SARS-CoV-2 infection induces robust germinal center CD4 T follicular helper cell responses in rhesus macaques

CD4 T follicular helper (T (fh) ) cells are important for the generation of durable and specific humoral protection against viral infections The degree to which SARS-CoV-2 infection generates T (fh) cells and stimulates the germinal center response is an important question as we investigate vaccine options for the current pandemic Here we report that SARS-CoV-2 infection resulted in transient accumulation of pro-inflammatory monocytes and proliferating T (fh) cells with a T (h) 1 profile in peripheral blood CD4 helper cell responses were skewed predominantly toward a T (h) 1 response in blood, lung, and lymph nodes We observed the generation of germinal center T (fh) cells specific for the SARS-CoV-2 spike (S) and nucleocapsid (N) proteins, and a corresponding early appearance of antiviral serum IgG antibodies Our data suggest that a vaccine promoting T (h) 1-type T (fh) responses that target the S protein may lead to protective immunity