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We evaluated longitudinal antibody and soluble immune mediator profiles to identify prognostic signatures associated with survival in severe COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective longitudinal study, peripheral blood samples were collected from 30 unvaccinated adults with severe COVID\u201019 admitted to the intensive care unit (ICU) and 30 healthy controls. Serum concentrations of SARS\u2010CoV\u20102\u2013specific IgM, IgG and IgA antibodies (S1, RBD and N) and 27 cytokines, chemokines and growth factors were quantified at ICU admission (D0), Day 7 (D7) and Day 14 (D14) using Luminex multiplex assays. Patients were classified according to clinical outcome: discharge (DIS) or death (DEA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DIS and DEA patients exhibited distinct immunological trajectories. DEA patients showed early elevations of IgM anti\u2010N and IgM anti\u2010RBD at D0, accompanied by increased IFN\u2010\u03b3. At D7, persistently elevated TNF\u2010\u03b1 and FGF\u2010basic differentiated nonsurvivors, while by D14, higher levels of CXCL8, CCL4, CXCL10 and G\u2010CSF were strongly associated with mortality. In contrast, DIS patients exhibited more coordinated immune regulation, including sustained IL\u201013 production and higher IgA anti\u2010S1 and IgA anti\u2010RBD levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrated humoral and inflammatory signatures, particularly early IgM anti\u2010N\/anti\u2010RBD responses and sequential increases in IFN\u2010\u03b3, TNF\u2010\u03b1, FGF\u2010basic, CXCL8, CCL4, CXCL10 and G\u2010CSF, highlight immune signatures associated with poor outcomes. IL\u201013 and coordinated antibody interactions may reflect protective immune pathways. These findings highlight the prognostic value of multidimensional immune monitoring in severe COVID\u201019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cti2.70082","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:43:40Z","timestamp":1772999020000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Integrated humoral and inflammatory signatures predict outcomes in severe\n                    <scp>COVID<\/scp>\n                    \u201019: a 14\u2010day longitudinal analysis"],"prefix":"10.1002","volume":"15","author":[{"given":"Hiochelson Najibe Santos","family":"Ibiapina","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas (UEA)  Manaus AM Brazil"},{"name":"Diretoria de Ensino e Pesquisa Funda\u00e7\u00e3o de Medicina Tropical Dr. Heitor Veira Dourado (FMT\u2010HVD)  Manaus Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1373-0953","authenticated-orcid":false,"given":"Fabio","family":"Magalh\u00e3es\u2010Gama","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade, Instituto Ren\u00e9 Rachou, Funda\u00e7\u00e3o Oswaldo Cruz (FIOCRUZ\u2010Minas)  Belo Horizonte Brazil"},{"name":"Grupo Integrado de Pesquisas em Biomarcadores, Instituto Ren\u00e9 Rachou, Funda\u00e7\u00e3o Oswaldo Cruz (FIOCRUZ\u2010Minas)  Belo Horizonte Brazil"},{"name":"Diretoria de Ensino e Pesquisa, Funda\u00e7\u00e3o Hospitalar de Hematologia e Hemoterapia do Amazonas (HEMOAM)  Manaus AM Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Costa Ferreira","family":"Neves","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Medicina Tropical, Universidade do Estado do Amazonas (UEA)  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