{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:25:34Z","timestamp":1772252734239,"version":"3.50.1"},"reference-count":59,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T00:00:00Z","timestamp":1645401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","award":["research scholarship (PQ2) from the CNPq"],"award-info":[{"award-number":["research scholarship (PQ2) from the CNPq"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordination for the Improvement of Higher Education Personnel","doi-asserted-by":"publisher","award":["(code 001)"],"award-info":[{"award-number":["(code 001)"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The harmful effects of coronavirus disease 2019 (COVID-19) can reach the autonomic nervous system (ANS) and endothelial function. Therefore, the detrimental multiorgan effects of COVID-19 could be induced by deregulations in ANS that may persist after the acute SARS-CoV-2 infection. Additionally, investigating the differences in ANS response in overweight\/obese, and physically inactive participants who had COVID-19 compared to those who did not have the disease is necessary. The aim of the study was to analyze the autonomic function of young adults after mild-to-moderate infection with SARS-CoV-2 and to assess whether body mass index (BMI) and levels of physical activity modulates autonomic function in participants with and without COVID-19. Patients previously infected with SARS-CoV-2 and healthy controls were recruited for this cross-sectional observational study. A general anamnesis was taken, and BMI and physical activity levels were assessed. The ANS was evaluated through heart rate variability. A total of 57 subjects were evaluated. Sympathetic nervous system activity in the post-COVID-19 group was increased (stress index; p = 0.0273). They also presented lower values of parasympathetic activity (p &lt; 0.05). Overweight\/obese subjects in the post-COVID-19 group presented significantly lower parasympathetic activity and reduced global variability compared to non-obese in control group (p &lt; 0.05). Physically inactive subjects in the post-COVID-19 group presented significantly higher sympathetic activity than active subjects in the control group. Parasympathetic activity was significantly increased in physically active subjects in the control group compared to the physically inactive post-COVID-19 group (p &lt; 0.05). COVID-19 promotes changes in the ANS of young adults, and these changes are modulated by overweight\/obesity and physical activity levels.<\/jats:p>","DOI":"10.3390\/ijerph19042457","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T20:47:45Z","timestamp":1645476465000},"page":"2457","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Role of Body Mass and Physical Activity in Autonomic Function Modulation on Post-COVID-19 Condition: An Observational Subanalysis of Fit-COVID Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2805-5746","authenticated-orcid":false,"given":"Ana Paula Coelho Figueira","family":"Freire","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Central Washington University Ellensburg, Ellensburg, WA 98926, USA"},{"name":"Physiotherapy Department, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9645-1003","authenticated-orcid":false,"given":"Fabio Santos","family":"Lira","sequence":"additional","affiliation":[{"name":"Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0733-5618","authenticated-orcid":false,"given":"Ana Elisa von Ah","family":"Morano","sequence":"additional","affiliation":[{"name":"Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9119-7774","authenticated-orcid":false,"given":"Telmo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Polytechnic of Coimbra, ESTESC, Laboratory Biomedical Sciences, 3046-854 Coimbra, Portugal"},{"name":"Molecular Physical-Chemistry R & D Unit, Faculty of Science and Technology, University of Coimbra, 3004-535 Coimbra, Portugal"},{"name":"Laboratory for Applied Health Research (LabinSa\u00fade), 3046-854 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4512-7331","authenticated-orcid":false,"given":"Manuel-Jo\u00e3o","family":"Coelho-E-Silva","sequence":"additional","affiliation":[{"name":"Faculty of Sport Science and Physiucal Education, University of Coimbra, CIDAF, 3000-456 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7844-0506","authenticated-orcid":false,"given":"Armando","family":"Caseiro","sequence":"additional","affiliation":[{"name":"Polytechnic of Coimbra, ESTESC, Laboratory Biomedical Sciences, 3046-854 Coimbra, Portugal"},{"name":"Molecular Physical-Chemistry R & D Unit, Faculty of Science and Technology, University of Coimbra, 3004-535 Coimbra, Portugal"},{"name":"Laboratory for Applied Health Research (LabinSa\u00fade), 3046-854 Coimbra, Portugal"}]},{"given":"Diego Giulliano Destro","family":"Christofaro","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil"}]},{"given":"Osmar","family":"Marchioto J\u00fanior","sequence":"additional","affiliation":[{"name":"Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6524-3204","authenticated-orcid":false,"given":"Gilson Pires","family":"Dorneles","sequence":"additional","affiliation":[{"name":"Cellular and Molecular Immunology Laboratory, Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre, Porto