Study: Mild, Moderate COVID-19 Can Affect Cardiovascular System in Young Adults


Obesity and a limited physical activity are key factors in post-COVID-19 recovery.

COVID-19 cases, even those that are mild to moderate in severity, can cause an imbalance in the cardiovascular system of young adults without pre-existing diseases, according to researchers at São Paulo State University (UNESP) in Brazil.

The investigators found that obesity and a limited physical activity are key factors in post-COVID-19 recovery that change the autonomic nervous system, affecting the regulation of functions such as blood pressure, heart rate, and breathing.

“The results offer elements that should encourage people even with mild symptoms of COVID-19 to seek a more detailed diagnosis. The processes triggered by the virus can have consequences of which the patient is unaware,” said principal study investigator Fábio Santos de Lira in a press release.

For the study, COVID-19 patients between 20 and 40 years of age were recruited prior to vaccination in Presidente Prudente, which by the end of February had 39,049 confirmed COVID cases and 982 deaths from the virus.

The patients were diagnosed via RT-PCR no more than 6 months previously with mild to moderate symptoms of COVID-19. The researchers compared the study population with a control group of age-matched healthy subjects. In total, 57 individuals were evaluated, 38 of whom remained as the study sample following exclusions due to reasons such as chronic disease, drug use, and vaccination.

For the study, patients received an initial assessment that included an assessment of body mass index (BMI) and physical activity levels by 3-axis accelerometer. Autonomic nervous system functioning was evaluated by measuring heart rate variability.

The investigators noted that post-COVID-19, patients showed augmented activity of the sympathetic nervous system, lower activity of the parasympathetic nervous system, and a drop in overall variability versus the control group.

Among patients who are overweight or obese and less physically inactive, autonomic heart rate modulation was less effective. The investigators said these findings offer a new perspective on the role of BMI and physical activity on post-COVID-19 autonomic deregulation that may contribute to a better understanding of the pathophysiology and treatment of post-acute COVID-19 symptoms, according to the study authors.

“We didn’t expect such an altered cardiovascular system, because they were young and didn’t have other diseases. Our study shows that significant functional alterations are possible in people who have had COVID, even without severe symptoms. This heart rate variation, for example, could become arrhythmia in future,” said study co-author Luciele Guerra Minuzzi, a postdoctoral fellow at UNESP, in a press release.

Variations in heart rate were reflected in the participants’ daily activities, such as the capacity to perform physical exercises, climb staircases, and walking, with fatigue and weakness reported.

The researchers plan to further evaluate other results of the same tests among these patients, who will continue to be monitored after receiving their vaccinations. The next assessment will be conducted in the 18th month post vaccination.


Even mild or moderate COVID-19 can affect the cardiovascular system in young adults, study shows. EurekAlert! March 15, 2022. Accessed March 30, 2022.

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