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Symptoms may appear during the acute phase of infection, but the literature on long-term recovery of young adults after mild to moderate infection is lacking. Heart rate variability (HRV) allows for the observation of autonomic nervous system (ANS) modulation post-SARS-CoV-2 infection. Since physical activity (PA) can help improve ANS modulation, investigating factors that can influence HRV outcomes after COVID-19 is essential to advancements in care and intervention strategies. Clinicians may use this research to aid in the development of non-medication interventions. At baseline, 18 control (CT) and 20 post-COVID-19 (PCOV) participants were observed where general anamnesis was performed, followed by HRV and PA assessment. Thus, 10 CT and 7 PCOV subjects returned for follow-up (FU) evaluation 6 weeks after complete immunization (two doses) and assessments were repeated. Over the follow-up period, a decrease in sympathetic (SNS) activity (mean heart rate: p = 0.0024, CI = \u221224.67\u2013\u22123.26; SNS index: p = 0.0068, CI = \u22122.50\u2013\u22120.32) and increase in parasympathetic (PNS) activity (mean RR: p = 0.0097, CI = 33.72\u2013225.51; PNS index: p = 0.0091, CI = \u22120.20\u20131.47) were observed. At follow-up, HRV was not different between groups (p &gt; 0.05). Additionally, no differences were observed in PA between moments and groups. This study provides evidence of ANS recovery after SARS-CoV-2 insult in young adults over a follow-up period, independent of changes in PA.<\/jats:p>","DOI":"10.3390\/ijerph20032251","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T03:31:11Z","timestamp":1675049471000},"page":"2251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Autonomic Function Recovery and Physical Activity Levels in Post-COVID-19 Young Adults after Immunization: An Observational Follow-Up Case-Control Study"],"prefix":"10.3390","volume":"20","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, WA 98926, USA"},{"name":"Physiotherapy Department, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil"},{"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\/0000-0002-5338-4541","authenticated-orcid":false,"given":"Shaan","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Central Washington University, Ellensburg, WA 98926, USA"}]},{"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"},{"name":"Faculty of Sport Science and Physical Education, University of Coimbra, CIDAF, 3000-456 Coimbra, Portugal"}]},{"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"}]},{"given":"Telmo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Faculty of Sport Science and Physical Education, University of Coimbra, CIDAF, 3000-456 Coimbra, Portugal"},{"name":"Polytechnic of Coimbra, ESTESC, 3046-854 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 Physical 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, 3046-854 Coimbra, Portugal"},{"name":"Laboratory for Applied Health Research (LabinSa\u00fade), 3046-854 Coimbra, Portugal"},{"name":"Molecular Physical-Chemistry R & D Unit, Faculty of Science and Technology, University of Coimbra, 3004-535 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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4454-888X","authenticated-orcid":false,"given":"Vanessa Ribeiro","family":"Dos Santos","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"}]},{"given":"Osmar Marchioto","family":"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\/0000-0003-3116-4553","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, 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