ROME — Paralympic champion Alex Zanardi was seriously injured again in a handbike crash on Friday — nearly 20 years after losing both of his legs in a horrific auto racing accident.
Zanardi was transported by helicopter to Santa Maria alle Scotte hospital in Siena following an incident near the Tuscan town of Pienza during a national race for Paralympic athletes, police told The Associated Press.
He reportedly suffered severe head trauma.
“You’ve never given up and with your extraordinary strength within you’ve overcome a thousand troubles. Forza Alex Zanardi,” Italian Premier Giuseppe Conte tweeted. “Don’t give up. All of Italy is with you.”
A Carabinieri police official in Montepulciano said the incident involved a “heavy vehicle.” The official did not give his name as per local custom.
Local TV at the scene of the crash showed what was apparently Zanardi’s handbike lying on its side and missing two of its three wheels. A large truck pulling a semitrailer appeared parked on the road ahead.
“It happened on a slightly downhill straightaway just before a slight curve in the road,” national team coach Mario Valentini, who was following the race, told La Repubblica Florence. “Alex veered slightly into the oncoming lane just when a truck came. (The truck) tried to swerve but couldn’t avoid the crash.
Repubblica said Zanardi remained conscious until medical personnel arrived, and that he was breathing by himself.
“Twenty minutes passed from the time of the accident to when the medical personnel arrived. It took some time to load him (into the ambulance). His wife helped. After the accident he was talking,” Valentini added in another interview with local media.
Valentini said he was not an eyewitness to the accident but arrived at the scene immediately afterward.
“It was a sunny day and everyone was happy. We were 20 kilometers (12 miles) from (the finish line) in Montalcino,” Valentini said. “The truck didn’t make a mistake. Alex made the mistake.”
The coach added Zanardi’s helmet came off during the crash.
Racing great Mario Andretti tweeted, “I am so anxious and frightened about Alex Zanardi that I’m holding my breath. I am his fan. I am his friend. Please do what I’m doing and pray pray (for) this wonderful man.”
Zanardi won four gold medals in handbike at the 2012 and 2016 Paralympics.
The 53-year-old Zanardi lost his legs in a horrific crash during a 2001 CART race in Germany.
At the time, Zanardi was a two-time CART champion who had recently returned from a second stint in Formula One and had plowed through the field to lead laps for the first time since he’d left the series after his 1998 title. The crash occurred when Zanardi spun his car after a pit stop and he was hit by another driver. Both legs were severed at impact.
Zanardi was an established racing star before the accident, and his accomplishments since transcend sports. An inspirational figure with an indomitable spirit, he designed his own prosthetics — he jokes he made himself taller — and learned to walk again. Then he returned to racing in touring cars. After that came hand cycling, a class victory in the New York City Marathon and Paralympic glory.
Last year, Zanardi competed in the prestigious Rolex 24 at Daytona endurance race, driving in a race for the first time without prosthetics. He used a special steering wheel designed for him by BMW that allowed him to drive with hand levers. 
“He has seven lives,” Valentini said. “Like cats.”
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