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Background Recent studies indicated that females have a lower morbidity, severe cases rate, mortality and better outcome than those of male. However, it remained to be addressed why this was the case. Methods and findings To find the factors that potentially protect females from COVID-19, we recruited all confirmed patients hospitalized at three branches of Tongji Hospital (n=1902) from January 28 to March 8, 2020, and analyzed the correlation between menstrual status (n=509，including 68 from Mobile Cabin Hospital)/female hormones (n=78)/ cytokines related to immunity and inflammation(n=263), and the severity/clinical outcomes in female patients under 60 years of age.Non-menopausal female patients had milder severity and better outcome compared with age-matched men (p<0.01/p<0.01). Menopausal patients had longer hospitalization times than non-menopausal patients ( hazard ratio [HR], 1.91; 95% confidence interval [CI], 1.06-3.46，p= 0.033). Both anti-müllerian hormone (AMH) and estradiol (E2) showed a negative correlation with severity of infection (AHR=0.146/0.304, 95%CI = [0.026-0.824]/[0.092-1.001], p=0.029/0.05). E2 levels were negatively correlated with IL-2R, IL-6, IL-8 and TNFα in luteal phase (Pearson Correlation=-0.592, -0.558, -0.545, -0.623; p=0.033, 0.048, 0.054, 0.023), and with C3 in follicular phase (Pearson Correlation=-0.651; p=0.030). Conclusion Menopause is an independent risk factor for female COVID-19 patients. AMH and E2 are potential protective factors, negatively correlated with COVID-19’s severity, among which E2 is attributed to its regulation of cytokines related to immunity and inflammation. Hormone supplement might be a potential therapy for COVID-19 patients.

To delineate the clinical characteristics of critically ill COVID-19 patients co-infected with influenza. Methods: This study included adult patients with laboratory-confirmed COVID-19 form Tongji Hospital (Wuhan, China), with or without influenza, and compared their clinical characteristics. Results: Among 93 patients, 44 died and 49 were discharged. Forty-four (47.3%) were infected with influenza virus A and two (2.2%) with influenza virus B. Twenty-two (50.0%) of the non-survivors and 24 (49.0%) of the survivors were infected with the influenza virus. Critically ill COVID-19 patients with influenza were more prone to cardiac injury than those without influenza. For the laboratory indicators at admission the following were higher in non-survivors with influenza than in those without influenza: white blood cell counts, neutrophil counts, levels of tumor necrosis factor-α, D-dimer value, and proportion of elevated creatinine. Conclusion:The results showed that a high proportion of COVID-19 patients were co-infected with influenza in Tongji Hospital, with no significant difference in the proportion of co-infection between survivors and non-survivors. The critically ill COVID-19 patients with influenza exhibited more severe inflammation and organ injury, indicating that co-infection with the influenza virus may induce an earlier and more frequently occurring cytokine storm.

Objective: This study was intended to investigate the relationship between COVID-19 disease and ovarian function in reproductive-aged women.Methods: Female COVID-19 patients of reproductive age were recruited between January 28 and March 8, 2020 from Tongji Hospital in Wuhan. Their baseline and clinical characteristics, as well as menstrual conditions, were recorded. Differentials in ovarian reserve markers and sex hormones (including anti-Müllerian hormone [AMH], follicle-stimulating hormone [FSH], the ratio of FSH to luteinizing hormone [LH], estradiol [E2], progesterone [P], testosterone [T], and prolactin [PRL] were compared to those of healthy women who were randomly selected and individually matched for age, region, and menstrual status. Uni- and multi-variable hierarchical linear regression analyses were performed to identify risk factors associated with ovarian function in COVID-19 women.Results: Seventy eight patients agreed to be tested for serum hormone, of whom 17 (21.79%) were diagnosed as the severe group and 39 (50%) were in the basal level group. Menstrual status (P = 0.55), menstrual volumes (P = 0.066), phase of menstrual cycle (P = 0.58), and dysmenorrhea history (P = 0.12) were similar without significant differences between non-severe and severe COVID-19 women. Significant lower serum AMH level/proportion (0.19/0.28 vs. 1.12 ng/ml, P = 0.003/0.027; AMH ≤ 1.1 ng/ml: 75/70.4 vs. 49.7%, P = 0.009/0.004), higher serum T (0.38/0.39 vs. 0.22 ng/ml, P < 0.001/0.001) and PRL (25.43/24.10 vs. 12.12 ng/ml, P < 0.001/0.001) levels were observed in basal level and the all-COVID-19 group compared with healthy age-matched control. When adjusted for age, menstrual status and parity variations in multivariate hierarchical linear regression analysis, COVID-19 disease was significantly associated with serum AMH (β = −0.191; 95% CI: −1.177–0.327; P = 0.001), T (β = 0.411; 95% CI: 11.154–22.709; P < 0.001), and PRL (β = 0.497; 95% CI: 10.787–20.266; P < 0.001), suggesting an independent risk factor for ovarian function, which accounted for 3.2% of the decline in AMH, 14.3% of the increase in T, and 20.7% of the increase in PRL.Conclusion: Ovarian injury, including declined ovarian reserve and reproductive endocrine disorder, can be observed in women with COVID-19. More attention should be paid to their ovarian function under this pandemic, especially regarding reproductive-aged women.Clinical Trial Number: ChiCTR2000030015.

