Richard Carapaz won stage four on Tuesday as a mass fall in the peloton seven kilometres from the finish cost 2017 champion Tom Dumoulin a devastating four minutes in the overall standings.
Dumoulin came second at both the Giro d’Italia and the Tour de France in 2018.
“For sure, the overall ranking is over for me,” said Dumoulin, who is now in 56th position 4min30sec behind race leader Primoz Roglic.
The fall saw a small group of eleven riders get away from the peloton, including overall leader Roglic and two of his top contenders to win the Giro, Simon Yates and Miguel Angel Lopez.
Dumoulin freewheeled most of the way to the finishing post after his fall with blood streaming from a knee, with his chances of winning the title in tatters.
The 28-year-old was then whisked away to hospital for x-rays as he was unable to bend his knee.
“I was leading the peloton so I simply could not avoid it,” continued Dumoulin. “There is no fracture, which is good news, but my knee is very swollen.
“I was not able to develop power in the last few kilometres, so I don’t know how I’ll be tomorrow (Wednesday), for sure, the overall ranking is over for me.”
Sunweb sports director Michiel Elijzen admitted Dumoulin’s chances had been massively compromised.
“It looks like it’s over for the GC,” he said referring to the overall standings. “It’s hard. We came here to win the Giro but after four stages if you are four minutes off the leader…”
“We just have to wait and see if he can continue in the Giro,” he said.
