Abstract : Background: Coronavirus disease (COVID-19) caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome) has spread worldwide, infecting more than 180 million people and 3.9 million deaths. The clinical manifestations of COVID-19 range from asymptomatic or mild infection to severe illness. This study aims to examine the risk of severe COVID-19 illness associated with obesity. Methods: A cross-sectional study was conducted among COVID-19 patients admitted to the University Hospital in 2020. Patients ages < 18 years and pregnant people were not included in the analysis. Data were obtained from medical records. Cases were selected for the analysis only if the information was complete. There were 725 COVID-19 cases included for the analysis. We used adjusted PRs (and 95% CI) to estimate the risk of COVID-19 severity associated with obesity. Results: 178 had severe symptoms. Patients with hypertension, diabetes, heart disease and chronic kidney disease were more likely to suffer severe COVID-19 symptoms. After taking into account on age, gender, diabetes and heart disease, obesity was associated with severe COVID-19 illness (PR 1.78 and 95% CI:1.32-2.38). The risk of COVID-19 severity associated with obesity were consistent on levels of age, sex, and comorbidities. Conclusion: Obesity increases the risk of severity in COVID-19. Maintaining healthy life style, including routine exercise, choice of healthy food and routine medical checkup may reduce the risk of COVID-19 severity