Zanardi was one of his country's most loved and respected sportsmen, credited with helping transform the perception of disability in Italy.

In a statement issued through the charity he founded, Obiettivo3, his family said he died "suddenly" on Friday evening, without giving any further details.

But they said he died "peacefully, surrounded by the love of his family and friends".

Zanardi had both his legs amputated in a motor racing accident in 2001, but went on to become a Paralympic champion with his handbike, wining four gold medals.

He had been out of the public eye since a second horror crash in June 2020, when his handbike crashed into an oncoming truck during a race in Tuscany.

Zanardi, who was married with a son, suffered serious head injuries and only returned home 18 months later.

"Alex was a pioneer, icon and legend of the Paralympic Movement," a spokesman for the International Paralympic Committee said.

"His performances were truly out of this world, engaged new fans to the Games, and showed the world that anything is possible.

"The iconic picture of him raising his handcycle above his head in victory at London 2012 will go down in history as one of the great sporting images.

"He will be remembered forever."

- 'Half that remained' -

Zanardi raced for Jordan, Minardi and Lotus in F1 in the early 1990s before switching to the CART championship in the United States where he was series champion in 1997 and 1998.

He returned to F1 with Williams in 1999 before heading back to CART.

But then came the horrific accident in 2001 at the Lausitzring track in Germany.

His car stalled in the middle of the track after a spin and was struck by another car at a speed of over 300 km/h (186 mph).

The impact tore off his two legs and Zanardi lost a lot of blood, with a chaplain giving him the last rites.

His heart stopped beating several times and he underwent 15 operations in a Berlin hospital.

"When I woke up, I didn't think about my legs. I thought about the half of me that remained," Zanardi recalled.

Just three months later, the Italian made his first public appearance in his hometown of Bologna during an award ceremony.

"What emotion, my legs are trembling," he said.

- Courage and determination -

After a few years driving in specially-adapted cars, Zanardi went on to become an icon for disabled athletes competing on his handbike.

He won two gold medals at the 2012 London Games and two more in Rio de Janeiro, four years later.

He also won the Rome marathon in 2010 and New York the following year, relying on what he described as his "five-seconds rule".

"When you have given everything, go on for five seconds. This is where the others can't do it anymore," he said.

He wrote several books, presented television shows and performed a voiceover for the Italian version of animated film "Cars".

Through his charity and his advocacy work, Zanardi encouraged countless other disabled athletes.

The FIA, motorsport’s governing body, said he was "an enduring symbol of courage and determination".

Cordiano Dagnoni, head of the Italian Cycling Federation, said he "transformed the culture of our country, bringing joy and happiness to those fortunate enough to know him, and hope to so many in Italy and around the world".

He said a minute's silence would be observed observed at this weekend's races in tribute.

On X, Italian Prime Minister Giorgia Meloni hailed Zanardi as "a great champion and an extraordinary man, capable of turning every trial of life into a lesson in courage, strength and dignity".