The temporal correlation between positive testing and death in Italy: from the first phase to the later evolution of the COVID-19 pandemic Time evolution of COVID-19 weekly lethality rate

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Vincenzo d'Alessandro
Nicole Balasco
Pietro Ferrara
Luigi Vitagliano


COVID-19, Italy, lethality rate, SARS-CoV-2, weekly lethality rate


Background and aim: After the global spread of the novel coronavirus disease 2019 (COVID-19), research has concentrated its efforts on several aspects of the epidemiological burden of pandemic. In this frame, the presented study follows a previous analysis of the temporal link between cases and deaths during the first epidemic wave (Phase 1) in Italy (March-June 2020).

Methods: We here analyze the COVID-19 epidemic in the time span from March 2020 to June 2021.

Results: The elaboration of the curves of cases and deaths allows identifying the temporal shift between the positive testing and the fatal event, which corresponds to one week from W2 to W33, two weeks from W34 to W41, and three weeks from W42 to W67. Based on this finding, we calculate the Weekly Lethality Rate (WLR). The WLR was grossly overestimated (~13.5%) in Phase 1, while a mean value of 2.6% was observed in most of Phase 2 (starting from October 2020), with a drop to 1.4% in the last investigated weeks.

Conclusions: Overall, these findings offer an interesting insight into the magnitude and time evolution of the lethality burden attributable to COVID-19 during the entire pandemic period in Italy. In particular, the analysis highlighted the impact of the effectiveness of public health and social measures, of changes in disease management, and of preventive strategies over time.



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1. Cascella M, Rajnik M, Aleem A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Apr 20.
2. Ferrara P, Albano L. COVID-19 and healthcare systems: what should we do next? Public Health 2020; 185: 1–2.
3. Muralidar S, Ambi SV, Sekaran S, Krishnan UM. The emergence of COVID-19 as a global pandemic: Understanding the epidemiology, immune response and potential therapeutic targets of SARS-CoV-2. Biochimie. 2020;179:85-100.
4. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. Available online: (Last accessed on July 10, 2021).
5. COVID-19 coronavirus pandemic. Available online: (Last accessed on July 10, 2021).
6. Chaqroun A, Hartard C, Schvoerer E. Anti-SARS-CoV-2 Vaccines and Monoclonal Antibodies Facing Viral Variants. Viruses 2021;13(6):1171.
7. Istituto Superiore di Sanità. Impatto della vaccinazione COVID-19 sul rischio di infezione da SARS-CoV-2 e successivo ricovero e decesso in Italia (27.12.2020 - 30.05.2021). Available online: (Last accessed on July 10, 2021).
8. Balasco N, d’Alessandro V, Ferrara P, Smaldone G, Vitagliano L. Analysis of the time evolution of COVID-19 lethality during the first epidemic wave in Italy. Acta Biomedica 2021;92(2): e2021171.
9. Balasco N, d’Alessandro V, Smaldone G, Vitagliano L. Analysis of the time evolution of SARS-CoV-2 lethality rate in Italy: Evidence of an unaltered virus potency. medRxiv 2020 doi:
10. Dipartimento della Protezione Civile. COVID-19 Italia – Monitoraggio della situazione. Available online: (Last accessed on July 10, 2021).
11. MATLAB R2014b, September 2014, MathWorks, Inc., Natick, Massachusetts, USA.
12. R Foundation for Statistical Computing. The R Foundation: Vienna, Austria. Available online:
13. Stevens GA, Alkema L, Black RE, et al. Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. Lancet 2016; 388: e19–23.
14. Palmieri L, Palmer K, Lo Noce C, et al. Differences in the clinical characteristics of COVID‐19 patients who died in hospital during different phases of the pandemic: national data from Italy. Aging Clinical and Experimental Research 2021;33:193–199.
15. Istituto Superiore di Sanità. Characteristics of SARS-CoV-2 patients dying in Italy (Nov 18, 2020). Available online: (Last accessed on July 4, 2021).
16. Cereda D, Tirani M, Rovida F, et al. The early phase of the COVID-19 outbreak in Lombardy, Italy. arXiv:2003.09320 [q-bio.PE].

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