This retrospective study looked at COVID-19 in people with HIV (PWH) in five New York emergency departments from March 2 to April 15, 2020 who tested positive for SARS-CoV2. Out of the 93 patients in the study, 40.9% were Black, 31.2% Hispanic/Latinx, and 72% were male. Of the patients with data available, the mean nadir CD4+ T cell count was 320 cells/uL (IQR 139-490, n=81) and the mean period of HIV infection was 20 years (IQR 1526, n=57). Out of the participants, 69.6% were on ART, 24.7% had a prior opportunistic infection, 34.4% had diabetes, 18.3% had heart disease, 15% were current smokers, 39.8% were former smokers, and 26.3% with an underlying lung disease. Patients presented with fever (65.6%), shortness of breath (61.3%), cough (76.3%) and elevated levels of inflammatory markers: D-dimer, fibrinogen, interleukin (IL)-6, IL-8, TNF-alpha, and Creactive protein (CRP). Out of the 72 patients hospitalized, 53 recovered (73.6%), and 19 died (26.4%). Results suggest that PWH who died had higher levels of immune activation and inflammation markers compared to those who recovered. PWH remain vulnerable to severe COVID-19 despite being on ART and further research is needed to understand the biological mechanism and clinical effect of SARS-CoV2 among PWH.