{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:00:44Z","timestamp":1790780444237,"version":"4.1.0"},"reference-count":63,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["24\/22713-3"],"award-info":[{"award-number":["24\/22713-3"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-026-41182-2","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T05:27:16Z","timestamp":1771997236000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A single bout of submaximal aerobic functional capacity test acutely promotes endothelial function in long COVID patients"],"prefix":"10.1038","volume":"16","author":[{"given":"Aldair Darlan","family":"Santos-de-Ara\u00fajo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara Rocha","family":"de Oliveira Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Bassi-Dibai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson Francisco Serr\u00e3o","family":"J\u00fanior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Ang\u00e9lica","family":"Ricci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia Faria","family":"Camargo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamilla Tays Marrara","family":"Marmorato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane A.","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Arena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Borghi-Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"41182_CR1","doi-asserted-by":"publisher","first-page":"1746","DOI":"10.1056\/NEJMsb2408466","volume":"391","author":"EW Ely","year":"2024","unstructured":"Ely, E. W., Brown, L. M. & Fineberg, H. V. Long Covid Defined, N. Engl. J. Med. 391, 1746\u20131753 (2024).","journal-title":"N. Engl. J. Med."},{"key":"41182_CR2","doi-asserted-by":"publisher","first-page":"e12118","DOI":"10.1590\/1414-431x2022e12118","volume":"55","author":"GD Back","year":"2022","unstructured":"Back, G. D. et al. Mild-to-moderate COVID-19 impact on the cardiorespiratory fitness inyoung and middle-aged populations. Brazilian J. Med. Biol. Res. 55, e12118 (2022).","journal-title":"Brazilian J. Med. Biol. Res."},{"key":"41182_CR3","doi-asserted-by":"publisher","first-page":"106469","DOI":"10.1016\/j.rmed.2021.106469","volume":"185","author":"MR Oliveira","year":"2021","unstructured":"Oliveira, M. R. et al. Endothelial function provides early prognostic information in patients with COVID-19: A cohort study. Respir Med. 185, 106469 (2021).","journal-title":"Respir Med."},{"key":"41182_CR4","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1002\/oby.23311","volume":"30","author":"AD Heubel","year":"2022","unstructured":"Heubel, A. D. et al. Determinants of endothelial dysfunction in noncritically ill hospitalized COVID-19 patients: A cross-sectional study. Obesity 30, 165\u2013171 (2022).","journal-title":"Obesity"},{"key":"41182_CR5","doi-asserted-by":"publisher","first-page":"e651","DOI":"10.1002\/mco2.651","volume":"5","author":"X Wang","year":"2024","unstructured":"Wang, X. & He, B. Endothelial dysfunction: molecular mechanisms and clinical implications. MedComm 5, e651 (2024).","journal-title":"MedComm"},{"key":"41182_CR6","doi-asserted-by":"publisher","first-page":"3624","DOI":"10.1002\/ehf2.15391","volume":"12","author":"K Prokopidis","year":"2025","unstructured":"Prokopidis, K. et al. Prognostic impact of peak oxygen consumption in heart failure: A systematic review and meta-analysis. ESC Hear. Fail. 12, 3624 (2025).","journal-title":"ESC Hear. Fail."},{"key":"41182_CR7","doi-asserted-by":"publisher","first-page":"5251","DOI":"10.1111\/dom.15877","volume":"26","author":"A da Borghi-Silva","year":"2024","unstructured":"Borghi-Silva, A., Vainshelboim, B., da Luz Goulart, C., Arena, R. & Myers, J. The prognostic role of cardiopulmonary exercise testing in obesity. Diabetes Obes. Metab. 26, 5251\u20135260 (2024).","journal-title":"Diabetes Obes. Metab."},{"key":"41182_CR8","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1113\/JP278931","volume":"599","author":"DC Poole","year":"2020","unstructured":"Poole, D. C., Behnke, B. J. & Musch, T. I. The role of vascular function on exercise capacity in health and disease. J. Physiol. 599, 889 (2020).","journal-title":"J. Physiol."