Abstract Background SARS-CoV-2 infection affects the cardiovascular system and can result in vascular dysregulation and dysfunction. However, the hospitalization rates due to pre-existing cardiovascular disease and concomitant SARS-CoV-2 infection are not fully known. Purpose To further elucidate the association between hospitalization and SARS-CoV-2 patients with pre-existing cardiovascular disease. We hypothesize that pre-existing cardiovascular disease is positively associated with hospitalization in patients who test positive for SARS-CoV-2. Methods This is a retrospective study of patients 18 years and older who tested positive for SARS-CoV-2 between March 2020 and April 2021. Patients with cardiovascular co-morbidities, specifically hypertension, coronary artery disease (CAD), heart failure, were analyzed. The primary outcome was hospitalization. Secondary outcomes were all-cause mortality, myocardial infarction (MI), vasopressor use, hypotension, intubation, and acute kidney injury. Multivariate logistic regression analysis adjusted for demographics and comorbidities. Results We identified 23,076 patients who tested positive for SARS-CoV-2; the hospitalization rate was 11.8% (2,721 patients). The incidence was 722 (26.5%) for CAD, 2068 (76%) for hypertension, 534 (91.3%) for heart failure, 188 (6.9%) for ESRD, 1484 (58.6%) for diabetes in patients who were hospitalized. The adjusted odds ratio (OR) of hospitalization was of 1.54 (95% Confidence Interval [CI]: 1.112–2.125; p<0.009) in patients with CAD, 5.730 (95% CI: 4.685–7.009; p<0.001) in patients with hypertension, 3.639 (95% CI: 2.308–5.737; p<0.001) in patients with heart failure. Use of angiotensin-converting enzyme inhibitor (ACEI) (p<0.001) was associated with reduced hospitalization, while the use of hydralazine (p<0.001), beta-blockers (p<0.001), and calcium channel blockers (p<0.001) were associated with increased hospitalization. Conclusion SARS-CoV-2 positive patients with CAD, hypertension or heart failure were associated with increased hospitalization. Admitted patients were more likely to be taking calcium channel blockers, beta-blockers, and hydralazine. In contrast, these patients were also less likely to be taking ACEI. Funding Acknowledgement Type of funding sources: None.