Therefore, considering the immunomodulatory potential of the purinergic system, we believe that the blockade of P2X1R, P2X4R P2X7R, P2Y1R, and P2Y2R and upregulation of A2AR and A3R could be ideal mechanisms for pharmacological therapy of myocardial injury caused by CS in COVID-19. This evidence concerns the gene P2RX4 and Cowden syndrome 1.