EPIDEMIOLOGY, CLINICAL CHARACTERISTICS, AND VIROLOGIC FEATURES OF COVID-19 PATIENTS IN KAZAKHSTAN: A NATION-WIDE RETROSPECTIVE COHORT STUDY

Background: The earliest coronavirus disease-2019 (COVID-19) cases in Central Asia were announced in March 2020 by Kazakhstan. Despite the implementation of aggressive measures to curb infection spread, gaps remain in the understanding of the clinical and epidemiologic features of the regional pandemic. Methods: We did a retrospective, observational cohort study of patients with laboratory-confirmed COVID-19 hospitalized in Kazakhstan between February and April 2020. We compared demographic, clinical, labora tory and radiological data of patients with different COVID-19 severities on admission. Logistic regression was used to assess factors associated with disease severity and in-hospital death. Whole-genome SARS-CoV 2 analysis was performed in 53 patients. Findings: Of the 1072 patients with laboratory-confirmed COVID-19 in March-April 2020, the median age was 36 years (IQR 24 50) and 484 (45%) were male. On admission, 683 (64%) participants had asymptomatic/ mild, 341 (32%) moderate, and 47 (4%) severe-to-critical COVID-19 manifestation; 20 in-hospital deaths (1 87%) were reported by 5 May 2020. Multivariable regression indicated increasing odds of severe disease associated with older age (odds ratio 1 05, 95% CI 1 03-1 07, per year increase; p<0 001), the presence of comorbidities (2 34, 95% CI 1 18-4 85; p=0 017) and elevated white blood cell count (WBC, 1 13, 95% CI 1 00- 1 27; p=0 044) on admission, while older age (1 09, 95% CI 1 06-1 13, per year increase; p