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Background: The establishment of empirical evidence in the Eastern Mediterranean Region necessitates the implementation of wide-scale studies to describe the demographic, clinical features, and severity profile of patients with COVID-19., Objective: This study aims to assess the patterns of COVID-19 severity and mortality in seven countries, and to determine the risk factors of COVID-19 severity and mortality., Methods: This multicountry study was based on a retrospective review of medical records of hospitalized patients confirmed to have COVID-19. This study includes data from Iraq, Pakistan, Sudan, Somalia, Morocco, Egypt, and Yemen. All demographic and clinical data were extracted from hospital records (paper files) by trained data collectors., Results: A total of 4141 patients were included in this study from seven countries. Comorbidities were reported by nearly half of the patients, with hypertension (n=1021, 24.7%) and diabetes (n=939, 22.7%) being the most common. Older age, diabetes mellitus, hypertension, and heart diseases were significantly associated with COVID-19 severity and mortality. Ever smoking and renal diseases were significantly associated with severity but not mortality, while male gender, respiratory diseases, and malignancy were significantly associated with mortality but not severity., Conclusions: The study confirms the role of comorbidities and demographic features on the severity and mortality of COVID-19. Understanding the contributing factors ensures attentive care and informs clinical management of patients with poorer prognoses in the early stages of diseases., (©Faris Lami, Maisa Elfadul, Hiba Rashak, Mohannad Al Nsour, Hashaam Akhtar, Yousef Khader, Ahmed M Hussein, Mariam Naciri, Sahar Samy, Yasser Ghaleb, Hana Taha, Alaa Hussein, Nameer A Ali, Raheem Hussein, Aamer Ikram, Fazal ur Rahman, Mohammad Mujeeb Khan, Reema Adam, Abdulrazaq Yusuf Ahmed, Salma Afifi. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 15.03.2022.)