A SLOW PACED BREATHING INTERVENTION TO REDUCE IL-6 IN PATIENTS WITH COVID-19-PNEUMONIA - A RANDOMIZED CONTROLLED TRIAL
Psychosomatic Medicine
; 84(5):A137, 2022.
Artigo
em Inglês
| EMBASE | ID: covidwho-2003188
ABSTRACT
Elevated pro-inflammatory cytokines such as interleukin-6 (IL-6) have been observed in patients with COVID-19 and are associated with adverse clinical outcomes. Systemic immune response is co-regulated via the vagally-mediated cholinergic anti-inflammatory reflex. Specifically, a reduced release of pro-inflammatory cytokines such as IL-6 from acetylcholine-synthesizing T-cells in response to Vagus nerve stimulation has been demonstrated in animal and human studies. A known non-invasive and cost-effective way to stimulate efferent vagal activity is slow-paced breathing. The primary aim of this RCT was to determine if high-dose breath-assisted reflex stimulation results in a reduction of systemic inflammatory levels in COVID-19 patients. 48 hospitalized COVID-19 patients with moderate to severe symptoms from two isolation wards were randomized to intervention (3x20min app-assisted slow-paced breathing @6BPM) or TAU control group at the University Medical Center Ulm (Germany) during March & May 2021 (BEAT-COVID-study;DRKS00023971). Morning samples of IL-6, protocol adherence and self-reported total practice time (TPT) were collected bi-daily. Mixed effect linear regression models were used to explore groupXtime differences as well as dose-response analysis. Models were adjusted for age, ward, and TAU protocols. A total of 40 patients (age 55±14;67% male) were included to the final analysis. Feasibility of the applied breathing protocol was good, oxygenation was stable and no adverse events occurred. Adherence was closely monitored and sufficient in 17 out of 25 IG patients. Primary reason for non-adherence was worsening of symptoms with transfer to ICU. Reduction rate in inflammatory markers were not statistically different between IG and CG. Investigating the effect of categorized TPT on next morning IL-6 levels in 25 IG patients from 112 intervention days revealed significant lower IL-6 values when TPT exceeded 40min (b= -0.898ln[pg/ml];p=0.043). This is equivalent to a ratio of 59.3% reduction in circulating IL-6 compared to days with TPT <10min. This is the first clinical RCT to study immediate anti-inflammatory effects of a slow-paced breathing protocol in hospitalized COVID-19 patients. Although no between group differences were found in the reduction rate of systemic inflammatory markers, promising dose-response effects were observed.
endogenous compound; interleukin 6; adult; antiinflammatory activity; breathing; clinical article; clinical trial; conference abstract; controlled study; coronavirus disease 2019; dose response; drug megadose; feasibility study; female; gene expression; Germany; human; linear regression analysis; male; oxygenation; protocol compliance; randomized controlled trial; reflex; university hospital; vagus nerve stimulation
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Coleções:
Bases de dados de organismos internacionais
Base de dados:
EMBASE
Tipo de estudo:
Estudo experimental
/
Ensaios controlados aleatorizados
Idioma:
Inglês
Revista:
Psychosomatic Medicine
Ano de publicação:
2022
Tipo de documento:
Artigo
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