Introduction: Ahmedabad city reported the highest number of cases and deaths. In order to guide various interventions and monitor future trends, evidence is required. Hence, we conducted the present study to explore the epidemiological determinants, clinical profile, risk factors, and predictors of mortality of COVID-19. Methods: This was a retrospective record-based descriptive study of 2268 confirmed COVID-19 patients admitted in a designated COVID hospital of Ahmedabad city from March to July 2020. Results: The median age of patients was 54 years, and 60.9% of them were males. Majority (83.27%) had comorbidities; the most common comorbidity was hypertension (62.59%) followed by diabetes (44.76%). The most common symptoms reported were fever (69.76%), breathlessness (55.47%), and cough (53.18%). Majority (61.12%) of the patients showed lymphocytopenia, and in one-third (34.85%), D-dimer levels were elevated (>1 μg/ml). Odds of inhospital deaths were higher in patients having breathlessness and gastrointestinal symptoms and comorbidities. More of the deceased had leukocytosis and lymphocytopenia, high D-dimer levels, C-reactive protein, and altered liver function tests as compared to the survivors. Conclusion: While making decisions such as prevention of exposure of high-risk population to the infection, control of the existing comorbid condition, and prioritization of this population for vaccination, criteria of case definition for surveillance keeping in mind the typical and atypical manifestations of the disease, require robust evidence which the current study could provide insight to.

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