},{"key":"41182_CR9","doi-asserted-by":"publisher","first-page":"e70216","DOI":"10.14814\/phy2.70216","volume":"13","author":"GD Back","year":"2025","unstructured":"Back, G. D. et al. The impact of COVID-19 severity on adult survivors: Is there a relationship between vascular reactivity and cardiorespiratory fitness? Physiol. Rep. 13, e70216 (2025).","journal-title":"Physiol. Rep."},{"key":"41182_CR10","unstructured":"de Andrade, C. H. S., Malaguti, R. G. C. C. & Corso, S. D. The use of step tests for the assessment of exercise capacity inhealthy subjects and in patients with chronic lung disease. 38, 116\u2013124 (2012)."},{"key":"41182_CR11","doi-asserted-by":"publisher","first-page":"e20210511","DOI":"10.36416\/1806-3756\/e20210511","volume":"48","author":"V Salles Albuquerque","year":"2022","unstructured":"Salles Albuquerque, V. et al. Normative values and reference equation for the six-minute step test to evaluate functional exercise capacity: A multicenter study. Jornal Brasileiro de Pneumologia. 48, e20210511. (2022). https:\/\/doi.org\/10.36416\/1806-3756\/e20210511","journal-title":"Jornal Brasileiro de Pneumologia"},{"key":"41182_CR12","doi-asserted-by":"crossref","first-page":"896","DOI":"10.36660\/abc.20210252","volume":"116","author":"RMRDEBQ Farah","year":"2021","unstructured":"Farah, R. M. R. D. E. B. Q. The six-minute step test as an alternative for functional capacity assessment in patients with cardiovascular diseases. Arq. Bras. Cardiol. 116, 896\u2013897 (2021).","journal-title":"Arq. Bras. Cardiol."},{"key":"41182_CR13","doi-asserted-by":"publisher","first-page":"e10514","DOI":"10.1590\/1414-431x2020e10514","volume":"54","author":"RS Marinho","year":"2021","unstructured":"Marinho, R. S. et al. Reliability and validity of six-minute step test in patients with heart failure. Brazil. J. Med. Biol. Res. 54, e10514 (2021).","journal-title":"Brazil. J. Med. Biol. Res."},{"key":"41182_CR14","doi-asserted-by":"publisher","first-page":"3649","DOI":"10.1038\/s41598-024-54338-9","volume":"14","author":"AD Santos-de-Ara\u00fajo","year":"2024","unstructured":"Santos-de-Ara\u00fajo, A. D. et al. The six-minute step test can predict COPD exacerbations: A 36-month follow-up study. Sci. Rep. 14, 3649 (2024).","journal-title":"Sci. Rep."},{"key":"41182_CR15","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1152\/japplphysiol.00450.2013115","volume":"115","author":"EA Dawson","year":"2013","unstructured":"Dawson, E. A., Green, D. J., Cable, N. T. & Thijssen, D. H. J. Effects of acute exercise on flow-mediated dilatation in healthy humans. J. Appl. Phisiol. 115, 1589\u20131598. (2013). https:\/\/doi.org\/10.1152\/japplphysiol.00450.2013115","journal-title":"J. Appl. Phisiol"},{"key":"41182_CR16","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1590\/S0034-89102010000300021","volume":"44","author":"M da Malta","year":"2010","unstructured":"Malta, M., Cardoso, L. O., Bastos, F. I., Magnanini, M. M. F. & da Silva, C. M. F. P. STROBE initiative: Guidelines on reporting observational studies. Rev. Saude Publica. 44, 559\u2013565 (2010).","journal-title":"Rev. Saude Publica"},{"key":"41182_CR17","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1111\/j.1748-1716.2012.02417.x","volume":"205","author":"TL Llewellyn","year":"2012","unstructured":"Llewellyn, T. L., Chaffin, M. E., Berg, K. E. & Meendering, J. R. The relationship between shear rate and flow-mediated dilation is altered by acute exercise. Acta Physiol. 205, 394\u2013402 (2012).","journal-title":"Acta Physiol."},{"key":"41182_CR18","doi-asserted-by":"publisher","first-page":"100503","DOI":"10.1016\/j.bjpt.2023.100503","volume":"27","author":"CA de Facio","year":"2023","unstructured":"de Facio, C. A. et al. Post-COVID-19 functional status scale: Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version. Brazilian J. Phys. Ther. 27, 100503 (2023).","journal-title":"Brazilian J. Phys. Ther."},{"key":"41182_CR19","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1136\/thx.54.7.581","volume":"54","author":"JC Bestall","year":"1999","unstructured":"Bestall, J. C. et al. