{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:35:53Z","timestamp":1790166953726,"version":"4.1.0"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004569","name":"Ministry of Science and Higher Education","doi-asserted-by":"publisher","award":["BR24992814"],"award-info":[{"award-number":["BR24992814"]}],"id":[{"id":"10.13039\/501100004569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background\/objectives<\/jats:title><jats:p>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\u201317\u202fyears) in Almaty, Kazakhstan, from 1 January 2021 to 31 December 2022, compared with major epidemiological events and public health measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The majority of children (99.3%) were asymptomatic or mild. Children in the younger age group (0\u20134) had a higher risk of severe course and hospitalization compared with adolescents aged 15\u201317\u202fyears. 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among outpatient COVID-19 cases in children, the likelihood of severe forms and hospitalization is higher if the child is under 5\u202fyears of age.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1665990","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T05:21:36Z","timestamp":1759728096000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Outpatient pediatric care during the COVID-19 pandemic, Almaty, Kazakhstan 2021\u20132022"],"prefix":"10.3389","volume":"13","author":[{"given":"Nailya","family":"Kozhekenova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Santric-Milicevic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhansaya","family":"Nurgaliyeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainash","family":"Oshibayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Jeremic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Dinic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saltanat","family":"Kyrykbayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanar","family":"Zhagiparova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshat","family":"Smasheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastassiya","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyryn","family":"Tolekova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalya","family":"Glushkova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e056086","DOI":"10.1136\/bmjopen-2021-056086","article-title":"Early 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