BACKGROUND: The Northern Sydney Local Health District was one of the first health regions to be affected by COVID-19 in Australia. AIM: To describe the clinical characteristics, risk factors and outcomes in our low-prevalence Australian population. METHODS: A retrospective analysis of 517 laboratory-confirmed COVID-19 cases between January and June 2020. Patient information was collected as part of routine care within the COVID-19 Virtual Hospital system. Outcomes examined were death, recovery at 30 days and intensive care unit (ICU) admission. RESULTS: The case fatality rate was 1.8%. Multivariate analysis showed factors independently associated with death, composite outcome of death/ICU admission or incomplete recovery at 30 days were age > 80 and presence of 2 or more comorbidities. Most cases acquired COVID-19 through international (50.9%) or cruise ship travel (9.1%). Health care workers comprised 12.8% of the cohort and represented a disproportionately high percentage of the "unknown" source group (27.6%). The median incubation period was 5 days (IQR 3-8); one patient had an incubation period of 15 days. Hospitalisation was required in 11.8%, ICU admission in 2.1% and ventilation in 1.4%. A RALE score on CXR of >10 was independently associated with death. CONCLUSIONS: In this low prevalence, well-resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of 2 or more comorbidities. This data can assist in early risk stratification of COVID-19 patients, and in surge capacity planning for hospitals. This article is protected by copyright. All rights reserved.