_{^{Published May 10, 2021}}

Ali Gholamrezanezhad

Assistant Professor of Clinical Radiology
Keck School of Medicine, University of Southern California

For valiant service selflessly rendered on the frontlines of the fight against COVID-19, the American Roentgen Ray Society symbolically awarded each and every one of our members the 2021 ARRS Gold Medal. The ARRS Gold Medal Story Series shares perspectives of imaging professionals who conquered the day-to-day challenges of battling COVID-19.

As an emergency radiologist, my research projects have focused on emergency radiology and critical medicine. Through these research initiatives, I have identified aspects of my field that I find most rewarding. Focused on exploring new horizons in critical situations, I have found collaboration to be among the most valuable takeaways for my work. Reason being, it complements my hands-on practice and teaching, allowing me to have both an immediate and long-term impact on patient care, especially during emergency situations, such as trauma cases, burn victims, and urgent situations related to coronavirus disease (COVID-19).

I am currently leading a multinational research team investigating the clinical and nonclinical features of COVID-19. Being able to have a personal impact in response to this pandemic has been a thrilling feeling for me. To date, our team has produced more than 45 journal articles, with over a dozen additional submissions under consideration. Our areas of focus have included: radiologic presentations of COVID-19, clinical factors predisposing patients to complications of COVID-19 (e.g., ICU admission, intubation, or death), long-term pulmonary consequences of COVID-19, the pandemic’s impact on health care workers and medical students, radiology department preparedness for surge potential, factors influencing differential case-fatality rates worldwide, and the best approach transitioning to the post-COVID-19 era. Over the past several months, my research team’s COVID-19 publications have been cited more than 2,500 times, accumulating more than 300,000 downloads by scientific and medical communities across the world. My colleagues’ work is considered a leading source of clinical information about SARS-CoV-2 infection.

While I have taken great pride in our ability to produce a significant number of research articles on COVID-19, I also feel that our development of a major repository of COVID-19 imaging in such a short period of time, given the significant limitations of social distancing, is just as notable. One of the core things I have learned about meaningful research during this pandemic has been how to accommodate the critical factor of time sensitivity. Having hosted more than 200 videoconferencing sessions, we demonstrated our ability to plan, organize, and lead a team, showcasing my own project management and multi-tasking skills. I look forward to utilizing this amalgamation seamlessly when approaching oversight of future research projects. Specifically, I intend to apply these cross-departmental collaboration skills to extend my impact ability beyond my given area.

During the outbreak of COVID-19, my team of researchers and medical students set out to educate the radiology community and broader health care system worldwide how to prepare for unusually high patient volumes, publishing several reference articles in various journals, including the AJR and Journal of the American College of Radiology. These articles were published in early February, when minimal COVID-19 cases had been reported in the United States. Our radiology research group formulated several critical recommendations for radiology departments to approach COVID-19 patients in the safest, most efficient manner. It was clear that if a flood of patients were to inundate even the most well-organized departments, that rush would be near impossible to accommodate. As a result, my team and I developed a mass casualty incident (MCI) plan, which consisted of several steps expressly geared toward viral outbreaks like COVID-19. We came up with a clear roadmap for preparation, resource mobilization, imaging chain, adjusting imaging protocols, and education. Specific to education, this plan included MCI simulation and in-service training. The core benefits to having an MCI plan in place include increased patient and staff safety, as well as a decrease in COVID-19 transmission.

At the height of the pandemic, we conducted a national survey to evaluate the impact of COVID-19 on imaging practices. More than 800 radiologists across the country participated. According to our findings, a large portion of surveyed radiologists, 61%, rated their COVID-19-related anxiety a 7 or higher on a 1–10 scale. Upon further examination, we found that the higher the number of reported cases in a respondent’s respective state, the higher their reported score. Another key finding was that concern regarding personal health was the strongest connector to a higher anxiety score. Therefore, we determined that additional attention must be given to radiologists working in drastically altered practice environments and in remote settings.