Introduction: Clinical manifestations of Covid-19 vary widely from asymptomatic to severe forms requiring intensive care unit admission. Predictive factors of severity associated with risks of hospitalization and death warrant investigation. Objective of our study: Identify epidemiological and clinical risk factors for poor prognosis and Identify risk factors for death among hospitalized patients Materials and Methods : This is a descriptive longitudinal study with an analytical aim based on active surveillance of notified cases of Covid-19 with follow-up of the cohort of hospitalized patients in our University Hospital over a period of one year from March 11, 2020, to March 11, 2021.Data collection was done in real-time on a predefined data collection form. Data entry and analysis were performed using Epi Info 6 and Epi Data Analysis software. Results: A total of 9788 patients were notified by the epidemiology and preventive medicine service, with 6253 (63.8%) confirmed cases, of which 49% (3064/6253) were hospitalized and 51% (3192/6253) were isolated at home. We recorded 646 deaths, resulting in a hospital lethality rate of 21.08%. Nearly one-third of deaths occurred in October and December. Our study found an increased risk of severe forms and/or death among older patients and those with comorbidities, as well as among male patients with COVID-19. Mortality was significantly higher in diabetic patients (RR=1.25 [1.09 – 1.44], p<0.001), those with kidney disease (RR=1.45 [1.13 – 1.85], p<0.001), hypertension (RR=1.74 [1.51 –2.0] p<0.001), respiratory diseases (RR=1.40 [1.11 – 1.77], p<0.01), immunosuppression (RR=1.58 [1.05 – 2.27], p<0.01), and cardiovascular disease (RR=1.27 [1.07 – 1.51], p<0.001). For pediatric cases, we observed a significantly higher risk of intensive care unit hospitalization among children with diabetes, hypertension, cardiovascular diseases, and those suffering from cancer. Clinical signs of poor prognosis with death occurrence include fever (RR=1.36 [1.16-1.60], p<0.001), cough (RR=1.16, 95% CI [1.01-1.34], p<0.04), resting dyspnea (RR=3.69, 95% CI [3.14- 4.33], p<0.001) in adults, and confusion in children (RR=23.8, 95% CI [8.35-67.8], p<0.01). Conclusion: Early medical management should be provided to patients with the disease, including for mild forms, especially when patients have comorbidities, to reduce hospital mortality. Rigorous follow-up is necessary for patients isolated at home to detect any deterioration in their health status early on. It would be interesting to adjust risk factors, particularly age in relation to comorbidities, and even the time to initiation of treatment.