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Background and objective: People with rheumatic diseases are particularly concerned with the coronavirus disease 2019 (COVID‐19) pandemic. Our work aimed to study the impact of pre‐existing autoimmune rheumatic disease (AIRD) and its immunosuppressive drugs on COVID‐19 severity and outcome. Patients and methods: This is a multicenter case‐control study performed between September 2020 and February 2021 on 130 adults with COVID‐19, including 66 patients with AIRD and 64 without AIRD, who served as a control group. Results: Regarding COVID‐19 clinical manifestations; diarrhea, fatigue, and headache were found with significantly higher frequency in the AIRD group while a higher frequency of cough was found in the control group. Comparing COVID‐19 complications, only septic shock was significantly higher in the AIRD group (P = 0.013). Both groups were treated with similar COVID‐19 drugs except for tocilizumab and anticoagulants, which were statistically significantly more frequently used in the control group (P < 0.001 for both). No statistically significant difference was found between the groups in the outcome or severity of COVID‐19. There was no impact of previous immunosuppressive drugs before COVID‐19 on the severity of the disease except for a longer duration of recovery in patients on steroids (P < 0.001). Patients with hypertension had severe COVID‐19 compared with those without (odds ratio 2.8, 95% confidence interval 1.2‐6.9; P = 0.020). Conclusion: AIRD may not affect COVID‐19 severity and outcome. Similarly, immunosuppressive medications had no effect; except that patients on systemic steroids had longer duration for recovery. Comorbid conditions, such as hypertension, may be associated with more severe COVID‐19 disease course. [ABSTRACT FROM AUTHOR]