Background: Hepatic decompensation and mortality are common after COVID-19 infection in patients with cirrhosis. According to Child-Pugh class, mortality rose in a linear pattern. Objective: The aim of the current study is to predict outcome of COVID-19 infection in cirrhotic patients. Patient and methods: A total of 104 patients with COVID-19 infection with history of cirrhosis admitted to Zagazig University Hospital and El-Ahrar Teaching Hospital participated in our case control study. Patients were divided into 2 groups: The case group included 52 COVID-19 cirrhotic patients, and the control group included 52 patients with cirrhosis but with no evidence of COVID-19 infection. All subjects were subjected to full history taking, clinical examination, laboratory investigations, and radiological findings. Results: The inflammatory markers (D-dimer, CRP, ESR first hour, ESR second hour and WBC) and Ferritin were statistically significant higher in the case group compared with the control group. There were high significant correlations between severity COVID-19 and Child Pugh classification. There were high significant correlations between laboratory parameters and severity of COVID-19. Mortality rate was significantly higher in the case group compared with the control group (13.4% vs. 25%, respectively). Length of hospital stay, Child Turcot Pugh, fresh frozen plasma transfusion to correct coagulopathy, ascites and hepatic encephalopathy could predict hospital mortality among COVID-19 patients. Conclusion: The in-hospital mortality rate for patients hospitalized with COVID-19 in the context of cirrhosis is higher than the in-hospital mortality rate for patients hospitalized for cirrhosis alone. It is essential to acknowledge that hospitalized patients with cirrhosis are at an elevated risk of mortality regardless of the presence of COVID-19.