- van der Ploeg, Kattria;
- Kirosingh, Adam S;
- Mori, Diego AM;
- Chakraborty, Saborni;
- Hu, Zicheng;
- Sievers, Benjamin L;
- Jacobson, Karen B;
- Bonilla, Hector;
- Parsonnet, Julie;
- Andrews, Jason R;
- Press, Kathleen D;
- Ty, Maureen C;
- Ruiz-Betancourt, Daniel R;
- de la Parte, Lauren;
- Tan, Gene S;
- Blish, Catherine A;
- Takahashi, Saki;
- Rodriguez-Barraquer, Isabel;
- Greenhouse, Bryan;
- Singh, Upinder;
- Wang, Taia T;
- Jagannathan, Prasanna
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific CD4+ T cells are likely important in immunity against coronavirus 2019 (COVID-19), but our understanding of CD4+ longitudinal dynamics following infection and of specific features that correlate with the maintenance of neutralizing antibodies remains limited. Here, we characterize SARS-CoV-2-specific CD4+ T cells in a longitudinal cohort of 109 COVID-19 outpatients enrolled during acute infection. The quality of the SARS-CoV-2-specific CD4+ response shifts from cells producing interferon gamma (IFNγ) to tumor necrosis factor alpha (TNF-α) from 5 days to 4 months post-enrollment, with IFNγ-IL-21-TNF-α+ CD4+ T cells the predominant population detected at later time points. Greater percentages of IFNγ-IL-21-TNF-α+ CD4+ T cells on day 28 correlate with SARS-CoV-2-neutralizing antibodies measured 7 months post-infection (⍴ = 0.4, p = 0.01). mRNA vaccination following SARS-CoV-2 infection boosts both IFNγ- and TNF-α-producing, spike-protein-specific CD4+ T cells. These data suggest that SARS-CoV-2-specific, TNF-α-producing CD4+ T cells may play an important role in antibody maintenance following COVID-19.