Key result
Delayed post-COVID-19 heart rate recovery is linked to ~57m shorter 6MWD and greater dyspnea.
Why the study?
COVID-19 can cause persistent cardiovascular autonomic dysfunction, and evaluating heart rate recovery after the 6MWT may help identify residual functional limitations.
Does delayed heart rate recovery after the six-minute walk test correlate with worse functional capacity and dyspnea in post-COVID-19 patients?
Cross-Sectional (n=75)
Does delayed heart rate recovery after the six-minute walk test correlate with worse functional capacity and dyspnea in post-COVID-19 patients?
Answers are grounded in this paper and cite their sources.
Delayed heart rate recovery after the six-minute walk test in post-COVID-19 patients is associated with worse functional capacity and greater dyspnea, suggesting persistent autonomic dysfunction.
Introduction: Coronavirus disease 2019 (COVID-19) can cause persistent cardiovascular alterations, including autonomic dysfunction. Heart rate (HR) recovery (HRR) after exercise is a simple marker of autonomic modulation associated with functional capacity and clinical prognosis. Evaluating HRR during the six-minute walk test (6MWT) may help identify residual functional limitations in diverse patients. Objective: To compare pulmonary function, maximal inspiratory pressure (MIP), functional capacity, dyspnea, fatigue, and functional status in post-COVID-19 patients. Methods: This cross-sectional study included 75 adults (mean age: 47.6 ± 13.1 years; 54.7% male) who recovered from COVID-19 divided into 2 groups based on HRR 1 min after the 6MWT: delayed (≤12 beats/min); and non-delayed (>12 beats/min). Pulmonary function, MIP, exercise capacity (via 6MWT), dyspnea, muscle fatigue, and functional status were assessed. Results: Based on HRR 1 min after 6MWT, 27 (36%) participants were classified with abnormal HRR and 48 (64%) with normal HRR. There were statistical differences between the groups regarding demographic or clinical characteristics, pulmonary function, MIP, muscle fatigue, or functional status (p > 0.05). The delayed HRR group exhibited a smaller reduction in HR in first minute of recovery (ΔHR = 6 vs. 23 beats/min), higher baseline HR (p = 0.010), and greater dyspnea (p = 0.020). Furthermore, this group exhibited worse functional performance in the 6MWT, with shorter distance walked (437.33 vs. 494.27 m; p = 0.019) and a lower percentage of predicted distance (74.66 ± 12.98% vs. 82.94 ± 15.71%; p = 0.023) compared with the non-delayed HRR group. Conclusion: Delayed HRR post-COVID-19 was associated with poorer functional performance and greater dyspnea, regardless of pulmonary function. The blunted reduction in HRR after exertion suggests impaired cardiovascular autonomic modulation, possibly related to attenuated vagal reactivation, which may contribute to exercise intolerance observed in this population.
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Fonseca et al. (2026) conducted a cross-sectional in Post-COVID-19 (n=75). Delayed heart rate recovery (≤12 beats/min) vs. Non-delayed heart rate recovery (>12 beats/min) was evaluated on Distance walked in the 6-minute walk test (meters) (p=0.019). Delayed heart rate recovery post-COVID-19 was associated with a shorter 6-minute walk distance (437.33 vs. 494.27 m; p=0.019) and greater dyspnea compared to non-delayed recovery.
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