Introduction: The apt description of COVID-19's clinical course throughout hospitalization provides experiences for dealing with subsequent outbreaks, especially in patients with severe COVID-19 who get admitted to the intensive care unit (ICU). This study aimed to evaluate the symptomatology of patients with COVID-19 admitted to the ICU of Peymaniyeh Hospital in Jahrom in the first to the fifth wave of coronavirus. Methods: This study was a descriptive-analytical on all ICU admitted COVID-19 patients during different outbreaks of COVID-19 from 2020 to 2022. Demographic data, symptomology at admission, and COVID-19 history were recorded along with the intubation rate. Data were compared among 5 different peaks of the COVID-19 in the whole country.Results: Three-hundred sixty-nine patients were evaluated in this study. There was a significant difference between gender and hospitalization in the first to the fifth wave (P <0.005). In the first, second, and third waves, the frequency of hospitalization was higher in men than women, while reversed in the fourth and fifth waves. There was a significant difference between the first and fifth waves in terms of fever symptoms, loss of consciousness, headache, dizziness, chest pain, and lethargy (P <0.05). Respiratory distress was the most common symptom in the first to the fifth wave followed by chest pain, cough and fever were most common after respiratory distress. Conclusion: diverse symptomatology in different waves of COVID-19 was found in our study, addressing the need for rapid clinical responses and policies specified for any new wave of outbreak.