CClinicalTrials.gg
Status unknownNCT04413747YOCOUpdated Aug 7, 2020

Yoga Pranayama Adjuvant to Treat Burden COVID-19

An interventional study of morning Yoga-based breathing support and pre_lunch Yoga-based breathing support in Coronavirus Infection, Cytokine Storm and Mental Disorder, sponsored by Health Ricerca e Sviluppo S.R.L.. Status unknown at 1 site in Italy. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2020-08-07.

Sponsored by Health Ricerca e Sviluppo S.R.L. · Not applicable, Interventional, and Supportive care

The sponsor has not verified this record recently (last verified Aug 2020), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
1,000
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

COronaVIrus Disease or Severe Acute Respiratory Syndrome -CoV-2 or COVID-19, mortality occurs mainly from immunological behavior or by suicide after healing . In both cases, the causal link is coronavirus within the host response. The rationale of use of deep yoga breathing as adjuvant treatment to COVID-19 disease , is linked to the mechanical action to stimulate the vagus nerve through scalene and sternocleidomastoid muscles function of which the continuity of action bring to modulate upto suppress, the inflammatory reflex and pro-inflammatory cytokines overproduction and contextual lowering of the sympathetic stress response as a first cause of sleep and late mental disorders which can increase the annual suicide rate. An easily breathing medical Yoga protocol has been developed to test a cost-effective care provision, training, contact tracing and mass efficacy testing.

Read the detailed description

COronaVIrus Disease or Severe Acute Respiratory Syndrome -CoV-2 or COVID-19, pandemic threatens patients, societies and healthcare systems around the world. Morbidity and lethality have a direct link with the early vicious circles triggered by an acute microcirculation endotheliopathy, a correlated coagulopathy, up to late hypoxic damage of multi organ tissue The host immunity determines the progress of the disease , its lethality and the need of care intensity. The clinical course of the infection consist of three stage of which only the third -which intervenes in a low incidence of patients - need of hospitalization for severe hyperinflammatory syndrome including acute respiratory failure, while first and the second or moderate pulmonary involvement, might manage and monitoring within a homecare program during quarantine. Actually, the rough mortality in Italy is - at the current date - 7.6 % with an expected death of 0.004 of the whole population. The late lethality - still little known - from COVID-19 is to be correlated with mental disorders from stress response emerging from the first three COVID-19's stages and which result in a significant increase in suicides that is estimated at 30% more than expected of 7.4 deaths for 100,000 residents. This estimate can be considered as stage 4 of the disease or post COVID-19 mortality. In this scenario, mortality of COVID-19 is by intensity response of "the host " and in the meantime, a cutoff for homecare, hospitalization and time-related stress disease. Lines of evidence reports that direct-indirect stimulation of vagus nerve bring to the modulating of pro-inflammatory cytokines with effective systemic anti-inflammatory effect and has shown antidepressant effects in chronic treatment resistant depression. Because the vagus nerve is linked to brain regions important in anxiety regulation (locus coeruleus, orbitofrontal cortex, insula, hippocampus and amygdala), this pathway is involved in perceiving various somatic and cognitive symptoms that characterize anxiety and mental disorder disorders. On the basis of all these reasoning we plan to introduce a medical based-yoga deep breathing for activation of vagus nerve by scalene and sternocleidomastoid muscles function during breathing, as an adjuvant of care of the 1-2 and 4 stages of the COVID-19 disease to counteract the cumulative incidence of mortality and better outcome. Medical yoga protocol has been developed and designed to test a cost-effective care provision, training, contact tracing and mass efficacy testing.

02

Conditions studied

  • Coronavirus Infection
  • Cytokine Storm
  • Mental Disorder

Keywords

  • COVID-19
  • CYTOKINE STORM
  • MEDICAL YOGA PRANAYAMA
  • VAGUS NERVE STIMOLATION
  • MENTAL DISORDER
03

In context

COVID-19

7,640 studies on the registry are indexed under COVID-19; 488 are open to participants now.

This study's planned enrollment of 1,000 is above the median of 100 across 4,099 interventional studies indexed under COVID-19.

Browse COVID-19 studies →

Lead sponsor

This is the only study on the registry with Health Ricerca e Sviluppo S.R.L. as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Participant is willing and able to give informed consent for participation in the trial;
  • Male or Female, aged 18 years or above;
  • Diagnosed COVID-19's infection;
  • Informed consent;
  • Having been diagnosed in the last 1 week;
  • In the Investigator's opinion, is able and willing to comply with all trial requirements;
  • Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the trial;
  • Patients who continue to be followed at home.

