevant studies were identified and the findings summarized in a narrative manner. Based on the evidence obtained in the present review, the authors propose that yoga can be used as an effective strategy in overcoming the psychosocial factors associated with COVID-19 particularly in this pandemic and related lockdown situation. It is also proposed here that teleyoga can serve as a practical, feasible and safe mode for providing therapeutic services for tinnitus-related issues particularly in the present pandemic situation.

Yoga for COVID-19: An ancient practice for a new condition - A literature review

A substantial proportion of people with acute COVID-19 develop post-COVID-19 condition (previously known as long-COVID) characterized by symptoms that persist for months after the initial infection, including neuropsychological sequelae. Post-COVID-19 condition frequency varies greatly according to different studies, with values ranging from 4 to 80% of the COVID-19 patients. Yoga is a psycho-somatic approach that increases physical, mental, emotional and spiritual strength, and connection. Yoga practice enhances innate immunity and mental health, so it can be used as complementary therapy in the COVID-19 treatment, namely the post-COVID-19 condition. In this article, we conducted a literature review on yoga and COVID-19, finding that an intervention comprising asana, pranayama, and meditation may be a strategy of choice for these patients' recovery. However, further studies are needed to show its effectiveness in this, still unknown, context.

Adjunct tele-yoga on clinical status at 14 days in hospitalized patients with mild and moderate COVID-19: A randomized control trial

Background

The initial insights from the studies on COVID-19 had been disappointing, indicating the necessity of an aggravated search for alternative strategies. In this regard, the adjunct potential of yoga has been proposed for enhancing the effectiveness of the standard of care with respect to COVID-19 management. We tested whether a telemodel of yoga intervention could aid in better clinical management for hospitalized patients with mild-to-moderate COVID-19 when complemented with the standard of care.

Methods

This was a randomized controlled trial conducted at the Narayana Hrudyalaya, Bengaluru, India, on hospitalized patients with mild-to-moderate COVID-19 infection enrolled between 31 May and 22 July 2021. The patients (n = 225) were randomized in a 1:1 ratio [adjunct tele-yoga (n = 113) or standard of care]. The adjunct yoga group received intervention in tele-mode within 4-h post-randomization until 14 days along with the standard of care. The primary outcome was the clinical status on day 14 post-randomization, assessed with a seven-category ordinal scale. The secondary outcome set included scores on the COVID Outcomes Scale on day 7, follow-up for clinical status and all-cause mortality on day 28, post-randomization, duration of days at the hospital, 5th-day changes post-randomization for viral load expressed as cyclic threshold (Ct), and inflammatory markers and perceived stress scores on day 14.

Results

As compared with the standard of care alone, the proportional odds of having a higher score on the 7-point ordinal scale on day 14 were ~1.8 for the adjunct tele-yoga group (OR = 1.83, 95% CI, 1.11-3.03). On day 5, there were significant reductions in CRP (P = 0.001) and LDH levels (P = 0.029) in the adjunct yoga group compared to the standard of care alone. CRP reduction was also observed as a potential mediator for the yoga-induced improvement of clinical outcomes. The Kaplan-Meier estimate of all-cause mortality on day 28 was the adjusted hazard ratio (HR) of 0.26 (95% CI, 0.05-1.30).

Conclusion

The observed 1.8-fold improvement in the clinical status on day 14 of patients of COVID-19 with adjunct use of tele-yoga contests its use as a complementary treatment in hospital settings.