Background: Hypertension has been reported as the most prevalent comorbidity in patients with coronavirus disease 2019 (COVID-19). This retrospective study aims to compare the clinical characteristics and outcomes in COVID-19 patients with or without hypertension. Methods: A total of 944 hospitalized patients with laboratory-confirmed COVID-19 were included from January to March 2020. Information from the medical record, including clinical features, radiographic and laboratory results, complications, treatments, and clinical outcomes, were extracted for the analysis. Results: A total of 311 (32.94%) patients had comorbidity with hypertension. In COVID-19 patients with hypertension, the coexistence of type 2 diabetes (56.06% vs 43.94%), coronary heart disease (65.71% vs 34.29%), poststroke syndrome (68.75% vs 31.25%) and chronic kidney diseases (77.78% vs 22.22%) was significantly higher, while the coexistence of hepatitis B infection (13.04% vs 86.96%) was significantly lower than in COVID-19 patients without hypertension. Computed tomography (CT) chest scans show that COVID-19 patients with hypertension have higher rates of pleural effusion than those without hypertension (56.60% vs 43.40%). In addition, the levels of blood glucose [5.80 (IQR, 5.05-7.50) vs 5.39 (IQR, 4.81-6.60)1, erythrocyte sedimentation rate (ESR) [28 (IQR, 17.1-55.6) vs 21.8 (IQR, 11.5-44.1), P=0.0081, C-reactive protein (CRP) [17.92 (IQR, 3.11-46.6) vs 3.15 (IQR, 3.11-23.4), P=0.0131 and serum amyloid A (SAA) [99.28 (IQR, 8.85-300) vs 15.97 (IQR, 5.97-236.1), P=0.0051 in COVID-19 patients with hypertension were significantly higher than in patients without hypertension. Conclusion: It is common for patients with COVID-19 to have the coexistence of hypertension, type 2 diabetes, coronary heart disease and so on, which may exacerbate the severity of COVID-19. Therefore, optimal management of hypertension and other comorbidities is essential for better clinical outcomes.