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To evaluate the incidence, type, and risk factors associated with adverse drug reactions (ADRs) among patients with coronavirus disease 2019 (COVID‐19) by Hospital Pharmacovigilance System (CHPS). A retrospective analysis was performed on 217 patients with COVID‐19 admitted to the First Hospital of Changsha in China, from January 17, 2020, to February 29, 2020. The active monitoring model in CHPS was used to detect ADR signals of the hospital information system. The risk factors for the ADRs were classified using the World Health Organization‐Uppsala Monitoring Centre (WHO‐UMC) system. Univariate and multivariate logistic regressions were carried out to analyze the risk factors of ADRs. Our results showed that the prevalence of ADRs was 37.8% in the patients, which was predominated by drug‐induced gastrointestinal disorders and liver system disorders (23.0% vs. 13.8%). The ADR could be explained by the use of lopinavir/ ritonavir and umifenovir by 63.8% and 18.1%, respectively. There were 96.8% of ADRs that occurred within 14 days of hospitalization. Multivariable analysis showed that length of stay (odds ratio (OR): 2.02; 95% confidence interval (CI) 1.03–3.96; P = 0.04), number of drugs used in the hospital (OR: 3.17; 95% CI 1.60–6.27; P = 0.001) and underlying basic diseases (OR: 2.07; 95% CI 1.02–4.23; P = 0.04) were independent risk factor for ADRs in the patients. Together, the incidence of ADRs was significantly high during the treatment period. Moreover, the active monitoring of the CHPS system reflected ADRs during COVID‐19 treatment in the real world, which provided reference for safe medication in the clinic. [ABSTRACT FROM AUTHOR]