Background: the current pandemic, COVID-19, caused by a novel coronavirus SARS-CoV-2 has claimed over a million lives, 6,561,757 people have died so far from the coronavirus COVID-19 outbreak as of October 10, 2022, 23:59 GMT worldwide according to the worldometer report, warranting the need for more research into the wider determinants of COVID-19 outcomes to support evidence-based policies Objective: This study aimed to investigate the outcome and factors determine the mortality of individuals with COVID-19. Methods: A retrospective cross sectional chart review for patients admitted to COVID treatment center and all the necessary data were collected from hospitalized patients’ cards using the pre-developed data collection format. Data was collected via Epicollect-5 and then exported to SPSS 25 version software database for analysis. The sample size was determined using computer-based Epi info7 software Stat Cal to be 221. In the specified study period from 620 patient, 221 COVID19 patient charts were taken by using simple random sampling with lottery method. The analysis results were summarized using descriptive summary measure by using frequency tables and charts. Binary logistic regression was used to assess the association of dependent and independent variables. Both bi-variable and multi-variable analysis was conducted. Independent variables with a p-value of less than 0.25 in the bi-variable analysis were considered in the multivariable analysis. Odds ratio with 95 % confidence intervals and associated p-values was computed to assess the presence and degree of association between dependent and independent variables. Result: a total of 221 patients fulfilled the inclusion criteria and were included in this study. The median age was 56.7. Among the total of 221 cases 142 (64.3%) were males and 79 (35.7%) were females. 108 cases (48.9%) lives in rural area and the remaining 51.13% lives in urban area. Among a total of 221 cases, 104 (47%) had one or more preexisting comorbidities. Hypertension is the most common comorbidity identified accounting for 23.1% of cases, Diabetes (19%), RVI (4.1%) and asthma (6.8%). Among the study population, 81cases (36.7%) were moderate in severity,115 (52%) were severe and 25 cases (11.3%) were critical at presentation. Among the study population, 171 (77.4%) patients were discharged with improvement, 50 cases (22.6%) patients were died. Age above 60, (AOR= 7.44 CI: 95%, 1.88-29.34, P= 0.004), hypertension (AOR= 2.82, CI: 95%, 1.17-6.79 p=0.02), diabetes mellitus (3.34, 1.29-8.65, CI: 95% P= 0.013), severity of the illness being severe and critical requiring mechanical ventilator (AOR 13, 2.69-62.84 p=0.001, AOR 271.8, 33.17-2227.2 p= <0.001respectively) were independent variables statistically significantly associated with poor COVID 19 treatment outcome. DISCUSSION: the proportion of death among COVID19 patients admitted to TGSH is 22.6%. age, presence of comorbidities such as hypertension, diabetes mellitus and clinical condition/severity of the illness at presentation are significantly associated with the outcome. Therefore, critical follow–up and management of patients with underlying diseases and worsening health conditions during admission is required. Keywords: corona virus disease 2019, outcome, associated factors