Introduction: Coronavirus disease 2019 (COVID-19) can present as a range of symptoms, from mild to critical; lower pulmonary involvement is often associated with severe and critical cases. Understanding the baseline characteristics of patients hospitalized with COVID-19 illness is essential for effectively targeting clinical care and allocating resources. This study describes baseline demographics and clinical characteristics of US patients hospitalized with COVID-19 and pulmonary involvement. Methods: US patients with COVID-19 and pulmonary involvement during an inpatient admission from December 1, 2019, to May 20, 2020, were identified from electronic health records using the IBM Explorys® database. Baseline (up to 12 months prior to first COVID-19 hospitalization) demographics and clinical characteristics, and preadmission (14 days to 1 day prior to admission) pulmonary diagnoses were assessed. Patients were stratified by sex, age, race, and geographic region. Results: Overall, 3471 US patients hospitalized with COVID-19 and pulmonary involvement were included. The mean (SD) age was 63.5 (16.3) years; 51.2% of patients were female, 55.0% African American, 81.6% from the South, and 16.8% from the Midwest. The most common comorbidities included hypertension (27.7%), diabetes (17.3%), hyperlipidemia (16.3%), and obesity (9.7%). Cough (27.3%) and dyspnea (15.2%) were the most common preadmission pulmonary symptoms. African American patients were younger (mean [SD], 62.5 [15.4] vs 67.8 [6.2]) with higher mean (SD) body mass index (33.66 [9.46] vs 30.42 [7.86]) and prevalence of diabetes (19.8% vs 16.7%) and lower prevalence of chronic obstructive pulmonary disease (5.6% vs 8.2%) and smoking/tobacco use (28.1% vs 37.2%) than White patients. Conclusions: Among US patients primarily from the South and Midwest hospitalized with COVID-19 and pulmonary involvement, the most common comorbidities were hypertension, diabetes, hyperlipidemia, and obesity. Differences observed between African American and White patients should be considered in context of the complex factors underlying racial disparities in COVID-19.