SARS-CoV-2 Vaccination Status and Post-Infection Cardiopulmonary Exercise Performance in Elite Male Team-Sport...

Background: SARS-CoV-2 infection may impair functional capacity in athletes, while prior vaccination status may be associated with post-infection functional status. However, evidence comparing objective post-infection exercise responses according to vaccination status in elite athletes remains limited. Methods: This study included a total of 220 male athletes with PCR-confirmed SARS-CoV-2 infections: 101 unvaccinated and 119 vaccinated with two doses prior to infection. Cardiopulmonary exercise testing (CPET) was performed 14 ± 1 days after confirmation of SARS-CoV-2 infection and before the athletes returned to full training. A two-way ANOVA was conducted for each CPET variable, using vaccination status and sport as fixed factors. Results: After accounting for the type of sport, vaccinated athletes showed significantly higher VO₂max, VO₂ at VT1, oxygen pulse, heart rate at VT1, and heart rate at VT2, as well as lower VE/VCO₂ values. No significant differences were found for VEmax, HRmax, or heart rate during recovery. The interaction between vaccination status and sport was not significant for the main CPET outcomes, indicating a similar pattern in both sports. Conclusions: These findings suggest that prior vaccination is associated with a more favorable early post-infection physiological profile in professional team-sport players.