Internal medicine

Disease

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Biology

Outbreak

Molecular biology

Follicular phase

Antibody

Virology

Immunology

B cell

2019-20 coronavirus outbreak

Cell biology

Germinal center

Cancer research

Genetics

Medicine

Cell

Shiv Pillai and colleagues show that in acute COVID-19, there is a striking loss of germinal centers in lymph nodes and spleens and depletion of Bcl-6+ B cells but preservation of AID+ B cells. A specific block in germinal center type Bcl-6+ T follicular helper cell differentiation may explain the loss of germinal centers and the accumulation of non-germinal-center-derived activated B cells. These data suggest an underlying basis for the lower quality and lack of durability of humoral immune responses observed during natural infection with SARS-CoV-2 and have significant implications for expectations of herd immunity.

Loss of Bcl-6-Expressing T Follicular Helper Cells and Germinal Centers in COVID-19