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 54, 581\u2013586 (1999).","journal-title":"Thorax"},{"key":"41182_CR20","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1093\/ajcn\/36.5.936","volume":"36","author":"JAH Baecke","year":"1982","unstructured":"Baecke, J. A. H., Burema, J. & Frijters, J. E. R. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am. J. Clin. Nutr. 36, 936\u2013942 (1982).","journal-title":"Am. J. Clin. Nutr."},{"key":"41182_CR21","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1590\/1806-9282.20211374","volume":"68","author":"DS Rocha","year":"2022","unstructured":"Rocha, D. S. et al. The Baecke Habitual Physical Activity Questionnaire (BHPAQ): a valid internal structure of the instrument to assess healthy Brazilian adults. Rev. Assoc. Med. Bras. 68, 912\u2013916 (2022).","journal-title":"Rev. Assoc. Med. Bras."},{"key":"41182_CR22","doi-asserted-by":"publisher","first-page":"E70","DOI":"10.1164\/rccm.201908-1590ST","volume":"200","author":"BL Graham","year":"2019","unstructured":"Graham, B. L. et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am. J. Respir. Crit. Care Med. 200, E70\u2013E88 (2019).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"41182_CR23","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1016\/j.rmed.2011.02.006","volume":"105","author":"CP Cri\u00e9e","year":"2011","unstructured":"Cri\u00e9e, C. P. et al. Body plethysmography\u2013its principles and clinical use. Respir. Med. 105, 959\u2013971 (2011).","journal-title":"Respir. Med."},{"key":"41182_CR24","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1590\/s1806-37562018000000082","volume":"44","author":"TA Prata","year":"2018","unstructured":"Prata, T. A. et al. Spirometry reference values for Black adults in Brazil. J. Bras. Pneumol. 44, 449\u2013455 (2018).","journal-title":"J. Bras. Pneumol."},{"key":"41182_CR25","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1590\/S1806-37132007000400008","volume":"33","author":"CA De Castro Pereira","year":"2007","unstructured":"De Castro Pereira, C. A., Sato, T. & Rodrigues, S. C. New reference values for forced spirometry in white adults in Brazil. J. Bras. Pneumol. 33, 397\u2013406 (2007).","journal-title":"J. Bras. Pneumol."},{"key":"41182_CR26","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1249\/MSS.0b013e3181923957","volume":"41","author":"DHJ Thijssen","year":"2009","unstructured":"Thijssen, D. H. J. et al. Brachial artery blood flow responses to different modalities of lower limb exercise. Med. Sci. Sports Exerc. 41, 1072\u20131079 (2009).","journal-title":"Med. Sci. Sports Exerc."},{"key":"41182_CR27","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1161\/HYPERTENSIONAHA.110.150821","volume":"55","author":"RA Harris","year":"2010","unstructured":"Harris, R. A., Nishiyama, S. K., Wray, D. W. & Richardson, R. S. Ultrasound assessment of flow-mediated dilation: A tutorial. Hypertension 55, 1075 (2010).","journal-title":"Hypertension"},{"key":"41182_CR28","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/S0735-1097(01)01746-6","volume":"39","author":"MC Corretti","year":"2002","unstructured":"Corretti, M. C. et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: A report of the international brachial artery reactivity task force. J. Am. Coll. Cardiol. 39, 257\u2013265 (2002).","journal-title":"J. Am. Coll. Cardiol."},{"key":"41182_CR29","doi-asserted-by":"publisher","first-page":"2534","DOI":"10.1093\/eurheartj\/ehz350","volume":"40","author":"DHJ Thijssen","year":"2019","unstructured":"Thijssen, D. H. J. et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur. Heart J. 40, 2534\u20132547 (2019).","journal-title":"Eur. Heart J."},{"key":"41182_CR30","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1519\/JSC.0000000000002537","volume":"34","author":"N Giacomantonio","year":"2020","unstructured":"Giacomantonio, N., Morrison, P., Rasmussen, R. & Mackay-Lyons, M. J. Reliability and validity of the 6-minute step test for clinical assessment of cardiorespiratory fitness in people at risk of cardiovascular disease. J. Strength. Cond Res. 34, 1376\u20131382 (2020).","journal-title":"J. Strength. Cond Res."},{"key":"41182_CR31","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1164\/ajrccm.166.1.at1102","volume":"166","author":"RO Crapo","year":"2002","unstructured":"Crapo, R. O. et al. ATS statement: guidelines for the six-minute walk test. Am. J. Respir. Crit. Care Med. 166, 111\u2013117 (2002).