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OBJECTIVES: With COVID-19 infections resulting in death according to a hierarchy of risks, with age and pre-existing health conditions enhancing disease severity, the objective of this study is to estimate the condition-specific case fatality ratio (CFR) for different subpopulations in Italy. STUDY DESIGN: The design of the study was to estimate the \'pre-existing comorbidity\'-conditional CFR to eventually explain the mortality risk variability reported around in different countries. METHODS: We use the available information on pre-existing health conditions identified for deceased patients \'positive with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)\' in Italy. We (i) estimated the total number of deaths for different pre-existing health conditions categories and (ii) calculated a conditional CFR based upon the number of comorbidities before SARS-CoV-2 infection. RESULTS: Our results show a 0.6% conditional CFR for a population with zero pre-existing pathology, increasing to 13.9% for a population diagnosed with one and more pre-existing health conditions. CONCLUSIONS: Condition-specific mortality risks are important to be evaluated during the COVID-19 pandemic, with potential elements to explain the CFR variability around the globe. A careful postmortem examination of deceased cases to differentiate death \'caused by COVID-19\' from death \'positive with SARS-CoV-2\' is therefore urgently needed and will likely improve our understanding of the COVID-19 mortality risk and virus pathogenicity.
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Condition-specific mortality risk can explain differences in COVID-19 case fatality ratios around the globe
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