Ventilatory efficiency in post‐COVID‐19 athletes

Limitation in exercise capacity has not been described in athletes affected by SARS‐CoV‐2 infection. However, patients who have recovered from COVID‐19 without cardiopulmonary impairment show exaggerated ventilatory response during exercise. Therefore, we aimed to evaluate the ventilatory efficiency (VEf) in competitive athletes recovered from COVID‐19 and to characterize the ventilation versus carbon dioxide relationship (VE/VCO(2)) slope in this population. Thirty‐seven competitive athletes with COVID‐19 were recruited for this study. All participants underwent spirometry, echocardiography, and cardiopulmonary exercise testing (CPET). z‐FVC values and end‐title pressure of CO(2) (P(ET)CO(2)) were lower in the third tertile compared with the first tertile: −0.753 ± 0.473 vs. 0.037 ± 0.911, p = 0.05; 42.2 ± 2.7 vs. 37.1 ± 2.5 mmHg, p < 0.01. VE/VCO(2) slope was significantly correlated to maximal VCO(2)/VE and maximal VO(2)/VE: coefficient = −0.5 R (2) = 0.58, p < 0.0001 and coefficient = −0.3 R (2) = 0.16, p = 0.008. Competitive athletes affected by SARS‐CoV‐2 infection, without cardio‐respiratory disease sequel, may present ventilatory inefficiency (ViE), without exercise capacity limitation. FVC is higher in athletes with better ventilatory performance during exercise, and increased VE/VCO(2) slope is inversely correlated to max VCO(2)/VE and max VO(2)/VE.