Alegre 90050-170, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9342-5563","authenticated-orcid":false,"given":"Luciele Guerra","family":"Minuzzi","sequence":"additional","affiliation":[{"name":"Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3116-4553","authenticated-orcid":false,"given":"Ricardo Aurino","family":"Pinho","sequence":"additional","affiliation":[{"name":"Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba 80215-901, Brazil"}]},{"given":"Bruna Spolador de Alencar","family":"Silva","sequence":"additional","affiliation":[{"name":"Exercise and Immunometabolism Research Group, Postgraduate Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente 19060-900, Brazil"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3633","DOI":"10.1111\/febs.15375","article-title":"A Guide to COVID-19: A global pandemic caused by the novel coronavirus SARS-CoV-2","volume":"287","author":"Atzrodt","year":"2020","journal-title":"FEBS J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"313","DOI":"10.4014\/jmb.2003.03011","article-title":"Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19)","volume":"30","author":"Ahn","year":"2020","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_3","first-page":"542","article-title":"Persistent symptoms 3\u2005months after a SARS-CoV-2 infection: The post-COVID-19 syndrome?","volume":"6","author":"Delbressine","year":"2020","journal-title":"ERJ Open Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"630038","DOI":"10.3389\/fphys.2021.630038","article-title":"Alteration of Autonomic Nervous System Is Associated with Severity and Outcomes in Patients with COVID-19","volume":"12","author":"Pan","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4269","DOI":"10.1113\/JP281888","article-title":"COVID-19 is getting on our nerves: Sympathetic neural activity and haemodynamics in young adults recovering from SARS-CoV-2","volume":"599","author":"Stute","year":"2021","journal-title":"J. Physiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e63","DOI":"10.7861\/clinmed.2020-0896","article-title":"Autonomic dysfunction in long COVID: Rationale, physiology and management strategies","volume":"21","author":"Dani","year":"2021","journal-title":"Clin. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s00134-021-06351-z","article-title":"SARS-CoV-2 in carotid body","volume":"47","author":"Lambermont","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1007\/s00415-020-10108-x","article-title":"Immune-Mediated neurological syndromes in SARS-CoV-2-infected patients","volume":"268","author":"Guilmot","year":"2021","journal-title":"J. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3345","DOI":"10.1172\/JCI139642","article-title":"Preventing cytokine storm syndrome in COVID-19 using \u03b1-1 adrenergic receptor antagonists","volume":"130","author":"Konig","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.jacc.2018.12.064","article-title":"Autonomic Nervous System Dysfunction: JACC Focus Seminar","volume":"73","author":"Goldberger","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1053\/euhj.2000.2407","article-title":"Effect of cardiac sympathetic nervous activity on mode of death in congestive heart failure","volume":"22","author":"Esler","year":"2001","journal-title":"Eur. Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/apha.12302","article-title":"Assessment of human baroreflex function using carotid ultrasonography: What have we learnt?","volume":"211","author":"Taylor","year":"2014","journal-title":"Acta Physiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1152\/jn.00064.2018","article-title":"Relative burst amplitude of muscle sympathetic nerve activity is an indicator of altered sympathetic outflow in chronic anxiety","volume":"120","author":"Holwerda","year":"2018","journal-title":"J. Neurophysiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.ijcard.2015.03.383","article-title":"Heart rate variability, but not heart rate, is associated with handgrip strength and mortality in older Africans at very low cardiovascular risk: A population-based study","volume":"187","author":"Koopman","year":"2015","journal-title":"Int. J. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"14042","DOI":"10.1038\/s41598-021-93546-5","article-title":"Clinical characterization of dysautonomia in long COVID-19 patients","volume":"11","author":"Barizien","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s10286-021-00798-2","article-title":"Long-COVID postural tachycardia syndrome: An American Autonomic Society statement","volume":"31","author":"Raj","year":"2021","journal-title":"Clin. Auton. Res. Off. J. Clin. Auton. Res. Soc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1111\/ner.13172","article-title":"The Use of Non-invasive Vagus Nerve Stimulation to Treat Respiratory Symptoms Associated with COVID-19: A Theoretical Hypothesis and Early Clinical Experience","volume":"23","author":"Staats","year":"2020","journal-title":"Neuromodulation J. Int. Neuromodul. Soc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/j.1478-3231.2009.02125.x","article-title":"Baroreceptor sensitivity and baroreceptor effectiveness index in cirrhosis: The relevance of hepatic venous pressure gradient","volume":"30","author":"Genovesi","year":"2010","journal-title":"Liver Int. Off. J. Int. Assoc. Study Liver"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1164\/ajrccm.150.1.8025764","article-title":"Virus-induced airway obstruction and parasympathetic hyperresponsiveness in adult rats","volume":"150","author":"Sorkness","year":"1994","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0002-9343(97)00087-9","article-title":"Does the chronic fatigue syndrome involve the autonomic nervous system?","volume":"102","author":"Freeman","year":"1997","journal-title":"Am. J. Med."