Background: The recovery process post-COVID-19 gained widespread recognition among social support groups and later in the scientific and medical communities. Long-term or post-acute COVID-19 persistent symptoms are challenging health problems that persist for< 2–3 months post-infection and may not resolve spontaneously. Until now, information regarding post-COVID-19 persistent symptoms, associated risk factors, and recovery duration has been varied. Aim: So, the current study aimed to investigate the prevalence of post-acute COVID-19 persistent symptoms and associated risk factors in previously hospitalized patients. Methods: A prospective cohort research design with a 2-month follow-up post-COVID-19 infection was used. A convenience sample of an eligible two hundred forty-six (246) survivors with confirmed COVID-19 who had previously been hospitalized in an isolation unit at Mansoura University Hospital was purposefully recruited to participate in the study. The data pertinent to the study was collected using two tools: demographic characteristics and health-related data, and a post-COVID-19 recovery symptoms questionnaire. Results: The follow-up analysis for COVID-19 survivors revealed that a high percentage (74.0%) experienced at least one post-acute COVID-19 persistent symptom for two months post-infection. The most prevalent symptoms among the participants were fatigue (72.5%), shortness of breath (68.1%), joint pain (66.5%), loss of smell (64.3%), and psychiatric disturbance (59.9%). Multivariate logistic regression analysis found that several factors were associated with an increased risk for post-acute COVID-19 persistent symptoms: increase in age 50–60 years AOR = 0.648 (CI = 0.132–3.181), P = 0.009*; current smoker AOR = 6.898 (CI = 1.303–36.521), P = 0.023*; overweight AOR =1.62 (CI = 1.15–4.28), P = 0.029*; and chronic disease AOR = 1.08 (CI = 0.96–1.39), P = 0.041*. Conclusion: The recovery process post-coronavirus infection is long-lasting; post-acute symptoms can persist for ≥ 2 months. The overwhelming persistent symptoms were fatigue, shortness of breath, joint pain, loss of smell, and psychological disturbances. High-risk groups for post-acute COVID-19 persistent symptoms were old age, smoker, overweight, and chronic diseases. Recommendation: We recommend that healthcare institutions plan for long-term follow-up for COVID-19 survivors, especially high-risk groups, to assess their health care needs and to implement early management, taking into consideration their psychological concerns.