Mindfulness practices may also improve HRV, potentially reducing the impact of sources of emotional stress related to PCC, such as anxiety and stress symptoms. Mindfulness can enhance dispositional awareness, moderating stress responses and physiological reactions [29; 30]. Recent reviews have provided tentative evidence of mindfulness-based training and other mind-body therapies [31], including Tai Chi, Yoga, Qi Gong, and meditation, modifying inflammatory biomarkers and HRV [32; 33]. The role of ANS in emotional regulation and HRV is well known, but its relationship with cognitive functions is less clear. The neurovisceral integration model proposes that sympathetic hyperactivation, resulting in prefrontal hypoactivation, facilitates disinhibition of the amygdala, leading to a decrease in HRV and an increase in heart rate [34]. This hypervigilant response could be associated with reduced cognitive flexibility. Conversely, parasympathetic activity, with its lack of prefrontal hypoactivation, could lead to an increase in HRV and improved cognitive functions [34]. Several studies have confirmed this link between higher resting HRV and active inhibitory prefrontal-subcortical circuits [35; 36]. To be more specific, higher resting-state HRV was linked to increased activity in executive brain regions [35], while lower resting HRV was associated with hypoactive prefrontal regulation [37; 38]. Consequently, vagal control of the heart has been associated with effective self-regulatory neural circuits, which putatively enable the organism to respond more quickly and flexibly to environmental demands [34; 35]. Considering the previous evidence, a multimodal therapeutic approach combining physical activity, mindfulness-based techniques, and cognitive training may offer significant benefits for COVID-19 survivors experiencing reduced HRV. Immersive virtual reality (IVR) is a promising technology that has the potential to enhance this multimodal program and offers varying levels of immersion. IVR typically produces a computer-generated 360\({}^{\circ}\) virtual world through an immersive display device [36]. Several studies have investigated the efficacy of using IVR cognitive training interventions to treat vulnerable populations. Recent systematic reviews and meta-analyses have found that VR exergames, which combine gaming and physical movement, can lead to significant improvements in cognitive function, memory, and mood in older adults [37, 38]. Such interventions are perceived as less intensive and more enjoyable than traditional exercises, thus encouraging longer and more frequent sessions and healthier changes in lifestyle [39]. Recent research underscores the transformative impact of VR in post-COVID-19 rehabilitation, offering significant benefits for patient recovery and quality of life. Recent studies have shown that digital interventions can enhance quality of life and hasten a return to independence [40], while home-based VR exercises have been well received, demonstrating notable improvements in participant health and well-being [41]. A systematic review further suggested that VR applications could mitigate functional and cognitive impairments associated with COVID-19, leading to high levels of patient satisfaction and empowering individuals to manage their own healthcare more effectively [42]. Other reviews of VR used in cardiac rehabilitation have revealed that such interactive tools make therapy more enjoyable and engaging, thereby increasing motivation [43]. Although these studies suggest that interactive VR can improve engagement in cognitive and/or physical activities, further research in hospital environments is needed to explore the full potential of VR in this field. Based on the previously reviewed evidence, there is growing support for the use of VR multimodal training paradigms. It has been demonstrated that they offer significant potential to transform rehabilitation for patients with PCC, including the modulation of HRV parameters.