Using Qigong to manage COVID-19 in older adults

By Dr. Liji Thomas, MDMay 25 2020

A recent study published in The American Journal of Geriatric Psychiatry in May 2020 reports on the possible usefulness of the integrative practice called Qigong to prevent and manage COVID-19 in older adults.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused the COVID-19 pandemic that first began in Wuhan, China, has now spread to over 188 countries and territories, with a staggering 5.4 million cases and over 344,000 deaths so far. Disease trends show that the disease is more severe in older people as well as individuals suffering from pre-existing medical conditions.

Alternative Remedies for COVID-19

In the absence of an effective vaccine or specific therapeutic drug, researchers are exploring a host of possibilities, from drugs that block inflammatory pathways like tocilizumab to antivirals like remdesivir. However, practitioners of complementary and alternative medicine are not to be left behind.

Traditional Chinese Medicine (TCM) and Qigong are reported to have been valuable in controlling the spread of the pandemic in China. The National Health Commission of China has recommended the Chinese herbal decoction Qingfei Paidu for mild to moderate COVID-19. The same herbs were used in conjunction with Western medicine to treat severe COVID-19 disease.

Close up of a man's during Qigong routine. Image Credit: Joanne Laskey / Shutterstock

In field hospitals set up to isolate patients with mild disease, rather than practice home quarantine, patients were treated with Ba Duan Jin Qigong under the tutelage of TCM practitioners. This was both a valuable means of exercise and a therapeutic approach.

COVID-19 is a viral infection which, however, becomes severe due to both immunosuppression and the cytokine storm syndrome. Patients with severe disease may rapidly develop severe respiratory difficulty. Once they recover, they may need rehabilitative management, including training of the respiratory muscles, whole-body exercise, and mental rehabilitation.

What is Qigong?

Qigong is a Chinese word formed of two characters, Qi and Gong. The first denotes the energy that underlies all human life processes, and Gong refers to the practice of developing control over this energy. In TCM, Qi is involved in virtually every process of health and disease. There are different types, such as defensive Wei Qi and organ-specific Qi, that is in charge of the function of each organ.

Qi moves through channels called meridians, running over the surface of the trunk and the limbs, and extending to the internal organs. The practice of Qigong is, therefore, a mind-body integrative skill, meant to train the practitioner to regulate body, breath, and mind. The operative techniques are adjustment of the posture and body movements, through gentle and smooth movements aimed at relaxation.

Another technique that forms part of Qigong is breath regulation, aimed at producing slow, long, and deep breaths. Abdominal breathing and breathing with phonation, or while making audible sounds, are both commonly used Qigong respiratory components.

Finally, mind regulation is an integral part of Qigong, via focused attention and visualization, similar to meditation. Though its roots go back to ancient times, the first modern Qigong institute came up in China in 1945.

Qigong is suitable for the elderly because of its smooth and gentle movements. It could be widely applied in geriatric medicine, to treat painful musculoskeletal disorders, strengthen muscle, and achieve pain relief. Its mental calming effects could help deal with psychosomatic disorders as well as mood disorders and even cognitive impairment.

Qigong can be practiced as dynamic or passive techniques, with each having its specific benefits.

Qigong in Respiratory Infections - Mechanisms

In TCM, respiratory infections are thought to be due to external pathogens that throw off the balance between good and evil. Defensive Wei Qi is thought to fight against them, this being the embodiment of immunity. Thus the strength of Wei Qi in relation to the exogenous pathogens decides the course of the disease and the outcome.

In older people, the organ function declines, and chronic medical conditions set in, causing their energy to decline. This is thought of as a deficiency of Qi and blood. TCM practitioners say that Qigong may help prevent and promote recovery from respiratory infections in such conditions because of its regulatory function in the human body, including Wei Qi.

Some of the possible mechanisms for the benefits of Qigong in this setting include:

• Reduction in stress due to meditation-induced physiological changes, such as decreased levels of stress hormones, reducing reactivity to negative thoughts, and regulating the level of reactivity of the hypothalamus-pituitary-adrenal axis and the autonomic nervous system. It could also change the function of various brain areas related to inflammation and stress and enhance a feeling of control.
• Strengthening respiratory muscles, especially the diaphragm
• Reducing inflammation via lower IL-6 and increased IL-10 levels, which are pro-inflammatory and anti-inflammatory, respectively
• Enhanced immune function by increasing the number and activity of both specific and nonspecific immune cells

Qigong in Respiratory Infections – Clinical Proof

Some studies show that Qigong can reduce the incidence of respiratory infections for two years after this exercise, and the incidence only went down afterward. Another study reports that Qigong, as practiced by swimmers, was linked to a significant reduction in colds and flu. The more frequent the practice, the fewer were the symptoms.

For those who already have an acute respiratory infection, Qigong may shorten the total duration of infection.

Qigong in Respiratory Infections – Rehabilitation

After recovering from a severe respiratory infection, respiratory muscles may be weakened. Limited research shows a possible role of Qigong in the rehabilitation of other lung diseases associated with respiratory impairment. For instance, in chronic obstructive pulmonary disease (COPD), Qigong could improve lung function and exercise capability, as well as the quality of life. Further research is necessary, given often conflicting findings.

Learning and Practicing Qigong

Videos alone are not a reliable source of Qigong instruction. A medical consultation should be held before beginning any new form of exercise, including Qigong. The current study recommends three forms of Qigong for use in elderly patients with respiratory disease.

These are Ba Duan Jin, Liu Zi Jue, and abdominal breathing, with their low intensity, smooth movement, and ease of learning, without a large range of movement or the need for wide-open spaces.

Taking the small amount of research into consideration, the authors say, “Qigong may be potentially useful for the prevention, treatment, and rehabilitation of respiratory infections, including COVID-19. The elderly, in particular, could benefit from Qigong during the ongoing pandemic.”