Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a systemic infection that ranges from asymptomatic to severe respiratory tract infections and influenza-like illness to severe disease with respiratory failure from acute respiratory distress syndrome (ARDS). The leading cause of mortality for SARS-CoV-2 is respiratory failure from ARDS. This study aimed to summarize the clinical outcomes of severe acute respiratory infection produced by SARS-CoV-2 in 293 Colombian adults. This retrospective study analyzed the clinical outcomes of severe acute respiratory infection produced by SARS-CoV-2 in 293 Colombian adults. The study collected data on age, clinical manifestations, comorbidities, radiological findings, and fatal cases. It was found that patients over 60 years old (53%) suffered the most severe symptoms, with frequent clinical manifestations of dyspnea (60.6%), cough (46.3%), and changes in osmotic diuresis (29.3%). About 55.3% of the patients had comorbidities, where cardiovascular disease (54.9%) was the most frequent coexisting condition. Regarding radiological findings, alveolar infiltrate and ground glass opacifications had the biggest frequency (58.9% and 40.7%, respectively). Fatal cases detected were 45.4%, where patients over 60 years (66.2%) were severely affected, however, adults from 40-59 years had a 27.8% mortality rate. Tachycardia and elevated serum biomarkers -ureic nitrogen, creatinine, D-dimer, troponin, LDH, AST, and ALT levels- were significantly more frequent in fatal cases compared to non-fatal patients. In conclusion, this study showed the clinical spectrum of severe acute respiratory infection produced by SARS-CoV-2 in Colombian adults, which is still having an active circulation and causing severe or fatal outcomes.