Background: Coronavirus Disease 2019 (COVID-19) is a paramount public health issue. The true statistics about COVID-19 in Egypt are veiled. Aim: To determine the incidence rate of moderate and severe SARS-CoV-2 infection among the patients seeking admission to Zagazig University Hospitals (ZUH), Egypt based on the chest Computed Tomography (CT) COVID-19 Reporting and Data System (CO-RADS) radiological criteria. Methods: All patients aged ≥ 18 years old seeking admission to ZUH between January 1st and March 31st, 2021, were eligible for enrollment in the study if they performed non-enhanced chest CT. Assessment of clinical, laboratory, and chest CT CO-RADS radiological criteria for each patient was carried out. The patients were defined to have moderate or severe COVID-19 if they met CO-RADS 4 or 5 radiological criteria, respectively, in association with the clinical and/or laboratory criteria. Results: A total of 5549 subjects were enrolled in the study. The total number of moderate and severe COVID-19 cases diagnosed at ZUH during January 2021 was 434/1827 with a monthly incidence rate of 23.75; 95% CI (21.9-25.8) per 100.000 of the population. The total number of moderate and severe COVID-19 cases during February 2021 was 215/1622 with a monthly incidence rate of 13.25; 95% CI (11.7-15). During March, the total number of moderate and severe COVID-19 cases was 416/2100 with a monthly incidence rate of 19.8; 95% CI (18.2-21.6). Conclusion: The incidence rate of moderate and severe COVID-19 infection at ZUH is in parallel with the national COVID-19 incidence reports
