Background: Coronavirus induced disease-19 (COVID-19), produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence and rapid spread of COVID-19 has caused enormous mortality worldwide. Egypt had reported the first case of COVID-19 infection in Africa on February 14, 2020. World health organization (WHO) declared COVID-19 a global pandemic on March 11, 2020. Aim of the work: Analyze factors affecting prognosis and outcome in COVID - 19 Egyptian patients who were admitted to Mansoura Health Insurance Hospital. Patients and methods: This current study is a combined retrospective and prospective. The retrospective part included 100 patients and the prospective part included 275 patients. All the included cases (or their records) were reviewed to obtain data about general history, clinical examination and investigations. The cases (or the records) were followed up to determine the study outcomes including (intensive care unit admission, length of hospital or ICU admission, need of mechanical ventilation and mortal ity)Results: Significant more cases in the second wave had transferred to ICU than first wave cases (p=0.02). There was statistically significant difference between the two waves regarding mortality rate which was significantly higher among the second wave patients (p=0.001). Conclusion: The second wave of COVID-19 in Egypt was linked to more severe disease and higher mortality rates. During both waves, COVID-19 mortality was independently predicted by age, male gender, and poor comorbidity.