Risk of coronavirus disease 2019 (COVID-19) from hospital admission during the pandemic

To the Editor-Since the onset of the coronavirus disease-2019 (COVID-19) pandemic, hospitals all over the world have treated an unprecedented number of patients with COVID-19.At the same time, hospitals have noticed a downward trend in hospital admissions for non-COVID-19-related illnesses including diseases that need time-sensitive treatments like strokes and acute coronary syndromes.1-3 Elective procedures and surgeries were deferred.One of the potential etiologies for the decrease in hospital admissions could be concerns of contracting COVID-19 in the hospitals.As hospitals gradually return to their routine, the risk of COVID-19 from hospital admissions needs to be examined to ensure patient safety.In this study, we examined the risk of acquiring COVID-19 in the patients admitted to the hospitals with non-COVID-19-related conditions.Data were obtained from TriNetX, a global clinical research platform that collects de-identified patient data that are updated in real time from 45 healthcare organizations."COVID-19 Research Network" in TriNetX is a large COVID-19 database, which is also being used by the Food and Drug Administration (FDA) Sentinel Operations Center at the Harvard Pilgrim Health Care Institute to monitor priority drugs used for the care of the hospitalized COVID-19 patients.We analyzed patients who were discharged from the hospital with non-COVID-19related illnesses (using discharges codes and excluding lab confirmed COVID-19 patients) between January 20, 2020, and June 30, 2020, who later tested positive for COVID-19 by reverse-transcription polymerase chain reaction (RT-PCR) within 14 days of discharge.For comparison, we obtained the total number of COVID-19-positive patients in United States, from the Centers of Disease Control and Prevention (CDC) 4 up to July 14, 2020, among the total population of the Unites States from the US Census Bureau.Our local institutional review board deemed this study to be 'not human subject research' using global deidentified COVID-19 research network data designated for research use (IRB no.261137).5 In total, 101,533 patients were discharged from the hospitals with non-COVID-19-related illnesses between January 20, 2020, and June 30, 2020.Among them, 44 patients (0.043%) tested