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Cooperative luminescence (CL) occurs in spectral regions in which single ions do not have energy levels. It was first observed more than 40 years ago, and all results reported so far are from a pair of ions. In this work, upconverted CL of three Yb 31 ions was observed in the ultraviolet (UV) region under near-infrared (NIR) excitation. The UV CL intensity showed a cubic dependence on the NIR pump power, whereas the luminescence lifetime was nearly one-third the luminescence lifetime of single Yb 31 ions. The triplet CL (TCL) has a clear spectral structure, in which most emission peaks are consistent with the self-convoluted spectra from single Yb 31 ions. Blue shifts were observed for certain peaks, indicating complex interactions among the excited Yb 31 ions. The probability of the TCL process versus the average distances among three Yb 31 ions was derived via the first-and second-order corrections to the wave functions of lanthanide ions, indicating that the formation of Yb 31 clusters containing closely spaced ions favors the occurrence of the multi-ion interaction processes. Furthermore, the cooperative sensitization of one Gd 31 ion by four excited Yb 31 ions (Yb 31 -tetramer) was demonstrated experimentally, which exhibited a novel upconversion mechanism-cluster sensitization. Our results are intriguing for further exploring quantum transitions that simultaneously involve multiple ions. Keywords: cooperative luminescence; cooperative sensitization; quantum transition; ytterbium cluster INTRODUCTION Cooperative luminescence (CL) usually describes the processes by which a pair of ions emits one photon by simultaneous depopulation from their excited states. It represents a special type of electronic transitions occurring in spectral regions where the individual ions do not have absorption or emission. Experimental CL results are essential clues to understanding the nature of cooperative quantum transitions, such as the energy shifts of pair levels from their parent single-ion levels, the selection rules obeyed by the cooperative transitions, and quantum entanglement in multibody systems. [1][2][3] The first CL was demonstrated with a pair of excited Yb 31 ions in 1970. 4 Since then, the CL from Yb 31 -dimers has been studied extensively due to their unique 4f 13 configuration with two multiplets ( 2 F 5/2 , 2 F 7/2 ) and the relatively large absorption cross-section at ,980 nm. Various applications, such as scintillators, structural probes in solids and optical bistability, have been demonstrated with the CL from Yb 31 -dimers. [5][6][7][8][9][10][11] However, the relatively low emission cross-section impedes further experimental investigation of multi-ion cooperative processes.Nevertheless, CL is fundamentally fascinating from a purely theoretical perspective. More than 50 years ago, Dexter explained the cooperative processes based on first-order perturbation theory, 12 in which Coulomb coupling between two ions allows for their cooperative transition as a pair of ions. For processes involving three ions si...

Autoimmune diseases are a worldwide health problem with growing rates of morbidity, and are characterized by breakdown and dysregulation of the immune system. Although their etiology and pathogenesis remain unclear, the application of dietary supplements is gradually increasing in patients with autoimmune diseases, mainly due to their positive effects, relatively safety, and low cost. Quercetin is a natural flavonoid that is widely present in fruits, herbs, and vegetables. It has been shown to have a wide range of beneficial effects and biological activities, including anti-inflammation, anti-oxidation, and neuroprotection. In several recent studies quercetin has reportedly attenuated rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, and systemic lupus erythematosus in humans or animal models. This review summarizes the evidence for the pharmacological application of quercetin for autoimmune diseases, which supports the view that quercetin may be useful for their prevention and treatment.

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