{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:44:51Z","timestamp":1780515891907,"version":"3.54.1"},"reference-count":39,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T00:00:00Z","timestamp":1641945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Italy was a country severely hit by the first coronavirus disease 2019 (COVID-19) pandemic wave in early 2020. Mortality studies have focused on the overall excess mortality observed during the pandemic. This paper investigates the cause-specific mortality in Italy from March 2020 to April 2020 and the variation in mortality rates compared with those in 2015\u20132019 regarding sex, age, and epidemic area. Causes of death were derived from the national cause-of-death register. COVID-19 was the leading cause of death among males and the second leading cause among females. Chronic diseases, such as diabetes and hypertensive, ischemic heart, and cerebrovascular diseases, with decreasing or stable mortality rates in 2015\u20132019, showed a reversal in the mortality trend. Moreover, mortality due to pneumonia and influenza increased. No increase in neoplasm mortality was observed. Among external causes of death, mortality increased for accidental falls but reduced for transport accidents and suicide. Mortality from causes other than COVID-19 increased similarly in both genders and more at ages 65 years or above. Compared with other areas in Italy, the Lombardy region showed the largest excess in mortality for all leading causes. Underdiagnosis of COVID-19 at the beginning of the pandemic may, to some extent, explain the mortality increase for some causes of death, especially pneumonia and other respiratory diseases.<\/jats:p>","DOI":"10.3390\/ijerph19020805","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T09:10:36Z","timestamp":1641978636000},"page":"805","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3382-2708","authenticated-orcid":false,"given":"Enrico","family":"Grande","sequence":"first","affiliation":[{"name":"Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9939-3398","authenticated-orcid":false,"given":"Ugo","family":"Fedeli","sequence":"additional","affiliation":[{"name":"Epidemiological Department, Azienda Zero, Veneto Region, 35132 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilena","family":"Pappagallo","sequence":"additional","affiliation":[{"name":"Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Crialesi","sequence":"additional","affiliation":[{"name":"Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2752-9989","authenticated-orcid":false,"given":"Giada","family":"Minelli","sequence":"additional","affiliation":[{"name":"Statistical Service, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-9484","authenticated-orcid":false,"given":"Ivano","family":"Iavarone","sequence":"additional","affiliation":[{"name":"Department of Environment and Health, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4594-1125","authenticated-orcid":false,"given":"Luisa","family":"Frova","sequence":"additional","affiliation":[{"name":"Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziano","family":"Onder","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5471-8964","authenticated-orcid":false,"given":"Francesco","family":"Grippo","sequence":"additional","affiliation":[{"name":"Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00198 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,12]]},"reference":[{"key":"ref_1","unstructured":"Morgan, D., Ino, J., Di Paolantonio, G., and Murtin, F. 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