Background In December 2019, Coronavirus Disease MESHD 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan, and Xi-shui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic and clinical data were collected. Clinical course of survivors and non-survivors were compared. Risk factors for death MESHD were analyzed. Results A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever MESHD fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP, lymphopenia MESHD lymphopenia HP and radiological multilobar pulmonary infiltrates HP. In severe cases, thrombocytopenia MESHD thrombocytopenia HP, acute kidney injury MESHD acute kidney injury HP, acute myocardial injury or adult respiratory distress syndrome MESHD adult TRANS respiratory distress HP syndrome were observed. During week 2, in mild cases, fever MESHD fever HP, cough MESHD cough HP and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia MESHD lymphopenia HP persisted. In severe cases, leukocytosis MESHD leukocytosis HP, neutrophilia HP and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia MESHD lymphopenia HP. However, severe cases showed persistent lymphopenia MESHD lymphopenia HP, severe acute respiratory dyspnea MESHD dyspnea HP syndrome MESHD , refractory shock MESHD shock HP, anuric acute kidney injury MESHD acute kidney injury HP, coagulopathy, thrombocytopenia MESHD thrombocytopenia HP and death MESHD. Older age TRANS and male TRANS sex were independent risk factors for poor outcome of the illness. Conclusions A period of 7–13 days after illness onset is the critical stage in COVID-19 course. Age TRANS and male TRANS gender TRANS were independent risk factors for death MESHD of COVID-19.