Background and objective: This study shares the experience of a covid-19 outbreak response in the university hospital of Naples “Federico ii”, elected as covid-19 regional hub for the mother-child department and the Paediatric Department. Methods: It has been composed a hospital task force with different experts which developed a hospital incident management system (HIMS) requiring a general reorganization of the hospital settings, ensuring hospital services both to the covid-19 patients and to those who needed non-deferrable cares. Data were collected from march 9 to May 8, 2020, and the HIMS efficacy was measured by key performance indicators such as number of covid-19 patients hospitalized/recovered/deads; number of patients/day for cancer therapies; number of patients/day for immunological therapies and many others data on SARS-CoV-2 patients were extracted from the platform “sinfonia”. This is the increase in department’s capacity: 1. intensive care unit: +57%, 2. sub intensive care unit: creation of a new unit dedicated to covid-19 patients, +18 beds, 3. infectious disease department, all the 14 beds. 4. Paediatric Department, regional hub, 18% converted in covid beds, 5. mother-child department, regional hub, 35,7% of converted in covid beds, 6. internal medicine department, 46,6 % of converted in covid beds staff management: training SARS-CoV-2 exposed staff-staff re-allocation phases. 1) permanent staff: already involved in emergency departments, 2) contingency staff: new workers hired to work in covid departments, +27,2%, 3) crisis staff: workers reallocated from ordinary activities, +18,6%resultsthe ordinary healthcare, despite the pandemic period, ensured 100 patients/day for cancer therapies, 50 patients/day for immunological therapies, 20 patients/week for cancer surgery, 20 patients/week for dialysis, 5 kidney transplants, in line with 2019 data. Conclusions: HIMS provided an appropriate response to covid-19 and guaranteed the non-deferrable hospital services. Our experience taught us the importance to have an extra-ordinary management plan to respond to future emergency challenges.