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"41182_CR32","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/S0735-1097(00)01054-8","volume":"37","author":"H Tanaka","year":"2001","unstructured":"Tanaka, H., Monahan, K. D. & Seals, D. R. Age-predicted maximal heart rate revisited. J. Am. Coll. Cardiol. 37, 153\u2013156 (2001).","journal-title":"J. Am. Coll. Cardiol."},{"key":"41182_CR33","first-page":"467","volume":"107","author":"AH Herdy","year":"2016","unstructured":"Herdy, A. H. et al. Cardiopulmonary Exercise test: background, applicability and interpretation. Arq. Bras. Cardiol. 107, 467 (2016).","journal-title":"Arq. Bras. Cardiol."},{"key":"41182_CR34","doi-asserted-by":"publisher","first-page":"67","DOI":"10.4103\/aca.ACA_157_18","volume":"22","author":"P Mishra","year":"2019","unstructured":"Mishra, P. et al. Descriptive statistics and normality tests for statistical data. Ann. Card. Anaesth. 22, 67 (2019).","journal-title":"Ann. Card. Anaesth."},{"key":"41182_CR35","doi-asserted-by":"publisher","first-page":"143","DOI":"10.11613\/BM.2013.018","volume":"23","author":"ML McHugh","year":"2013","unstructured":"McHugh, M. L. The Chi-square test of independence. Biochem. Medica 23, 143 (2013).","journal-title":"Biochem. Medica"},{"key":"41182_CR36","doi-asserted-by":"publisher","first-page":"407","DOI":"10.4103\/aca.ACA_94_19","volume":"22","author":"P Mishra","year":"2019","unstructured":"Mishra, P., Singh, U., Pandey, C. M., Mishra, P. & Pandey, G. Application of student\u2019s t-test, analysis of variance, and covariance. Ann. Card Anaesth. 22, 407 (2019).","journal-title":"Ann. Card Anaesth."},{"key":"41182_CR37","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511974175","volume-title":"Multivariable Analysis: A Practical Guide for Clinicians and Public Health Researchers","author":"MH Katz","year":"2011","unstructured":"Katz, M. H. Multivariable Analysis: A Practical Guide for Clinicians and Public Health Researchers (Cambridge University Press, 2011)."},{"key":"41182_CR38","first-page":"409","volume":"37","author":"J Durbin","year":"1950","unstructured":"Durbin, J. & Watson, G. Testing for serial correlation in least squares regression. Biometrika 37, 409\u2013428 (1950).","journal-title":"Biometrika"},{"key":"41182_CR39","doi-asserted-by":"publisher","first-page":"558","DOI":"10.4097\/kja.19087","volume":"72","author":"JH Kim","year":"2019","unstructured":"Kim, J. H. Multicollinearity and misleading statistical results. Korean J. Anesthesiol. 72, 558 (2019).","journal-title":"Korean J. Anesthesiol."},{"key":"41182_CR40","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3462-1","volume-title":"Regression Modeling Strategies","author":"FE Harrell","year":"2001","unstructured":"Harrell, F. E. Regression Modeling Strategies (Springer, 2001)."},{"key":"41182_CR41","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1177\/001316447103100310","volume":"31","author":"FL Schmidt","year":"1971","unstructured":"Schmidt, F. L. The relative efficiency of regression and simple unit predictor weights in applied differential psychology. Educ. Psychol. Meas. 31, 699\u2013714 (1971).","journal-title":"Educ. Psychol. Meas."},{"key":"41182_CR42","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3389\/fpsyg.2012.00111","volume":"3","author":"AS Selya","year":"2012","unstructured":"Selya, A. S., Rose, J. S., Dierker, L. C., Hedeker, D. & Mermelstein, R. J. A practical guide to calculating Cohen\u2019s f2, a measure of local effect size, from PROC MIXED. Front. Psychol. 3, 111 (2012).","journal-title":"Front. Psychol."},{"key":"41182_CR43","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1152\/japplphysiol.01489.2011112","volume":"112","author":"GK Birk","year":"2012","unstructured":"Birk, G. K. et al. Brachial artery adaptation to lower limb exercise training: Role of shear stress. J. Appl. Phisiol. 112, 1653\u20131658. (2012). https:\/\/doi.org\/10.1152\/japplphysiol.01489.2011112","journal-title":"J. Appl. Phisiol"},{"key":"41182_CR44","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1113\/expphysiol.2011.059584","volume":"96","author":"J Padilla","year":"2011","unstructured":"Padilla, J. et al. Brachial artery vasodilatation during prolonged lower limb exercise: Role of shear rate. Exp. Physiol. 