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

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.