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To describe the clinical features and assess the determinants of severity and in-hospital mortality of patients with coronavirus disease 2019 (COVID-19) from a unique setting in Ethiopia. Consecutive patients admitted to a COVID-19 isolation and treatment centre were included in this study. The overall clinical spectrum of COVID-19, and factors associated with risk of severe COVID-19 and in-hospital mortality were analysed. Of 2617 quarantined patients, three-quarters (n = 1935, 74%) were asymptomatic and only 114 (4.4%) presented with