Owen Farrell missed the first two conversions but he racked up England's third try - only his sixth try in 54 worldwide matches - and added the extras on that occasion as well as on his next three attempts.
Otherwise there were no new injury worries and although Italy managed a try in each half by wings Tommaso Benvenuti and Mattia Bellini, the obvious highlights were the blasting tries scored at high pace by the 23-year-old Simmonds in his fourth Test and first Six Nations start. "It was a tough game of rugby but we ran away with it in the end".
"They played exceptionally well", England head coach Eddie Jones said.
"Against Ireland we need to be disciplined, and if we are going to play we need to respect the ball".
The result takes England to the top of the Six Nations table ahead of their next game against Wales on Saturday.
However, from the moment Watson ran in the opening try after 172 seconds, a 24th straight victory over Italy looked assured.
Youngs' distress points to a significant lay-off and having relied on just two players in the position for virtually his entire reign, Jones will finally have to summon a third option.
But England floored the hosts with three quick tries in the closing minutes from Ford, Simmonds and Nowell to seal an emphatic victory.
"We'll know more tomorrow but he's unlikely to be fit for the Wales game", Jones said immediately after the match.
"It felt like they were spending time in our half early on, they put some press on us".
Italy scored two tries which Jones put down to "individual discipline errors" but England were also able to hand an global debut to Alec Hepburn in Rome. "But our lads held out and we built and built", Farrell said. However, there are clear signs of improvement under coach Conor O'Shea despite Italy's continued problems in defence.
"It will be another statistic in the book but anyone here today could see what we were trying to do". I am stubborn. I am here for Italian rugby, to make it better, and hopefully we are seeing the beginnings of that. "But we're making it".
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