Background: COVID-19-infected pregnant women may be asymptomatic or symptomatic. Symptomatic tend to have a severe infection and could be at increased risk of complications such as preterm birth, NICU, and stillbirth. This study aimed to identify the most common signs and symptoms and assess the pre-existing risk of COVID-19 infection during pregnancy:  length of hospital stay, premature labor, and complications according to the severity of COVID-19 illness. Methods: This retrospective study was conducted in the obstetric and gynecological wards of 359 pregnant women. After reviewing medical records, patient and disease data were collected. Results: Most patients were asymptomatic and mild. The most common signs and symptoms were fever, cough, and dyspnea. COVID-19 infected pregnant with a medical history of hypertension, or diabetes had more severe COVID-19 infection. COVID-19-infected pregnant women with severe illness or aged ≥ 40 years had a prolonged hospital stay. Severe COVID-19 disease was significantly associated with preterm birth, stillbirth, and the need for a neonatal intensive care unit. Conclusion: Severe COVID-19 infection in pregnancy is linked to pregnancy and birth complications, mainly among pregnant women with a positive medical history.