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The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) has had a global effect on mortality. Many attempts were made to identify those at the highest risk of death if infected with SARS-CoV-2, yet the relative importance and global generalizability of individual risk factors remain unclear. At the Croatian Institute of Public Health, electronic health data from multiple databases were combined to examine factors associated with COVID-19 related death. Data on 212 615 patients confir med to have COVID-19 by a positive RT-PCR in 2020 were pseudonymously linked to hospital records and 16 150 hospitalized patients were identified. Apart from older age and male sex, major factors associated with an increased rate of mortality among patients hospitalized with COVID-19 were cardiovascular diseases (adjusted HR: 1.20; 95% CI 1.12-1.28); diabetes (adjusted HR: 1.17; 95% CI 1.09-1.25); and chronic lower respiratory diseases (adjusted HR: 1.10; 95% CI 1.02-1.18). This Croatian study used primary care and hospital data to establish factors associated with COVID-19 related death among patients hospitalized with COVID-19. The results of this study provide rigorous evaluation of the previously defined risk factors and offer guidance for further studies that will create prognostic models based on empirical data from 2020.