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Data from the rapid mortality surveillance system in 19 major Italian cities were used to carry out a timely assessment of the health impact of the COVID-19 epidemic. By 18 April, a + 45% excess in mortality was observed, with a higher impact in the north of the country (+ 76%). The excess was greatest among men, with an increasing trend by age. Surveillance data can be used to evaluate the lockdown and re-opening phases.doi:10.2807/1560-7917.es.2020.25.19.2000620 pmid:32431289 fatcat:tb3ovd77ynglbk5p3ji63fdiua