# Outpatient pediatric care during the COVID-19 pandemic, Almaty, Kazakhstan 2021–2022

## TL;DR

This study examines how children in Almaty, Kazakhstan, were affected by outpatient care during the COVID-19 pandemic from 2021 to 2022.

## Contribution

The study identifies age-related risk factors for severe outpatient pediatric COVID-19 cases during the pandemic in Kazakhstan.

## Key findings

- Most children with outpatient COVID-19 cases were asymptomatic or had mild symptoms.
- Children aged 0–4 had a higher risk of severe illness and hospitalization compared to older children.
- The highest number of outpatient cases coincided with the Omicron variant's spread.

## Abstract

During the COVID-19 pandemic, primary health care systems worldwide adapted to manage cases in outpatient settings, including those involving children. The aim of this study was to investigate the epidemiological characteristics of 27,205 outpatient COVID-19 cases among children (0–17 years) in Almaty, Kazakhstan, from 1 January 2021 to 31 December 2022, compared with major epidemiological events and public health measures.

A cross-sectional analysis was conducted to assess the likelihood of hospitalization regarding demographic characteristics, concomitant diseases, the severity of COVID-19 course, as well as the dynamic of cases.

The majority of children (99.3%) were asymptomatic or mild. Children in the younger age group (0–4) had a higher risk of severe course and hospitalization compared with adolescents aged 15–17 years. Sex and chronic diseases (diabetes mellitus, obesity and chronic obstructive pulmonary disease) did not demonstrate statistical significance. The longest spike in outpatient COVID-19 cases in children coincided with the circulation of Delta and Eta strains, the highest with Omicron.

Among outpatient COVID-19 cases in children, the likelihood of severe forms and hospitalization is higher if the child is under 5 years of age.