Bias in algorithms of AI systems developed for COVID-19: A scoping review

Janet Delgado, Alicia de Manuel, Iris Parra, Cristian Moyano, Jon Rueda, Ariel Guersenzvaig, Txetxu Ausin, Maite Cruz, David Casacuberta*, Angel Puyol

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

17 Citations (Scopus)


To analyze which ethically relevant biases have been identified by academic literature in artificial intelligence (AI) algorithms developed either for patient risk prediction and triage, or for contact tracing to deal with the COVID-19 pandemic. Additionally, to specifically investigate whether the role of social determinants of health (SDOH) have been considered in these AI developments or not. We conducted a scoping review of the literature, which covered publications from March 2020 to April 2021. ​Studies mentioning biases on AI algorithms developed for contact tracing and medical triage or risk prediction regarding COVID-19 were included. From 1054 identified articles, 20 studies were finally included. We propose a typology of biases identified in the literature based on bias, limitations and other ethical issues in both areas of analysis. Results on health disparities and SDOH were classified into five categories: racial disparities, biased data, socio-economic disparities, unequal accessibility and workforce, and information communication. SDOH needs to be considered in the clinical context, where they still seem underestimated. Epidemiological conditions depend on geographic location, so the use of local data in studies to develop international solutions may increase some biases. Gender bias was not specifically addressed in the articles included. The main biases are related to data collection and management. Ethical problems related to privacy, consent, and lack of regulation have been identified in contact tracing while some bias-related health inequalities have been highlighted. There is a need for further research focusing on SDOH and these specific AI apps.

Original languageEnglish
Pages (from-to)407-419
Number of pages13
JournalJournal of Bioethical Inquiry
Issue number3
Early online date20 Jul 2022
Publication statusPublished - 1 Sept 2022


  • COVID-19
  • artificial intelligence
  • bias
  • digital contact tracing
  • patient risk prediction


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