A new study published in The Lancet Digital Health has found that “ENO Breathe,” an online breathing and wellbeing program developed by English National Opera in collaboration with clinicians from Imperial College Healthcare NHS Trust, delivers significant improvements for people living with long COVID.

Launched in September 2020, ENO Breathe is a free six-week program that uses singing techniques to improve breathing, wellbeing, and quality of life. Delivered through live online group sessions led by ENO vocal specialists, the program is available nationally via referral from partnered NHS Trusts. To date, more than 4,829 participants have completed the program, with 80 percent reporting improved breathlessness, 73 percent reporting reduced anxiety, and 87 percent saying it had a positive impact on their overall wellbeing.

The newly published study analyzed outcomes from 1,438 participants referred through 51 NHS long COVID services across England. It found clinically meaningful improvements across multiple validated health measures, with 61 percent of participants achieving clinically important reductions in breathlessness. No serious adverse events were reported.

“Long COVID is still a really important health issue, negatively impacting quality of life and limiting what people can do, and this study shows that ENO Breathe can improve a range of symptoms in the real world, not just in a clinical trial. The participants experienced important improvements in respiratory symptoms, mental health, and quality of life, all while doing something they really enjoyed. Central to this programme is that it treats people as people, not just numbers, and capitalises on their pleasure in joining in with others,” said lead author of the study, Dr Keir Philip, Clinical Lecturer at the National Heart and Lung Institute at Imperial College London and an Honorary Consultant in Respiratory and General Medicine at Imperial College Healthcare NHS Trust, per an official press release.

Building on the findings, ENO will pilot an expanded version of the program in London and Greater Manchester through 2026-27, extending support to people living with COPD and asthma.