text: Evidence for impaired chronotropic responses to and recovery from 6 minute walk test in women with post acute COVID 19 syndrome What is the central question of this study Are chronotropic responses to a 6 minute walk test different in women with post acute coronavirus disease 2019 COVID 19 syndrome compared with control subjects What is the main finding and its importance Compared with control subjects the increase in heart rate was attenuated and recovery delayed after a 6 minute walk test in participants after infection with severe acute respiratory syndrome coronavirus 2 SARS CoV 2 Women reporting specific symptoms at time of testing had greater impairments compared with control subjects and SARS CoV 2 participants not actively experiencing these symptoms Such alterations have potential to constrain not only exercise tolerance but also participation in free living physical activity in women during post acute recovery from COVID 19 The short term cardiopulmonary manifestations of severe acute respiratory syndrome coronavirus 2 SARS CoV 2 are well defined However the implications of cardiopulmonary sequelae persisting beyond acute illness on physical function are largely unknown Herein we characterized heart rate responses to and recovery from a 6 minute walk test 6MWT in women 3 months after mild to moderate SARS CoV 2 infection compared with non infected control subjects Forty five women n 29 SARS CoV 2 n 16 controls age 56 11 years body mass index 25 8 6 0 kg m sup 2 sup completed pulmonary function testing and a 6MWT The SARS CoV 2 participants demonstrated reduced total lung capacity 84 8 vs 93 13 P 0 006 vital capacity 87 10 vs 93 10 P 0 040 functional residual capacity 75 16 vs 88 16 P 0 006 and residual volume 76 18 vs 93 22 P 0 001 compared with control subjects No between group differences were observed in 6MWT distance P 0 194 however the increase in heart rate with exertion was attenuated among SARS CoV 2 participants compared with control subjects 52 20 vs 65 18 beats min P 0 029 The decrease in heart rate was also delayed for minutes 1 5 of recovery among SARS CoV 2 participants all P 0 05 Women reporting specific symptoms at the time of testing had greater impairments compared with control subjects and SARS CoV 2 participants not actively experiencing these symptoms Our findings provide evidence for marked differences in chronotropic responses to and recovery from a 6MWT in women several months after acute SARS CoV 2 infection 