Extended urbanisation has emerged in the contemporary debate as a notion embracing the globalised nature of urban phenomena. This includes how urbanisation exerts an influence beyond the city’s limits, often in places far beyond dense population centres, through a global network connecting geographically distant areas. With its sprawling urbanisation patterns and a globalised industrialisation and economy, Northern Italy perfectly fits within this definition. The context of extended urbanisation is also at the core of the theoretical framework provided by a range of studies devoted to the spatialities of infectious disease (Connolly, Keil, and Ali 2020; Connolly, Ali, and Keil 2020). A spatial analysis of excess mortality during the first wave of Covid-19 in Northern Italy is proposed at the scale of Labour Market Areas (LMAs – Sistemi Locali del Lavoro), with specific attention to density. More in detail, some topological density indices relating to relational intensity and territorial permeability are correlated with 2020 COVID-related deaths, that is, excess deaths compared to the previous five years. This analysis allows combining a snapshot of the contemporary situation with an overview of inter-area disparities. This can highlight the chronic weaknesses of different territorial development models and inform resilience strategies at the inter-municipal scale.