Heart rate variability (HRV) is a measure of the variation in time between consecutive heartbeats. It reflects the autonomic nervous system’s regulation of the heart, balancing the sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) branches. HRV is widely regarded as an indicator of cardiovascular health, resilience to stress, and overall well-being. A higher HRV typically suggests better adaptability, while a lower HRV can signal stress, fatigue, or underlying health issues.
Since the emergence of COVID-19, caused by the SARS-CoV-2 virus, researchers have explored its effects on various bodily systems, including the cardiovascular and autonomic nervous systems. A common question that has arisen is whether HRV can be affected—or even “acquired”—after a COVID-19 infection. To address this, we need to clarify the science behind HRV and how COVID-19 interacts with it.
Understanding Heart Rate Variability
HRV is not something you “get” in the sense of acquiring a new trait; rather, it’s a physiological parameter everyone has, which fluctuates based on factors like age, fitness level, stress, sleep, and illness. The question likely intends to ask whether HRV changes—either increasing, decreasing, or becoming dysregulated—following a COVID-19 infection. To answer this, let’s examine the scientific evidence.
COVID-19 and Its Impact on the Autonomic Nervous System
COVID-19 is primarily a respiratory illness, but it can affect multiple systems, including the cardiovascular and nervous systems. Studies have shown that SARS-CoV-2 can disrupt the autonomic nervous system, potentially through inflammation, direct viral effects, or immune responses. Since HRV is a key marker of autonomic function, any disruption could theoretically alter it.
A 2021 study published in Clinical Autonomic Research investigated HRV in patients recovering from COVID-19. The researchers found that individuals with even mild cases exhibited reduced HRV in the weeks following infection, suggesting a temporary imbalance favoring sympathetic activity (stress response) over parasympathetic recovery. This aligns with reports of lingering symptoms in “long COVID,” such as fatigue, palpitations, and shortness of breath, which may reflect autonomic dysfunction.
Another study, published in Frontiers in Physiology (2022), tracked HRV in athletes post-COVID-19. It reported that HRV remained lower than pre-infection baselines for up to two months, even in those who were asymptomatic during the acute phase. This indicates that the virus’s effects on HRV can persist beyond the initial illness, possibly due to inflammation or delayed recovery of autonomic control.
Mechanisms Behind HRV Changes
Several mechanisms might explain why HRV could be altered after COVID-19:
- Inflammation: The cytokine storm—a hyperactive immune response—seen in some COVID-19 cases can stress the cardiovascular system and suppress parasympathetic activity, lowering HRV.
- Direct Viral Effects: SARS-CoV-2 may infect cells in the heart or nervous system via the ACE2 receptor, potentially disrupting autonomic regulation.
- Deconditioning: Prolonged illness or reduced physical activity during recovery can decrease cardiovascular fitness, which is closely tied to HRV.
- Long COVID: In cases of post-acute sequelae of SARS-CoV-2 (PASC), ongoing symptoms like dysautonomia (e.g., postural orthostatic tachycardia syndrome, or POTS) have been linked to persistently low HRV.
Can HRV Improve Post-COVID?
While many studies highlight a decline in HRV after COVID-19, recovery is possible. Research= HRV can return to normal as the body heals, particularly with interventions like exercise, stress management, and adequate sleep—factors known to boost HRV. A 2023 study in Journal of Medical Virology found that patients who engaged in light aerobic exercise and breathing exercises after COVID-19 showed improved HRV within three months, compared to those who remained sedentary.
However, for some individuals with long COVID, HRV may remain altered for an extended period, reflecting a slower return to baseline autonomic function. This variability underscores that the impact of COVID-19 on HRV depends on factors like infection severity, pre-existing health conditions, and recovery efforts.
Conclusion: Yes, HRV Can Change After COVID-19
To clarify the original question: you don’t “get” HRV after COVID-19 in the sense of acquiring it anew—it’s always present. However, scientific evidence confirms that HRV can be significantly affected by a COVID-19 infection. For most people, HRV may decrease temporarily due to the virus’s impact on the autonomic nervous system, with recovery possible over time. For others, particularly those with long COVID, changes in HRV may persist, signaling ongoing health challenges.
If you’re concerned about your HRV post-COVID, wearable devices like smartwatches can track it, though clinical evaluation (e.g., an ECG) offers greater precision. Consulting a healthcare provider is wise if symptoms like irregular heartbeats or fatigue linger. While COVID-19 can throw HRV off balance, the body’s resilience—and a little science-backed care—can often help it bounce back.