ObjectiveTo evaluate survival and direct medical costs of patients admitted in private hospitals with COVID-19 during the first wave.MethodsA retrospective, observational study analyzing survival and the economic data retrieved on hospitalized patients with COVID-19. Data from March 2020 to December 2020. The direct cost of hospitalization was estimated using the microcosting method with each individual hospitalization.Results342 cases were evaluated. Median age of 61.0 (95% CI 57.0‒65.0). 194 (56.7%) were men. The mortality rate was higher in the female sex (p= 0.0037), ICU (p< 0.001), mechanical ventilation (p<0.001) and elderly groups. 143 (41.8%) patients were admitted to the ICU (95% CI 36.6%–47.1%), of which 60 (41.9%) required MV (95% CI 34.0%–50.0%). Global LOS presented median of 6.7 days (95% CI 6.0–7.2). Mean costs were US$ 7,060,00 (95% CI 5,300.94–8,819,00) for each patient. Mean cost for patients discharged alive and patients deceased was US$ 5,475.53 (95% CI 3,692.91–7,258.14) and US$ 12,955.19 (95% CI 8,106.61–17,803.76), respectively (p< 0.001).ConclusionsPatients admitted with COVID-19 in these private hospitals point to great economic impact, mainly in the elderly and high-risk patients. It is key to better understand such costs in order to be prepared to make wise decisions during the current and future global health emergencies.