Introduction: COVID-19 remains associated with high morbidity and mortality among patients admitted to intensive care units (ICUs), particularly in resource-constrained settings. Identifying factors associated with mortality and analyzing time to death are essential to improve clinical management and inform prevention strategies. This study aimed to analyze survival among ICU patients with COVID-19 and to identify factors associated with mortality. Methods: This was an observational analytical study including patients admitted to the ICU for COVID-19. Total ICU length of stay (DTS), expressed in days, was used as the time variable. Death in the ICU was considered the event of interest, while patients discharged alive or transferred were treated as censored observations. Survival probabilities were estimated using the Kaplan–Meier method with calculation of medians and 95% confidence intervals. Survival comparisons were performed using the log-rank test. Bivariate logistic regression was used to estimate odds ratios (ORs), followed by a multivariable Cox proportional hazards model to identify factors independently associated with mortality. Results: A total of 175 patients were included, with an overall mortality rate of 65.7%. The median overall survival was 6 days. In bivariate analysis, age ≥ 60 years (OR = 2.45; 95 % CI [1,30 –4,60]), unvaccinated status (OR = 2.10; 95 % CI [1,15 –3,85]), and diabetes (OR = 1.80; 95 % CI [1,00 –3,20]) were significantly associated with mortality. The use of invasive mechanical ventilation was strongly associated with death (OR = 10.5; 95 % CI [4,8 –23,0]). In multivariable analysis, age, vaccination status, and type of ventilatory support remained independently associated with mortality. Conclusion: This study highlights a high and early mortality among patients admitted to the ICU for COVID-19. Advanced age, lack of vaccination, diabetes, and severe respiratory failure requiring invasive mechanical ventilation were the main determinants of poor prognosis. These findings underscore the importance of preventive strategies, particularly vaccination, and early, appropriate management of severe COVID-19 to reduce ICU mortality.