96, 1019 (2011).","journal-title":"Exp. Physiol."},{"key":"41182_CR45","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1113\/jphysiol.2005.089755","volume":"568","author":"KE Pyke","year":"2005","unstructured":"Pyke, K. E. & Tschakovsky, M. E. The relationship between shear stress and flow-mediated dilatation: implications for the assessment of endothelial function. J. Physiol. 568, 357\u2013369 (2005).","journal-title":"J. Physiol."},{"key":"41182_CR46","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.hrtlng.2025.07.011","volume":"74","author":"LLM Carvalho","year":"2025","unstructured":"Carvalho, L. L. M. et al. Associations between lung and endothelial function in long COVID: Two years after acute infection. Hear. Lung. 74, 168\u2013173 (2025).","journal-title":"Hear. Lung"},{"key":"41182_CR47","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.1152\/ajpheart.00771.2005290","volume":"290","author":"KS Dyson","year":"2006","unstructured":"Dyson, K. S., Shoemaker, J. K. & Hughson, R. L. Effect of acute sympathetic nervous system activation on flow-mediated dilation of brachial artery. Am. J. Physiol. Heart Circulat Physiol. 290, 1446\u20131453 (2006). https:\/\/doi.org\/10.1152\/ajpheart.00771.2005290 \u00a0","journal-title":"Am. J. Physiol. Heart Circulat Physiol."},{"key":"41182_CR48","doi-asserted-by":"publisher","first-page":"e70180","DOI":"10.14814\/phy2.70180","volume":"13","author":"BE Hanson","year":"2025","unstructured":"Hanson, B. E. et al. Acute sympathetic activation blunts the hyperemic and vasodilatory response to passive leg movement in young healthy males. Physiol. Rep. 13, e70180 (2025).","journal-title":"Physiol. Rep."},{"key":"41182_CR49","doi-asserted-by":"publisher","first-page":"5145","DOI":"10.1113\/JP270946","volume":"593","author":"CL Atkinson","year":"2015","unstructured":"Atkinson, C. L. et al. Impact of sympathetic nervous system activity on post-exercise flow\u2010mediated dilatation in humans. J. Physiol. 593, 5145 (2015).","journal-title":"J. Physiol."},{"key":"41182_CR50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-024-82411-w","volume":"14","author":"AD Santos-de-Ara\u00fajo","year":"2024","unstructured":"Santos-de-Ara\u00fajo, A. D. et al. Impact of COVID-19 on heart rate variability in post-COVID individuals compared to a control group. Sci. Rep. 14, 1\u201316 (2024).","journal-title":"Sci. Rep."},{"issue":"13","key":"41182_CR51","first-page":"1","volume":"131","author":"ALG da Silva","year":"2023","unstructured":"da Silva, A. L. G. et al. Impact of long COVID on the heart rate variability at rest and during deep breathing maneuver. Sci. Rep. 2023. 131(13), 1\u20137 (2023).","journal-title":"Sci. Rep. 2023"},{"key":"41182_CR52","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.3390\/healthcare11081095","volume":"11","author":"HW Suh","year":"2023","unstructured":"Suh, H. W., Kwon, C. Y. & Lee, B. Long-term impact of COVID-19 on heart rate variability: A systematic review of observational studies. Healthcare 11, 1095 (2023).","journal-title":"Healthcare"},{"key":"41182_CR53","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1007\/s10840-022-01138-8","volume":"63","author":"LD Asarcikli","year":"2022","unstructured":"Asarcikli, L. D. et al. Heart rate variability and cardiac autonomic functions in post-COVID period. J. Interv Card. Electrophysiol. 63, 715 (2022).","journal-title":"J. Interv Card. Electrophysiol."},{"key":"41182_CR54","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1111\/j.1520-037X.2006.05408.x","volume":"9","author":"LM Cosio-Lima","year":"2006","unstructured":"Cosio-Lima, L. M. et al. The acute effect of aerobic exercise on brachial artery endothelial function in renal transplant recipients. Prev. Cardiol. 9, 211\u2013214 (2006).","journal-title":"Prev. Cardiol."