In the trenches of COVID-19 in Iran
By Dr. Ali Sabri
I would like to share my “in the trenches” experiences as one of the earliest responders in this COVID-19 pandemic.
On February 18, 2020, in response to the pandemic and a shortage of onsite thoracic radiologists, the Iranian Society of Radiology (ISR) — a nongovernmental, nonprofit organization representing more than 3,000 radiologists — assembled a second-opinion teleradiology group called the Iranian Society of Radiology COVID-19 Consultants (ISRCC). The ISRCC comprised 11 radiologists: nine in Iran, one in the United States and one (me) in Canada. All of us are all subspecialty trained chest radiologists. Together, we established a CT-based triage strategy based on the literature being published at the time on the COVID-19 outbreak in Wuhan, China, and in response to the short supply of test kits in Iran.
Patients in Iran with early clinical and laboratory findings suspicious for COVID-19 infection, underwent chest CT interpreted by a local general radiologist. Using the ISR’s public website, physicians and general radiologists across Iran were encouraged to submit abnormal chest CT examinations for second opinions. The teleconsultation system required referring physicians to submit anonymized CT images to the volunteer network coordinator (a physician assigned by ISR) using the ISR’s secure social media messaging software. The participation of expert radiologist consultants in different time zones (the ISRCC) enabled efficient and timely review of these images. Through this process, we also created and published several standardized reporting templates and protocols on COVID-19 imaging. (See the Journal of the American College of Radiology: https://doi.org/10.1016/j.jacr.2020.03.015).
Sharing my learning on COVID-19
I am grateful to be able to contribute to the literature and growing knowledgebase on COVID-19. Based on the invaluable experience I gained from the review of approximately 2,600 cases of potential COVID-19 cases in Iran, I was asked to present our findings at the first McMaster University Diagnostic Imaging Regional Professor Rounds on April 9, 2020. This presentation was well-received by colleagues and other members of the medical profession at McMaster.
The ISRCC’s joint efforts have also resulted in the publication of two peer-reviewed articles in Europe for different stakeholders (i.e. medical students and radiologists) describing cases of COVID-19 with detailed clinical and imaging presentations. (See the Polish Archives of Internal Medicine: https://www.mp.pl/paim/issue/article/15271). I also contributed a chapter on COVID-19 Computed Tomography (CT) to the McMaster Textbook of Internal Medicine, which was recently published. Additional publications are currently under review.
I would like to extend my gratitude to Professor and Chair of the Department of Radiology at McMaster University, Julian Dobranowski, MD, FRCPC, and to Professor Morteza Sanei Taheri, head of the ISR, for their support and leadership during this testing time.
Ali Sabri, MD, FRCPC, is a cardiothoracic and breast radiologist. He works at Niagara health system as an assistant clinical professor (adjunct), radiology, in the Faculty of Health Sciences at McMaster University.
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