Ekko feels the pain from previous attempts at fighting the mutant
In the Ekko
teaser it is clear that Ekko is feeling the pain from wounds that he endured while previously attempting to fight the mutant after using his time thingy majigger. So it is bs that he gets his HP back in game after using his back in time ult, it would be allot more consistent if he retained the damage that you have done to him.