},{"key":"41182_CR55","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1038\/oby.2007.87","volume":"16","author":"RA Harris","year":"2008","unstructured":"Harris, R. A., Padilla, J., Hanlon, K. P., Rink, L. D. & Wallace, J. P. The flow-mediated dilation response to acute exercise in overweight active and inactive men. Obesity 16, 578\u2013584 (2008).","journal-title":"Obesity"},{"key":"41182_CR56","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.ahj.2004.08.036","volume":"149","author":"PJ Harvey","year":"2005","unstructured":"Harvey, P. J. et al. Exercise as an alternative to oral estrogen for amelioration of endothelial dysfunction in postmenopausal women. Am. Heart J. 149, 291\u2013297 (2005).","journal-title":"Am. Heart J."},{"key":"41182_CR57","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1007\/s00421-006-0272-z","volume":"98","author":"J Padilla","year":"2006","unstructured":"Padilla, J., Harris, R. A., Fly, A. D., Rink, L. D. & Wallace, J. P. The effect of acute exercise on endothelial function following a high-fat meal. Eur. J. Appl. Physiol. 98, 256\u2013262 (2006).","journal-title":"Eur. J. Appl. Physiol."},{"key":"41182_CR58","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1113\/EP085238","volume":"100","author":"RM Restaino","year":"2015","unstructured":"Restaino, R. M., Holwerda, S. W., Credeur, D. P., Fadel, P. J. & Padilla, J. Impact of Prolonged Sitting on Lower and Upper Limb Micro- and Macrovascular Dilator Function. Exp. Physiol. 100, 829 (2015).","journal-title":"Exp. Physiol."},{"key":"41182_CR59","doi-asserted-by":"publisher","first-page":"1386","DOI":"10.3390\/healthcare11101386","volume":"11","author":"A de Omar","year":"2023","unstructured":"Omar, A., Ferreira, A., de Hegazy, S., Alaparthi, G. K. & F. A. & Cardiorespiratory response to six-minute step test in post COVID-19 patients\u2014A cross sectional study. Healthcare 11, 1386 (2023).","journal-title":"Healthcare"},{"key":"41182_CR60","doi-asserted-by":"publisher","first-page":"e12118","DOI":"10.1590\/1414-431x2022e12118","volume":"55","author":"GD Back","year":"2022","unstructured":"Back, G. D. et al. Mild-to-moderate COVID-19 impact on the cardiorespiratory fitness in young and middle-aged populations. Brazilian J. Med. Biol. Res. = Rev. Bras. Pesqui medicas e Biol. 55, e12118 (2022).","journal-title":"Brazilian J. Med. Biol. Res. = Rev. Bras. Pesqui medicas e Biol."},{"key":"41182_CR61","doi-asserted-by":"publisher","first-page":"15940","DOI":"10.14814\/phy2.15940","volume":"12","author":"A Jamieson","year":"2024","unstructured":"Jamieson, A. et al. Mechanisms underlying exercise intolerance in long COVID: An accumulation of multisystem dysfunction. Physiol. Rep. 12, 15940 (2024).","journal-title":"Physiol. Rep."},{"key":"41182_CR62","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1177\/2047487314553780","volume":"22","author":"D Montero","year":"2015","unstructured":"Montero, D. The association of cardiorespiratory fitness with endothelial or smooth muscle vasodilator function. Eur. J. Prev. Cardiol. 22, 1200\u20131211 (2015).","journal-title":"Eur. J. Prev. Cardiol."},{"key":"41182_CR63","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1007\/s12016-022-08921-5","volume":"64","author":"J Zhang","year":"2022","unstructured":"Zhang, J., jin, Dong, X., Liu, G. & Gao, Y. Risk and Protective Factors for COVID-19 Morbidity, Severity, and Mortality. Clin. Rev. Allergy Immunol. 64, 90 (2022).","journal-title":"Clin. Rev. Allergy Immunol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41182-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41182-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41182-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:04:10Z","timestamp":1774609450000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-026-41182-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":63,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["41182"],"URL":"https:\/\/doi.org\/10.1038\/s41598-026-41182-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"assertion":[{"value":"5 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Informed consent was obtained from all the participants. All respondents participated in this study freely and with consent. This study was approved by the Research Ethics Committee of the Federal University of S\u00e3o Carlos (report number: 6.714.763).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"10439"}}