Coronavirus disease 2019 (COVID-19) pandemic had a 1st wave in Europe from March to May 2020 and a 2nd wave since September 2020. We previously studied 35 hospitalized COVID-19 patients of the 1st wave demonstrating a cytokine storm and the exhaustion of most lymphocyte subpopulations. Herein, we describe the results obtained from COVID-19 patients of the 2nd wave. We analyzed interleukin (IL)-6 by human-specific enzyme-linked immunosorbent assay and a large set of lymphocyte subpopulations by flow cytometry in 274 COVID-19 patients hospitalized from September 2020 to May 2021. Patients of 2nd wave compared with those of 1st wave showed lower serum IL-6 levels and a higher number of B and most T lymphocyte subpopulations in advanced stages, in relation with the age and the gender. On the other hand, we observed in 2nd wave patients: (i) a reduction of most lymphocyte subpopulations at mild and moderate stages; (ii) a reduction of natural killer cells and T regulatory cells together with a higher number of activated T helper (TH) 17 lymphocytes in all stages, which were mainly related to steroid and azithromycin therapies before hospitalization. COVID-19 had a less severe impact in patients of the 2nd wave in advanced stages, while the impact appeared more severe in patients of mild and moderate stages, as compared with 1st wave patients. This finding suggests that in COVID-19 patients with milder expression at diagnosis, steroid and azithromycin therapies appear to worsen the immune response against the virus. Furthermore, the cytometric profile may help to drive targeted therapies by monoclonal antibodies to modulate specific IL/lymphocyte inhibition or activation in COVID-19 patients.

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COVID-19 患者的细胞学分析：第二波有什么变化？

2019 年冠状病毒病 (COVID-19) 大流行于 2020 年 3 月至 5 月在欧洲出现了第一波，自 2020 年 9 月以来出现了第二波。我们之前研究了第一波的 35 名住院 COVID-19 患者，这些患者表现出细胞因子风暴和大多数人的疲惫淋巴细胞亚群。在此，我们描述了从第二波 COVID-19 患者获得的结果。我们在 2020 年 9 月至 2021 年 5 月期间住院的 274 名 COVID-19 患者中，通过人类特异性酶联免疫吸附试验分析了白细胞介素 (IL)-6，并通过流式细胞术分析了大量淋巴细胞亚群。第二波患者与第一波患者相比与年龄和性别相关的 B 和大多数 T 淋巴细胞亚群在晚期显示较低的血清 IL-6 水平和较高的数量。另一方面，我们在第二波患者中观察到：(i) 在轻度和中度阶段，大多数淋巴细胞亚群减少；(ii) 在所有阶段，自然杀伤细胞和 T 调节细胞的减少以及更多数量的活化 T 辅助 (TH) 17 淋巴细胞，这主要与住院前的类固醇和阿奇霉素治疗有关。COVID-19对晚期第二波患者的影响较轻，而与第一波患者相比，对轻度和中度患者的影响更为严重。这一发现表明，在诊断时表达较轻的 COVID-19 患者中，类固醇和阿奇霉素治疗似乎会恶化对病毒的免疫反应。此外，