},{"key":"ref_21","first-page":"1995","article-title":"Cardiac Autonomic Neuropathy in Obesity, the Metabolic Syndrome and Prediabetes: A Narrative Review","volume":"10","author":"Williams","year":"2019","journal-title":"Diabetes Ther. Res. Treat. Educ. Diabetes Relat. Disord."},{"key":"ref_22","first-page":"430","article-title":"Aging, heart rate variability and metabolic impact of obesity","volume":"58","author":"Barak","year":"2019","journal-title":"Acta Clin. Croat."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.neubiorev.2008.04.009","article-title":"Individual responses to aerobic exercise: The role of the autonomic nervous system","volume":"33","author":"Hautala","year":"2009","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/B978-0-444-53491-0.00013-4","article-title":"Exercise and the autonomic nervous system","volume":"117","author":"Fu","year":"2013","journal-title":"Handb. Clin. Neurol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s40001-020-00464-9","article-title":"Obesity is associated with increased severity of disease in COVID-19 pneumonia: A systematic review and meta-analysis","volume":"25","author":"Chu","year":"2020","journal-title":"Eur. J. Med. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"784429","DOI":"10.3389\/fnut.2021.784429","article-title":"COVID-19 Outcome Relates with Circulating BDNF, according to Patient Adiposity and Age","volume":"8","author":"Minuzzi","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e72","DOI":"10.2337\/dc20-0682","article-title":"Obesity Is a Risk Factor for Greater COVID-19 Severity","volume":"43","author":"Gao","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1136\/bjsports-2021-104080","article-title":"Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: A study in 48,440 adult patients","volume":"55","author":"Sallis","year":"2021","journal-title":"Br. J. Sports Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1016\/j.jsams.2021.05.011","article-title":"Association of physical activity levels and the prevalence of COVID-19-associated hospitalization","volume":"24","author":"Cardozo","year":"2021","journal-title":"J. Sci. Med. Sport"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Strahm, C., Seneghini, M., G\u00fcsewell, S., Egger, T., Leal, O., Brucher, A., Lemmenmeier, E., Kleeb, D.M., M\u00f6ller, J.C., and Rieder, P. (2021). Symptoms compatible with long-COVID in healthcare workers with and without SARS-CoV-2 infection\u2013Results of a prospective multicenter cohort. medRxiv.","DOI":"10.1101\/2021.10.19.21265187"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1161\/01.CIR.93.5.1043","article-title":"Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: Standards of measurement, physiological interpretation and clinical use","volume":"93","author":"Camm","year":"1996","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Lira, F.S., Pereira, T., Guerra Minuzzi, L., Figueiredo, C., Olean-Oliveira, T., Figueira Freire, A.P.C., Coelho, E.S.M.J., Caseiro, A., Thomatieli-Santos, R.V., and Dos Santos, V.R. (2021). Modulatory Effects of Physical Activity Levels on Immune Responses and General Clinical Functions in Adult Patients with Mild to Moderate SARS-CoV-2 Infections-A Protocol for an Observational Prospective Follow-Up Investigation: Fit-COVID-19 Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182413249"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_35","unstructured":"(2021, July 26). World Health Organization COVID-19: Surveillance, Case Investigation and Epidemiological Protocols. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-Surveillance_Case_Definition-2020.2."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1136\/bmj.322.7293.1043","article-title":"Blood pressure measurement","volume":"322","author":"Beevers","year":"2001","journal-title":"BMJ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/NT.0000000000000092","article-title":"Body Mass Index: Obesity, BMI, and Health: A Critical Review","volume":"50","author":"Nuttall","year":"2015","journal-title":"Nutr. Today"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1093\/aje\/kwm390","article-title":"Amount of time spent in sedentary behaviors in the United States, 2003\u20132004","volume":"167","author":"Matthews","year":"2008","journal-title":"Am. J. Epidemiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1249\/mss.0b013e31815a51b3","article-title":"Physical activity in the United States measured by accelerometer","volume":"40","author":"Troiano","year":"2008","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1590\/S0102-76382009000200018","article-title":"No\u00e7\u00f5es b\u00e1sicas de variabilidade da frequ\u00eancia card\u00edaca e sua aplicabilidade cl\u00ednica","volume":"24","author":"Vanderlei","year":"2009","journal-title":"Braz. J. Cardiovasc. Surg."