| Summary: | Research into using artificial intelligence (AI) in health care is growing and several observers predicted that AI would play a key role in the clinical response to the COVID-19. Many AI models have been proposed though previous reviews have identified only a few applications used in clinical practice. In this study, we aim to (1) identify and characterize AI applications used in the clinical response to COVID-19; (2) examine the timing, location, and extent of their use; (3) examine how they relate to pre-pandemic applications and the U.S. regulatory approval process; and (4) characterize the evidence that is available to support their use. We searched academic and grey literature sources to identify 66 AI applications that performed a wide range of diagnostic, prognostic, and triage functions in the clinical response to COVID-19. Many were deployed early in the pandemic and most were used in the U.S., other high-income countries, or China. While some applications were used to care for hundreds of thousands of patients, others were used to an unknown or limited extent. We found studies supporting the use of 39 applications, though few of these were independent evaluations and we found no clinical trials evaluating any application’s impact on patient health. Due to limited evidence, it is impossible to determine the extent to which the clinical use of AI in the pandemic response has benefited patients overall. Further research is needed, particularly independent evaluations on AI application performance and health impacts in real-world care settings. Author summary In this study we describe the use of artificial intelligence (AI) in the clinical response to COVID-19. AI has been variously predicted to play a key role during the pandemic or has been reported to have had little or no impact on patient care. Our findings support a balanced view. We identified 66 applications—specific AI products or tools—used in a variety of ways to diagnose, guide treatment, or prioritize patients during the pandemic response. Many were deployed early in 2020 and most were used in the U.S., other high-income countries, or China. Some were used to care for hundreds of thousands of patients though most were adopted at smaller scales. We found evaluation studies that supported the use of 39 of these applications, though few of these evaluations were written by independent authors, not affiliated with application developers. We found no clinical trials that evaluated the effect of using an AI application on patient health outcomes. Future research is needed to better understand the impact of using AI in clinical care.
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