Suchergebnisse

OBJECTIVE: Social distancing has been one of the primary interventions used to slow the spread of COVID-19 during the ongoing pandemic. Although state-wide stay-at-home orders in the United States received a large degree of media and political attention, relatively little peer-reviewed research has examined the impacts of such orders social distancing behaviors. METHOD: This study used daily GPS-derived movement from 2,858 counties in the United States from March 1 to May 7, 2020 to test the degree to which changes in state-level stay-at-home orders were associated with movement outside the home. RESULTS: From early March to early April, people in counties with state-level stay-at-home orders decreased their movement significantly more than counties without state-level stay-at-home orders; 3.1% more people stayed within 1 mile of home and 1.6% fewer vehicle miles were driven per day. From early April to early May, people in counties within states that ended their stay-at-home orders increased their movement significantly more than counties in states whose stay-at-home orders remained in place; 1.2% fewer people remained within 1 mile of home and 6.2% more vehicle miles were driven per day. The magnitude of changes associated with state-level stay-at-home orders were many times smaller than the total changes in movement across all counties over the same periods. CONCLUSIONS: Stay-at-home orders were associated with greater social distancing, but accounted for only part of this behavioral change. Research on behavior change would be useful to determine additional interventions that could support social distancing during the COVID-19 pandemic.

Abstract

Background
Sickle cell disease (SCD) is a chronic medical condition characterized by red blood cell sickling, vaso-occlusion, hemolytic anemia, and subsequently, end-organ damage and reduced survival. Because of this significant pathophysiology and early mortality, we hypothesized that patients with SCD are experiencing accelerated biological aging compared to individuals without SCD.


Methods
We utilized the DunedinPACE measure to compare the epigenetic pace of aging in 131 Black Americans with SCD to 1391 Black American veterans without SCD.


Results
SCD patients displayed a significantly accelerated pace of aging (DunedinPACE mean difference of 0.057 points) compared to the veterans without SCD, whereby SCD patients were aging approximately 0.7 months more per year than those without SCD (p=4.49x10-8). This was true, even though the SCD patients were significantly younger according to chronological age than the individuals without SCD, making the epigenetic aging discrepancy even more apparent. This association became stronger when we removed individuals with PTSD from the non-SCD group (p=2.18x10-9), and stronger still when we restricted the SCD patients to those with hemoglobin SS and Sβ0 thalassemia genotypes (p=1.61x10-10).


Conclusions
These data support our hypothesis that individuals with SCD experience accelerated biological aging as measured by global epigenetic variation. The assessment of epigenetic measures of biological aging may prove useful to identify which SCD patients would most benefit from clinical interventions to reduce mortality.