Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial

We report the first long-term follow-up of a randomized trial (NCT04978259) addressing the effects of remdesivir on recovery (primary outcome) and other patient-important outcomes one year after hospitalization resulting from COVID-19. Of the 208 patients recruited from 11 Finnish hospitals, 198 survived, of whom 181 (92%) completed follow-up. At one year, self-reported recovery occurred in 85% in remdesivir and 86% in standard of care (SoC) (RR 0.94, 95% CI 0.47-1.90). We infer no convincing difference between remdesivir and SoC in quality of life or symptom outcomes (p > 0.05). Of the 21 potential long-COVID symptoms, patients reported moderate/major bother from fatigue (26%), joint pain (22%), and problems with memory (19%) and attention/concentration (18%). In conclusion, after a one-year follow-up of hospitalized patients, one in six reported they had not recovered well from COVID-19. Our results provide no convincing evidence of remdesivir benefit, but wide confidence intervals included possible benefit and harm.Peer reviewe

Social media and small entrepreneurial firms’ internationalization

Abstract Small entrepreneurial firms often need to be quite creative when allocating and deploying their limited resources. Especially in grasping international opportunities, social media provides a seemingly affordable and far-reaching medium. However, challenges—such as the controllability of the content and the outcomes of using social media—become apparent as the reach of social media marketing expands beyond certain threshold limits. In this study, we rely on data from multiple case studies to evaluate to what extent and under which conditions social media can support small entrepreneurial firms’ international expansion. Thereby, we contribute to research on SME internationalization and business implications of digitalization. Our findings indicate that small entrepreneurial firms face somewhat different social media–related challenges in the international business environment compared to domestic settings. The controllability of the contents comes with new tones. Furthermore, small firms’ resources, both in terms of social media use and in different functions, play an important role in determining the extent to which the use of social media supports these firms’ internationalization

52-year follow-up of a birth cohort reveals a high pneumonia incidence among young men

Abstract Background: Knowledge of pneumonia incidence and risk factors in adults is mainly based on clinical studies of selected patient data and registers with ageing populations. Prospective population-based investigations, such as birth cohort studies, are needed to understand pneumonia incidence and risk factors among young and working-age populations. Methods: Northern Finland Birth Cohort (NFBC) 1966 data (n=6750) were analysed for pneumonia incidence and risk factors. Incidence analysis was replicated using data from an independent NFBC 1986 cohort (n=9207). Pneumonia in relation to chronic conditions and lifestyle factors was analysed. Results: A peak with a maximum of 227 pneumonia episodes per 10 000 among men between the ages of 19 and 21 years was found in two independent cohorts. Pneumonia was associated with male sex (relative risk 1.72, 95% CI 1.45–2.04; p<0.001), low educational level (relative risk 2.30, 95% CI 1.72–3.09; p<0.001), smoking (relative risk 1.55, 95% CI 1.31–1.84; p<0.001), asthma (relative risk 2.19, 95% CI 1.73–2.75; p<0.001), cardiovascular diseases (relative risk 2.50, 95% CI 2.04–3.07; p=0.001), kidney diseases (relative risk 4.14, 95% CI 2.81–6.10; p<0.001), rheumatoid arthritis (relative risk 2.69, 95% CI 1.80–4.01; p<0.001), psoriasis (relative risk 2.91, 95% CI 1.92–4.41; p<0.001) and type II diabetes (relative risk 1.80, 95% CI 1.34–2.42; p<0.001). Men with excessive alcohol consumption at age 31 years were at risk of future pneumonia (relative risk 2.40, 95% CI 1.58–3.64; p<0.001). Conclusions: Birth cohort data can reveal novel high-risk subpopulations, such as young males. Our study provides understanding of pneumonia incidence and risk factors among young and working age populations

Low and high serum IgG associates with respiratory infections in a young and working age population

Abstract Background: We investigated health consequences and genetic properties associated with serum IgG concentration in a young and working age general population. Methods: Northern Finland Birth Cohort 1966 (NFBC1966, n = 12,231) health data have been collected from birth to 52 years of age. Relationships between life-long health events, medications, chronic conditions, lifestyle, and serum IgG concentration measured at age 46 years (n = 5430) were analysed. Regulatory mechanisms of serum IgG concentration were considered. Findings: Smoking and genetic variation (FCGR2B and TNFRSF13B) were the most important determinants of serum IgG concentration. Laboratory findings suggestive of common variable immunodeficiency (CVID) were 10-fold higher compared to previous reports (73.7 per 100,000 vs 0.6–6.9 per 100,000). Low IgG was associated with antibiotic use (relative risk 1.285, 95% CI 1.001–1.648; p = 0.049) and sinus surgery (relative risk 2.257, 95% CI 1.163–4.379; p = 0.016). High serum IgG was associated with at least one pneumonia episode (relative risk 1.737, 95% CI 1.032–2.922; p = 0.038) and with total number of pneumonia episodes (relative risk 2.167, 95% CI 1.443–3.254; p < 0.001). Interpretation: CVID-like laboratory findings are surprisingly common in our unselected study population. Any deviation of serum IgG from normal values can be harmful; both low and high serum IgG may indicate immunological insufficiency. Critical evaluation of clinical presentation must accompany immunological laboratory parameters. Funding: Oulu University Hospital VTR, CSL Behring, Foundation for Pediatric Research