Prisons in the United States have become a hotbed for spreading COVID-19 among incarcerated individuals . COVID-19 cases among prisoners are on the rise, with more than 143,000 confirmed cases to date . However, there is paucity of data addressing clinical outcomes and mortality in prisoners hospitalized with COVID-19 . An observational study of all patients hospitalized with COVID-19 between March 10 and May 10, 2020 at two Henry Ford Health System hospitals in Michigan . Clinical outcomes were compared amongst hospitalized prisoners and non-prisoner patients . The primary outcomes were intubation rates, in-hospital mortality, and 30-day mortality . Multivariable logistic regression and Cox-regression models were used to investigate primary outcomes . Of the 706 hospitalized COVID-19 patients (mean age 66.7 ± 16.1 years, 57% males, and 44% black), 108 were prisoners and 598 were non-prisoners . Compared to non-prisoners, prisoners were more likely to present with fever, tachypnea, hypoxemia, and markedly elevated inflammatory markers . Prisoners were more commonly admitted to the intensive care unit (ICU) (26.9% vs. 18.7 %), required vasopressors (24.1% vs. 9.9 %), and intubated (25.0% vs. 15.2 %). Prisoners had higher unadjusted inpatient mortality (29.6% vs. 20.1 %) and 30-day mortality (34.3% vs. 24.6 %). In the adjusted models, prisoner status was associated with higher in-hospital death (odds ratio , 2.32; 95% confidence interval (CI), 1.33 to 4.05) and 30-day mortality (hazard ratio , 2.00; 95% CI , 1.33 to 3.00). In this cohort of hospitalized COVID-19 patients, prisoner status was associated with more severe clinical presentation, higher rates of ICU admissions, vasopressors requirement, intubation, in-hospital mortality, and 30-day mortality.