OBJECTIVE: The coronavirus disease 2019 (COVID-19) outbreak started in Italy on February 20 , 2020, and has resulted in many deaths and intensive care unit (ICU) admissions . This study aimed to illustrate the epidemic COVID-19 growth pattern in Italy by considering the regional differences in disease diffusion during the first 3 mo of the epidemic .
METHODS: Official COVID-19 data were obtained from the Italian Civil Protection Department of the Council of Ministers Presidency . The mortality and ICU admission rates per 100,000 inhabitants were calculated at the regional level and summarized by means of a Bayesian multilevel meta-analysis . Data were retrieved until April 21 , 2020 .
RESULTS: The highest cumulative mortality rates per 100 000 inhabitants were observed in northern Italy, particularly in Lombardia (85.3; 95% credibility intervals [CI], 75.7-94.7). The difference in the mortality rates between northern and southern Italy increased over time, reaching a difference of 67.72 (95% CI , 66-67) cases on April 2 , 2020 .
CONCLUSIONS: Northern Italy showed higher and increasing mortality rates during the first 3 mo of the epidemic . The uncontrolled virus circulation preceding the infection spreading in southern Italy had a considerable impact on system burnout . This experience demonstrates that preparedness against the pandemic is of crucial importance to contain its disruptive effects.
Index: COVID-19, ICU, hospitalization, lag effect, mortality rate