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De Flora S, La Maestra S. Growth and decline of the COVID-19 epidemic wave in Italy from March to June 2020 [published online ahead of print, 2020 Sep 9]. J Med Virol. 2020;10.1002/jmv.26499. doi:10.1002/jmv.26499

March 21, 2020 was the ridgeline between the growth of the COVID-19 epidemic wave in Italy and the start of its decline. We analyzed the epidemic patterns from March 1 to June 30. There was a progressive drop of cases from March (104,710) to April (94,888), May (25,705) and June (8,110). Likewise, after a slight increase of deaths in April (14,804) compared to March (12,396), a considerable decline occurred in May (5,170) and June (1,464). Doubling times of cumulative cases grew from 2-6 days until March 20 to 2 weeks up to April 5, and thereafter no further doubling occurred until June 30. There was a striking North-South gradient of both cases and deaths. At the end of June, the 9 northern Italian regions or provinces, 5 central regions and 7 southern regions had contributed to the 81.1%, 12.4% and 6.5% of the 240,578 national cases, respectively. Lombardy, the most populous region, was by far the most heavily affected one, accounting for the 39.0% of the national cases occurring over the analyzed 4-month period. However, in relative terms, it was preceded by Aosta Valley, the least populous region, less than 1% of the population of both regions having been affected by cases of COVID-19. The curves showing the ratio of daily cumulative cases and deaths to those of the previous day tended to flatten with time by approaching the zero growth but without reaching it, which documents some persisting circulation of SARS-CoV-2 in the Italian territory

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