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The way he says these days makes it seem like a recent issue. Remember Khamzat got COVID, was coughing up blood and was gonna retire. His cardio has looked sus and he's looked bad when his fights have gone past the 1st round when he can't get an early finish and has to go the distance noticeably slowing down.
It seems like COVID or vax might have gotten Khamzat. The way Gus talks about it seems like a recent thing and Khamzat can't go as hard in training as he used to without bad physical reactions. In any case his days are numbered IMO and it's gonna be tough for him to ever be champ if he even gets a title fight he has to finish it early or he's fooked in 5 rounders like Zabit would've been.