Asanas in Prone Posture and Slow Pranayamas Can Prevent Respiratory Complications in COVID-19 Patients

Worldwide more than 31 million have been reported till date to suffer from corona virus disease 2019 (COVID-19) and daily about ninety thousand positive cases are reported from India alone. About 10% of all symptomatic COVID-19 patients present with dyspnoea, interstitial pneumonia and few may progress to acute respiratory distress syndrome (ARDS) and multiorgan dysfunction.[1] It has been reported that most common cause of mortality in COVID-19 is the acute respiratory failure. Though antiviral drugs, chloroquine or hydroxychloroquine and respiratory therapies are being used, there are several ongoing clinical trials on traditional medicines for development of new therapies and vaccines, till date there is no evidence of any effective treatment for COVID-19. Prone positioning has been used as an effective therapy in ARDS, particularly when initiated in the early stage of it.[2] Recent reports have suggested improvement in respiratory functions of COVID-19 patients with prone positioning.[3] Based on postures in which asanas are practiced, they are divided into standing asanas, sitting asanas, supine asanas and prone asanas.[4] As prone positioning facilitates pulmonary functions, it is expected that prone asanas will promote respiratory functions. The practice of chandranadi pranayama (left-nostril breathing) and anulom-vilom pranayama (alternatenostril breathing) has been demonstrated to have maximum beneficial effects on autonomic and cardiorespiratory functions.[5,6] Pal’s slow pranayama schedule that comprises of both chandranadi and anulom-vilom pranayama’s has been documented to be effective in preventing ventricular tachycardia by improving vagal tone by modulating the process of respiratory sinus arrythmia.[7] Therefore, we assume that practice of asanas in prone posture and slow pranayama will improve cardio-respiratory functions in COVID-19, especially if practiced in the early phase of the disease.The asana-pranayama schedule could be as given below. Following eight asanas in prone posture as described in yoga book,[4] can be practiced: