Coronavirus disease 2019 (COVID-19) has spread worldwide, causing significant stress on the medical system. We explored the risk factors for condition changes in COVID-19 pneumonia patients after admission.The patients diagnosed with COVID-19 pneumonia at 2 medical centers in Hunan Province were studied, and those whose conditions changed after admission were compared. Their clinical characteristics and experimental indicators were compared using SPSS software and R language to build a disease risk prediction model.Patients with condition changes after admission were older and had more blood cell abnormalities and impaired organ function (decreased albumin, elevated D-dimer) than normal patients. We found that age, neutrophil ratio, D-dimer, chest Computed tomograpgy (CT) changes, and glucocorticoid use were risk factors for COVID-19 pneumonia after admission.Elderly patients are more susceptible to disease changes after COVID-19 pneumonia; COVID-19 pneumonia patients who develop disease changes after admission have higher neutrophil ratios, increased D-dimer levels, chest imaging changes, and glucocorticoid usage. Additional research is needed.