Background Data on outcomes for people with gout and COVID-19 are extremely few. Our primary objective was to assess whether gout is a risk factor for diagnosis of COVID-19 and death related to COVID-19. The secondary objectives were to test for sex- and drug-specific differences in risk.Methods We used data from the UK Biobank that included 15,560 people with gout. Multivariable-adjusted logistic regression was employed in the following analyses using a case-control study design: Analysis A, to test for association between gout and COVID-19 diagnosis (n=459,837); Analysis B, to test for association between gout and death related to COVID-19 in a case-control cohort of people who died or survived with COVID-19 (n=16,336); Analysis C, to test for association between gout and death related to COVID-19 in the entire UK Biobank cohort (n=459,837); Analysis D, to stratify by prescription of urate-lowering therapy (ULT) and colchicine on the risk of death related to COVID-19 in a subset of the UK Biobank cohort with medication data (n=341,398).Findings Gout was associated with diagnosis of COVID-19 in analysis A (OR=1.2 [1.1 ; 1.3]) but not with risk of death in the COVID-19-diagnosed group in analysis B. In analysis C gout associated with risk of death related to COVID-19 in the unadjusted model (OR=3.9 [3.3 ; 4.7]), in Model 1 adjusted for demographic factors (OR=1.8 [1.5 ; 2.1]) and in the fully adjusted Model 2 (OR=1.3 [1.1 ; 1.6]). In Analysis C risk was higher in women than men in Model 1 adjusted for demographic factors (OR=3.5 [2.4 ; 5.0] and OR=1.5 [1.2 ; 1.8], respectively) with the difference maintained after additional adjustment for eight metabolic co-morbidities (OR Men =1.2 [0.9 ; 1.5], OR Women =1.9 [1.3 ; 2.9]). There were no statistically significant differences in risk of death related to COVID-19 according to prescription of ULT or colchicine.Interpretation Gout is a risk factor for death related to COVID-19 using the UK Biobank cohort with an increased risk in women with gout that was also driven by risk factors outside metabolic co-morbidities of gout.Funding Information: The study was funded by the Health Research Council of New Zealand. The funder had no in study design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the paper for publication.Declaration of Interests: PCR reports personal fees from Abbvie, Atom Biosciences, Eli Lilly, Gilead, Janssen, Novartis, UCB, Roche, Pfizer; meeting attendance support from BMS, Pfizer and UCB Pharma and grant funding from Janssen, Novartis, Pfizer and UCB Pharma, all outside the submitted work. ND reports personal fees from AbbVie, Horizon, Janssen, Dyve Biosciences, Cello Health, PK Med, JW Pharmaceuticals, Selecta, Arthrosi and AstraZeneca; grants from Amgen and AstraZeneca; and non-financial support from AbbVie, all outside the submitted work. LKS reports personal fees from the New Zealand PHARMAC Therapeutic Advisory Committee. RKT, AG and TRM have no conflicts of interest to declare.Ethics Approval Statement: The UK Biobank resource was conducted under an ethical approval from the North West Multi-centre Research Ethics Committee (MREC) of the United Kingdom. The study complies with the Declaration of Helsinki and informed consent was obtained from all participants.