Conclusion: Italy is experiencing one of the highest CFR from the COVID-19 pandemic in the world. Time delay adjusted CFR in all the regions in Italy except the Island region were higher than that estimated for Wuhan, China. The CFR in Northwest Italy is 2.5-fold higher than that in Wuhan. Our finding reflects the need of urgent medical support in the Northwest region and the appropriate planning and supplies procurement in other regions of Italy with . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.