Diffuse alveolar damage (DAD) resulting from coronavirus disease 2019 Infection is Morphologically Indistinguishable from Other Causes of DAD Aims: Diffuse alveolar damage (DAD) is a ubiquitous finding in inpatient coronavirus disease 2019 (COVID-19)-related deaths, but recent reports have also described additional atypical findings, including vascular changes. An aim of this study was to assess lung autopsy findings in COVID-19 inpatients, and in untreated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive individuals who died in the community, in order to understand the relative impact of medical intervention on lung histology. Additionally, we aimed to investigate whether COVID-19 represents a unique histological variant of DAD by comparing the pathological findings with those of uninfected control patients. Methods and results: Lung sections from autopsy cases were reviewed by three pulmonary pathologists, including two who were blinded to patient cohort. The cohorts included four COVID-19 inpatients, four cases with postmortem SARS-CoV-2 diagnoses who died in the community, and eight SARS-CoV-2-negative control cases. DAD was present in all but one SARS-CoV-2-positive patient, who was asymptomatic and died in the community. Although SARS-CoV-2-positive patients were noted to have more focal perivascular inflammation/endothelialitis than control patients, there were no significant differences in the presence of hyaline membranes, fibrin thrombi, airspace organisation, and 'acute fibrinous and organising pneumonia'-like intra-alveolar fibrin deposition between the cohorts. Fibrinoid vessel wall necrosis, haemorrhage and capillaritis were not features of COVID-19-related DAD. Conclusions: DAD is the primary histological manifestation of severe lung disease in COVID-19 patients who die both in hospital and in the community, suggesting no contribution of hyperoxaemic mechanical ventilation to the histological changes. There are no distinctive morphological features with which to confidently differentiate COVID-19-related DAD from DAD due to other causes.

Given the increasing proportion of ethnic minority individuals in the United States and psychology's historical reliance on theories derived from Euro American populations, it is important to monitor the status of cultural diversity research. We conducted a 10-year follow-up to Hall and Maramba's (2001) report of cross-cultural (CC) and ethnic minority (EM) publication trends. Comparing data from 1993-1999 and 2003-2009, we found that research on CC and EM issues continues to be underrepresented in the literature, particularly in top-tier journals. The American Psychological Association and Association for Psychological Science journals mirrored this discouraging trend, and the absence of top CC and EM authors on their editorial boards may point to a structural barrier to broader inclusion of cultural diversity research. We also found that fewer top CC and EM researchers are employed in psychology departments than one might hope, reflecting predominant attitudes within psychology of CC and EM research as peripheral to the larger field. Although clear that few gains have been made despite numerous awareness-raising efforts, the precise deficits were somewhat obscured, because the CC and EM terminology employed by Hall and Maramba (2001) did not fully capture the breadth of cultural diversity research currently underway in psychology. Thus, future attempts to assess the field would benefit from wider-reaching search terms. Additionally, we suggest that attention to reorganization within the evolving fields of cultural diversity research and to developing new categories of inquiry for research on cultural diversity that maintain focus on minority statuses in the United States may be productive routes forward for psychology as a discipline.

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Background SARS-CoV-2 has become a global pandemic. Given the challenges in implementing widespread SARS-CoV-2 testing, there is increasing interest in alternative surveillance strategies. Methods We tested nasopharyngeal swabs from 1094 decedents in the Wayne County Medical Examiner’s office for SARS-CoV-2. All decedents were assessed by a COVID-19 checklist, and decedents flagged by the checklist (298) were preferentially tested. A random sample of decedents not flagged by the checklist were also tested (796). We statistically analyzed the characteristics of decedents (age, sex, race, and manner of death), differentiating between those flagged by the checklist and not and between those SARS-CoV-2 positive and not. Results A larger percentage of decedents overall were male (70% vs 48%) and Black (55% vs 36%) compared to the catchment population. Seven-day average percent positivity among flagged decedents closely matched the trajectory of percent positivity in the catchment population, particularly during the peak of the outbreak (March and April). After a lull in May to mid-June, new positive tests in late June coincided with increased case detection in the catchment. We found large racial disparities in test results: despite no statistical difference in the racial distribution between those flagged and not, SARS-CoV-2 positive decedents were substantially more likely to be Black (82% vs 51%). SARS-CoV-2 positive decedents were also more likely to be older and to have died of natural causes, including of COVID-19 disease. Conclusions Disease surveillance through medical examiners and coroners could supplement other forms of surveillance and may serve as a possible early outbreak warning sign.