Epidemiological characteristics of COVID-19 cases in Italy and estimates of the reproductive numbers one month into the epidemic
Author:
Riccardo FlaviaORCID, Ajelli Marco, Andrianou Xanthi D, Bella AntoninoORCID, Del Manso MartinaORCID, Fabiani MassimoORCID, Bellino StefaniaORCID, Boros Stefano, Urdiales Alberto MateoORCID, Marziano ValentinaORCID, Rota Maria CristinaORCID, Filia AntoniettaORCID, D’Ancona Fortunato PaoloORCID, Siddu AndreaORCID, Punzo OrnellaORCID, Trentini Filippo, Guzzetta GiorgioORCID, Poletti PieroORCID, Stefanelli PaolaORCID, Castrucci Maria RitaORCID, Ciervo Alessandra, Di Benedetto Corrado, Tallon Marco, Piccioli AndreaORCID, Brusaferro SilvioORCID, Rezza GiovanniORCID, Merler StefanoORCID, Pezzotti Patrizio,
Abstract
SUMMARYBackgroundIn February 2020, a locally-acquired COVID-19 case was detected in Lombardia, Italy. This was the first signal of ongoing transmission of SARS-CoV-2 in the country. The outbreak rapidly escalated to a national level epidemic, amid the WHO declaration of a pandemic.MethodsWe analysed data from the national case-based integrated surveillance system of all RT-PCR confirmed COVID-19 infections as of March 24th 2020, collected from all Italian regions and autonomous provinces. Here we provide a descriptive epidemiological summary on the first 62,843 COVID-19 cases in Italy as well as estimates of the basic and net reproductive numbers by region.FindingsOf the 62,843 cases of COVID-19 analysed, 71.6% were reported from three Regions (Lombardia, Veneto and Emilia-Romagna). All cases reported after February 20th were locally acquired. Estimates of R0 varied between 2.5 (95%CI: 2.18-2.83) in Toscana and 3 (95%CI: 2.68-3.33) in Lazio, with epidemic doubling time of 3.2 days (95%CI: 2.3-5.2) and 2.9 days (95%CI: 2.2-4.3), respectively. The net reproduction number showed a decreasing trend starting around February 20-25, 2020 in Northern regions. Notably, 5,760 cases were reported among health care workers. Of the 5,541 reported COVID-19 associated deaths, 49% occurred in people aged 80 years or above with an overall crude CFR of 8.8%. Male sex and age were independent risk factors for COVID-19 death.InterpretationThe COVID-19 infection in Italy emerged with a clustering onset similar to the one described in Wuhan, China and likewise showed worse outcomes in older males with comorbidities. Initial R0 at 2.96 in Lombardia, explains the high case-load and rapid geographical spread observed. Overall Rt in Italian regions is currently decreasing albeit with large diversities across the country, supporting the importance of combined non-pharmacological control measures.Fundingroutine institutional funding was used to perform this work.
Publisher
Cold Spring Harbor Laboratory
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