The new coronavirus infection COVID-19, according to a number of studies, is associated with an increased risk of gestational complications and poor obstetric and perinatal outcomes. The question of the influence of gestational age at the time of manifestation of COVID-19 on the course of pregnancy and childbirth, their outcomes for the mother and fetus remains controversial. The aim of the research – to determine the characteristics of the course of pregnancy, obstetric and perinatal outcomes during the manifestation of COVID-19 of varying severity in the first trimester of gestation. Materials and methods. The study included 251 pregnant women. The main group consisted of 161 pregnant women with manifestations of COVID-19 of varying severity in the first trimester of gestation. Patients of the main group were divided into 3 groups based on the severity of COVID-19: group 1 – mild (n = 84), group 2 – moderate (n = 74), group 3 – severe infection (n = 3). The comparison group included 90 pregnant women in the third trimester of gestation without a history of COVID-19. Results. COVID-19 in the first trimester of gestation has a predominantly mild and moderate course. Against the background of manifestation, regardless of the severity of the infection, a high frequency of missed miscarriage is recorded. In moderate cases of COVID-19, both during the period of manifestation and in convalescents, the incidence of diabetes mellitus that first developed during pregnancy increases statistically significantly. Features of the course of labor during the period of convalescence have not been established. Newborns have a statistically significantly lower body weight at birth. Conclusion. The period of manifestation of COVID-19 in the first trimester of pregnancy, even with a mild infection, is associated with a high frequency of spontaneous miscarriage (statistically significantly more often in the form of a missed miscarriage). During the period of convalescence, pregnancy is characterized by favorable obstetric and perinatal outcomes.