Abstract Background: This study here in tried to study the effect of age and associated comorbidities in accordance to the initial CT findings on the clinical deterioration of patients affected with COVID-19, aiming to help the health providers to triage patients that might require prompt medical care attention. Aim of Study: This study aimed to investigate the effect of age and medical co-morbidities in accordance to the initial CT findings on the clinical deterioration of patients affected with COVID-19. Patients and Methods: The study protocol was approved by the institutional review board of our university hospital, and an informed written consent from the participants was waived. The High-risk group included 88 males and 32 females, their age ranged from 20 to 73 (mean age 60.2±11.6) while the low-risk group included 78 males and 36 females. Results: This retrospective study included 234 confirmed COVID-19 patients including 120 high risk patients and 114 low risk patients. The CT severity was classified as mild and severe according to a visual scoring system of 25 points previously used in other series using a score of 18 as a cut of value. Clinical deterioration was significantly higher among the high-risk group. ICU admission and mortality were re-corded in 44.2% and 3.5% of the high-risk group versus 19.2% and 0.9% of the low-risk group. Among patients with initial severe CT changes, clinical deterioration was more significant either in the high-risk group. ICU admission, and mortality occurred in 77.9% and 33.8% on the high risk-group versus 28.6% and 7.1% of the low- risk patients respectively. None of the patients who initially presented with mild CT changes (at either groups) were admitted to ICU or had died. Conclusions: Our results show that clinical deterioration in form of ICU admission, and mortality were significantly higher among high risk patients and among those who presents initially with severe CT changes.