DISCUSSION
The devastating impact of COVID 19 infection in our area, forced the RHCS to arrange an emergency plan to face the pandemic. The majority of regional hospitals were converted entirely to the treatment of COVID patients; as a consequence, all other activities had to be reorganized. Hub-spoke network had been applied to all the major critical areas as trauma, stroke, and myocardial infarction. As far as we know, our region is the first European region to re-arrange the cardio-vascular emergency/urgent network to face the pandemic. In particular the geographical area covered by our Hub and spoke networks has been the most affected by the pandemic with more than 39.000 confirmed case of Sars-Cov19 infection.