COVID-19 Research Paper Volume 12, Issue 15 pp 15186—15195

COVID-19 mortality in Lombardy: the vulnerability of the oldest old and the resilience of male centenarians

Gabriella Marcon1,2,3, , Mauro Tettamanti4, , Giorgia Capacci5, , Giulia Fontanel3, , Marco Spanò2, , Alessandro Nobili4, , Gianluigi Forloni4, , Claudio Franceschi6,7, ,

  • 1 DAME, University of Udine, Udine, Italy
  • 2 Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), Trieste, Italy
  • 3 Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
  • 4 Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
  • 5 Directorate for Social Statistics and Population Census, Istat, Italy
  • 6 Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
  • 7 Laboratory of Systems Medicine of Healthy Aging, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia

Received: June 18, 2020       Accepted: July 21, 2020       Published: August 12, 2020
How to Cite

Copyright © 2020 Marcon et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Italy was the first European nation to be affected by COVID-19. The biggest cluster of cases occurred in Lombardy, the most populous Italian region, and elderly men were the population hit in the hardest way. Besides its high infectivity, COVID-19 causes a severe cytokine storm and old people, especially those with comorbidities, appear to be the most vulnerable, presumably in connection to inflammaging. In centenarians inflammaging is much lower than predicted by their chronological age and females, presenting survival advantage in almost all centenarian populations, outnumber males, a phenomenon particularly evident in Northern Italy. Within this scenario, we wondered if: a) the COVID-19 mortality in centenarians was lower than that in people aged between 50 and 80 and b) the mortality from COVID-19 in nonagenarians and centenarians highlighted gender differences.

We checked COVID-19-related vulnerability/mortality at the peak of infection (March 2020), using data on total deaths (i.e. not only confirmed COVID-19 cases). Our conclusion is that excess mortality increases steadily up to very old ages and at the same time men older than 90 years become relatively more resilient than age-matched females.


ACE: Angiotensin-converting-enzyme; ARD: age-related diseases; BMI: body mass index; CaT: Centenari a Trieste; COVID-19: coronavirus disease 2019; SARS-CoV-2: severe acute respiratory syndrome coronavirus; IL: interleukin.