Role of mast cell proteases in cardiac damage in new coronavirus infection

INTRODUCTION: Coronavirus Disease 2019 (COVID-19) is the cause of the global pandemic of 2019–2023. Despite the fact that COVID-19 primarily affects the lung tissue, cardiovascular complications are not uncommon both at the height of the disease, and in the post-COVID period. The presence of previous cardiovascular diseases and advanced age of the patient are proven risk factors of adverse outcomes in COVID-19. AIM: Based on the analysis of the current literature sources, to determine the role of mast cell proteases in the pathogenesis of cardiovascular complications of COVID-19. Excessive production of pro-inflammatory cytokines and chemokines by mast cells in the new coronavirus infection conditions the initiation of a severe systemic inflammatory response that affects not only the lung tissue, but also the myocardium. One most significant mechanism of the development of cardiovascular complications in patients with COVID-19 is endothelial dysfunction of the microcirculatory system with the formation of ischemic areas with subsequent local apoptosis of cardiac myocytes. CONCLUSION: Cardiovascular complications of COVID-19 develop primarily due to the damaging effect of proinflammatory cytokines, the production of which is stimulated by proteases of activated mast cells. Because of small amount of published data, additional investigation is required.