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

Kozhekenova N. Moiynbayeva S. Jeremic D. Dinic M. Semenov P. Nurgaliyeva Z. Tolekova S. Miller A. Smasheva A. Milicevic M.S.
December 2025 Nature Research

Scientific Reports
2025 #15 Issue 1

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.

Comorbidity , COVID-19 , Epidemiology , Outpatient , Risk factors

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Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, 050038, Kazakhstan
Kazakhstan Medical University “Higher School of Public Health”, Almaty, Kazakhstan
Faculty of Medicine, Institute for Orthopaedics “Banjica”, University of Belgrade, Belgrade, Serbia
Laboratory for Strengthening Capacity and Performance of Health System and Workforce for Health Equity, Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Nazarbayev University School of Engineering and Digital Sciences, Astana, Kazakhstan
Telemedicine Center at the Municipal State Enterprise on the Right of Economic management “Central City Clinical Hospital” of the Department of Public Health of Almaty, Almaty, Kazakhstan
School of Sciences and Humanities, Nazarbayev University, Astana, Kazakhstan
Karaganda University Named After Academician E.A. Buketov, Karaganda, Kazakhstan
Vizim Hospital, Medical Department, Belgrade, Serbia
Alatau City Hospital, Almaty, Kazakhstan

Faculty of Medicine and Healthcare
Kazakhstan Medical University “Higher School of Public Health”
Faculty of Medicine
Laboratory for Strengthening Capacity and Performance of Health System and Workforce for Health Equity
Nazarbayev University School of Engineering and Digital Sciences
Telemedicine Center at the Municipal State Enterprise on the Right of Economic management “Central City Clinical Hospital” of the Department of Public Health of Almaty
School of Sciences and Humanities
Karaganda University Named After Academician E.A. Buketov
Vizim Hospital
Alatau City Hospital

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