Coronavirus disease 19 (COVID-19) severity data is highly variable and many factors were linked to increased severity. Owing to the dense population, varied demographic characteristics, and high burden of various diseases, it is important to identify risk factors resulting in severe COVID-19 in Pakistan. It was a descriptive study, and 652 COVID-19-positive patients were enrolled from Mayo Hospital Lahore and grouped into mild and severe cases. Demographic, clinical history and laboratory findings at the time of admission were collected. Data were analyzed using SPSS V21. The results indicated that the patients with age above 30 years showed a significant association with disease severity and with increasing every 10 years, the odds of disease severity became double. Further, male gender (OR 1.729, p 0.002), low socioeconomic status (OR 4.01, p <0.0001), diabetes mellitus (OR 2.52, p 0.001), hypertension (OR 1.81, p 0.01) and heart attack (OR 2.05, p 0.02) were significantly increasing disease severity. Interestingly, malarial history and smoking showed a significant association with a milder form of the disease. We conclude that young people (30 and above) were at significant risk of severe COVID-19 infection. Similarly, diabetes mellitus, hypertension and cardiovascular diseases were identified as independent risk factors for COVID-19 severity in Pakistan.