Impact of COVID-19 on older adults and role of long-term care facilities during early stages of epidemic in Italy

older adults are the main victims of the novel COVID-19 coronavirus outbreak and elderly in long term care facilities (LTCFs) are severely hit in terms of mortality. this paper presents a quantitative study of the impact of COVID-19 outbreak in Italy during first stages of the epidemic, focusing on the effects on mortality increase among older adults over 80 and its correlation with LTCFs. the study of growth patterns shows a power-law scaling regime for the first stage of the pandemic with an uneven behaviour among different regions as well as for the overall mortality increase according to the different impact of COVID-19. however, COVID-19 incidence rate does not fully explain the differences of mortality impact in older adults among different regions. we define a quantitative correlation between mortality in older adults and the number of people in LTCFs confirming the tremendous impact of COVID-19 on LTCFs. In addition a correlation between LTCFs and undiagnosed cases as well as effects of health system dysfunction is also observed. our results confirm that LTCFs did not play a protective role on older adults during the pandemic, but the higher the number of elderly people living in LTCFs the greater the increase of both general and COVID-19 related mortality. We also observed that the handling of the crises in LTCFs hampered an efficient tracing of COVID-19 spread and promoted the increase of deaths not directly attributed to SARS-CoV-2.