ArticleFrontiers in cardiovascular medicine2026
Engagement of chymase-positive mast cells in myocardial damage associated with COVID-19.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute myocardial injury is a frequent and severe complication of COVID-19, contributing to increased mortality. This study investigates the role of chymase-positive mast cells (MCs) in myocardial damage among patients who died from severe or critical COVID-19. Methods: Cardiac tissue samples from 60 deceased patients were analyzed histologically and immunohistochemically to assess MC density, degranulation status, and associated fibrotic remodeling. Clinical and laboratory parameters, including troponin I levels and inflammatory markers were obtained during hospitalization period. Results: The findings revealed a low overall density of cardiac MCs, with a predominance of degranulated chymase-positive cells. These MCs were significantly correlated with indicators of severe COVID-19 progression, such as neutrophilic leukocytosis, elevated band neutrophils, monocytosis, and increased erythrocyte sedimentation rate. A strong association was also observed between chymase-positive MCs and elevated troponin I levels, the association between troponin I and degranulating chymase-positive MC density remained statistically significant after multivariable adjustment, supporting an independent link to myocardial injury. Additionally, increased MC presence coincided with extensive interstitial and perivascular fibrosis, marked by a predominance of type III collagen. Conclusions: These results support the hypothesis that chymase-positive MCs contribute to myocardial inflammation and fibrosis in the context of COVID-19. Understanding their role may open avenues for targeted therapies aimed at mitigating cardiac complications in future coronavirus-related diseases.
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