This comprehensive study on COVID-19 and pregnancy from January 2020 to May 2023 revealed several key findings. Pregnant women (PW) were not more likely to contract COVID-19 compared to non-pregnant women (NPW), but those with pre-existing immunosuppression and renal disease showed increased infection risk. PW with COVID-19 had significantly higher rates of hospitalization, intubation, and ICU admission compared to NPW. COVID-19 infection was associated with increased mortality among women of reproductive age, with renal disease being a significant risk factor for death in infected PW. For NPW, age, COPD, immunosuppression, and renal disease were important mortality risk factors. Both PW and NPW with diabetes or obesity had higher odds of COVID-19 infection. Diabetes, hypertension, and obesity were associated with increased hospitalization risk in both groups. The study emphasizes the importance of considering demographic factors and pre-existing comorbidities when managing COVID-19 in pregnant women.