IntroductionFew studies focused on the impact of food insecurity severity on the risk of malnutrition among COVID-19 patients in Saudi Arabia.ObjectivesThis study described the prevalence of food insecurity among COVID-19 patients, its severity, and its associated factors. Additionally, the impact of the severity of food insecurity on the risk of malnutrition was determined. It is hypothesized that food insecurity is associated with an increased risk of malnutrition among COVID-19 patients.MethodA cross-sectional study was conducted in Al Madinah Al Munawarah in Saudi Arabia. Patients with confirmed COVID-19 and acute severe or nonsevere illness were enrolled. The Food Insecurity Experience Scale was used to determine the severity of food insecurity, and risk of malnutrition was assessed using the Malnutrition Screening Tool. Demographic characteristics, history of medical conditions, food intake, and body mass index (BMI) were assessed.ResultsA total of 514 patients were enrolled, with 391 (76%) having acute nonsevere COVID-19 symptoms. A total of 14.2% of patients suffered from food insecurity. Of these, 17% had severe symptoms. The severity of food insecurity was influenced by patients’ education (P = 0.02, 95% CI 0.019–0.225), weight loss (P = 0.0001, 95% CI 0.252–0.752), and loss of appetite (P = 0.0001, 95% CI 0.293–0.604). Fifteen percent of patients were at risk of malnutrition. Many obese patients suffered from severe COVID-19 symptoms (P = 0.029, 95% CI 0.02–0.539). The risk of malnutrition was associated with the severity of food insecurity (P = 0.001, 95% CI -0.056- -0.014), BMI (P = 0.049, 95% CI 0.000–0.042), and employment status (P = 0.034, 95% CI 0.002–0.048).ConclusionFood insecurity and the risk of malnutrition among COVID-19 patients should be assessed to prevent adverse health outcomes.