},{"key":"ref_41","unstructured":"Kubios (2021, September 25). HRV in Evaluating ANS Function. Available online: https:\/\/www.kubios.com\/hrv-ans-function\/."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1037\/a0024338","article-title":"Effect size estimates: Current use, calculations, and interpretation","volume":"141","author":"Fritz","year":"2012","journal-title":"J. Exp. Psychology. Gen."},{"key":"ref_43","first-page":"767","article-title":"Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China","volume":"26","author":"Zhang","year":"2020","journal-title":"Clin. Microbiol. Infect. Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e2115959","DOI":"10.1001\/jamanetworkopen.2021.15959","article-title":"Assessment of Prolonged Physiological and Behavioral Changes Associated with COVID-19 Infection","volume":"4","author":"Radin","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3681","DOI":"10.1111\/febs.15481","article-title":"Sympathetic activation: A potential link between comorbidities and COVID-19","volume":"287","author":"Porzionato","year":"2020","journal-title":"FEBS J."},{"key":"ref_46","first-page":"L383","article-title":"Oxidant stress responses in influenza virus pneumonia: Gene expression and transcription factor activation","volume":"271","author":"Choi","year":"1996","journal-title":"Am. J. Physiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e000960","DOI":"10.1136\/bmjsem-2020-000960","article-title":"Changes in physical activity and sedentary behaviours from before to during the COVID-19 pandemic lockdown: A systematic review","volume":"7","author":"Stockwell","year":"2021","journal-title":"BMJ Open Sport Exerc. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"718877","DOI":"10.3389\/fnut.2021.718877","article-title":"Lifestyle Changes Related to Eating Habits, Physical Activity, and Weight Status During COVID-19 Quarantine in Italy and Some European Countries","volume":"8","author":"Catucci","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Alamri, E.S. (2021). Effects of COVID-19 home confinement on eating behavior: A review. J. Public Health Res., 10.","DOI":"10.4081\/jphr.2021.2088"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.3892\/etm.2016.3104","article-title":"The role of heart rate variability in sports physiology","volume":"11","author":"Dong","year":"2016","journal-title":"Exp. Ther. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/FBP.0000000000000383","article-title":"Heart-rate variability: A biomarker to study the influence of nutrition on physiological and psychological health?","volume":"29","author":"Young","year":"2018","journal-title":"Behav. Pharmacol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/obr.12003","article-title":"Obesity and C-reactive protein in various populations: A systematic review and meta-analysis","volume":"14","author":"Choi","year":"2013","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s10286-007-0441-0","article-title":"Exercise training improves cardiovascular and autonomic profiles in HIV","volume":"17","author":"Spierer","year":"2007","journal-title":"Clin. Auton. Res. Off. J. Clin. Auton. Res. Soc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/25787489.2020.1810452","article-title":"Short-Term aerobic training improves heart rate variability in men living with HIV: A pre-post pilot study","volume":"21","author":"Deresz","year":"2020","journal-title":"HIV Res. Clin. Pract."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/anec.12237","article-title":"Heart rate variability indexes as a marker of chronic adaptation in athletes: A systematic review","volume":"20","author":"Silveira","year":"2015","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1113\/expphysiol.2009.047449","article-title":"Exercise-induced neuronal plasticity in central autonomic networks: Role in cardiovascular control","volume":"94","author":"Michelini","year":"2009","journal-title":"Exp. Physiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1093\/qjmed\/hcr029","article-title":"Physical activity intensity but not sedentary activity is reduced in chronic fatigue syndrome and is associated with autonomic regulation","volume":"104","author":"Newton","year":"2011","journal-title":"QJM Mon. J. Assoc. Physicians"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"561749","DOI":"10.3389\/fphys.2020.561749","article-title":"Potential Role of Autonomic Dysfunction in COVID-19 Morbidity and Mortality","volume":"11","author":"Marcus","year":"2020","journal-title":"Front. Physiol."},{"key":"ref_59","unstructured":"(2021, December 12). Mendeley Data. Available online: https:\/\/data.mendeley.com\/datasets\/t45r8yd6jd\/1."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/4\/2457\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:23:46Z","timestamp":1760135026000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/4\/2457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,21]]},"references-count":59,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["ijerph19042457"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19042457","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.11.17.21266473","asserted-by":"object"}]},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,21]]}}}