Exclusion criteria

Exclusion Criteria:

The participant may not enter the trial if ANY of the following apply:

  • No informed consent;
  • Participant is not willing and able to give informed consent for participation in the trial;
  • Female participant who is pregnant, lactating or planning pregnancy during the course of the trial;
  • Hospitalization patients;
  • Having a serious cognitive impairment;
  • Having serious hearing and vision problems;
  • Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial;
  • Participants who have participated in another research trial involving an investigational product in the past 12 weeks.
05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
1,000 participants (estimated)

Study arms

  • Experimental
    Yoga-based breathing support

    Three daily yoga pranayama breathing cycles within existing home-care provision of Covid19's patients (protocols shared dated 27 March 2020 by Italian Society of Infectious and Tropical Diseases - Italian General Practitioners Physician - Italian Society of General Medicine, Italy)

    Behavioral: morning Yoga-based breathing support · Behavioral: pre_lunch Yoga-based breathing support · Behavioral: pre_dinner Yoga-based breathing support

Interventions

  • Behavioralmorning Yoga-based breathing support

    Low and deep inspiration and phonetic syllable OM laryngeal vibration ( OM technique) as expiratory exercises, sitting in easy pose. The length of more than 5 -8 sec. and frequency between 20 and 23 breaths /min. Conscious breath number (n°) of 15 respiratory acts (RAc) and OM technique n° of 5 RAc and Bhramari pranayama n° of 5 RAc.

    Also known as: First procedure

  • Behavioralpre_lunch Yoga-based breathing support

    Low and deep inspiration and OM technique as expiratory exercises, sitting in easy pose.The length of more than 5 -8 sec. and frequency between 20 and 23 breaths /min. Conscious breath number (n°) of 15 respiratory acts (RAc) and OM technique n° of 5 RAc and Surya Bheda pranayama n° of 5 RAc.

    Also known as: Second procedure

  • Behavioralpre_dinner Yoga-based breathing support

    Low and deep inspiration and OM technique as expiratory exercises, sitting in easy pose.The length of more than 5 -8 sec. and frequency between 20 and 23 breaths /min. Conscious breath number (n°) of 15 respiratory acts (RAc) and OM technique n° of 5 RAc and Nadi Shodhana pranayama n° of 5 RAc.

    Also known as: Third procedure

06

What researchers measure

Primary outcomes

  1. Mortality

    COVID-19's Patients mortality all cause: incidence proportion.

    Time frame: 12 months.

  2. Mortality-suicide

    COVID-19's Patients suicide: incidence proportion.

    Time frame: 12 months.

Secondary outcomes

  1. Incidence of hospitalization for respiratory failure of COVID-19's Patients-

    In-hospital COVID-19's Patients oxygen invasive ventilation or high flow oxygen devices :incidence proportion of Brescia COVID-19 respiratory Severity Scale Index (Levels 0-3 worse outcome) cutoff Level ≥ 2 -

    Time frame: 1 months.

  2. Incidence of al home professional psychiatric-psychological interventions for mental disorder.

    Homecare interventions for anxiety and depression requiring drugs treatment: incidence proportion.

    Time frame: 12 months.

  3. Incidence of mental disorder: Beck Depression Inventory-Second Edition (BDI-II).

    Scoring system for depression and anxiety requiring drugs treatment: incidence proportion of BDI-II aggregate components score 0- 63 ( worse outcome) , cutoff \> 29.

    Time frame: 12 months.

  4. Incidence od spleep disorder:Pittsburgh Sleep Quality Index (PSQI).

    Scoring system for sleep disorders requiring drugs treatment: incidence proportion of aggregate PSQI score 0-21 (worse outcome) , cutoff \> 8.

    Time frame: 12 months.

