Introduction: To better understand the risk factors associated with the severity of COVID-19, we sought to analyze the relationship between hypertension (HTN) and mortality and the need for admission to the intensive care unit (ICU) in patients with COVID-19. Methods: Databases such as Medline, Embase, CINAHL PLUS with full text, Cochrane Library Trials, Web of Science, and Scopus were consulted. Using the PRISMA-S diagram, studies were organized and tracked. Two reviewers, following PECOS criteria, evaluated and selected titles, abstracts, and full texts. Results: Out of 28 studies (n = 23,696), hypertensive patients had survival rates of 35.59%-97.47% while non-hypertensive patients had rates of 56.85%-98.34%. Hypertension was significantly associated with COVID-19 mortality (RR = 3.97, p < 0.01) and a higher need for ICU admission (14.9% vs 0.7%). Conclusions: The results indicate that HTN is a decisive factor in the progression of COVID-19 and the need for ICU admission.