The burden of COVID-19 in primary care of Almaty, Kazakhstan, 2021-2022

Primary healthcare played a crucial role during the COVID-19 pandemic by preventing, timely diagnosing, and referring severe cases to hospitals, as well as monitoring and counseling patients via telemedicine. We used a cross-sectional approach to analyze the severity outcomes of 174,540 COVID-19 cases treated in primary care in Almaty between 2021 and 2022, by age, sex, disease severity, and comorbidities. Outpatients with COVID-19 were mainly aged 30-39 (20.3%) with a mild course (88.9%). Among adults, females predominated (≥ 60-25.5% vs. 19.2%, < 0.001), and among children (0-17), boys - 21.2% vs. 12.1% (p < 0.001). A higher risk for moderate to severe COVID-19 and adverse outcomes was assessed among older adults, particularly those aged 60 and older compared with younger groups (OR = 9.01, 95% CI: 7.72-10.51). Pregnant women had a low risk of severe disease (OR = 0.5, 95% CI: 0.38-0.65). Patients with concomitant disease were at higher likelihood of severe COVID-19 (p < 0.001, OR = 2.51, 95% CI: 1.9-3.15 for obesity, p < 0.001, OR = 1.43, 95% CI: 1.27-1.6 for diabetes mellitus, OR = 1.16, 95% CI: 1.07-1.26 for arterial hypertension, and p < 0.001, OR = 2.5, 95% CI: 2.13-3.02 for chronic obstructive pulmonary disease). The study emphasizes an often-overlooked impact of COVID-19 on primary care, which is essential for improving outpatient care.