Lancet study: Singing helps battle long Covid

In London, a group of Opera singers is helping people with long Covid reset their breathing patterns’.

According to a study published in The Lancet Respiratory Medicine on May 7, it appears to be working. The online breathing and wellness programme, ENO Breathe, was developed by clinicians at Imperial College, London, and English National Opera.

It combines breathing retraining and singing techniques with mental Health support for patients struggling with persistent breathlessness after a Covid-19 infection.

The ENO Breathe programme

What started as an experimental therapy has shown positive results in thousands of patients. The researchers say the programme is now being expanded to include other causes of breathlessness, such as asthma and chronic obstructive pulmonary disease.

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This is one of the first clinical trials to report an effective intervention for people with post-Covid syndrome, also known as long Covid.

“This is the largest real-world evaluation of a creative health intervention for long Covid breathlessness to date," said the study's lead author Dr Keir Philip, Clinical Lecturer in Respiratory Medicine, National Heart and Lung Institute, Imperial College London.

Dr Philip told Firstpost over email that the analysis included data from more than 1,400 participants referred through 51 NHS long Covid services across England.

“ENO Breathe combines breathing retraining, singing techniques, and wellbeing support, delivered digitally," he said.

“It was created by the English National Opera in partnership with the Imperial College Healthcare NHS Trust and wider NHS partners. With research from us at the National Heart and Lung Institute, Imperial College London," he added.

Why long Covid breathlessness matters

Long Covid remains one of the least understood legacies of the pandemic. Some patients develop respiratory, neurological, and mental health symptoms that persist for years after Covid-19 infection.

According to the study, long Covid remains a major public health issue for which few evidence-based treatment options exist. In the UK, an estimated 2 million people (3.3 per cent of the population) were living with long Covid as of 2024. Breathlessness is a common long Covid symptom, with complex biopsychosocial components and frequently debilitating impacts.

Global estimates suggest that roughly 10-20 per cent of those infected with Covid-19 have long-lasting symptoms. Breathlessness is among the most common and debilitating symptoms.

Even though Covid-19 is no longer a pandemic, infections are still reported worldwide. According to the WHO, 20,441 Covid-19 cases were reported worldwide in the last 28 days, though reporting has sharply declined in many countries, including India.

Like other countries, India also encounters a significant proportion of the population suffering from the aftereffects of Covid-19 infection, imposing a considerable burden on the healthcare system. According to some sources, over 50 to 100 million people could have suffered from long Covid in India.

How significant was the improvement?

Researchers said 61 per cent of participants showed clinically important improvements in breathlessness. Participants reported improved mental health and quality of life.

Additionally, a 10.48 point reduction in breathlessness was seen during physical activity, denoting that participants also showed improvement in respiratory symptoms and anxiety.

"Findings further reveal around 40 per cent experienced significant improvement in mental health. Among participants completing the six-week programme, we observed clinically meaningful improvements across multiple validated outcomes relating to breathlessness, quality of life, mental health and well-being, and respiratory symptoms,” says Dr Philip.

How does singing help?

The benefits, researchers say, appear to result from a combination of physical and psychosocial effects.

According to doctors, many long Covid patients develop inefficient breathing patterns, including shallow breathing, irregular breathing patterns, or overuse of the chest muscles.

The singing exercise helped retrain breathing by slowing the breathing rate and improving breathing control.

“It helped people improve the way they breathe in terms of the rhythm, rate, and muscles used, as inefficient breathing patterns can be very common. Engaging with breathing in a calm and enjoyable way seems to help reduce anxiety that had become associated with breathing,” says Dr Philip.

“Important factor for some people is the community of people with shared experience, not feeling different or judged, which helped rebuild confidence and was positive for mental health,” he adds.

The programme he says, does not cure the condition; it provides people with tools and experiences that help them manage their symptoms and improve their quality of life.

A bigger shift in medicine

The study's findings suggest that including “art in health” interventions can be helpful and part of holistic healthcare.

Some hospitals and researchers are studying interventions such as dance therapy for Parkinson’s disease, music therapy for dementia, or art therapy for trauma; the study is a step in that direction.

For these long Covid patients, learning to breathe through song is a step towards living a normal life again.