Introduction: COVID-19 (Corona virus disease 2019) pandemic has been causing significant morbidity & mortality world-wide. Insulin resistance markers such as TyG index, lipid ratio, and LAP have been studied in relation to the severity and hospital outcome of COVID-19 patients. Early diagnosis with severity assessment and optimum supportive care is the mainstay of treatment. Aim of the Study: The aim of this study was to assess the association of insulin resistance markers TyG index, lipid ratios & lipid accumulation product (LAP) with the severity and hospital outcome of COVID-19 patients. Methods: This prospective observational study was carried out in COVID unit of BSMMU (Bangabandhu Sheikh Mujib Medical University) among hospital admitted COVID patients from March 2021 to February 2022. Total 138 COVID-19 patients were enrolled in this study. Result: Majority of patients (27.5%) was in 41-50 years age group and there was male predominance (65.9%). Majority (31.2%) of the study patients were clinically severe. There is significant correlation between disease severity and IR markers with moderate correlation with LDL/HDL and strong correlation with all other IR markers. There was significant correlation between TC/HDL and development of ARDS and & of HFNC with no other significant correlation with other outcomes. There was no significant correlation between LDL/HDL and hospital outcomes. There was significant correlation between TG/HDL and development of ARDS, also with use of rebreather and HFNC. No other significant correlation found with other outcomes. There was significant correlation between TyG index and use of rebreather & development of ARDS. No other significant correlation found with other outcomes. There was significant correlation between LAP and development of ARDS, use of rebreather & HFNC with no other significant correlation with other outcomes. Conclusion: In conclusion, this study found the insulin resistance markers TyG index. .......