Akila Rayapuraju

Background: Long COVID affects millions of adults, causing fatigue, dyspnea, cognitive symptoms, and mood disturbances. Effective treatments are limited, and many patients cannot access multidisciplinary rehabilitation because of symptom fluctuation, distance, or specialist shortages. Web-based mind-body interventions may offer accessible, scalable support alongside existing care. Objective: We assessed the feasibility and efficacy of a 3-week web-based yogic breathing and meditation program for long COVID symptoms. Methods: In this completed, parallel-group, 6-week waitlist-controlled, mixed methods randomized trial, adults aged 18‐70 years with physician-confirmed long COVID were recruited from US clinics and self-referral and randomized 1:1 to immediate intervention or waitlist control, crossing over at week 3. The program included live webinars and video guides for daily self-practice. The primary outcome was adherence, defined as practicing at least 1 of 3 techniques on ≥4 days/week across all 3 active-intervention weeks. Secondary outcomes included perceived stressmood, quality of life, dyspnea, and somatic symptom burden, assessed at baseline, 3 weeks, and 6 weeks. Quantitative outcomes were analyzed using linear mixed-effects models. Semistructured interviews and focus groups underwent conventional content analysis and were integrated with quantitative findings via joint display. Results: Of 189 randomized participants, 1 was excluded post-randomization for a protocol deviation; 188 (96 intervention, 92 waitlist) began the study. Of these, 124 reached the active intervention period. Among 58 with complete adherence data, 55% met the adherence threshold (60% intervention, 50% waitlist). Secondary analyses included 185 participants with ≥1 assessment. No adverse events were reported. Compared with waitlist control, the intervention group showed greater reductions in total mood disturbance (MD=−10; 95% CI −19 to −1.6; P=.02), negative mood (MD=−7.5; 95% CI −15 to −0.44; P=.04), fatigue (MD=−2.9; 95% CI −4.6 to −1.2; P=.001), MDP immediate perception (MD=−5.5; 95% CI −9.4 to −1.6; P=.007), MDP sensory dimension (MD=−5.1; 95% CI −8.5 to −1.7; P=.003), and somatic symptom burden (MD=−2.0; 95% CI −3.6 to −0.38; P=.02), and greater increases in positive mood (MD=2.9; 95% CI 0.66 to 5.1; P=.01) and vigor (MD=1.7; 95% CI 0.18 to 3.2; P=.03). Stress and quality of life did not differ significantly. Qualitative findings identified medical-system struggles, digital delivery, online support, and practices’ effects on resilience and identity. Integration showed convergence for dyspnea and mood, divergence for stress and quality of life, and expansion through themes of medical-system experience, identity, and social connection. Conclusions: This web-based yogic breathing and meditation program appears feasible and accessible for people with long COVID. By combining 3 practices in a brief protocol and integrating quantitative and qualitative evidence, this study provides novel insight into both symptom outcomes and dimensions of recovery not captured by standardized measures. Further evaluation should assess longer-term effects and integration into scalable telehealth and virtual rehabilitation pathways.

Background: Anxiety and other non-motor symptoms can greatly diminish quality of life in people with Parkinson's Disease (PD). Yet, few randomized controlled trials (RCTs) have assessed accessible, non-pharmacological mental health treatments for people with PD. Objective: To assess the feasibility and impact of brief, remotely-delivered meditation and breathwork on neuropsychiatric symptoms in people with PD. Methods: In this 18-week RCT, intervention participants attended weekly webinars for six weeks, while waitlisted controls maintained their usual routine before crossing over at six weeks. Participants were assessed for weekly compliance trends (primary outcome) and changes in anxiety (primary outcome), depression, perceived stress, and other non-motor symptoms at 6-week intervals: baseline and weeks 6 (T2), 12 (T3), and 18 (T4). Weekly compliance was collected in each group for 12 weeks. Anxiety was measured using the Parkinson's Anxiety Scale. Results: There was a significant decrease in the primary outcome, anxiety, in the intervention group (n = 17) compared to the waitlist control (n = 21) after 6 weeks of meditation and breathwork practice (mean difference (MD)= −5.0, 95% CI [−9.5, −0.49], P = .03). Within-group analysis further confirmed a significant reduction in anxiety (MD = −4.7, 95% CI [2.10,7.33], P < .001) in the intervention group (n = 28). Thirty-one percent of participants met the compliance definition. Conclusion: Remotely-delivered meditation and breathwork through the BSM program significantly reduced anxiety in individuals with PD in our study and may be a promising non-pharmacological therapy. A larger RCT with continuous wellness coaching is warranted to more rigorously assess efficacy and optimize protocols. Clinical trial registration: ClinicalTrials.gov, NCT05335850, https://clinicaltrials.gov/study/NCT05335850

BACKGROUND Long COVID imposes severe functional impairments and strains health systems. Web-based mind-body interventions may offer scalable support for multidisciplinary care. OBJECTIVE We assessed the feasibility and efficacy of a 3-week web-based yogic breathing and meditation program on quality of life in individuals with long COVID. METHODS : In this 6-week waitlisted, mixed-methods randomized controlled trial, participants were recruited from U.S. long COVID clinics and self-referrals and randomized to intervention or waitlist control groups. The meditation and breathwork intervention was delivered via instructor-guided live webinars supplemented with video guides for daily self-practice. Weekly logs tracked compliance, and secondary outcomes including perceived stress (PSS), mood (POMS), quality of life (SF-12), multidimensional dyspnea (MDP), and somatic symptom burden (SS8), were assessed at baseline, 3 weeks, and 6 weeks. The data was analyzed using linear mixed effects models with qualitative insights regarding experience with long COVID and the intervention contextualizing quantitative findings. RESULTS Of the 68 participants who completed the study, 50 (74%) were compliant. Linear mixed-effects models showed significant between-group improvements favoring the intervention group, with small to medium effect sizes. Compared with the waitlisted control, the intervention group demonstrated greater reductions in total mood disturbance (Mean Difference (MD) = -10; 95% CI [-19 to -1.6]; p = .02), immediate perception (MD = -5.5; 95% CI [-9.4 to -1.6]; P = .007) and sensory dimension (MD = -5.1; 95% CI [-8.5 to -1.7; P = .003] of dyspnea, and somatic symptom burden ( MD = -2.0; 95% CI [-3.6 to -0.38]; P = .02) over time in the intervention group compared to the waitlisted control. No meaningful differences were found in stress and quality of life. Qualitative findings complemented the quantitative result revealing four key themes: (1) meditation building resilience, (2) online support networks, (3) benefits and challenges of digital delivery, and (4) struggles with the medical system. CONCLUSIONS This web-based, low-burden yogic breathing and meditation program appears feasible and accessible for people with Long COVID. In three weeks, participants demonstrated meaningful improvements across validated clinical scales for mood, dyspnea, and somatic symptoms as well as in their lived experience of symptom management. These findings support further evaluation of this scalable approach as a supportive intervention while more definitive medical treatments continue to evolve. CLINICALTRIAL ClinicalTrials.gov (NCT05139979); https://clinicaltrials.gov/study/NCT05139979