07

Study locations

1 site
  • Ambulatorio Telemedicina Giardino St Lucia
    Massa Lombarda, Ravenna 48024, Italy
08

References and documents

Publications

  • Wenham C, Smith J, Morgan R; Gender and COVID-19 Working Group. COVID-19: the gendered impacts of the outbreak. Lancet. 2020 Mar 14;395(10227):846-848. doi: 10.1016/S0140-6736(20)30526-2. Epub 2020 Mar 6. No abstract available. PubMed 32151325 ↗
  • Johansson PI, Stensballe J, Ostrowski SR. Shock induced endotheliopathy (SHINE) in acute critical illness - a unifying pathophysiologic mechanism. Crit Care. 2017 Feb 9;21(1):25. doi: 10.1186/s13054-017-1605-5. Erratum In: Crit Care. 2017 Jul 13;21(1):187. doi: 10.1186/s13054-017-1756-4. PubMed 28179016 ↗
  • Borovikova LV, Ivanova S, Zhang M, Yang H, Botchkina GI, Watkins LR, Wang H, Abumrad N, Eaton JW, Tracey KJ. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature. 2000 May 25;405(6785):458-62. doi: 10.1038/35013070. PubMed 10839541 ↗
  • Koopman FA, Chavan SS, Miljko S, Grazio S, Sokolovic S, Schuurman PR, Mehta AD, Levine YA, Faltys M, Zitnik R, Tracey KJ, Tak PP. Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis. Proc Natl Acad Sci U S A. 2016 Jul 19;113(29):8284-9. doi: 10.1073/pnas.1605635113. Epub 2016 Jul 5. PubMed 27382171 ↗
  • Thayer JF, Sternberg EM. Neural aspects of immunomodulation: focus on the vagus nerve. Brain Behav Immun. 2010 Nov;24(8):1223-8. doi: 10.1016/j.bbi.2010.07.247. Epub 2010 Jul 30. PubMed 20674737 ↗
  • Lv H, Zhao YH, Chen JG, Wang DY, Chen H. Vagus Nerve Stimulation for Depression: A Systematic Review. Front Psychol. 2019 Jan 31;10:64. doi: 10.3389/fpsyg.2019.00064. eCollection 2019. PubMed 30766497 ↗
  • O'Reardon JP, Cristancho P, Peshek AD. Vagus Nerve Stimulation (VNS) and Treatment of Depression: To the Brainstem and Beyond. Psychiatry (Edgmont). 2006 May;3(5):54-63. PubMed 21103178 ↗
  • Jordana J, Trivino-Salazar JC. Where are the ECDC and the EU-wide responses in the COVID-19 pandemic? Lancet. 2020 May 23;395(10237):1611-1612. doi: 10.1016/S0140-6736(20)31132-6. Epub 2020 May 13. No abstract available. PubMed 32410757 ↗
  • Zhu S, Wu Y, Zhu CY, Hong WC, Yu ZX, Chen ZK, Chen ZL, Jiang DG, Wang YG. The immediate mental health impacts of the COVID-19 pandemic among people with or without quarantine managements. Brain Behav Immun. 2020 Jul;87:56-58. doi: 10.1016/j.bbi.2020.04.045. Epub 2020 Apr 18. PubMed 32315758 ↗

Individual participant data

Plan to share: Yes — The datasets generated during and/or analysed during the current study will be available upon request within a web_ client structure

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 7, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04413747
Lead sponsor
Health Ricerca e Sviluppo S.R.L.
Collaborators
Swami Vivekananda Yoga Anusandhana Samsthana, Bangaluru , India, Yoga Experience Association,Cervia (Ra), Italy, EJTN GEIE, Brussellese, Belgium, Casa di Riposo e Ambulatorio Giardino St Lucia, Massa Lomabarda (Ra) Italy, Halnet Srl, Faenza (Ra), Italy
Responsible party
Sponsor
First posted
Jun 4, 2020
Start date
Aug 15, 2020 (estimated)
Primary completion
Jun 1, 2021 (estimated)
Completion
Sep 30, 2021 (estimated)
Last update
Aug 7, 2020

Study contacts

Giorgio Noera, MD, PhD
Contact
presidenza@healthricercaesviluppo.it
+393358294727
Boris Bazzani, ERYT
Contact
amministrazione@fbiteam.it
+393384841931
Nagarathna Raghuram, MD
principal investigator · Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
HR Nagendra., Eng
study chair · Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
Maria Donatella Barbagallo, MD
principal investigator · Yoga Experience Association,Cervia (Ra), Italy
Enrico Ricci, MD
principal investigator · Yoga Experience Association,Cervia (Ra), Italy
Morena Gaddoni, MD
principal investigator · Casa di Riposo Giardino St Lucia, Massa Lombarda (Ra) Italy
Maria Luisa Vitobello
study director · EJTN GEIE, Brussellese, Belgium
Luca Ghetti, Eng.
study director · Halnet Srl
Fabio Zucchetta, MD
principal investigator · Casa di Riposo Giardino St Lucia, Massa Lombarda (Ra) Italy

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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