An analysis of primary and secondary myocardial lesions under the conditions of transmission of the COVID-19 infection, causative factors and consequences of the progression of the pathological condition was carried out. Some possibilities of protection against infection and its consequences are noted. Among the first problems with the spread of SARS-CoV-2 in patients with heart failure is the need to distinguish viral lung disease from acute edema. Particular attention is paid to disorders of immune regulation and inflammation, which can exacerbate the imbalance between oxygen supply and myocardial energy needs. At the same time, the importance of troponin I, natriuretic peptide type B and C-reactive protein and creatinine, hypokalemia are highlighted. The central role is played by angiotensin-converting enzyme 2, the suppression of which enhances the local inflammatory response and fibrosis. Progression of infection is associated with stress cardiomyopathy and acute decompensation of chronic heart failure. They note the possibility of reducing infection, protecting the heart from systolic dysfunction, and correcting stress-induced biological reactions of the body, in particular, by the action of low temperatures.